Is the Pauwels' theory of hip biomechanics still valid? A critical analysis, based on modern methods

The Pauwels' theory of hip biomechanics assuming bending stresses of the proximal femur has been critisized by recent authors. Therefore, the fundamentals of the classic theory have been reviewed, analysed by means of modern methods, and completed. The conclusion is that, hypothetically, a totally bending-free skeletal scaffold could be obtained by muscular tear strings. The analysis of anatomical specimens and considerations on optimisation show, however, that the bending theory of the proximal femur gives still the best explanation for the observations. Furthermore, the classic model has to be completed by two important conditions: 1. The supporting foot must be positioned on the action line of the gravity force of the body, and 2. the abductorial forces on the hip (to balance the momentum of the body weight) is composed by the forces of the lesser glutei (70%) and the muscles tending the tractus iliotibialis (30%).