Li Jie,Long Jiangtao,Wang Qianqian,et al.Effect of different femoral neck anteversion angles on femoral biomechanics in children with developmental dislocation of the hip[J].Journal of Clinical Pediatric Surgery,,22():757-761.[doi:10.3760/cma.j.cn101785-202205019-011]
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Effect of different femoral neck anteversion angles on femoral biomechanics in children with developmental dislocation of the hip

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第22卷 Number: 2023 08 Page: 757-761 Column: 论著 Date of publication: 2023-08-28
Author(s):
Li Jie1;  Long Jiangtao1;  Wang Qianqian1;  Xi Hongwei2;  Cheng Xinkui1;  Cheng Yi1;  Xu ShuMing3
1. Department of Orthopedics, Shanxi Children’s Hospital, Taiyuan 030013, China;
2. Department of General Surgery, Shanxi Children’s Hospital, Taiyuan 030013, China;
3. Department of Medical Imaging, Shanxi Children’s Hospital, Taiyuan 030013, China
Keywords:
Developmental Dysplasia of the Hip; Hip Dislocation;  Congenital; Femur Neck; Bone Anteversion; Lower Extremity; Biomechanical Phenomena; Child
DOI:
10.3760/cma.j.cn101785-202205019-011
Abstract:
Objective To apply computer simulation technology to simulate the stress distribution of femur in children with developmental dislocation of the hip (DDH) with different angles of femoral neck anteversion to find the significance of femoral neck anteversion correction in DDH children and guide the formulation of surgical plan.Methods A 6-year-old girl of right developmental hip dislocation was retrospectively analyzed in June 2021.The femoral scan data of left hip joint at normal side were extracted.A three-dimensional femoral model was reconstructed by 3D-CT scan.The mechanical simulation models of femoral neck anteversion at 35°, 25° and 15° were designed respectively.The finite element software was utilized for simulation calculation to observe the biomechanical distribution of femur at different neck anteversion angles.Results At a femoral neck anteversion angle of 35°, 25° and 15°, maximal stress of femoral model was 21.18 MPa, 17.36 MPa and 9.847 MPa respectively.At a femoral neck anteversion angle of 35°, stress of femoral shaft was concentrated.At a femoral neck anteversion angle of 25°, stress of distal femoral epiphysis declined by 25%.At a femoral neck anteversion angle of 15°, femoral stress was concentrated in femoral head and neck to upper femoral shaft.At a femoral neck anteversion angle of 35°, a displacement >1 mm interval was from femoral head to middle of femoral shaft; at a femoral neck anteversion angle of 25°, the range of displacement >1 mm was from femoral head to middle/upper end of femoral shaft; at a femoral neck anteversion angle of 15°, the range of displacement >1 mm was from femoral head to femoral neck.At a femoral neck anteversion angle of 35°, 25° and 15°, the maximal displacement of distal femoral epiphysis was 0.0041, 0.0018 and 0.0012 mm respectively.Conclusion Femoral neck anteversion has an important impact on femoral mechanics in children with developmental hip dislocation.With the angles of femoral neck anteversion, stress distribution of femur changes.With a rising femoral neck angle, stress of femoral shaft gradually increases and stress concentration occurs at femoral shaft position.The greater anteversion angle of femoral neck, the greater shielding effect of stress transfer in femoral shaft area and the greater deformation of distal femoral epiphysis in cross section.With a femoral neck anteversion angle of 15°, femoral stress distribution is satisfactory.

References:

