By Docteur Paul G. J. Maquet (auth.)
Dr. MAQUET, the main disciple of Professor PAUWELS' and the orthopae dic inheritor to the PAUWELS' options of osteotomy of the hip for arthritis, has assembled during this one e-book the most powerful and so much lucid modern assertion of the foundations and perform of this extremely important tuition of hip surgical procedure. Professor PAUWELS' contributions to the knowledge of the biomechanics of the hip and to the ideas and execution of osteotomy of the hip for arthritis are notable and undying. With readability, Dr. MAQUET articulates this place and refines it extra within the mild of his personal investiga tion. whereas different investigators, in fact, vary on person thoughts or princi ples during this e-book or disagree with particular positions, assumptions, or conclu sions, it really is transparent to all that this publication is a benchmark paintings. Dr. MAQUET, as Professor PAUWELS consistently did, illustrates his textual content lavishly with appealing examples of person circumstances illuminating the rules advert vanced. but additionally, he has long past extra and provides long term follow-up information, quantifying the result of those surgical precepts as skilled in his personal perform. it's a paintings that has been lengthy sought and is richly acquired. Boston, Massachusetts, 1984 WILLIAM H. HARRIS, M.D.
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Extra resources for Biomechanics of the Hip: As Applied to Osteoarthritis and Related Conditions
Example text
49 B. Multiple Tenotomy Voss (1956) proposed carrying out tenotomy of the adductor and abductor muscles in order to decrease the load transmitted across the hip joint. This procedure fell into disrepute after it had been used for any kind of case of osteoarthritis. It did not succeed when the weight-bearing surface of the joint was significantly decreased. But it is still indicated in some circumstances: it is treated in more detail in Chap. III. C. Shelf Operation The shelf operations aim at covering the femoral head.
If the axis of the lower part of the column is brought beneath the pivot of the balance, the column will then be subjected to compressive stress (Fig. 50b). Nothing will have changed in the joint with the balance whatever the shape of the column supporting it, whether it be offset or straight. Fig. 49. Medial displacement of the upper extremity of the femoral shaft leads to a valgus deformity of the knee. (After PAUWELS 1963a) 48 Fig. 50. a The balance lies off-centre in relation to the lower part of the offset column.
The moment F s is smaller because force F is less and it acts with a lever arm which is shorter than h'. The stick allows the trunk to straighten without increasing the force acting on the hip. e. to limp. 54 b Fig. 55. The action of a walking stick can be compared with the use of a wheelbarrow. C. force exerted on the walking stick; K, force exerted by the part of the body supported by the hip; R, resultant of the forces Kand C Force K is counterbalanced by M, the force exerted by the abductor muscles, acting with the lever arm h (=4 cm): M=Fs h Kh'-CJ h The hip supports the resultant R of forces F andM: ~--------------~- R=VP+M2+2F M cos (FM) /'.