Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge

Hip fractures represent a significant public health challenge, particularly among the elderly, due to their high incidence, morbidity, and mortality rates. This review provides a comprehensive understanding of hip fractures through clinical, biomaterial, and biomechanical perspectives. Clinically, w...

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Main Author: Yunhua Luo
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/12/6/580
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author Yunhua Luo
author_facet Yunhua Luo
author_sort Yunhua Luo
collection DOAJ
description Hip fractures represent a significant public health challenge, particularly among the elderly, due to their high incidence, morbidity, and mortality rates. This review provides a comprehensive understanding of hip fractures through clinical, biomaterial, and biomechanical perspectives. Clinically, we examined key risk factors, including age, bone mineral density, and the high prevalence of falls, which account for over 95% of hip fractures. However, current clinical tools, such as FRAX, have notable limitations in accurately assessing fracture risk in individuals due to their reliance on statistical models, the treatment of interdependent risk factors as independent, and the omission of key variables like diabetes. From a biomaterial perspective, we analyzed bone composition—specifically the balance of inorganic minerals, organic proteins, and water—and its role in determining bone strength and fracture susceptibility. Various risk factors ultimately influence this composition balance, thereby affecting bone strength. Therefore, accurately measuring bone composition may provide a more reliable assessment of hip fracture risk. Although emerging imaging technologies such as dual-energy CT and MRI show promise for in vivo assessments of bone composition, these techniques still face significant challenges and remain an active area of research. Biomechanically, we explored the forces generated during falls, noting that impact forces can vastly exceed normal physiological loads and may exploit the anisotropic properties of bone, leading to fractures even in healthy individuals with strong bones. This understanding emphasizes the critical role of fall prevention in reducing fracture risk and highlights the limitations of using fall-induced fracture incidence as a validation metric for clinical assessment tools. Lastly, we discuss preventive strategies, including passive measures like environmental modifications for individuals diagnosed with low bone strength and proactive measures such as muscle strengthening and cognitive training. While passive measures are necessary for immediate protection, proactive strategies are more effective in the long term by addressing underlying risk factors for falls and promoting sustained bone health. This interdisciplinary review underscores the need to integrate clinical, biomaterial, and biomechanical factors to improve diagnostic accuracy, prevention, and treatment strategies for hip fractures, ultimately advancing public health outcomes in aging populations.
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spelling doaj-art-eff56ed2abc74bcbb3ce03a255b165532025-08-20T03:32:27ZengMDPI AGBioengineering2306-53542025-05-0112658010.3390/bioengineering12060580Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health ChallengeYunhua Luo0Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, CanadaHip fractures represent a significant public health challenge, particularly among the elderly, due to their high incidence, morbidity, and mortality rates. This review provides a comprehensive understanding of hip fractures through clinical, biomaterial, and biomechanical perspectives. Clinically, we examined key risk factors, including age, bone mineral density, and the high prevalence of falls, which account for over 95% of hip fractures. However, current clinical tools, such as FRAX, have notable limitations in accurately assessing fracture risk in individuals due to their reliance on statistical models, the treatment of interdependent risk factors as independent, and the omission of key variables like diabetes. From a biomaterial perspective, we analyzed bone composition—specifically the balance of inorganic minerals, organic proteins, and water—and its role in determining bone strength and fracture susceptibility. Various risk factors ultimately influence this composition balance, thereby affecting bone strength. Therefore, accurately measuring bone composition may provide a more reliable assessment of hip fracture risk. Although emerging imaging technologies such as dual-energy CT and MRI show promise for in vivo assessments of bone composition, these techniques still face significant challenges and remain an active area of research. Biomechanically, we explored the forces generated during falls, noting that impact forces can vastly exceed normal physiological loads and may exploit the anisotropic properties of bone, leading to fractures even in healthy individuals with strong bones. This understanding emphasizes the critical role of fall prevention in reducing fracture risk and highlights the limitations of using fall-induced fracture incidence as a validation metric for clinical assessment tools. Lastly, we discuss preventive strategies, including passive measures like environmental modifications for individuals diagnosed with low bone strength and proactive measures such as muscle strengthening and cognitive training. While passive measures are necessary for immediate protection, proactive strategies are more effective in the long term by addressing underlying risk factors for falls and promoting sustained bone health. This interdisciplinary review underscores the need to integrate clinical, biomaterial, and biomechanical factors to improve diagnostic accuracy, prevention, and treatment strategies for hip fractures, ultimately advancing public health outcomes in aging populations.https://www.mdpi.com/2306-5354/12/6/580hip fractureclinical risk factorsosteoporosisdiabetes type 2bone compositioncomposition imbalance
spellingShingle Yunhua Luo
Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge
Bioengineering
hip fracture
clinical risk factors
osteoporosis
diabetes type 2
bone composition
composition imbalance
title Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge
title_full Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge
title_fullStr Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge
title_full_unstemmed Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge
title_short Hip Fractures: Clinical, Biomaterial and Biomechanical Insights into a Common Health Challenge
title_sort hip fractures clinical biomaterial and biomechanical insights into a common health challenge
topic hip fracture
clinical risk factors
osteoporosis
diabetes type 2
bone composition
composition imbalance
url https://www.mdpi.com/2306-5354/12/6/580
work_keys_str_mv AT yunhualuo hipfracturesclinicalbiomaterialandbiomechanicalinsightsintoacommonhealthchallenge