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1

Screening for congenital dislocation of the hip  

International Nuclear Information System (INIS)

Although the prevalence of (idiopathic) congenital dislocation of the hip (CDH) within the Member States of the European Community is not exactly known, it must be considered as a major problem of public health care and protection. By assessment of available data one can assume that between 1 and 2% of all newborns have dislocation or instability of one or both hips. There is a female predominance of 4:1 and some risk factors are known. The reasons of a higher prevalence in some areas are not yet well understood. Most of instable hips will spontaneously become stable within the first days or weeks of life. However, a considerable number of infants (less than 1%) will remain with instable hips which may dislocate. Dislocation either present at birth or as a result of persistent instability leads to subsequent hip deformation. This is a serious event for each affected individual, and is a heavy load on health care and social costs for the public. Treatment of CDH is easy and usually effective when started early, i.e. before the fourth month of life. The earlier treatment is started the easier, shorter, safer and less expensive it is and its impairment on child development and mother-child interaction can be held to a minimum. Screening for CDH is therefore the most important part of health protection in early infancy. However, this paper concludes that neither sonography nor X-ray examinations are appropriate for CDH screening

2

Infantile and congenital hip dislocation: Assessment by MR imaging  

International Nuclear Information System (INIS)

Dislocations of the infant hip, particularly those that responded poorly to standard treatment, were imaged using a 1.5-T MR imaging unit. Excellent detail of the cartilaginous structures of the femoral head, acetabulum, labrum, pulvinar, and capsular abnormalities was achieved. The most detailed images were obtained using a 3-inch surface coil. The shape and orientation of the acetabulum and femoral head cannot otherwise be as well evaluated, nor can their relationship be as clearly established. Technical factors and considerations of imaging with a 1.5-T magnet, the anatomy of the normal and dislocated hip, and observed variations in acetabular shape and orientation are discussed. MR imaging reliably demonstrates dislocation, and the prolonged T2 of synovial fluid produced an ''arthrogram'' effect, which is useful in the treatment of complicated hip dislocation

3

Congenital dislocation of the hip: optimal screening strategies in 2014.  

Science.gov (United States)

A prospective multi-centre nationwide study of patients with congenital dislocation of the hip (CDH) diagnosed after 3 months of age was conducted with support from the French Society for Paediatric Orthopaedics (Société Française d'Orthopédie Pédiatrique [SoFOP]), French Organisation for Outpatient Paediatrics (Association Française de Pédiatrie Ambulatoire [AFPA]), and French-Speaking Society for Paediatric and Pre-Natal Imaging (Société Francophone d'Imagerie Pédiatrique et Prénatale [SFIPP]). The results showed inadequacies in clinical screening for CDH that were patent when assessed quantitatively and probably also present qualitatively. These findings indicate a need for a communication and educational campaign aimed at highlighting good clinical practice guidelines in the field of CDH screening. The usefulness of routine ultrasound screening has not been established. The findings from this study have been used by the authors and French National Health Authority (Haute Autorité de Santé [HAS]) to develop recommendations about CDH screening. There is an urgent need for a prospective randomised multi-centre nationwide study, which should involve primary-care physicians. PMID:25217030

Wicart, P; Bocquet, A; Gelbert, N; Beley, G; Proslier, R; Pracos-Deffrenne, P; Vie le Sage, F; Assathiany, R; Chapuis, M; Fron, D; Guillard, S; Mainard-Simard, L; Ducou le Pointe, H; Kohler, R; Seringe, R; Morin, C

2014-10-01

4

Three-dimensional computerized selection of hip prostheses in patients with congenital dislocated hips.  

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This study assessed the effectiveness of the combined use of computed tomography (CT) and computer-aided design (CAD) in the preoperative evaluation and implant selection in 20 patients (20 hips) with congenital dislocation of the hip who were scheduled to undergo total hip arthroplasty. Computerized selection of the femoral implant with optimum fit and fill was made after a three-dimensional reconstruction of the femoral canal using CT data and CAD. Implantation of all sizes of 5 noncemented and 2 cemented femoral implants was simulated using CATIA software (IBM, Kingstone, NY). When patients underwent surgery, 18 of 20 preselected prostheses agreed by type and size with the prostheses implanted. The remaining 2 preselected implants agreed by type only. In patients with dislocated and dysplastic hips, combined use of CT and CAD allows effective preoperative planning by providing the surgeon with vital information about the proximal femoral canal geometry and the possible femoral implant with optimum fit and fill to be used. PMID:11727804

Gelalis, L D; Xenakis, T A; Hantes, M; Vartziotis, K; Soucacos, P N

2001-11-01

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Proposal for a plan of treatment of congenital dislocation of the hip (Belgian Association of Pediatric Orthopaedics).  

Science.gov (United States)

After several round table discussions between the members of the Belgian Association of Pediatric Orthopedics (BAPO) a plan of treatment of congenital dislocation of the hip was adopted. The purpose of this publication, is to propose this plan as a basis for a general approach to the problem of congenital dislocation of the hip (CDH). PMID:2382544

Fabry, G; Lokietek, W; Peeters, M; Uyttendaele, D; Legaye, J

1990-01-01

6

THA following deformities due to congenital dislocation of the hip joint.  

Science.gov (United States)

Total hip replacement is the treatment of choice for the patient suffering from end-stage hip osteoarthritis. Excellent long-term results have been published. In the presence of deformities due to congenital hip dislocation, total hip replacement is, in most of the cases, a difficult task, since the technique of performing such an operation is demanding and the results could vary. This paper presents our experience and preferred strategies focusing on challenges and surgical techniques associated with reconstructing the dysplastic hip. PMID:24970032

Macheras, George A; Koutsostathis, Stefanos D; Lepetsos, Panagiotis; Anastasopoulos, Panagiotis P; Galanakos, Spyridon; Papadakis, Stamatios A

2014-01-01

7

[Y-shaped cartilage in the development of the normal pelvis and in congenital hip dislocation].  

Science.gov (United States)

The authors use a radiographic approach to demonstrate the primary role of the triradiate cartilage in hip development in the normal child and in congenital dislocation of the hip. The orientation of this cartilage with respect to the dysplasia gives an indication as to the prognosis of the CDH. The acetabular angle is of lesser interest with respect to the orientation of the triradiate cartilage on the pelvic radiographic examination. PMID:2382546

Lokietek, W; Legaye, J

1990-01-01

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The futility of the roentgen-screening of infants for congenital dislocation of the hip  

International Nuclear Information System (INIS)

Already the very first issue of the journal 'Fortschritte auf dem Gebiet der Roentgenstrahlen' founded in 1897 contains an article by Albert Hoffa which deals with congenital dislocation of the hip. This is an indication that radiology has been concerned with this disorder from its beginning. This paper discusses the incidence of the disease and the ineffectiveness of mass radiological screening

9

Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot – A rare Packaging disorder  

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Full Text Available ntroduction: Reduced intrauterine space gives rise to ‘packaging disorder’ which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK, bilateral congenital hip dislocation (CDH and congenital talipes equino varus (CTEVdeformities. Case Report: A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support. Conclusion: Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good. Keywords: Congenital genu recurvatum, Develpmental dysplasia hip, CTEV, Clubfoot, serial manipulation, packaging disorders

Mukesh Tiwari

2013-04-01

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Pathogeny and natural history of congenital dislocation of the hip.  

Science.gov (United States)

Based on a review of the literature, the authors have made a critical study of several etiological factors. Endogenous factors such as acetabular dysplasia, increased anteversion of the femoral neck, and capsular laxity support the genetic theory but are neither constant nor necessary and are only facilitating factors. The major factor seems to be a mechanical one linked to the position in the uterus: hyperflexion with adduction and external rotation constituting the dislocating foetal posture combined with abnormal pressure on the greater trochanter and leading to expulsion of the head upward and backward. This theory can explain the natural history of C D H which is first, at birth a hip instability followed by two possible evolutions: either persistent luxation becoming irreducible or spontaneous stabilisation leading sometimes to complete healing or to residual abnormalities (subluxation or dysplasia). This concept suggests practical conclusions: the importance of an early diagnosis, the selection of the signs of the hip at risk, the pattern of prevention, the role for non-clinical investigations, the principles of the treatment based on postures, the indications for the different types of treatment. PMID:24456762

Seringe, R; Bonnet, J-C; Katti, E

2014-02-01

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New Aspects of Correlation of Free Radical Oxidation and the Severity of Pathological Process in Congenital Dislocated Hip and Degenerative Dystrophic Diseases of Hip Joint in Children  

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The aim of the investigation is to prove the correlation of free radical processes and the state of anti-oxidant system, and the severity of pathological process in children with congenital dislocated hip.Materials and Methods. There were examined 143 patients with congenital dislocated hip aged from 4 to 17 years, they were divided into three groups: the 1st group (n=39) — children with noncomplicated disease, the 2nd group (n=47) — children with coxarthrosis, the 3rd group (n=32) — ch...

