Hip fracture has serious repercussions at both the societal and personal levels. For better fracture prevention, it is essential to understand the material changes of femoral cortical bone that contribute to hip fragility, and the deformation and fracture process during hip fractures. Therefore, the aim of this dissertation was to study the mechanisms of hip fracture from both structural and mechanical perspectives.
Using quantitative backscattered electron (qBSE) imaging and polarized Raman microspectroscopy, periosteal hypermineralization in aged human proximal femur was found with significantly higher mineral content/mineral-to-matrix ratio than lamellar bone. Accompanying the increased mineralization was the “brittle” cracking behavior upon microindentation in the hypermineralized tissue. Small- and wide-angle X-ray scattering (SAXS/WAXS) measurement showed substantially thinner, shorter and more irregularly distributed mineral platelets in the hypermineralized region, indicating the material changes at the ultrastructural level.
Combined second harmonic generation (SHG) and two photon excitation fluorescence (TPEF) techniques were used to study shear microcracking and its association with the organization of collagen fibrils in the femoral cortical bone. Unique arc-shaped shear microcracks, differing from either tensile or compressive microcracks, were identified at the peripheral zone of the osteons. These microcracks were further located within the “bright” lamellae where collagen fibrils are primarily oriented at the circumferential direction to the osteons’ long axes.
Microcracking analysis on clinically retrieved femoral neck components identified shear, compressive and tensile microcracks associated with major fractures. The results pointed to the central role of the superior cortex in resisting a hip fracture, whereby higher density of microcracks and buckling failure were found in the superior cortical bone. BSE imaging at the fracture sites found the direct involvement of hypermineralization, which lacked crack deviation and had fewer microcracks than the tough lamellar bone.
This dissertation answered fundamental questions regarding the role of femoral cortical bone in clinical hip fractures, and elucidated the underlying failure mechanisms due to microstructural changes and the complex stress states under external loading. The findings thus provided new insights into better identifying at-risk population of hip fracture.