Outline

! types and composition of bone

! adaptations of bone to imposed loads (Wolffs

Mechanics of Bone Law)

! effect on bone strength of load characteristics

(direction, rate of application, number of

Ozkaya and Nordin cycles)
Chapter 9, pages 206-211 ! effect of density and age on bone strength

! osteoporotic fractures

! tension band principle

! mechanics of fracture fixation

KIN 201 2007-1 Stephen Robinovitch, Ph.D. 1 2

There are two primary types of Bone is a composite material

bone: cortical and trabecular ! Bone is a composite
! trabecular bone: interior material composed of
meshwork of trabeculae 66% hydroxyapatite
(thin struts); also known as (HA) crystals and 33%
cancellous or spongy bone; collagen fibrils (by dry
E ! 1 GPa; porosity ranges weight)
from 30% to 90% ! water makes up 25% of

! cortical bone: dense outer the wet weight of bone

shell of bone; also known ! HA crystals are strong

as compact bone; modulus and stiff but brittle;

E ! 18 GPa; porosity trabecular collagen prevents
ranges from 5% to 30% cortical brittle cracking
3 4
 Skeletal structures are adapted to Optimal design theories: Wolffs Law
support musculoskeletal loads Wolff (1869): Wolffs Law:
bone adapts (remodels) in
! the structural
response to the mechanical
properties and
loads placed on it
failure force of
skeletal structures is Roux (1895): Principle of
well adapted to functional adaptation: bone
functional loads adapts to its function by
practicing the latter.
! does this reflect
Principle of maximum-
adaptation of human
minimum design: trajectorial
activity or
system of trabeculae
adaptation of
increasing increasing provides maximum strength
musculoskeletal
area load 5 with minimum material 6
anatomy?

Optimal design theories (cont) The strength and modulus of bone

(1) theory of uniform strength:
vary with the direction of loading
structure is designed so every ! bone is stronger in
bit of material is subjected to compression than tension
the same maximum stress ! bone is anisotropic: its

under a specific set of modulus and strength (in

loading conditions tension or compression)
(2) theory of trajectorial depend on the orientation
architecture: structure is of the tissue with respect
designed so material is to the load
located only in the paths of ! for cortical bone:

transmission of forces, Elong ! 17 GPa (! ult )tension

long
comp
" 135 MPa (! ult )long " #190 MPa
elsewhere there are voids Etrans ! 11 GPa (! ult )tension comp
(! ult )trans
trans " 50 MPa " #130 MPa
7 8
 The modulus and strength of bone The strength of bone declines with
depends on rate of loading number of cycles during cyclic loading
Bone is viscoelastic - stress
FAST Like all materials, stress ultimate
its modulus and ! loading bone is susceptible to !
stress

strength increase with (N/m2) fatigue - when subject (N/m2)

SLOW
increasing rate of loading to repetitive or
loading fluctuating stress, it Fatigue (or
F will fail at a stress endurance) limit

strain " (m/m) level much lower than

damper (dashpot) with damping that required to cause 100 106
x, x constant b [N ! s m]. The force developed log (number of cycles
fracture on a single
k b by an ideal viscous damper is F = b ! x. to failure, N)
It' s presence in parallel with k adds a rate
application of load
dependance to the overall mechanical behavior.9 10

The strength and modulus of bone Osteoporosis: age-related decline in

vary with density (and microstructure) bone density and strength
! the strength and modulus of ! with age, bone becomes less
bone associate with density: dense (and therefore weaker)
! strength " (density)2 and more mineralized (and
! modulus " (density)3 therefore more brittle)
! density however can explain ! trabecular bone exhibits

only a small percent of the permanent microdamage and

variability between samples loss of connectivity healthy osteoporotic
in bone strength (R~0.4); adult
therefore microstructure
must also be important
11 12
Osteoporosis: age-related decline in Risk for injury depends on
bone density and strength (cont)
applied loads and failure loads
every decade after age 55: healthy
bone density declines by young applied load
10-20%, on average
stress ! = factor of risk =
modulus of elasticity
!
(N/m2)
failure load
decreases by 2%, on elderly
average
! " 1 # failure
ultimate strain declines by
7% , on average strain " (m/m)
energy to failure declines
by 5%, on average
! < 1 # no failure
13

Osteoporotic fractures Tensile stress due to bending moments

vertebral fractures:
is reduced by a tension band
50,000/yr in Canada F
hip fractures: F
most are
23,000/yr in Canada
undiagnosed,
$1 billion in costs
asymptomatic
major cause of spring spring both springs
morbidity, death, under under
wrist fractures: under
need for skilled tension compression
most common fx compression
nursing
site
etiology related to
as common as hip
both bone strength
fractures for the
and falls
elderly tension band: a device located far
much less important from the neutral axis, that takes
in terms of $, up the tensile load, leaving the
morbidity, and death 15 bone entirely in compression 16
 Muscles act as natural tension bands
to reduce tensile stress in bone
Area moment of inertia affects
stresses due to bending moments
Recall that the stress due to an internal bending moment
M "y
is ! b = b , where Mb is the bending moment, y is
Ia
the distance from the neutral axis, and I a is the area
moment of inertia of the structure Ia = # y 2 dA.

dA R Ro
y
h
dA
y
Ri

beam b solid rod hollow rod

1 3 ! !
17 I = bh
12
I = R4
4
I= (
4 o
)
R 4 " Ri418

Stability of fracture fixation devices:

compression plate versus
intramedulary rod.
9 mm 9 mm OD x 2.0 cm x 0.5 cm
Fp solid rod 6 mm ID plate
tubular rod
! ! 1
I= (. 45)4 I= [0. 454 " 0. 30 4 ] I= (0.5)(2. 0)3
4 4 12
F = 0.03cm 4 = 0.33cm 4
= 0.02cm 4
OR
Fd 1
I = (2. 0)(0.5)3
12
= 0.02cm 4
19
 Plate orientation with respect to applied
I A! P =
1
(0.5)(2. 0)3
load affects stability of fracture fixation
L 12
= 0.33cm 4 Most-to-least stable:
A P A no
loading mode apposition
FA-P apposition
1
IM ! L = (2.0)(0. 5)3
0.5 cm 12 C, A, B C, B, A
= 0.021cm 4 B
2.0 cm
C, B, A C, B, A
FM-L
I A! P
= 16 C, B(=A) C, B(=A)
IM ! L C

22

Review questions
! What optimal design theories does bone appear to
satisfy?
! What evidence suggests that bone responds to

mechanical loads?
! How does bone strength and modulus vary with

density?
! What is meant by the statement that bone is

anisotropic? viscoelastic? susceptible to fatigue?

! That are the three most common sites for osteoporotic

fracture? Which type of fracture is most important?

! What is a tension band? How does it protect bone?

! How does the orientation of a plate used for fracture

fixation affect the rigidity of the fixation? 23