By Professor Friedrich Pauwels Dr. med., Dr. med. h. c., Dr. Ing. E. h. (auth.)
The contents of this e-book are dependent nearly completely on simply anatomical researches. those have been prompted by means of questions posed in scientific perform. the implications are directed to practising surgeons. Their chronological series results in a step-by-step improvement of theoretical bases and to a revolutionary rejection of outdated conceptions. specially within the box of orthopaedic surgical procedure, a dependable angle is feasible neither with no strong anatomical wisdom, nor with out an idea of useful relationships. W. Roux had already confirmed this and he sought after his works of useful anatomy to be thought of from this viewpoint. He particularly preoccupied himself with a uniform concept of sensible edition. therefore it truly is comprehensible that the theories ofRoux shaped the root from which to begin. Our personal researches appeared before everything to corroborate the guidelines of Roux, no less than 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 whilst he deserted the shear idea postulated through Roux and held that compression was once the one potent stimulus for the forma tion of cartilage. The learn in regards to the therapeutic of fractures is based partially at the conception of KROMPECHER which was once new at the moment. yet finally an increasing number of discoveries may well now not be defined by way of this perception which used to be basically a little varied from the older theories (1. WOLF, W. Roux, W.
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Extra resources for Biomechanics of the Locomotor Apparatus: Contributions on the Functional Anatomy of the Locomotor Apparatus
The Fracture of the Femoral Neck. A Mechanical Problem Fig. 33) The effective shearing force is also able to destroy healthy bony tissue the diameter of which is much greater than that of the bony trabeculae. This is demonstrated by a case the X -rays of which were put at my disposal by FROND of Osnabriick. The reduction had led to a very favourable impaction of the upper corner of the neck fragment into the head fragment (Fig. 62). But, as a result of the pronounced inclination of the plane of the fracture, the effect of the effective shearing force was so great that the bony tissue was unable to withstand it.
The acting forces press the fragments one against the other and no damaging forces arise that would endanger the formation of the bony regeneration tissue or the position of the fragments. Consequently the nail does not have a specific role to fulfill in type 1 fractures because the mechanical situation is such that functional compression acts on all the regeneration tissue. This is especially true for the so-called abduction fracture in which, in most cases, impaction guarantees the indispensable apposition of the fragments and sufficient solidity to withstand casual external violence.
The two are apparently bound ends were subjected to tensile and shearing forces. The tensile stress can exert an attrition effect. This together by interposed connective tissue. appears in the X-rays of cases 72 and 76. In these Meanwhile, microscopy shows that it is not cases, only the action of pure tensile stress can be interposed connective tissue but rather conheld responsible for the disintegration of the bony nective tissue organized longitudinally. This tissue. The X-rays taken after a new reduction of tissue takes the form of a wide check ligathe fragments clearly show the progressive degeneration of the tissue during treatment by continu- ment running from the trochanter to the head (Fig.
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