By Professor Friedrich Pauwels Dr. med., Dr. med. h. c., Dr. Ing. E. h. (auth.)
The contents of this booklet are established virtually completely on only anatomical researches. those have been inspired through questions posed in medical perform. the implications are directed to working towards surgeons. Their chronological series ends up in a step-by-step improvement of theoretical bases and to a revolutionary rejection of previous conceptions. specially within the box of orthopaedic surgical procedure, a accountable angle is feasible neither with no strong anatomical wisdom, nor with out an concept of useful relationships. W. Roux had already verified this and he sought after his works of useful anatomy to be thought of from this perspective. He primarily preoccupied himself with a uniform thought of practical version. therefore it really is comprehensible that the theories ofRoux shaped the foundation from which to begin. Our personal researches appeared before everything to corroborate the tips of Roux, at the least partly. this is often nonetheless obtrusive within the monograph relating fractures of the femoral neck. Later it seemed that ST. KROMPECHER had made a step forwards within the topic of chondrogenesis whilst he deserted the shear conception postulated via Roux and held that compression was once the one potent stimulus for the forma tion of cartilage. The examine about the therapeutic of fractures is predicated in part at the idea of KROMPECHER which was once new at the moment. yet finally progressively more discoveries may well not be defined by means of this notion which used to be purely a bit of various from the older theories (1. WOLF, W. Roux, W.
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Additional resources for Biomechanics of the Locomotor Apparatus: Contributions on the Functional Anatomy of the Locomotor Apparatus
Mechanical analysis of an adduction fracture. The regeneration tissue is subjected to the effect of a great effective shearing force (Ks) and at the same time to that of a tensile force (Z) caused by the effective tipping moment (R . Oa). the factor starting the resorption, as SCHMORL and WmTMAN suspected, but functional stressing must be understood here only as pure compressive stressing. As far as resorption of the femoral neck is concerned, according to me, one must distin- 32 The Fracture of the Femoral Neck.
Planation in the analysis of the forces acting in each particular case. If the magnitude of the effective shearing force overcomes the capacity of the bony regeneration tissue to resist, the latter regresses in a typical way. In this case, the head fragment must more or less rapidly follow the effective shearing force and slide distally. If, on its way, it meets no solid point of support, its distal displacement will continue and its union with the trochanteric fragment by connective tissue becomes stretched until the greater trochanter finds a certain support against the wing of the iIi urn or until the displacement is stopped by the maximum tension of the soft parts.
Nail and screw exert a specific action on type 2 fractures. They effectively attack the stressing of the regenerative tissue and modify it decisively. They can exert this action because they represent a technical contrivance which can absorb shearing stressing and get rid of the shear between two surfaces. If the functional compressive stressing causes the formation of bony regeneration tissue (Roux), the formation of bony callus must begin firstly and above all in this area of the fracture line which is subjected to active compression.