By Professor Friedrich Pauwels Dr. med. Dr. med. h.c. Dr.-Ing. E.h. (auth.)

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Extra info for Biomechanics of the Normal and Diseased Hip: Theoretical Foundation, Technique and Results of Treatment An Atlas

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Die Atiologie der Hliftgelenkdeformitaten. Z. Orthop. -H. (1938). 24 a 74kp b Fig. 34a to c illustrates how the neck/shaft angle influences the direction, position and magnitude of the forces at play. In coxa vara the greater trochanter is shifted so it is higher than normal whereas in coxa valga it is lower. Consequently, the muscular force M lies in an abnormal position and direction; its point of intersection X with the line of action of the partial body weight K is displaced downward in coxa vara and upward in coxa valga.

56f): the neck has further bent and shortened and the head has slipped distally even more. The latter picture (Fig. 56f) reveals the narrowing of the proximal end of the femoral neck by resorption of tissue on the lateral part where the greatest tensile stresses are present due to bending. On the medial side, there is a zone of resorption which cuts off the base of the thinned bracket that supports the femoral head. J I ! ( f a b c d Fig. 5 a-d 49 This gap is not a limb of a Y-shaped epiphyseal cartilage, although until recently it had been incorrectly thought to be so.

Maximum compressive stresses attain 297 kp/cm 2, maximum tensile stresses 165 kp/cm2, and shearing stresses 46 kp/cm2• In coxa valga (Fig. 37 c), with a neck/shaft angle of 150-155°, the resultant compressive force R lies within the core. Consequently, the additional bending stress is so small that in cross-section there are only compressive Dl~ c ig. 37a-c 28 stresses and no tensile stresses. In this case the femoral neck is stressed purely in compression. The stressing (99 kp/cm2) is about three times less than in coxa vara (297 kp/cm2) and shearing stress is either minimal or nonexistent.

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