Stress characteristics after fixation in herringbone position in children with developmental dislocation of the hip by finite element analysis

doi:10.3969/j.issn.2095-4344.1909

Abstract

Abstract:

BACKGROUND: The fixed position after reduction of the children developmental dislocation of the hip remains controversial. Large abduction angle of the hip joint has been shown to contribute to the joint stability after reduction, but larger abduction angle will cause abnormal biomechanics, and high pressure in the acetabulum, thus further inducing femoral head necrosis. Herringbone position is commonly used in clinical practice, but its biomechanical properties are unclear.

OBJECTIVE: To investigate the stress distribution of the hip joint after fixation in herringbone position in children developmental dislocation of the hip by finite element analysis, and to explore the optimal position in clinic.

METHODS: The CT data of pelvis and proximal femur were collected from a patient with unilateral developmental dislocation of the hip at the Central Hospital of Shenyang Medical College, and imported into Mimics 15.0 software to reconstruct the three-dimensional finite element model of bilateral hip joints after region growing, editing, smoothing and wrapping. Meshing, material property definition, boundary setting and loading were conducted on Hypermesh 12.0 software to simulate hip joint fixed in herringbone position and calculate the stress distribution. The Von Mises stress distribution and mechanical displacement nephograms of pelvis, acetabulum and proximal femur were obtained, the mechanical properties were evaluated. The average contact pressure between femoral head and acetabulum, maximal contact pressure, and contact area were calculated.

RESULTS AND CONCLUSION: (1) After fixed in the herringbone position, the average contact pressure between femoral head and acetabulum, maximal contact pressure, and maximal Von Misas value of the femoral head at the affected side were higher than those at the unaffected side, and the contact area at the affected sided was lower than that at the unaffected side. The contact area, maximal contact pressure, and maximal Von Misas value of the femoral head showed significant differences (P < 0.05). (2) To conclude, for children with developmental dislocation of the hip, abnormal biomechanical distribution occurs on the affected hip joint after fixed in the herringbone position, and high pressure between femoral head and acetabulum is easy to induce femoral head necrosis. This trial was approved by the Medical Ethics Committee, the Central Hospital of Shenyang Medical College in 2018 (approval No. 20180987).

Key words: developmental dislocation of the hip, treatment, fixation position, biomechanics, hip joint, fixation in herringbone position, finite element analysis, femoral head necrosis, acetabulum development, children

CLC Number:

R445|R604|R726

Cai Zhencun, Piao Chengzhe, Zhou Hongyu, Sun Ming, Gao Zhenhuai. Stress characteristics after fixation in herringbone position in children with developmental dislocation of the hip by finite element analysis[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(36): 5841-5845.

Figures/Tables 2

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