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Für Mutter und Kind konnte das Risiko der Geburt durch die Weiterentwicklung der Medizin drastisch reduziert werden. Doch wie ist es um das Wohl derer bestellt, die die Gebärende unterstützen? Eine Studie der Ostbayerischen Technischen Hochschule Regensburg hat sich mit den muskuloskelettalen Beschwerden von Geburtshelfer:innen auseinandergesetzt
In the structure of musculoskeletal injuries, calcaneal fractures account for up to 4 % of all skeletal fractures and up to 60 % of hindfoot fractures. The effect of the displacement of the peripheral fragment of the calcaneus on the calf muscles’s reaction forces at the time of the adoption of the simplified squatting position was investigated by modeling in AnyBody Modeling System 6.0 software. M.gastrocnemius (lateralis et medialis) in the initial phase of motion in all variants of the peripheral fragment displacement did not develop sufficient muscular effort in comparison to the intact calcaneus. M.soleus medialis et lateralis showed significant increase in muscle activity rates in the initial phase of motion (41.87 ± 1.90 H and 52.07 ± 2.10 H) before reaching its maximum values, as compared with those of the intact calcaneus. In the final phase of the movement, upon muscle reaches its maximum length, muscular strength indicators of the m.soleus returned to their original values or were significantly below them. The decline in muscle strength was due to shortening of the moment arm or muscle excursion in case of convergence of muscle attachment points. When the peripheral fragment is displaced, due to putting down the heel to the surface of the support in terms of anatomical muscle lengthening, it takes extra effort to achieve rest length and its maximum power. In all types of the displacement of the peripheral fragment, the function of three-headed calf muscle is disturbed with involvement of additional muscular effort and energy expenditure. This fact should motivate the surgeon on the need for accurate repositioning of bone fragments in calcaneal fractures with the displacement of the peripheral fragment.
The fatigue behaviour of materials is of particular interest for the failure prediction of materials and structures exposed to cyclic loading. For trabecular bone structures only a few sets of lifetime data have been reported in the literature and structural measures are commonly not considered. The influence of load contributions which are not aligned with the main physiological axis remains unclear. Furthermore site and species dependent relationships are not well described. In this study five different groups of trabecular bone, defined in terms of orientation, species and site were exposed to cyclic compression. In total, 108 fatigue tests were analysed. The lifetimes were found to decrease drastically when off-axis loads were applied. Additionally, species and site strongly affect fatigue lifetimes. Strains at failure were also found to be a function of orientation.
Football players have a high risk of leg muscle injuries, especially when exposed to mental stress. Injuries to muscles of the thigh are common in amateur and professional football, representing almost a third of all injuries. These injuries occur primarily in non-contact situations and from overuse. They can lead to a range of costs, including financial costs associated with treatment as well as those associated with long-term recovery, and absence from training and/or competition. Further, there is a high risk of injury recurrence and subsequent injury.
The mechanical complications of osteosyntheses after hip fractures are previously investigated by mostly static or dynamic uniaxial loading test systems. However, the physiologic loading of the hip joint during a normal gait is a multiplanar, dynamic movement. Therefore, we constructed a system to test osteosyntheses for hip fractures under physiologic multiplanar loading representative of normal gait. To evaluate the testing system, 12 femora pairs were tested under 25,000 cycles with two standard osteosyntheses (Proximal Femoral Nail Antirotation/Gamma3 Nail). For angular movement, the varus collapse to cut out (∝CO) (∝CO=4.8°±2.1° for blade and ∝CO=7.8°±3.8° for screw) was the dominant failure mode, and only slight rotational angle shifts (∝Rot) (∝Rot=1.7°±0.4° for blade and ∝Rot=2.4°±0.3° for screw) of the femoral head around the implant axis were observed. Angular displacements in varus direction and rotation were higher in specimens reinforced with screws. Hence, the cut out model and the migration directions showed a distinction between helical blade and hip screw. However, there were no significant differences between the different implants. The new setup is able to create clinical failures and allows to give evidence about the anchorage stability of different implant types under dynamic gait motion pattern.
We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of “femur first/combined anteversion,” which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient’s gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.