Strelkova, I. G.; Musikhina, I. V.; Bogosian, ?. B.; Sidorkin, V. G.; Starikova, ?. ?.; Sidorkina, ?. N.; Kusnetsova, V. L.

2012-01-01

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[Preliminary treatment of congenital hip dislocation using physical therapy based on neurophysiology].  

Science.gov (United States)

Adductor tightness is a typical symptom in CDH. In cases of subluxation and complete dislocation even a rigid abduction contracture can occur, preventing reduction and favouring redislocation. The contracture of the hip joint is the result of neurophysiological disorders, which can be treated by an exercise program on a neurophysiological basis. 62 children with 73 severely contracted and 5 hypotonic hip dislocations have been treated by the so-called "Vojta-program" before reduction. In a prospective study over 5 years this kind of treatment has been very successful: the incidence of necrosis of the femoral head could be reduced to 4%, long-lasting traction was not necessary anymore and the rigid hip joints required open reduction only in 2 cases. PMID:3577341

Niethard, F U

1987-01-01

13

The ranking of computed tomography in congenital hip dysplasia and hip dislocation  

International Nuclear Information System (INIS)

A lot of methods of measurement have been developed to record precisely the degrees of luxation and the deviations from the normal form in the hip joints of the child and adult. The orthopaedic surgeon needs those data for a preoperative ''coxometric program'' before performing acetabuloplastic operations with osteotomia, osteotomia of the pelvis and combined operations. Computed tomography yields a series of informations and of possibilities of measurements which can determine the operative procedure in particular. These informations concern among other things the dimensions of the dysplasia of the acetabulum in the horizontal plane with the extension of the posterior lip and the angle of the acetabular opening, furthermore the physiological or pathological congruence between the head of the femur and the acetabulum, the angle of antetorsion of the neck of the femur and, in the small infant, the direct noninvasive imaging of the tube of the capsule with imaging of possible obstacles to reposition. (orig.)

14

Hip CT in congenital dislocation: appearance of tight iliopsoas tendon and pulvinar hypertrophy  

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The iliopsoas tendon can interpose between the femoral head and the acetabulum, preventing reduction or stability of reduction of a dislocated hip by a closed method. The tendon produces an infolding of the capsule and labrum. This infolding of the capsule and labrum creates an ''isthmus'' between the capital and the acetabular parts of the capsule. This deformity of the capsule was recognizable on computed tomography (CT) in 10 patients, all of whom had surgical confirmation of the findings. The presence of hypertrophied pulvinar can also be recognized by CT.

Hernandez, R.J.; Tachdjian, M.O.; Dias, L.S.

1982-08-01

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Hip CT in congenital dislocation: appearance of tight iliopsoas tendon and pulvinar hypertrophy  

International Nuclear Information System (INIS)

The iliopsoas tendon can interpose between the femoral head and the acetabulum, preventing reduction or stability of reduction of a dislocated hip by a closed method. The tendon produces an infolding of the capsule and labrum. This infolding of the capsule and labrum creates an ''isthmus'' between the capital and the acetabular parts of the capsule. This deformity of the capsule was recognizable on computed tomography (CT) in 10 patients, all of whom had surgical confirmation of the findings. The presence of hypertrophied pulvinar can also be recognized by CT

16

Outcome of one stage combined open reduction, pelvic and derotation femoral osteotomy in congenital dislocated hips of children younger than three years age  

International Nuclear Information System (INIS)

Objective: To determine the outcome of one-stage combined operative management of congenital dislocation of hips in children aged 18-36 months. Methods: The descriptive case series study was conducted at the Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre, Karachi, from January 2005 to December 2011. Children aged 18-36 months suffering from congenital dislocation of hips were included. Those with Tonnis stage III and IV were managed with one-stage operative procedure without preliminary traction. The operative procedure included adductor tenotomy, open reduction, capsulorraphy, Salter's osteotomy and a femoral derotation osteotomy. Catteral's 'Test of Stability' was used after open reduction as an indicator for need of pelvic and femoral osteotomies. Follow-up ranged between 1 and 7 years. The patients were evaluated clinically on McKay's criteria and radiologically on Severin's criteria. Klisic's overall rating was used to know mean of the assessments. Results: There were 38 patients with 50 congenital dislocations of hip. There were 26(68.42%) females and 12(31.57%) males with a female-to-male ratio of 2:1. Mean age at the time of operation was 24.26+-7.6 months. Of the total, 12(31.57%) patients had bilateral involvement, 11(28.94%) had right-sided and 15(39.47%) had left- sided involvement. Right side to Left ratio was 1:1.2. At the time of last follow-up, 25(50%) hips behaved excellent on McKay's criteria. According to radiographic classification on Severin's criteria, 24(48%) hips were in excellent class. Avascular necrosis of femoral head was noted in 3(6%) hips, re-subluxation/re-dislocations were observed in 3(6%) hips and 1(2.6%) patient had 1cm femoral lengthening. Conclusion: One-stage open reduction, capsulorrapyhy, Salter's osteotomy and femoral derotation osteotomy without preliminary traction to re-locate congenital dislocation of hips in late presenting children is a safe and highly effective method. It produces a low rate of complication and need for repeat surgery. It reduces the cost of treatment, minimises socio-economic burden and psychological trauma incurred by lengthy hospitalisation of treatment with traction followed by closed reduction. (author)

17

Developmental Dislocation (Dysplasia) of the Hip (DDH)  

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... the American Academy of Orthopaedic Surgeons. Developmental Dislocation (Dysplasia) of the Hip (DDH) The hip is a “ ... pelvis bone. In babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint ...

18

Anteversion of the femoral neck in congenital dislocation of the hip.  

Directory of Open Access Journals (Sweden)

Full Text Available A ten year follow-up study was made of 107 hips of 97 patients to find if derotation osteotomy affected the growth of the hip joint. The anteversion angles before and after treatment were measured in four groups classified according to treatment method: Pavlik harness, frog plaster, Colonna operation and derotation osteotomy. The difference in the angle was greatest in the derotation osteotomy group. However, no significant relation between the CE angles and the anteversion angles or the degree of derotation at the time of the follow-up study was found. The author concluded that the growth of the hip is not influenced by the extent of anteversion as much as was previously believed before.

Koshimune,Gisaburo

1985-06-01

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Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy Tratamento cirúrgico da luxação congênita do quadril pós marcha: redução aberta e osteotomia de Salter  

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Full Text Available The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter. In this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months (age after march, mean age of 19 months. Fifteen were female and 3 were male, 4 patients had bilateral dislocation and in the remaining, 8 had their left hip dislocated and 6 had their right hip dislocated. The results were evaluated according to Dutoit et al.(3 clinical criteria and to Severin(12 radiological criteria, after a mean follow-up of 48 months. Eighteen percent of excellent clinical results (4; 54% of good results (12; 14% of regular results (3 and 14% of bad results(3 were obtained. As to the radiologic criteria, 36% of the hips were classified as excellent (8; 45% as good (10; 5% regular (1 and 14% bad (3. There were 3 cases of re-dislocation which were treated by a different surgical technique. No cases of infection, graft fracture and vascular or nervous injury were reported.A luxação congênita do quadril (LCQ, após a marcha, requer o tratamento cirúrgico, sendo uma das opções a redução aberta associada a osteotomia do osso inominado (tipo Salter. Neste estudo foram avaliados 18 pacientes, 22 quadris, que apresentavam LCQ tratados cirurgicamente, entre 1989 e 1995, utilizando a osteotomia do osso inominado, pela técnica de Salter, pós redução aberta. A idade dos pacientes, na época da cirurgia, variou de 12 a 30 meses, com média de 19 meses, sendo 15 do sexo feminino e 3 do masculino, 4 pacientes tinham acometimento bilateral, sendo que nos demais, 8 tinham o quadril esquerdo acometido e 6 o lado direito. Os resultados foram avaliados segundo critérios clínicos de Dutoit et al.(3 e radiográficos de Severin(12, após um seguimento médio de 48 meses. Clinicamente foram obtidos 18% de resultados excelentes (4; 54% resultados bons (12; 14% regulares (3; e 14% ruins (3. Quanto aos critérios radiográficos, encontramos 36% dos quadris classificados como excelentes (8; 45% bons (10; 5% regulares (1; e 14% ruins(3. Como complicações foram constatados 3 casos de reluxação, tratados com outra técnica cirúrgica. Não foi observado nenhum caso de infecção, fratura do enxerto e lesão vascular ou nervosa.

