Abstract
Objectives: To measure the effect of an impaction fracture of the femoral head on load transmission in the hip joint. Design: We measured the contact areas and pressure between the acetabulum and femoral head of cadaveric pelves in four different conditions: intact, with an operatively created one-square-centimeter defect in the superior femoral head, with a two-square-centimeter defect, and with a four-square-centimeter defect. All defects were uniformly three millimeters deep. Setting: Hips were loaded in a simulated single-limb stance. Pressure and area measurements were made with Fuji pressure-sensitive film. Specimens: Seven hip joints in seven whole pelves were tested. Main Outcome Measurements: Contact area, load, and mean and maximum pressures were measured. Results: Peripheral loading was seen in the intact acetabulum. This was not disrupted after impaction fractures of any size. A significant increase in mean maximum pressures in the superior acetabulum was seen with two-square-centimeter and four-square-centimeter defects. Conclusions: In contrast to prior biomechanical studies of acetabular fractures, our investigation revealed that disruption of the peripheral distribution of load does not occur with impaction fractures of the femoral head. Clinical series indicate that impaction injuries to the femoral head are associated with a poor prognosis. Previous biomechanical data on acetabular fracture patterns associated with a poor prognosis have shown increases in mean and peak pressures in the superior acetabulum. This was seen with two-square-centimeter and four-square-centimeter impaction injuries. Other factors, such as wear of the articular cartilage during joint motion or associated microscopic damage to the remainder of the joint surface at the time of injury, may also contribute to the rapid joint deterioration seen in these injuries. Further study is indicated.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 407-413 |
| Number of pages | 7 |
| Journal | Journal of orthopaedic trauma |
| Volume | 13 |
| Issue number | 6 |
| DOIs | |
| State | Published - Aug 1 1999 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Orthopedics and Sports Medicine
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Biomechanical evaluation of impaction fractures of the femoral head. / Konrath, Gregory A.; Hamel, Andrew J.; Guerin, Justin; Olson, Steve A.; Bay, Brian; Sharkey, Neil.
In: Journal of orthopaedic trauma, Vol. 13, No. 6, 01.08.1999, p. 407-413.Research output: Contribution to journal › Article
TY - JOUR
T1 - Biomechanical evaluation of impaction fractures of the femoral head
AU - Konrath, Gregory A.
AU - Hamel, Andrew J.
AU - Guerin, Justin
AU - Olson, Steve A.
AU - Bay, Brian
AU - Sharkey, Neil
PY - 1999/8/1
Y1 - 1999/8/1
N2 - Objectives: To measure the effect of an impaction fracture of the femoral head on load transmission in the hip joint. Design: We measured the contact areas and pressure between the acetabulum and femoral head of cadaveric pelves in four different conditions: intact, with an operatively created one-square-centimeter defect in the superior femoral head, with a two-square-centimeter defect, and with a four-square-centimeter defect. All defects were uniformly three millimeters deep. Setting: Hips were loaded in a simulated single-limb stance. Pressure and area measurements were made with Fuji pressure-sensitive film. Specimens: Seven hip joints in seven whole pelves were tested. Main Outcome Measurements: Contact area, load, and mean and maximum pressures were measured. Results: Peripheral loading was seen in the intact acetabulum. This was not disrupted after impaction fractures of any size. A significant increase in mean maximum pressures in the superior acetabulum was seen with two-square-centimeter and four-square-centimeter defects. Conclusions: In contrast to prior biomechanical studies of acetabular fractures, our investigation revealed that disruption of the peripheral distribution of load does not occur with impaction fractures of the femoral head. Clinical series indicate that impaction injuries to the femoral head are associated with a poor prognosis. Previous biomechanical data on acetabular fracture patterns associated with a poor prognosis have shown increases in mean and peak pressures in the superior acetabulum. This was seen with two-square-centimeter and four-square-centimeter impaction injuries. Other factors, such as wear of the articular cartilage during joint motion or associated microscopic damage to the remainder of the joint surface at the time of injury, may also contribute to the rapid joint deterioration seen in these injuries. Further study is indicated.
AB - Objectives: To measure the effect of an impaction fracture of the femoral head on load transmission in the hip joint. Design: We measured the contact areas and pressure between the acetabulum and femoral head of cadaveric pelves in four different conditions: intact, with an operatively created one-square-centimeter defect in the superior femoral head, with a two-square-centimeter defect, and with a four-square-centimeter defect. All defects were uniformly three millimeters deep. Setting: Hips were loaded in a simulated single-limb stance. Pressure and area measurements were made with Fuji pressure-sensitive film. Specimens: Seven hip joints in seven whole pelves were tested. Main Outcome Measurements: Contact area, load, and mean and maximum pressures were measured. Results: Peripheral loading was seen in the intact acetabulum. This was not disrupted after impaction fractures of any size. A significant increase in mean maximum pressures in the superior acetabulum was seen with two-square-centimeter and four-square-centimeter defects. Conclusions: In contrast to prior biomechanical studies of acetabular fractures, our investigation revealed that disruption of the peripheral distribution of load does not occur with impaction fractures of the femoral head. Clinical series indicate that impaction injuries to the femoral head are associated with a poor prognosis. Previous biomechanical data on acetabular fracture patterns associated with a poor prognosis have shown increases in mean and peak pressures in the superior acetabulum. This was seen with two-square-centimeter and four-square-centimeter impaction injuries. Other factors, such as wear of the articular cartilage during joint motion or associated microscopic damage to the remainder of the joint surface at the time of injury, may also contribute to the rapid joint deterioration seen in these injuries. Further study is indicated.
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U2 - 10.1097/00005131-199908000-00003
DO - 10.1097/00005131-199908000-00003
M3 - Article
C2 - 10459599
AN - SCOPUS:0033176094
VL - 13
SP - 407
EP - 413
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
SN - 0890-5339
IS - 6
ER -