By Professor Friedrich Pauwels Dr. med. Dr. med. h.c. Dr.-Ing. E.h. (auth.)
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Additional info for Biomechanics of the Normal and Diseased Hip: Theoretical Foundation, Technique and Results of Treatment An Atlas
The number of the orders of isochromes shows that the gap seen in the X-ray (Fig. 58a) corresponds exactly to the place where the maximal stresses appear in the model (Fig. 58b). In brief, the analysis shows that the characteristic deformity originates and develops according to a complicated process started by the bending of the mechanically insufficient femoral neck under the effect of physiological a Fig. 58a and b 50 bending stress of normal magnitude. The deformation starts a vicious circle.
Shortening of the femoral neck will reduce the length of the lever arm of the muscular force M. In order to preserve equilibrium, the muscular force must be considerably greater and so, in consequence, must be the resultant compressive force. The reduction of the bending moment as a result of shortening of the neck is more than compensated for by the increase in the resultant compressive force R. Thus, shortening of the femoral neck does not reduce bending stress but, on the contrary, increases it (Fig.
Fig. 38a-c 4) An alteration of the neck/shaft angle causes the head to turn in the socket. Thus, when the joint surfaces in contact and the articular weight-bearing surfaces are reduced by incongruence of the joint contours, they can be increased only by inward or outward rotation of the femoral head, calculated exactly according to the situation of each case (Fig. 38b, c). 29 12. The Trajectorial Structure of Cancellous Bone as a Proof of the Stressing of the Femoral Neck The stress in the femoral neck differs in quality and quantity according to whether the neck/shaft angle is normal, reduced (coxa vara) , or increased (coxa valga).