[1] 翁刘其, 李明, 刘传康, 等.股骨颈前倾角的矫正在治疗儿童DDH的价值[J].重庆医学, 2013, 42(24):2866-2868.DOI:10.3969/j.issn.1671-8348.2013.24.018. Weng LQ, Li M, Liu CK, et al.Application of femoral neck anteversion’s correction for developmental dysplasia of the hip in children[J].Chongqing Med, 2013, 42(24):2866-2868.DOI:10.3969/j.issn.1671-8348.2013.24.018.
[2] Jia GQ, Wang EB, Lian P, et al.Anterior approach with mini-bikini incision in open reduction in infants with developmental dysplasia of the hip[J].J Orthop Surg Res, 2020, 15(1):180.DOI:10.1186/s13018-020-01700-y.
[3] 景小博, 张琦豪, 程富礼, 等.儿童髋关节发育不良相关危险影响因素研究[J].中华实验外科杂志, 2021, 38(4):762-765.DOI:10.3760/cma.j.cn421213-20200917-01318. Jing XB, Zhang QH, Cheng FL, et al.Risk factors related to hip dysplasia in children[J].Chin J Exp Surg, 2021, 38(4):762-765.DOI:10.3760/cma.j.cn421213-20200917-01318.
[4] 邵永科, 李慧武, 常永云, 等.术前测量预估DDH患者全髋置换术后股骨柄前倾角方法[J].医用生物力学, 2019, 34(4):346-351, 364.DOI:10.16156/j.1004-7220.2019.04.002. Shao YK, Li HW, Chang YY, et al.Preoperative measurement to estimate stem anteversion in DDH patients after total hip arthroplasty[J].J Med Biomech, 2019, 34(4):346-351, 364.DOI:10.16156/j.1004-7220.2019.04.002.
[5] 贾国强, 王恩波, 赵群.儿童髋臼发育不良与髋关节骨关节炎的相关研究进展[J].中国骨与关节杂志, 2020, 9(12):899-903.DOI:10.3969/j.issn.2095-252X.2020.12.005. Jia GQ, Wang EB, Zhao Q.Research advances on acetabular dysplasia and hip osteoarthritis in children[J].Chin J Bone Joint, 2020, 9(12):899-903.DOI:10.3969/j.issn.2095-252X.2020.12.005.
[6] 唐学阳.发育性髋关节脱位股骨颈前倾角矫正的相关问题[J].临床小儿外科杂志, 2018, 17(10):726-730.DOI:10.3969/j.issn.1671-6353.2018.10.002. Tang XY.Correcting femoral neck anteversion for DDH[J].J Clin Ped Sur, 2018, 17(10):726-730.DOI:10.3969/j.issn.1671-6353.2018.10.002.
[7] Taniguchi N, Jinno T, Koga D, et al.Comparative study of stem anteversion using a cementless tapered wedge stem in dysplastic hips between the posterolateral and anterolateral approaches[J].Orthop Traumatol Surg Res, 2019, 105(7):1271-1276.DOI:10.1016/j.otsr.2019.08.006.
[8] 李杰, 白德明, 龙江涛, 等.3D打印技术在儿童发育性髋脱位骨盆截骨运用中的临床研究[J].中国药物与临床, 2020, 20(13):2221-2223.DOI:10.11655/zgywylc2020.13.055. Li J, Bai DM, Long JT, et al.Clinical study of 3D printing technology in DDH pelvic osteotomy[J].Chinese Remedies & Clinics, 2020, 20(13):2221-2223.DOI:10.11655/zgywylc2020.13.055.
[9] Bortoluzzi A, Furini F, Scirè CA.Osteoarthritis and its management-epidemiology, nutritional aspects and environmental factors[J].Autoimmun Rev, 2018, 17(11):1097-1104.DOI:10.1016/j.autrev.2018.06.002.
[10] Tian H, Gao SC, Yu JJ, et al.Application of digital modeling and three-dimensional printing of titanium mesh for reconstruction of thyroid cartilage in partial laryngectomy[J].Acta Otolaryngol, 2022, 142(3/4):363-368.DOI:10.1080/00016489.2022.2055138.
[11] Tu Q, Ding HW, Chen H, et al.Preliminary application of 3D-printed individualised guiding templates for total hip arthroplasty in Crowe type IV developmental dysplasia of the hip[J].Hip Int, 2022, 32(3):334-344.DOI:10.1177/1120700020948006.
[12] 程亮亮.发育性髋关节发育不良的生物力学与血运研究及临床转化[D].广州:南方医科大学, 2018. Cheng LL.Biomechanics and blood supply of developmental dysplasia of the hip and clinical transformation[D].Guangzhou:Southern Medical University, 2018.
[13] Song K, Gaffney BMM, Shelburne KB, et al.Dysplastic hip anatomy alters muscle moment arm lengths, lines of action, and contributions to joint reaction forces during gait[J].J Biomech, 2020, 110:109968.DOI:10.1016/j.jbiomech.2020.109968.
[14] Gaffney BMM, Harris-Hayes M, Clohisy JC, et al.Effect of simulated rehabilitation on hip joint loading during single limb squat in patients with hip dysplasia[J].J Biomech, 2021, 116:110183.DOI:10.1016/j.jbiomech.2020.110183.
[15] 田丰德, 赵德伟, 李东怡, 等.三维有限元法分析成人髋关节发育不良重建髋臼的生物力学特征[J].中国组织工程研究, 2018, 22(35):5642-5647.DOI:10.3969/j.issn.2095-4344.1010. Tian FD, Zhao DW, Li DY, et al.Biomechanical properties of acetabular reconstruction in adult developmental dysplasia of the hip by a three-dimensional finite element analysis[J].Chin J Tissue Eng Res, 2018, 22(35):5642-5647.DOI:10.3969/j.issn.2095-4344.1010.

Memo

收稿日期:2022-05-06。
基金项目:山西省卫生健康委科研基金（2021131）；山西省教育厅科研基金（2022L198）
通讯作者:席红卫,Email:xihongwei148@sina.com

Last Update: 1900-01-01