Keywords

Developmental dysplasia of the hip, pavlik harness, biomechanical model, least energy path, passive muscle behaviour

Abstract

Developmental dysplasia of the hip (DDH) is a common newborn condition where the femoral head is not located in its natural position in the acetabulum (hip socket). Several treatment methods are being implemented worldwide to treat this abnormal condition. One of the most effective methods of treatment is the use of Pavlik Harness, which directs the femoral head toward the natural position inside the acetabulum. This dissertation presents a developed method for identifying the least energy path that the femoral head would follow during reduction. This is achieved by utilizing a validated computational biomechanical model that allows the determination of the potential energy, and then implementing the principle of stationary potential energy. The potential energy stems from strain energy stored in the muscles and gravitational potential energy of four rigid-body components of lower limb bones. Five muscles are identified and modeled because of their effect on DDH reduction. Clinical observations indicate that reduction with the Pavlik Harness occurs passively in deep sleep under the combined effects of gravity and the constraints of the Pavlik Harness. A non-linear constitutive equation, describing the passive muscle response, is used in the potential energy computation. Different DDH abnormalities with various flexion, abduction, and hip rotation angles are considered, and least energy paths are identified. Several constraints, such as geometry and harness configuration, are considered to closely simulate real cases of DDH. Results confirm the clinical observations of two different pathways for closed reduction. The path of least energy closely approximated the modified Hoffman-Daimler method. Release of the pectineus muscle favored a more direct pathway over the posterior rim of the acetabulum. The direct path over the posterior rim of the acetabulum requires more energy. This model supports the observation that Grade IV dislocations may require manual reduction by the direct path. However, the indirect path requires less energy and may be an alternative to direct manual reduction of Grade IV infantile hip dislocations. Of great importance, as a result of this work, identifying the minimum energy path that the femoral head would travel would provide a non-surgical tool that effectively aids the surgeon in treating DDH.

Notes

If this is your thesis or dissertation, and want to learn how to access it or for more information about readership statistics, contact us at STARS@ucf.edu

Graduation Date

2015

Semester

Fall

Advisor

Moslehy, Faissal

Degree

Doctor of Philosophy (Ph.D.)

College

College of Engineering and Computer Science

Department

Mechanical and Aerospace Engineering

Degree Program

Mechanical Engineering

Format

application/pdf

Identifier

CFE0006022

URL

http://purl.fcla.edu/fcla/etd/CFE0006022

Language

English

Release Date

December 2015

Length of Campus-only Access

None

Access Status

Doctoral Dissertation (Open Access)

Subjects

Dissertations, Academic -- Engineering and Computer Science; Engineering and Computer Science -- Dissertations, Academic

Download

Share

COinS