Guaracy Carvalho Filho

2003-01-01

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Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy / Tratamento cirúrgico da luxação congênita do quadril pós marcha: redução aberta e osteotomia de Salter  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A luxação congênita do quadril (LCQ), após a marcha, requer o tratamento cirúrgico, sendo uma das opções a redução aberta associada a osteotomia do osso inominado (tipo Salter). Neste estudo foram avaliados 18 pacientes, 22 quadris, que apresentavam LCQ tratados cirurgicamente, entre 1989 e 1995, ut [...] ilizando a osteotomia do osso inominado, pela técnica de Salter, pós redução aberta. A idade dos pacientes, na época da cirurgia, variou de 12 a 30 meses, com média de 19 meses, sendo 15 do sexo feminino e 3 do masculino, 4 pacientes tinham acometimento bilateral, sendo que nos demais, 8 tinham o quadril esquerdo acometido e 6 o lado direito. Os resultados foram avaliados segundo critérios clínicos de Dutoit et al.(3) e radiográficos de Severin(12), após um seguimento médio de 48 meses. Clinicamente foram obtidos 18% de resultados excelentes (4); 54% resultados bons (12); 14% regulares (3); e 14% ruins (3). Quanto aos critérios radiográficos, encontramos 36% dos quadris classificados como excelentes (8); 45% bons (10); 5% regulares (1); e 14% ruins(3). Como complicações foram constatados 3 casos de reluxação, tratados com outra técnica cirúrgica. Não foi observado nenhum caso de infecção, fratura do enxerto e lesão vascular ou nervosa. Abstract in english The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter). In this study, the results of 18 patients, 22 surgically treated hips with congenit [...] al dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months (age after march), mean age of 19 months. Fifteen were female and 3 were male, 4 patients had bilateral dislocation and in the remaining, 8 had their left hip dislocated and 6 had their right hip dislocated. The results were evaluated according to Dutoit et al.(3) clinical criteria and to Severin(12) radiological criteria, after a mean follow-up of 48 months. Eighteen percent of excellent clinical results (4); 54% of good results (12); 14% of regular results (3) and 14% of bad results(3) were obtained. As to the radiologic criteria, 36% of the hips were classified as excellent (8); 45% as good (10); 5% regular (1) and 14% bad (3). There were 3 cases of re-dislocation which were treated by a different surgical technique. No cases of infection, graft fracture and vascular or nervous injury were reported.

Guaracy, Carvalho Filho; Alceu Gomes, Chueire; Helencar, Ignácio; Márcio de Oliveira, Carneiro; João, Francese Neto; Augusto César, Canesin.

2003-01-01

 
 
 
 
21

Hereditary congenital posterior dislocation of radial heads.  

Science.gov (United States)

We report on 4 patients with congenital posterior dislocation of radial heads in 3 generations of a family. Radiographs of the elbow joints of 3 individuals are presented. All affected subjects have mild limitation of extension and a strong restriction of rotation in the elbows. Comparison with previously described patients shows similarities in the X-ray findings. Congenital posterior dislocation of the radial head can be unilateral or bilateral. This malformation is also found in patients with antecubital pterygium or nail-patella syndrome. This family confirms the autosomal dominant inheritance of congenital posterior dislocation of radial heads. PMID:7702079

Reichenbach, H; Hörmann, D; Theile, H

1995-01-01

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Bilateral traumatic posterior hip dislocation: CT findings  

International Nuclear Information System (INIS)

A case of bilateral posterior traumatic hip dislocation with plain radiographic and computed tomographic (CT) findings is presented. It is estimated that preoperative CT is of unique value in demonstrating subtle associated fractures, displacement of fracture fragments and intra-articular fragments. 8 refs., 3 figs

23

Bilateral Asymmetrical Traumatic Hip Dislocation in an Adult  

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Full Text Available Bilateral hip dislocation occurring as a result of trauma is a rare condition. Simultaneous anterior andposterior traumatic dislocation of both hips is even more unusual. A case is reported of bilateral asymmetricaltraumatic hip dislocation in previously normal hips in a 20 year old adult male without an associatedfracture of the pelvis or femur. An unusual mechanism for this injury is also described.

Neeraj Mahajan, Arti Khurana*, Dara Singh, Ghanshyam Dev*

2010-10-01

24

Complications after posterior dislocation of the hip  

Science.gov (United States)

Thirty-five consecutive patients with unilateral posterior dislocation of the hip were studied for complications at an average follow-up of 4.6 years (range 2–10 years). Thompson–Epstein type IV dislocation was most frequent (10/35), reflecting an increase in high-speed motor vehicles in the developing countries. It is also a severe injury that leads to a maximum number of complications, which include avascular necrosis, osteoarthosis, sciatic nerve injury and heterotrophic ossification. Avascular necrosis and osteoarthritis of the hip were observed maximally in type IV patients, even when reduction was achieved in less than twelve hours and may reflect the severity of initial injury. Heterotrophic ossification was observed in five of the ten patients with type IV dislocation and was associated with multiple attempts at reduction. Sciatic nerve injury did not recover completely in all cases, especially when reduction was delayed over twelve hours. Observing that the greatest numbers of complications were seen among patients with type IV dislocations, it may be prudent to warn such individuals about the likely prognosis at the outset, especially in today’s world when the demands and expectations are high. PMID:16521016

John, B.; Singh, S. A.; Mam, M. K.

2006-01-01

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Recurrent spontaneous hip dislocation in a patient with neurofibromatosis type 1: a case report.  

LENUS (Irish Health Repository)

Neurofibromatosis type-1 is a common genetic disorder which often affects the skeleton. Skeletal manifestations of neurofibromatosis type-1 include scoliosis, congenital pseudarthrosis of the tibia and intraosseous cystic lesions. Dislocation of the hip associated with neurofibromatosis type-1 is a rare occurrence and is underreported in the literature.

Galbraith, John G

2011-01-01

26

The surgical treatment for congenital atlantoaxial dislocation  

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Full Text Available Congenital atlantoaxial dislocation (CAAD is one common disease of craniovertebral junction (CVJ malformations, which diagnosis depends on CT and MRI. The treatment of CAAD is complex, as a result, the corresponding surgical techniques are different, mainly includes anterioposterior combined approach surgery, single anterior approach surgery and single posterior approach surgery. There is also simple posterior decompression surgery, but it seems not convincible. The complications related to different surgical techniques are various, hence we suggest the experienced neurosurgeons to investigate such operations.

WANG Kun

2012-08-01

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CT findings of traumatic posterior hip dislocation after reduction  

International Nuclear Information System (INIS)

To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients

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Paralytic dislocations of the hip in adolescence: Orthopaedic treatment  

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Full Text Available Paralytic dislocation of the hip in adolescence is not typical, but presents a serious problem whether diagnosed primarily in adolescence or due to the lack of treatment or failed treatment in earlier age. It is characteristic of cerebral palsy and myelomeningocele. If the paralytic dislocation of the hip in adolescence is asymmetric, then pelvic obliquity, leg-length discrepancy, imbalance in sitting position, scoliosis and secondary spondylosis with all its consequences ensue. Complications like hip pains due to secondary arthrosis and walking ability impairment are frequent in ambulatory patients. The dislocation is the result of muscle imbalances in the hip region. The diagnosis is based on Illness history, clinical examination, neurological examination and radiography. Treatment is mostly operative, except in cases of pelvic symmetry and absence of difficulties. Pelvic and/or femoral osteotomy with or without open reduction of the hip is done in ambulatory patients with cerebral palsy. Soft-tissue surgery, hip flexors release and tenotomy of the hip adductors, are done in non-ambulatory patients with cerebral palsy. In patients with myelomeningocele soft-tissue surgery, hip flexors release and tractus iliotibialis resection on the lower side of the pelvis, are done regardless of the ability to walk. The same bone surgery procedures as in cerebral palsy are done only in ambulatory patients with unilateral dislocations if soft-tissue surgery failed.

?obelji? Goran

2009-01-01

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Why is congenital dislocation of the hip still missed? Analysis of 96,891 infants screened in Malmö 1956-1987.  

Science.gov (United States)

During 1956 through 1987, 96,891 children have been screened for neonatal hip instability according to the tests of Ortolani and Barlow. In 1956 through 1972 only 4/58, 759 (0.07 permille) were missed, whereas during 1980 through 1987, 12/19, 398 (0.6 permille) were missed. This increase is not caused by any formal alteration of the screening programme. The screening has prevented a late diagnosis in all children born in breech presentation and in all boys except one. General factors such as female sex and joint laxity imply an increased risk for being missed in the screening, whereas mechanical factors such as breech presentation and the primogeniture effect likely facilitate an early diagnosis in the screening. The time between birth and the first examination is also of some importance. PMID:2014732

Sanfridson, J; Redlund-Johnell, I; Udén, A

1991-04-01

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Recurrent spontaneous hip dislocation in a patient with neurofibromatosis type 1: a case report  

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Full Text Available Abstract Introduction Neurofibromatosis type-1 is a common genetic disorder which often affects the skeleton. Skeletal manifestations of neurofibromatosis type-1 include scoliosis, congenital pseudarthrosis of the tibia and intraosseous cystic lesions. Dislocation of the hip associated with neurofibromatosis type-1 is a rare occurrence and is underreported in the literature. Case presentation We report a case of hip dislocation resulting from an intra-articular neurofibroma in an 18-year-old Caucasian woman following minor trauma. This was originally suggested by the abnormalities on early radiographs of her pelvis and later confirmed with computed tomography and magnetic resonance imaging. Treatment was successful with skeletal traction for six weeks with no further hip dislocations at a 12-year follow-up. Conclusion This case illustrates the radiological features of this rare complication of neurofibromatosis type-1 using the modalities of plain radiograph, magnetic resonance imaging and computed tomography reconstruction. The radiological images give a clear insight into the mechanism by which neurofibromatosis type-1 leads to hip dislocation. It also demonstrates one treatment option with excellent results on long-term follow-up.

