In trabecular bone, damage refers to both the physical microstructural changes which can occur in the tissue due to mechanical loads as well as to the degradations in mechanical properties which may result from such morphological changes. One hypothesis to explain age-related increases in osteoporotic fracture risk is that a history of overloads or falls can cause damage to accumulate in trabecular bone and ultimately lead to a catastrophic fracture. The purpose of this paper is to review what is known about the complex damage behavior of trabecular bone and to suggest further avenues of research.

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