Universal Digital Model of a Child's Pelvis
ARTICLE PDF (Українська)


developmental dysplasia of the hip
pelvic osteotomy
digital model
hinge point

How to Cite

Suvorov, V., Filipchuk, V., & Melnyk, M. (2022). Universal Digital Model of a Child’s Pelvis. Herald of Orthopaedics, Traumatology and Prosthetics, (1(112), 18-24. https://doi.org/10.37647/0132-2486-2022-112-1-18-24


Summary. Relevance. Developmental dysplasia of the hip (DDH) is a common hip joint pathology in pediatric orthopedist’s practice. Untreated DDH or residual acetabular dysplasia in walking patients usually requires surgery (pelvic osteotomy is one of the surgical options). During pelvic osteotomies, plastic changes take place in so-called 'hinge points'. These hinge points are described in the literature; however, there are some contradictions regarding the classical locations of these hinge points.

Objective: to develop a digital pelvic model that can be used for various pelvic osteotomies modeling.

Materials and Methods. Pelvic CT scans of a 6-year-old child were obtained, and a virtual model of pelvic bones was created. Pemberton pelvic osteotomy was simulated, material properties were assigned, and pelvic ligaments were added. Simulation of the Pemberton osteotomy was performed, and biomechanical changes during this intervention were assessed.

Results. The digital pelvic model of a 6-year-old child was created, Pemberton pelvic osteotomy was simulated, and biomechanical changes during this surgery were evaluated. It was found that there is no single hinge point during this surgery (as believed previously); the main stress generation took place in triradiate cartilage anterior and posterior arms. Pelvic ligaments’ role during Pemberton pelvic osteotomy was assessed (sacrospinous and sacrotuberous ligaments were the main constraints during the lower iliac fragment movement). Also, the possibility of simultaneous bilateral application of Pemberton pelvic osteotomy or its combination with other pelvic osteotomies in 6 years old patients was biomechanically justified.

Conclusions. The development of a digital pelvic model with subsequent pelvic osteotomies modeling according to the method described in this article allows to evaluate biomechanical changes during these osteotomies.

ARTICLE PDF (Українська)


Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop. 2011 Oct 10;2011:238607. DOI: 10.5402/2011/238607.

Pun S. Hip dysplasia in the young adult caused by residual childhood and adolescent- onset dysplasia. Curr Rev Musculoskelet Med. 2016 Dec;9(4):427-434. DOI: 10.1007/s12178-016-9369-0.

Cooper AP, Doddabasappa SN, Mulpuri K. Evidence-based management of developmental dysplasia of the hip. Orthop Clin North Am. 2014 Jul;45(3):341-54. DOI: 10.1016/j.ocl.2014.03.005.

Kothari A, Grammatopoulos G, Hopewell S, Theologis T. How Does Bony Surgery Affect Results of Anterior Open Reduction in Walking-age Children With Developmental Hip Dysplasia? Clin Orthop Relat Res. 2016 May;474(5):1199-208. DOI: 10.1007/s11999-015-4598-x.

Chunho C, Ting-Ming W, Ken NK. Pelvic Osteotomies for Developmental Dysplasiaї of the Hip, 2017 (http://dx.doi.org/10.5772/67516).

Novais EN, Pan Z, Autruong PT, Meyers ML, Chang FM. Normal Percentile Reference Curves and Correlation of Acetabular Index and Acetabular Depth Ratio in Children. J Pediatr Orthop. 2018 Mar;38(3):163-169. DOI: 10.1097/BPO.0000000000000791.

Heimkes B, Schmidutz F, Rösner J, Frimberger V, Weber P. Modifizierte Salter-Innominatum-Osteotomie für Erwachsene [Modified Salter innominate osteotomy in adults]. Oper Orthop Traumatol. 2018 Dec;30(6):457-468. German. DOI: 10.1007/s00064-018-0560-x.

Sales de Gauzy J. Pelvic reorientation osteotomies and acetabuloplasties in children.Surgical technique. Orthop Traumatol Surg Res. 2010 Nov;96(7):793-9. DOI: 10.1016/j.otsr.2010.07.004.

Czubak J, Kowalik K, Kawalec A, Kwiatkowska M. Dega pelvic osteotomy: indications, results and complications. J Child Orthop. 2018 Aug 1;12(4):342-348. DOI: 10.1302/1863-2548.12.180091.

Esmaeilnejad-Ganji SM, Esmaeilnejad-Ganji SMR, Zamani M, Alitaleshi H. A. Newly Modified Salter Osteotomy Technique for Treatment of Developmental Dysplasia of Hip That Is Associated with Decrease in Pressure on Femoral Head and Triradiate Cartilage. Biomed Res Int. 2019 Feb 6;2019:6021271. DOI: 10.1155/2019/6021271.