Harty James A

2011-03-01

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Is congenital talipes equinovarus a risk factor for pathological dysplasia of the hip? : a 21-year prospective, longitudinal observational study.  

Science.gov (United States)

There is controversy whether congenital foot abnormalities are true risk factors for pathological dysplasia of the hip. Previous United Kingdom screening guidelines considered congenital talipes equinovarus (CTEV) to be a risk factor for hip dysplasia, but present guidelines do not. We assessed the potential relationship between pathological dysplasia of the hip and fixed idiopathic CTEV. We present a single-centre 21-year prospective longitudinal observational study. All fixed idiopathic CTEV cases were classified (Harrold and Walker Types 1 to 3) and the hips clinically and sonographically assessed. Sonographic Graf Type III, IV and radiological irreducible hip dislocation were considered to be pathological hip dysplasia. Over 21 years there were 139 children with 199 cases of fixed idiopathic CTEV feet. Sonographically, there were 259 normal hips, 18 Graf Type II hips, 1 Graf Type III hip and 0 Graf Type IV hip. There were no cases of radiological or sonographic irreducible hip dislocation. Fixed idiopathic CTEV should not be considered as a significant risk factor for pathological hip dysplasia. This conclusion is in keeping with the current newborn and infant physical examination guidelines in which the only risk factors routinely screened are family history and breech presentation. Our findings suggest CTEV should not be considered a significant risk factor in pathological dysplasia of the hip. Cite this article: Bone Joint J 2014;96-B:1553-5. PMID:25371473

Paton, R W; Choudry, Q A; Jugdey, R; Hughes, S

2014-11-01

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Anesthesia for a patient with Fanconi anemia for developmental dislocation of the hip: a case report.  

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Fanconi anemia is a rare autosomal recessive inherited bone marrow failure syndrome with congenital and hematological abnormalities. Literature regarding the anesthetic management in these patients is limited. A management of a developmental dislocation of the hip was described in a patient with fanconi anemia. Because of the heterogeneous nature, a patient with fanconi anemia should be established thorough preoperative evaluation in order to diagnose on clinical features. In conclusion, we preferred caudal anesthesia in this patient with fanconi anemia without thrombocytopenia, because of avoiding from N2O, reducing amount of anesthetic, existing microcephaly, hypothyroidism and elevated liver enzymes, providing postoperative analgesia, and reducing amount of analgesic used postoperatively. PMID:24907882

Dogan, Zafer; Yildiz, Huseyin; Coskuner, Ismail; Uzel, Murat; Garipardic, Mesut

2014-01-01

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Central dislocation of the hip secondary to insufficiency fracture  

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Full Text Available We present a case report of a 45-year old man who sustained a central dislocation of the hip secondary to an insufficiency fracture of the acetabulum. At the time of presentation he was on alendronate therapy for osteoporosis which had been previously investigated. CT scanning of the pelvis was useful for pre-operative planning which confirmed collapse of the femoral head but no discontinuity of the pelvis. The femoral head was morcellized and used as bone graft for the acetabular defect and an uncemented total hip replacement was performed.

Charles E.R. Gibbons

2010-03-01

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Effect of head diameter on passive and active dynamic hip dislocation.  

Science.gov (United States)

Hip dislocation is a major short-term complication after total hip arthroplasty (THA). One factor thought to reduce the risk for dislocation is head size. We constructed subject-specific computer models to study the effect of head size on risk for postoperative dislocation. Femoral and acetabular geometry was constructed after segmenting CT scans of nine hips. CAD models of THA components with four head diameters (28, 32, 36, and 44?mm) were virtually implanted. Hip capsular ligaments were simulated using rigid-body ellipsoids connected by non-linear springs. Posterior dislocation was simulated during a rise from a low chair; anterior dislocation was simulated during a pivot activity. Intraoperative stability tests were simulated for anterior or posterior dislocation. While rising from a low chair (posterior dislocation) and during the pivot activity (anterior dislocation), increasing head size significantly increased hip flexion angle at dislocation and generated higher dislocation moments. Larger heads reduced the risk for dislocation. Intraoperative stability tests detected the relative increased resistance to dislocation despite differences in the absolute magnitude of moments. This model can be useful preclinical tool for assessing design changes, the effect of component placement, and the activity-based risk for dislocation. PMID:24961686

Bunn, Adam; Colwell, Clifford W; D'Lima, Darryl D

2014-11-01

35

Total hip arthroplasty in a patient with congenital insensitivity to pain: a case report  

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Full Text Available Abstract Introduction Congenital insensitivity to pain, a rare neurological entity, is characterized by varying degrees of sensory loss and autonomic dysfunction. Orthopedic manifestations of congenital insensitivity to pain include delayed diagnosis of fractures, nonunions, malunions, Charcot arthropathy, acro-osteolysis, avascular necrosis, osteomyelitis, heterotopic ossification and joint dislocations. We here report the case of a patient with congenital insensitivity to pain who had multiple lower extremity fractures at varying intervals, the most recent being a femoral neck fracture managed by total hip replacement. To the best of our knowledge, this is the first report of cementless hip arthroplasty in such a patient. Case presentation A 37-year-old Caucasian woman was admitted to our hospital complaining of painless swellings in her lower limb and limping. She had been diagnosed with multiple lower extremity fractures at different times. On physical examination, we found multiple perioral mucosal ulcers, shortening of her nails and acro-osteolysis, a prematurely aged facial appearance, undersized skeletal structure, Charcot arthropathy of her right ankle, anosmia, insensitivity to temperature differences and evidence of mild intellectual disability. A right subtrochanteric femur fracture was treated with an intramedullary nail. Eighteen months later, she presented with similar symptoms and we diagnosed a right femoral neck fracture. We removed the nail and performed cementless total right hip arthroplasty. Conclusions Congenital insensitivity to pain is a rare condition that is associated with severe orthopedic problems. This case report, which will be of particular interest to orthopedic surgeons, presents several difficulties in the management of patients with congenital insensitivity to pain and notes the importance of close follow-up and early recognition of complications. Cementless total hip arthroplasty may be a good therapeutic option for femoral neck fracture in these patients.

Erdil Mehmet

2012-07-01

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Course of fracture-dislocation of the hip during coma: value of computed tomography  

International Nuclear Information System (INIS)

Based on a case of repeated dislocation of a fracture-dislocation of the hip, despite effective traction in a comatose patient, the authors emphasise the value of computed tomography in the initial assessment of traumatic lesions of the hip. They also stress the value of repeating this examination during the course of the coma

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Dislocation of primary total hip arthroplasty and the risk of redislocation.  

LENUS (Irish Health Repository)

6554 primary total hip arthroplasties were reviewed. Risk factors for dislocation were analysed to assess which were important in terms of predicting recurrent instability. The patients risk of having a second dislocation was independently associated with the surgical approach adopted (p = 0.03) and the time to first dislocation from the primary hip replacement (p = 0.002). Early dislocators whose surgery was performed through an anterolateral approach had less recurrence than late dislocators through a posterior or transtrochanteric approach. None of the other risk factors including head size (p = 0.59), modularity (p = 0.54), mechanism of dislocation (p = 0.23), leg length discrepancy (p = 0.69) and acetabular inclination (p = 0.31) were influential. The use of an abduction brace was not useful in preventing a further dislocation with 69.2% of those braced re-dislocating compared to 68.5% who were not braced (p = 0.96).

