Biomechanics of the Locomotor Apparatus: Contributions on by Professor Friedrich Pauwels Dr. med., Dr. med. h. c., Dr.

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

The contents of this ebook are dependent virtually solely on in simple terms anatomical researches. those have been motivated via questions posed in scientific perform. the consequences are directed to working towards surgeons. Their chronological series results in a step-by-step improvement of theoretical bases and to a revolutionary rejection of previous conceptions. specifically within the box of orthopaedic surgical procedure, a liable angle is feasible neither with no reliable anatomical wisdom, nor with no an idea of useful relationships. W. Roux had already tested this and he sought after his works of useful anatomy to be thought of from this viewpoint. He mainly preoccupied himself with a uniform idea of useful variation. hence it truly is comprehensible that the theories ofRoux shaped the root from which to begin. Our personal researches appeared at the beginning to corroborate the tips of Roux, a minimum of partly. this is often nonetheless glaring within the monograph referring to fractures of the femoral neck. Later it seemed that ST. KROMPECHER had made a step forwards within the subject of chondrogenesis while he deserted the shear concept postulated by way of Roux and held that compression was once the one powerful stimulus for the forma­ tion of cartilage. The examine in regards to the therapeutic of fractures is predicated partially at the concept of KROMPECHER which was once new at the moment. yet eventually progressively more discoveries may possibly not be defined via this notion which was once in basic terms a bit of diverse from the older theories (1. WOLF, W. Roux, W.

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81). This alters the mechanical conditions of the fracture because the top of the greater trochanter makes a fulcrum R around which the pelvis tends to tum in a clockwise direction. Consequently, the head fragment is compressed against its support. Instead of an effective shearing force, it is now pure functional compression which acts on the interposed tissue. It acts with a nutcracker effect thanks to which bony union takes place (Fig. 77). On the X-rays (Figs. 78-80), the evolution of the mechanical stressing thus modified can be followed.

3. 28). "Additional support" of the capital fragment at the level of the lesser trochanter. Fig. 73 I Figs. 72, 73. By means of an "accessory support" of the capital fragment in the region of the lesser trochanter, the effective shearing force is eliminated. Because of the action of the effective tipping moment (R . Oa), the regeneration tissue is subjected to a tensile stress which causes a pseudarthrosis. Fig. 74. Diagram howing how an effective tipping moment tre e the regeneration ti ue (chain) in ten i n (al 0 ee ig.

To the part of the fracture in which the regeneration tissue at first is subjected to effective compressive stressing. Most frequently it extends progressively throughout the whole fracture site. This appearance is in accord with the action of the mechanical stimuli which are not always easy to understand and the explanation of which would lead us too far. 87. X-ray of the specimen Fig. 84. In the zone subjected to compressive stress, bony consolidation occurred. On the contrary, there is no bone formation in the zone subjected to tensile stress.

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