Birnbaum Klaus, Prescher Andreas, Niethard Fritz-Uwe
Orthopaedic Clinic Hennef, Adenauerplatz, Hennef, Germany.
J Pediatr Orthop B. 2010 Mar;19(2):140-9. doi: 10.1097/BPB.0b013e328332355e.
A contentious issue in the literature is the function and the biomechanical properties of the iliotibial tract. On account of this fact the aim was to take a measurement about the hip centralizing forces of the iliotibial tract by using a custom-made hip prosthesis with adjustable femoral neck angles and lengths in an anatomic model. By increasing the collodiaphyseal (CCD) angle (coxa valga) a higher load of the hip joint results. Decreasing the CCD angle (coxa vara) leads to a lower load of the hip joint. In the case of lengthening the femoral neck we saw a considerable increase of the forces along the femoral neck. Furthermore, we registered intraoperatively the subligamentous forces of the iliotibial tract in the height of the greater trochanter to analyse the axial forces into the acetabular cavity. The iliotibial tract showed increasing forces within adduction as well as decreasing forces within abduction of the hip joint. The clinical relevance consists of the predictability of the increasing or decreasing tension band wiring effect of the iliotibial tract in correlation to the CCD angle. The measurement gives the clinical users a benchmark for the expected subligamentous forces of the iliotibial tract and the resulting hip centralizing forces.
文献中一个有争议的问题是髂胫束的功能和生物力学特性。基于这一事实,目的是通过在解剖模型中使用具有可调节股骨颈角度和长度的定制髋关节假体来测量髂胫束的髋关节中心化力。通过增加颈干角(髋外翻),髋关节的负荷会增加。减小颈干角(髋内翻)会导致髋关节负荷降低。在股骨颈延长的情况下,我们看到沿股骨颈的力有相当大的增加。此外,我们在术中记录了大转子高度处髂胫束的韧带下力,以分析进入髋臼腔的轴向力。髂胫束在髋关节内收时显示力增加,在髋关节外展时显示力减小。临床相关性在于髂胫束张力带绑扎效应增加或减少与颈干角的相关性的可预测性。该测量为临床使用者提供了髂胫束预期韧带下力和由此产生的髋关节中心化力的基准。