Brennan, Stephen A

2012-09-01

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Epidemiology of traumatic hip dislocation in patients treated in Cear?, Brazil  

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OBJECTIVE: To describe the epidemiological profile of patients with traumatic hip dislocation treated in our Institute from November/2012 to July/2013. METHODS: A descriptive cross-sectional study based on interviews and involving 43 patients who suffered traumatic hip dislocation was conducted. RESULTS: The mean age of patients was 34.4 years old and 90.7% were male. Regarding the mechanism of injury, 95% involved traffic accidents. The posterior dislocation of the hip was the most common injury (93%). Associated lesions were observed in 74.4% of patients, hip fractures being the most frequent. The time span between accident and dislocation reduction was less than 6 hours in 37.2% of patients, between 6 and 12 hours in 32.5% and over 12 hours in 30.3%, ranging from 1 hour to 15 days. A fraction of 90.7% of patients was submitted to closed reduction. CONCLUSION: Traumatic hip dislocation affected mostly young adults, victims of traffic accidents. The posterior dislocation of the hip was the most frequent injury and closed reduction was performed in 90.7% of patients. The time span between accident and dislocation reduction was less than 12 hours in most patients. Level of Evidence III, Study of Nonconsecutive Patients. PMID:25061422

Lima, Luciana Cascao; do Nascimento, Robson Alves; de Almeida, Victor Monte Tenorio; Facanha, Fernando Antonio Mendes

2014-01-01

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Epidemiology of traumatic hip dislocation in patients treated in Ceará, Brazil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To describe the epidemiological profile of patients with traumatic hip dislocation treated in our Institute from November/2012 to July/2013. METHODS: A descriptive cross-sectional study based on interviews and involving 43 patients who suffered traumatic hip dislocation was conducte [...] d. RESULTS: The mean age of patients was 34.4 years old and 90.7% were male. Regarding the mechanism of injury, 95% involved traffic accidents. The posterior dislocation of the hip was the most common injury (93%). Associated lesions were observed in 74.4% of patients, hip fractures being the most frequent. The time span between accident and dislocation reduction was less than 6 hours in 37.2% of patients, between 6 and 12 hours in 32.5% and over 12 hours in 30.3%, ranging from 1 hour to 15 days. A fraction of 90.7% of patients was submitted to closed reduction. CONCLUSION: Traumatic hip dislocation affected mostly young adults, victims of traffic accidents. The posterior dislocation of the hip was the most frequent injury and closed reduction was performed in 90.7% of patients. The time span between accident and dislocation reduction was less than 12 hours in most patients. Level of Evidence III, Study of Nonconsecutive Patients.

Luciana Cascão, Lima; Robson Alves do, Nascimento; Victor Monte Tenório de, Almeida; Fernando Antônio Mendes, Façanha Filho.

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Traumatic obturator hip dislocation in a 9-year-old boy.  

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Traumatic hip dislocation is a rare but potentially devastating injury in a child. Although most hip dislocations are posterior, other variants have been described. An anterior dislocation in the pediatric population is uncommon and, to our knowledge, this is the first case of anterior-inferior (obturator) dislocation (ie, the femoral head lies in the obturator foramen), to be reported in the English-language literature. In this article, we describe the case of a young boy with a traumatic obturator hip dislocation treated conservatively with closed reduction and followed closely for 1 year. The patient did not develop any sequelae throughout the follow-up year. This case report, along with a review of the literature, will help guide clinicians in the care of patients with this rare injury. PMID:24078972

Avery, Daniel M; Carolan, Gregory F

2013-09-01

 
 
 
 
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Traumatic posterior dislocation of the hip in a 3-year-old child.  

LENUS (Irish Health Repository)

We report the case of a traumatic posterior dislocation of the hip in a 3-year-old boy. After a fall in the garden, the boy was brought to our emergency department where an x-ray confirmed a posterior dislocation of his right hip. A successful prompt reduction was performed in the operating room under general anesthesia. This uncommon injury represents an orthopedic emergency and requires prompt reduction to lessen the risk of complications including avascular necrosis of the femoral head.

Forde, James C

2012-02-01

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Atraumatic posterior dislocation of the native hip: an unusual presentation of septic arthritis.  

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We present a case of chronic posterior hip dislocation after severe joint destruction following septic arthritis. In the absence of trauma, infection must be considered in the differential diagnosis of a dislocated joint particularly in patients with risk factors such as intravenous drug abuse and immune compromise. Excision arthroplasty of the hip was performed with good pain relief and functional outcomes. This is an excellent temporary or permanent solution in managing such complex cases although alternative management options are discussed. PMID:22684539

Patel, N K; Windley, J; Naique, S

2014-06-01

43

Traumatic fracture-dislocation of the hip following rugby tackle: a case report  

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Full Text Available Abstract Posterior fracture-dislocation of hip is uncommonly encountered in rugby injuries. We report such a case in an adult while playing rugby. The treating orthopaedician can be caught unaware and injuries in such sports can be potentially misdiagnosed as hip sprains. Immediate reduction of the dislocation was performed in theatres. The fracture was fixed with two lag screws and a neutralization plate. This led to early rehabilitation and speedy recovery with return to sporting activities by 12 months.

Venkatachalam Santosh

2009-12-01

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A Case Report of Simultaneous Anterior and Posterior Traumatic Dislocation of the Hips  

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Full Text Available Introduction: Bilateral hip dislocation (especially asymmetric type occurs rarely. By review of literature (published since 1951 till 2004, we found 15 cases of bilateral asymmetric hip dislocation (age between 3 and 36 years that contained 12 cases in males. All of the patients were treated using closed reduction and then traction. There was no considerable difference between the results of treatment in these patients and unilateral hip dislocations.Case Report: The case was a 39 years old man who had bilateral hip dislocation in a head on automobile collision while standing at the back of a van. The position of left hip was in adduction, flexion and internal rotation and the position of right hip was in abduction, flexion and external rotation. Closed reduction was conducted, first for left hip and then for right hip using traction and counter-traction. Then skeletal traction was applied for 8 weeks. The patient started PWB during 4 weeks after the end of traction, then FWB.Conclusion: After 6 months, control radiography did not show any sign of AVN or other lesion and patient’s walking was painless.

A. Ebrahim Pour

2006-10-01

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Two-dimensional and three-dimensional CT analysis of congenital hip dysplasia in the older child and adult  

International Nuclear Information System (INIS)

In the older child or adult with congenital dysplasia of the hip, a spectrum of developmental abnormalities of the femoral head, neck, and acetabulum produce progressive hip dysfunction, pain, and premature arthritis. Treatment is oriented to restoring normal and pain-free function, although (unlike the infant with successfully treated dislocation) a truly normal hip cannot be restored. For these patients, who may require extensive reconstruction, transaxial CT with both static 2D (coronal and sagittal) and animated volumetric 3D image reformatting offers the most complete, accurate, and integrated approach to diagnosis and therapeutic planning. Parameters preoperatively assessed include head subluxation, neck anteversion, quadrilateral plate thickness, degree of dysplasia, potential for concentric reduction, acetabular capacity, and muscle status. Postoperatively, both immediate and long-term results or complications are easily assessed and readily compared

46

Congenital radial head dislocation with a progressive cubitus valgus: a case report.  

Science.gov (United States)

Congenital dislocation of the radial head is rare, although it is the most common congenital anomaly of the elbow. A concomitant progressive cubitus valgus of the elbow has not previously been described in literature. We describe a case of an 8-year-old girl with an unilateral congenital radial head dislocation with a progressive cubitus valgus of 35°, caused by a prematurely closing physis of the lateral humeral condyle. This might be caused by an increased pressure on the lateral physis by the anteriorly dislocated radial head. As no complaints or limitations were present, treatment was non-operative with clinical observation, with satisfactory results after a follow-up of 18 months. A concomitant progressive cubitus valgus can be present in patients with a congenital radial head dislocation. Non-operative treatment can provide satisfactory results. PMID:22223165

Kaas, Laurens; Struijs, Peter A A

2012-04-01

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Body mass characteristics of hip osteoarthritis patients experiencing aseptic loosening, periprosthetic fractures, dislocation, and infections after total hip replacement  

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Full Text Available Ray MarksCity University of New York and Columbia University, New York, NY, USAAbstract: This work assessed the body mass characteristics of a cohort of community dwelling adults requiring surgery for complications related to primary hip arthroplasty, among other factors. The specific aim was to identify the extent to which high body mass prevailed in the cohort as a whole, to identify a role for subnormal body mass in the pathogenesis of post-operative complications following hip joint arthroplasty, and to identify whether different complication types could be differentiated on the basis of body mass profiles. The subjects were males and females drawn from a representative sample of 1,040 hip osteoarthritis patients between the ages of 30–89 years hospitalized for purposes of primary hip arthroplasty or complications related to prior replacement surgery. An analysis of their medical records showed: 1 Approximately 20% of the present cohort was constituted by patients with various complications related to prior arthroplasties, or to general deterioration of their condition; 2 The most common reasons for their re-hospitalization were aseptic prosthetic loosening followed by infection, prosthetic dislocations, prosthetic and periprosthetic fractures, and second surgeries on the opposite hip; 3 The presence of a high body mass index differentiated those presenting with aseptic prosthetic loosening, periprosthetic fractures, and those with infected hips (p < 0.007. Those with infection diagnoses were significantly heavier on average than those with no infection, regardless of diagnosis, and more cases with a dislocation history were underweight, rather than overweight (p < 0.05. It is concluded, a small but clinically relevant proportion of obese or underweight adults with hip osteoarthritis who undergo primary total hip replacement may experience complications at higher rates than cases with normal body weight, despite the generally successful outcomes experienced by the majority of hip arthroplasty patients.Keywords: body mass, hip joint, osteoarthritis, replacement surgery

Ray Marks

2009-05-01

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Operative treatment of bilateral hip dislocation in children with arthrogryposis multiplex congenita.  

