Mechanics of hip dysplasia reductions in infants using the Pavlik harness: a physics-based computational model
| Autor: | Eduardo Divo, George T. Rab, Charles T. Price, F.A. Moslehy, Alain J. Kassab, Orlando J. Ardila |
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| Rok vydání: | 2012 |
| Předmět: |
musculoskeletal diseases
Restraint Physical Biomedical Engineering Biophysics Dislocated hips Medicine Humans Orthopedics and Sports Medicine Pavlik harness In patient Computer Simulation Muscle Skeletal Hip Dislocation Congenital business.industry Developmental dysplasia Rehabilitation Infant Anatomy Physics based Models Theoretical musculoskeletal system Lower Extremity Female Adductor muscles business Tomography X-Ray Computed |
| Zdroj: | Journal of biomechanics. 46(9) |
| ISSN: | 1873-2380 |
| Popis: | Biomechanical factors influencing the reduction of dislocated hips with the Pavlik harness in patients of Developmental Dysplasia of the Hip (DDH) were studied using a three-dimensional computer model simulating hip reduction dynamics in (1) subluxated and (2) fully dislocated hip joints. Five hip adductor muscles were identified as key mediators of DDH prognosis, and the non-dimensional force contribution of each in the direction necessary to achieve concentric hip reductions was determined. Results point to the adductor muscles as mediators of subluxated hip reductions, as their mechanical action is a function of the degree of hip dislocation. For subluxated hips in abduction and flexion, the Pectineus, Adductor Brevis, Adductor Longus, and proximal Adductor Magnus contribute positively to reduction, while the rest of the Adductor Magnus contributes negatively. In full dislocations all muscles contribute detrimentally to reduction, elucidating the need for traction to reduce Graf IV type dislocations. Reduction of dysplastic hips was found to occur in two distinct phases: (a) release phase and (b) reduction phase. |
| Databáze: | OpenAIRE |
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