Ezirmik N, Yildiz K. A Biomechanical Comparison between Salter Innominate Osteotomy and Pemberton Pericapsular Osteotomy. Eurasian J Med. 2012 Apr;44(1):40-2. DOI: 10.5152/eajm.2012.08.

Ertürk C, Altay MA, Işikan UE. A radiological comparison of Salter and Pemberton osteotomies to improve acetabular deformations in developmental dysplasia of the hip. J Pediatr Orthop B. 2013 Nov;22(6):527-32. DOI: 10.1097/BPB.0b013e32836337cd.

Thompson A, Bertocci G, Kaczor K, Smalley C, Pierce MC. Biomechanical investigation of the classic metaphyseal lesion using an immature porcine model. AJR Am J Roentgenol. 2015 May;204(5):W503-9. DOI: 10.2214/AJR.14.13267.

Grudziak JS, Ward WT. Dega osteotomy for the treatment of congenital dysplasia of the hip. J Bone Joint Surg Am. 2001 Jun;83(6):845-54. DOI: 10.2106/00004623-200106000-00005.

Armiger RS, Armand M, Tallroth K, Lepistö J, Mears SC. Three-dimensional mechanical evaluation of joint contact pressure in 12 periacetabular osteotomy patients with 10-year follow-up. Acta Orthop. 2009 Apr;80(2):155-61. DOI: 10.3109/17453670902947390.

Rab GT, DeNatale JS, Herrmann LR. Three-dimensional finite element analysis of Legg-Calve-Perthes disease. J Pediatr Orthop. 1982 Mar;2(1):39-44. DOI: 10.1097/01241398-198202010-00005.

Shen M, Zhu F, Mao H, Fan H, Mone N, Sanghavi V et al. Finite element modelling of 10-year-old child pelvis and lower extremities with growth plates for pedestrian protection. International Journal of Vehicle Safety. 2015 Aug;8(3): 263. DOI: 10.1504/ijvs.2015.070788.

Anderson AE, Peters CL, Tuttle BD, Weiss JA. Subject-specific finite element model of the pelvis: development, validation and sensitivity studies. J Biomech Eng. 2005 Jun;127(3):364-73. DOI: 10.1115/1.1894148.

Zaharie DT, Phillips ATM. Pelvic Construct Prediction of Trabecular and Cortical Bone Structural Architecture. J Biomech Eng. 2018 Sep 1;140(9). DOI: 10.1115/1.4039894.

Phillips AT, Pankaj P, Howie CR, Usmani AS, Simpson AH. Finite element modelling of the pelvis: inclusion of muscular and ligamentous boundary conditions. Med Eng Phys. 2007 Sep;29(7):739-48. DOI: 10.1016/j.medengphy.2006.08.010.

Verbruggen SW, Nowlan NC. Ontogeny of the Human Pelvis. Anat Rec (Hoboken). 2017 Apr;300(4):643-652. DOI: 10.1002/ar.23541.

Crawford RP, Cann CE, Keaveny TM. Finite element models predict in vitro vertebral body compressive strength better than quantitative computed tomography. Bone. 2003 Oct;33(4):744-50. DOI: 10.1016/s8756-3282(03)00210-2.

Ma Z, Lan F, Chen J, Liu W. Finite element study of human pelvis model in sid impact for Chinese adult occupants. Traffic Inj Prev. 2015;16(4):409-17. DOI: 10.1080/15389588.2014.

Sun W, Starly B, Nam J, Darling A. Bio-CAD modeling and its applications in computer-aided tissue engineering. Computer-Aided Design. 2005 Sep;37(11):1097–1114. doi:10.1016/j.cad.2005.02.002.

Zaidi Q, Danisa OA, Cheng W. Measurement Techniques and Utility of Hounsfield Unit Values for Assessment of Bone Quality Prior to Spinal Instrumentation: A Review of Current Literature. Spine (Phila Pa 1976). 2019 Feb 15;44(4):E239-E244. DOI: 10.1097/BRS.0000000000002813.

Hao Z, Wan C, Gao X, Ji T. The effect of boundary condition on the biomechanics of a human pelvic joint under an axial compressive load: a three-dimensional finite element model. J Biomech Eng. 2011 Oct;133(10):101006. DOI: 10.1115/1.4005223.

Carter DR, Hayes WC. The compressive behavior of bone as a two-phase porous structure. J Bone Joint Surg Am. 1977 Oct;59(7):954-62.

Gamble JG, Simmons SC, Freedman M. The symphysis pubis. Anatomic and pathologic considerations. Clin Orthop Relat Res. 1986 Feb;(203):261-72.

Chaudhry SR, Imonugo O, Chaudhry K. Anatomy, Abdomen and Pelvis, Ligaments. 2022 Jan 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.

Gervais B, Vadean A, Brochu M, Raison M. Influence of the load modelling duringgait on the stress distribution in a femoral implant. Multibody System Dynamics. 2018 Mar;44(1):93–105. DOI: 10.1007/s11044-018-9621-z.

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