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Full Text Available PURPOSE. Arthrogryposis multiplex congenita (AMC is a rare syndrome with multiple joint contractures. It is commonly believed that bilaterally dislocated hips associated with joint contractures should not be reduced, because movement is satisfactory, while open reduction leads to poor results. This report presents our experience with surgical management of bilateral dislocation of hips in children with AMC. METHODS. During the period 1990 to 2000, we performed open reduction on 8 hips of 4 children with AMC. The mean age at surgery was 23 months (range, 5-48 months. Open reduction and capsular plication without any bony procedure were performed in 4 hips (2 patients. De-rotation and varus osteotomy of the femur was performed in 4 hips, and Salter osteotomy of the innominate bone in 2 hips. The average acetabular index was 44 degrees, and the mean centreedge angle was -41 degrees preoperatively. RESULTS. The average follow-up period was 4 years (range, 2-9 years. The average acetabular index and centre-edge angle were 19 and 18 degrees, respectively at the time of last follow-up. All children could walk without support. One child required re-opening for redislocation of hip joint. The clinical results were good in 6 hips and fair in 2 hips, according to Severin's and McKay's classifications. CONCLUSION. Our experience shows that open reduction for bilateral dislocation of hips in children with AMC is a suitable option with generally good results. Surgery performed at earlier age gives the best functional outcome.

Asif S

2004-06-01

49

Computed tomography in abnormalities of the hip  

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The value of computed tomography in the assessment of abnormalities of the hip is demonstrated with the aid of an anatomical preparation and in patients with, respectively, congenital dislocation of a hip, dislocation of the hip in spina bifida, an acetabular fracture and a Ewing tumour. The anteversion of the acetabulum and femur and the instability index of the hip joint can be measured by means of computed tomography.

Visser, J.D.; Jonkers, A.; Klasen, H.J. (Rijksuniversiteit Groningen (Netherlands). Academisch Ziekenhuis); Hillen, B. (Rijksuniversiteit Groningen (Netherlands). Lab. voor Anatomie en Embryologie)

1982-06-26

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A new technique for closed reduction of traumatic posterior dislocations of the hip: the 'PGI technique'.  

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Many techniques have been described for closed reduction of posterior hip dislocations, but most require forceful and sustained traction, assistants to stabilise the pelvis and awkward positioning of the surgeon and/or the patient. We describe a new technique of closed reduction that does not need traction-countertraction or special positioning and can be safely and effectively performed by one surgeon.Fifteen patients, mean age 36.4 years, were subjected to reduction. There were five type I, four type II and six type III dislocations; ipsilateral injuries included one knee dislocation with patellar fracture, and two cases of tibia fracture. Closed reduction was achieved in 14 (93.3%) hips, with single attempt successful in 13 cases, while one needed two attempts. One hip could not be reduced due to incarceration of a posterior wall fragment and was managed by open reduction and internal fixation.Our new technique has proved to be a reliable, safe and effective alternative for closed reduction of posterior hip dislocations. It can be carried out by one surgeon, does not need traction and can be especially beneficial in polytrauma patients and also in those patients who have pelvic fractures and ipsilateral lower limb injuries. PMID:24817398

Sharma, Siddhartha; Kumar, Vishal; Dhillon, Mandeep S

2014-01-01

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MRI assessment of the posterior acetabular wall fracture in traumatic dislocation of the hip in children  

International Nuclear Information System (INIS)

Traumatic hip dislocations associated with posterior wall fractures of the acetabulum in the pediatric population are in general a consequence of high-energy trauma. After expeditious reduction, instability mandates for further diagnosis and intervention. Plain radiographs or computerized tomography (CT) scans can misjudge the involvement of the posterior wall of the acetabulum due to the partially calcified nature of the pediatric bone. We present two cases of pediatric traumatic hip dislocation associated with posterior wall fractures of the acetabulum. In both cases, obvious postreduction instability was noted without conclusive findings of etiology on plain X-rays or CT scans. Magnetic resonance imaging (MRI) disclosed an extensive posterior wall traumatic involvement in both cases and helped to decide in favor of open reduction of the hip and internal fixation of the posterior wall fragment. (orig.)

52

A very rare case with neglected hip dislocation coexisted with posterior acetabular lip fracture  

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Full Text Available Neglected hip dislocation is a rare situation among children. The coexistence of acetabulum fracture is less common. The result of treatment depends on the time of diagnosis. Early treatment is mandatory in such cases. Seven years old female brought to our outpatient clinic with the complaints of right hip pain and walking difficulty. Her parents said that she had fallen from a horse one month ago. X-ray and CT showed a posterior dislocation of her right hip and a fracture on her right posterior acetabular lip. We performed an open reduction via posterior approach. Because the hip was unstable we fixed the femoral head to the acetabulum by a Kirshner wire. Pelvipedal cast was applied after the operation for 6 weeks. After 6 months avascular necrosis (AVN developed on her right femoral head, the range of motion (ROM of the hip was restricted and she had minimal pain on her right hip. J Clin Exp Invest 2011;2(2:228-31

Samet Karabulut

2011-06-01

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The dislocating hip replacement - revision with a dual mobility cup in 56 consecutive patients  

DEFF Research Database (Denmark)

INTRODUCTION: Recurrent dislocations of hip replacements are a difficult challenge. One treatment option for recurrent dislocations is the use of a dual mobility cup. The aim of this study was to retrospective investigate the effect of dual mobility cups as a treatment for recurrent dislocations in a consecutive series. Materials and. METHODS: 56 consecutive patients were revised in the period November 2000 to December 2010. The mean age at revision was 72 years (SD 11, range 37-92)) and median number of dislocations before revision surgery were 4 (IQR, 2-11). In all cases, revision was made with a Saturne dual mobility cup (Amplitude, Neyron, France). The mean follow-up period was 44 months (SD 30, range 0.1-119). RESULTS: One patient (1.8%) experienced a re-dislocation. Three patients (5.3%) had to be revised. One due to disintegration between the femoral head and inner shell, one due to loosening of the acetabular component, and one due to infection. Harris Hip Score improved from a mean of 76 before index surgery to 87 within one year after index surgery. CONCLUSION: This study advocates the use of a dual mobility cup for treatment of recurrent dislocations of THR. However, studies with a longer follow up are needed in order to evaluate implant survival.

Jakobsen, Thomas; Kappel, Andreas

2014-01-01

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Femoral Nerve Palsy Following Delayed Reduction of a Dislocated Hip in a 44- Year-old Man  

Science.gov (United States)

Introduction: Incidence of nerve injury in traumatic hip dislocations is up to 10 %. Sciatic nerve is the most common injured nerve in this setting. In the medical literature, there are few documented cases of femoral nerve injury following hip dislocations. Case Report: We report a 44-year-old man with right femoral nerve palsy following delayed reduction of an anterior dislocation of hip. Conclusion: Two months after closed reduction, complete clinical recovery of right femoral nerve was achieved and the patient was able to resume his job. PMID:24719726

Rahimi Shorin, Hassan; Azizbeig Mohajer, Mohammad; Parsa, Ali; Azhari, Amin; Assadian, Maryam

2014-01-01

55

Hip dislocation following the treatment of femoral neck fracture: Case report  

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Full Text Available Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

Vukašinovi? Zoran

2010-01-01

56

Giant congenital melanocytic nevus with developmental dysplasia of bilateral hip: a rare association.  

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Giant congenital melanocytic nevi are rare congenital disfiguring benign neoplasms with a risk of transformation to malignant melanoma. They often present with various extra-cutaneous features. Here, we describe a case of giant melanocytic nevus with developmental dysplasia of bilateral hip, a novel association. PMID:24249902

Imchen, Sutsungkokla; Ghosh, Sangita; Dayal, Surabhi; Marwah, Nisha; Jindal, Nidhi; Sangal, Shikha

2013-11-01

57

Developmental dislocation of the hip is still important problem: Therapeutic guidelines  

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Full Text Available The authors are describing currently important problem - developmental dislocation of the hip. Guidelines for the treatment have been given according to literature date and upon their own experience. Therapeutic suggestions for the first twelve months of life are based on the ultrasound typing - it is advised to perform nonoperative treatment (abduction devices, "over head" traction, Pavlik harnesses. During the second year of life a pause in the treatment should be advised in order to avoid postreduction avascular hip necrosis as a very important complication. After that period surgical treatment has to be done (open reduction, pelvic and femoral osteotomies. Special suggestions have been given for the treatment of consecutive leg length inequality and the deformities caused by postreduction avascular hip necrosis.

Slavkovi? N.

2006-01-01

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Incongruent reduction following post-traumatic hip dislocations as an indicator of intra-articular loose bodies: A prospective study of 117 dislocations  

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Background: Intra-articular loose bodies following simple dislocations can lead to early degeneration. Nonconcentric reduction may indicate retained loose bodies and offer a method to identify patients requiring exploration so that this undesirable outcome can be avoided. Materials and Methods: One hundred and seventeen consecutive simple dislocations of the hip presenting to the hospital from January 2000 to June 2006 were assessed for congruency after reduction by fluoroscopi...

Karthik K; Sundararajan S; Dheenadhayalan J; Rajasekaran S

2011-01-01

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Dual mobility cups for preventing early hip arthroplasty dislocation in patients at risk: experience in a county hospital  

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Full Text Available Dislocation remains a major concern after hip arthroplasty. We asked whether dual mobility cups (DMC would improve early hip stability in patients with high risk of dislocation. We followed 34 patients (21 females, 13 males treated between 2009 and 2012 with cemented DMC for hip revisions caused recurrent hip prosthetic dislocation or as a primary procedure in patients with high risk of instability. Functional outcome and quality of life were evaluated using Harris Hip Score and EQ-5D respectively. We found that the cemented DMC gave stability in 94%. Seven patients (20% were re-operated due to infection. One patient sustained a periprosthetic fracture. At follow-up (6 to 36 months, mean 18, the mean Harris hip score was 67 (standard deviation: 14 and mean EQ-5D was 0.76 (standard deviation: 0.12. We concluded that treating patients with high risk of dislocation with DMC can give good stability. However, complications such as postoperative infection can be frequent and should be managed carefully.

Göran O. Sjödén

2013-06-01

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[Obturator dislocation--a rare complication of the total hip prosthesis. Case study].  

Science.gov (United States)

The article presents the case of a 55-year-old patient with an injury of the right leg, which was due to a falling lightly at her buttocks during squatting. Patient was transferred to hospital with complaints of severe pain and limited motion in her right hip. In view of the patient's clinical status and following radiological diagnostic work-up, she was diagnosed with femoral neck fractures, the decision was made to perform a primary total hip arthroplasty (THA) using an lateral approach in the lateral decubitus position. A good clinical and radiological outcome was achieved. Patient after 12 days without complications was released home. After 4 days being home she was transferred to hospital again with complaints of severe pain and limited motion in her operated hip. On admission, her right lower leg was lying in an extremely rotated and abducted position. However, the extremity was neurologically intact with good pedal pulses. Physical examination and an initial anteroposterior radiograph showed obturator dislocation of the hip prosthesis. The decision was made to perform an open reduction. The operative problem in this particular case was removing the head of the prosthesis from the obturator foramen without making any jatrogenic harm. PMID:22420183

Niciejewski, Krzysztof; Banachowski, Witold; Kowalczyk, Adam

2011-01-01

 
 
 
 
61

Experiencia inicial con la luxación controlada de cadera / Initial experience with surgical hip dislocation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Introducción: La luxación controlada de cadera es un abordaje quirúrgico que permite una amplia visualización del acetábulo, la cabeza y el cuello femoral. El objetivo del presente trabajo fue describir los resultados funcionales y las complicaciones obtenidos en nuestra institución. Materiales y mé [...] todos: Se incluyeron 16 caderas (13 pacientes) intervenidas entre enero de 2003 y enero de 2010. El promedio de edad fue de 31 años (r 11 a 55 años). La cirugía se indicó en los pacientes con pellizcamiento femoroacetabular (4), coxa profunda (4), epifisiólisis de cadera (5), condromatosis sinovial (1), lesión condral (1), necrosis focal de la cabeza femoral (1). Se analizaron los datos clínicos y radiográficos prequirúrgicos y posquirúrgicos. Resultados: Tres pacientes requirieron reemplazo total de cadera (RTC), uno por necrosis avascular (NAV) y dos por progresión de los síntomas. Siete pacientes presentaron buenos a excelentes resultados, dos regulares y cuatro pobres. Tres pacientes presentaron complicaciones mayores (NAV); dos de ellos fueron secuela de una epifisiólisis inestable severa. Las complicaciones menores fueron molestias en el trocánter mayor (2) y el aflojamiento de la osteosíntesis (1). Seis pacientes requirieron cirugías adicionales. Conclusiones: La luxación controlada de cadera, en nuestra experiencia inicial, mostró ser un abordaje demandante que requiere un minucioso conocimiento anatómico y una exacta selección de los pacientes, no exento de complicaciones mayores. Abstract in english Background: Surgical dislocation of the hip is a recently described surgical approach that allows a complete visualization of the acetabulum, and femoral head and neck. The aim of this study is to analyze the functional results and complications we had with this approach at our institution. Methods: [...] Sixteen hips that underwent surgical hip dislocation between January 2003 and January 2010 were included. Surgery was indicated in femoroacetabular impingement (4), coxa profunda (4), slipped capital femoral epiphysis (5), synovial chondromatosis (1), chondral injury (1), and segmental osteonecrosis of the femoral head (1). We analyzed clinical and radiographic data before and after surgery. Results: Three patients required total hip replacement (THR), one because of avascular necrosis (AVN), and the remaining two because of symptom progression. Seven patients had good and excellent results, two fair, and four poor results. Three patients had major complications (AVN), while three had minor complications: painful greater trochanter (2), and loosening of the trochanter fixation (1). Six patients required additional surgery: oste-osynthesis removal 5 cases, THR 3 cases, valgus osteotomy 1 case, and greater trochanter osteosynthesis revision 1 case. Conclusions: In our initial experience, surgical dislocation of the hip has shown to be a challenging approach that requires thorough anatomical knowledge, and accurate patient selection.

Andrés, Ferreyra; Victoria, Allende; Julio Javier, Masquijo; Guillermo José, Allende.

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Experiencia inicial con la luxación controlada de cadera / Initial experience with surgical hip dislocation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Introducción: La luxación controlada de cadera es un abordaje quirúrgico que permite una amplia visualización del acetábulo, la cabeza y el cuello femoral. El objetivo del presente trabajo fue describir los resultados funcionales y las complicaciones obtenidos en nuestra institución. Materiales y mé [...] todos: Se incluyeron 16 caderas (13 pacientes) intervenidas entre enero de 2003 y enero de 2010. El promedio de edad fue de 31 años (r 11 a 55 años). La cirugía se indicó en los pacientes con pellizcamiento femoroacetabular (4), coxa profunda (4), epifisiólisis de cadera (5), condromatosis sinovial (1), lesión condral (1), necrosis focal de la cabeza femoral (1). Se analizaron los datos clínicos y radiográficos prequirúrgicos y posquirúrgicos. Resultados: Tres pacientes requirieron reemplazo total de cadera (RTC), uno por necrosis avascular (NAV) y dos por progresión de los síntomas. Siete pacientes presentaron buenos a excelentes resultados, dos regulares y cuatro pobres. Tres pacientes presentaron complicaciones mayores (NAV); dos de ellos fueron secuela de una epifisiólisis inestable severa. Las complicaciones menores fueron molestias en el trocánter mayor (2) y el aflojamiento de la osteosíntesis (1). Seis pacientes requirieron cirugías adicionales. Conclusiones: La luxación controlada de cadera, en nuestra experiencia inicial, mostró ser un abordaje demandante que requiere un minucioso conocimiento anatómico y una exacta selección de los pacientes, no exento de complicaciones mayores. Abstract in english Background: Surgical dislocation of the hip is a recently described surgical approach that allows a complete visualization of the acetabulum, and femoral head and neck. The aim of this study is to analyze the functional results and complications we had with this approach at our institution. Methods: [...] Sixteen hips that underwent surgical hip dislocation between January 2003 and January 2010 were included. Surgery was indicated in femoroacetabular impingement (4), coxa profunda (4), slipped capital femoral epiphysis (5), synovial chondromatosis (1), chondral injury (1), and segmental osteonecrosis of the femoral head (1). We analyzed clinical and radiographic data before and after surgery. Results: Three patients required total hip replacement (THR), one because of avascular necrosis (AVN), and the remaining two because of symptom progression. Seven patients had good and excellent results, two fair, and four poor results. Three patients had major complications (AVN), while three had minor complications: painful greater trochanter (2), and loosening of the trochanter fixation (1). Six patients required additional surgery: oste-osynthesis removal 5 cases, THR 3 cases, valgus osteotomy 1 case, and greater trochanter osteosynthesis revision 1 case. Conclusions: In our initial experience, surgical dislocation of the hip has shown to be a challenging approach that requires thorough anatomical knowledge, and accurate patient selection.

Andrés, Ferreyra; Victoria, Allende; Julio Javier, Masquijo; Guillermo José, Allende.

2012-03-01

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Evaluación y tratamiento de la luxación protésica de cadera / Evaluation and treatment of prosthetic hip dislocation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish La luxación de cadera es la segunda complicación más frecuente de una artroplastía total de cadera, seguida del aflojamiento aséptico que es la segunda complicación más frecuente de una ATC, presentándose con una incidencia de 2.4-3.9% en procedimientos primarios y una incidencia de hasta 28% en cir [...] ugías de revisión. Las luxaciones de cadera pueden clasificarse en 3 grupos: temprana, intermedia y tardía. De manera general las luxaciones tempranas responden de manera favorable a tratamiento no quirúrgico y tienen bajo índice de recurrencia. En este caso la necesidad de realizar una cirugía de revisión es mucho mayor. El diagnóstico de una luxación de cadera es relativamente sencillo de realizar ya que el cuadro clínico es muy típico. Una vez identificada una luxación de cadera el primer paso a seguir es realizar un intento por reducirla de manera cerrada. Dentro las opciones encontramos las siguientes: cambio de los componentes modulares, avances trocantéricos, revisión de la orientación de los componentes y, en última instancia, el uso de componentes constreñidos. Uno de los problemas más frecuentes por los que el paciente presenta inestabilidad recurrente temprana es la inadecuada orientación de los componentes protésicos. La ATC es una de las cirugías más útiles y con mayor éxito de los últimos 100 años, sin embargo, exige una técnica quirúrgica depurada, adecuada planeación y selección del paciente para poder cumplir las expectativas de la misma. Actualmente se cuenta con una gran gama de posibles tratamientos para la resolución del problema, con la intención de restablecer una cadera estable y funcional. Abstract in english Hip dislocation is the second most common complication of Total Hip Arthroplasty followed by aseptic loosening, is the second most common complication of THA presenting with an incidence of 2.4-3.9% in primary procedures and an incidence of up to 28% in revision surgeries. The hip dislocations can b [...] e classified into 3 groups: Early, middle and late. Generally early dislocations respond favorably to nonsurgical treatment and have low recurrence rate. In this case the need for revision surgery is much higher. The diagnosis of a dislocated hip is relatively easy to perform because the clinical picture is very typical. Having identified a dislocated hip the first step is to make an attempt to reduce a closed manner. Among the options are the following: Change of modular components, trochanteric progress, review of component orientation and ultimately the use of constrained components. One of the most common problems for which the patient presents early recurrent instability is inadequate orientation of the prosthetic components. The THA is one of the most useful and most successful surgeries the last 100 years, however requires a refined surgical technique, proper patient selection and planning to meet the expectations of it. It currently has a range of possible treatments for problem resolution, with the intent of restoring a stable and functional hip.

A, Dabaghi; J, Saleme; L, Ochoa.

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Evaluación y tratamiento de la luxación protésica de cadera / Evaluation and treatment of prosthetic hip dislocation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish La luxación de cadera es la segunda complicación más frecuente de una artroplastía total de cadera, seguida del aflojamiento aséptico que es la segunda complicación más frecuente de una ATC, presentándose con una incidencia de 2.4-3.9% en procedimientos primarios y una incidencia de hasta 28% en cir [...] ugías de revisión. Las luxaciones de cadera pueden clasificarse en 3 grupos: temprana, intermedia y tardía. De manera general las luxaciones tempranas responden de manera favorable a tratamiento no quirúrgico y tienen bajo índice de recurrencia. En este caso la necesidad de realizar una cirugía de revisión es mucho mayor. El diagnóstico de una luxación de cadera es relativamente sencillo de realizar ya que el cuadro clínico es muy típico. Una vez identificada una luxación de cadera el primer paso a seguir es realizar un intento por reducirla de manera cerrada. Dentro las opciones encontramos las siguientes: cambio de los componentes modulares, avances trocantéricos, revisión de la orientación de los componentes y, en última instancia, el uso de componentes constreñidos. Uno de los problemas más frecuentes por los que el paciente presenta inestabilidad recurrente temprana es la inadecuada orientación de los componentes protésicos. La ATC es una de las cirugías más útiles y con mayor éxito de los últimos 100 años, sin embargo, exige una técnica quirúrgica depurada, adecuada planeación y selección del paciente para poder cumplir las expectativas de la misma. Actualmente se cuenta con una gran gama de posibles tratamientos para la resolución del problema, con la intención de restablecer una cadera estable y funcional. Abstract in english Hip dislocation is the second most common complication of Total Hip Arthroplasty followed by aseptic loosening, is the second most common complication of THA presenting with an incidence of 2.4-3.9% in primary procedures and an incidence of up to 28% in revision surgeries. The hip dislocations can b [...] e classified into 3 groups: Early, middle and late. Generally early dislocations respond favorably to nonsurgical treatment and have low recurrence rate. In this case the need for revision surgery is much higher. The diagnosis of a dislocated hip is relatively easy to perform because the clinical picture is very typical. Having identified a dislocated hip the first step is to make an attempt to reduce a closed manner. Among the options are the following: Change of modular components, trochanteric progress, review of component orientation and ultimately the use of constrained components. One of the most common problems for which the patient presents early recurrent instability is inadequate orientation of the prosthetic components. The THA is one of the most useful and most successful surgeries the last 100 years, however requires a refined surgical technique, proper patient selection and planning to meet the expectations of it. It currently has a range of possible treatments for problem resolution, with the intent of restoring a stable and functional hip.

A, Dabaghi; J, Saleme; L, Ochoa.

2014-04-01

65

Luxação congénita do joelho: que abordagem? Revisão teórica e experiência de um Hospital Pediátrico / Congenital dislocation of the knee: what approach? Review and experience of a pediatric hospital  

Scientific Electronic Library Online (English)

Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese Introdução e objectivos: A luxação congénita do joelho é uma anomalia rara que se integra no grupo das deformidades de hiperextensão do joelho. A sua incidência é cerca de 1% da displasia do desenvolvimento da anca. Associa-se com frequência a outras anomalias músculo-esqueléticas, sendo as mais com [...] uns a displasia do desenvolvimento da anca e o pé equino-varo. Em geral, o diagnóstico é estabelecido imediatamente após o nascimento. O tratamento pode ser conservador ou cirúrgico, sendo que o primeiro habitualmente resulta em melhor prognóstico. Os autores relatam a sua experiência no tratamento da luxação congénita do joelho e os resultados favoráveis nos doentes submetidos a redução conservadora imediata nas primeiras horas de vida. Material e métodos: Realizou-se um estudo retrospectivo descritivo com base na análise dos processos clínicos dos doentes com o diagnóstico de luxação congénita do joelho tratados no Serviço de Ortopedia Pediátrica do Hospital Maria Pia, entre 1990 e 2008. Resultados: Apresentam-se quatro casos de luxação congénita do joelho: três tratados por métodos conservadores e um submetido a tratamento cirúrgico. Discussão e conclusões: Os autores salientam a importância da redução imediata da luxação nas primeiras horas de vida como fronteira de atitude terapêutica e prognóstico, onde o pediatra pode assumir um papel determinante no reconhecimento e referenciação atempadas. Destacam a importância do exame ortopédico completo, para exclusão de outras deformidades associadas e a aparente irrelevância da patologia de base para o sucesso do tratamento conservador precoce. A propósito dos casos clínicos apresentados, faz-se uma revisão sumária desta patologia. Abstract in english Background and objective: Congenital dislocation of the knee is a rare anomaly that includes a group of hyperextension deformities of the knee. Its incidence is about 1% of the developmental dysplasia of the hip. It is often associated with other musculoskeletal anomalies, the most common being the [...] developmental dysplasia of the hip and clubfoot. In general, the diagnosis is established immediately after birth. Treatment can be conservative or surgical, and the first one usually results in better prognosis. The authors report their experience in the treatment of congenital dislocation of the knee and the favorable outcome in patients undergoing early reduction. Material and methods: A retrospective descriptive study was conducted based upon the analysis of medical records of patients diagnosed with congenital dislocation of the knee, treated at the Department of Pediatric Orthopedics of Hospital Maria Pia between 1990 and 2008. Results: Four patients with congenital dislocation of the knee are presented: three treated by conservative methods and one that required surgery. Discussion and conclusions: The authors highlight the importance of early reduction of congenital dislocation of the knee in the first hours of life as a frontier of therapeutic approach and prognosis. Pediatricians can play a key role in timely recognition and referral. They also emphasize the importance of complete orthopedic examination in order to exclude other associated deformities, and the apparent irrelevance of the underlying pathology for the success of early conservative treatment. A brief review of congenital dislocation of the knee is presented.

Luísa Neiva, Araújo; Eduardo, Almeida.

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Extreme femoral shortening: an approach to the chronically dislocated hip in the nonambulatory pediatric population.  

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There are many surgical techniques for treating the chronically dislocated, painful hip in patients with neuromuscular spasticity, but each has significant complication rates. We conducted a study to examine the outcomes of a novel technique, an extreme varus femoral shortening osteotomy, used in nonambulatory patients with neuromuscular spasticity. Patients who underwent the procedure were identified retrospectively by surgical codes. Medical records were reviewed for range of motion, pain and functional assessment, surgical indications, complications, and results. In addition, preoperative and postoperative radiographs were assessed, and caretaker questionnaires reviewed. Between 2001 and 2010, 1 surgeon performed 6 femoral shortening osteotomies in 5 nonambulatory patients with neuromuscular spasticity. In all 5 cases, there were improvements in pain, sitting tolerance, ease of hygiene, and ease of transfers at a minimum follow-up of 2 years (mean, 3.4 years). Postoperative complications included asymptomatic heterotopic ossification and recurrent subluxation. Extreme femoral shortening is a reproducible surgical technique that alleviates pain and makes hygiene easier in nonambulatory children with symptomatic hip dislocations caused by neuromuscular spasticity. Our complication rate was comparable to that of other procedures. PMID:25251533

Kalawadia, Jay V; Patel, Ronak M; Jensen, Layne; