Year 2020 Vol. 28 No 4

TRAUMATOLOGY AND ORTHOPEDICS

V.G. BARSUKOV 1, V.P. DEIKALO 2, A.E. GORBACHYOV 3, G.A. KOSHMAN 4

BIOMECHANICAL ANALYSIS OF VALGUS TROCHANTERIC OSTEOTOMY FOR TREATMENT TRANSCERVIAL HIP FRACTURES

Yanka Kupala State University of Grodno 1, Grodno,
Vitebsk State Medical University 2, Vitebsk,
Grodno City Clinical Hospital of Emergency Care 3, Grodno,
Grodno State Medical University 4, Grodno,
The Republic of Belarus

Objective. To study the influence of rotation angles of a wedge-shaped resected bone fragment of the proximal femur in valgus trochanteric osteotomy, the diameter of the femur in the zone of osteotomy achieved after resection of a bone wedge using mathematical modeling methods.
Methods. The object of the study is a surgical operation of valgus trochanteric osteotomy of the femur. The method of mathematical modeling of changes in axial loads and bending moment acting on the femoral proximal part and diaphysis, as well as the value of vertical and horizontal movements of the center of the femoral head and points of the supporting surface in valgus trochanteric osteotomy of the proximal femur has been designed and used.
Results. Using the designed methods of mathematical modeling of biomechanical aspects of the valgus trochanteric osteotomy, analytical dependences were obtained that allow calculating compressive and bending loads affecting on the proximal and diaphyseal part of the femur, as well as the magnitude of vertical and horizontal displacements of the center of the head and points of the supporting surface during valgus trochanteric osteotomy of proximal part of the femur. Changes in the force and kinematic biomechanical parameters of the femur were calculated for a wide range of rotation angles of the proximal femoral part , and the most frequently encountered in practice the values of specific dimensions (diameter of the femur, lesser-trochanter-to-center-of-femoral-head-distance) were calculated. It was shown that horizontal displacement of the center of femoral head and points of the support surface creates more favorable biomechanical conditions in the zone of unstable fracture and the femoral shaft. Unfavorable displacement of the support surface in the vertical plane, which leads to elongation of the operated limb, can be neutralized by resection of a wedge-shaped femoral fragment.
Conclusion. The designed method and the results of mathematical modeling obtained on its basis make it possible to perform rational preoperative planning of valgus trochanteric osteotomy of the hip.

Keywords: biomechanical analysis, valgus trochanteric osteotomy, proximal femur, femoral head, angle of rotation, bone diameter, support surface
p. 396-404 of the original issue
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Address for correspondence:
230015, Republic of Belarus,
Grodno, Kurchatov str., 1 ,
Yanka Kupala State University of Grodno,
Department of Technical Mechanics,
tel.: 8 (0152) 410873,
e-mail: v.g.barsukov@grsu.by,
Barsukov Vladimir Georgievich
Information about the authors:
Barsukov Vladimir G., MD, Associate Professor, Head of the Department of Technical Mechanics, Yanka Kupala State University of Grodno, Grodno, Republic of Belarus.
https://orcid.org/0000-0001-5490-9293
Deikalo Valeriy P., MD, Professor of the Department of Traumatology, Orthopedics and Military Field Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-7768-3696
Gorbachyov Alexander E., Orthopedic Surgeon of Higher Category of the Department of Traumatology and Orthopedics, Grodno City Clinical Hospital of Emergency Care, Grodno, Republic of Belarus.
https://orcid.org/0000-0002-5651-0005
Koshman Gennadiy A., PhD, Senior Lecturer of the Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Grodno, Republic of Belarus.
https://orcid.org/0000-0001-7451-1282
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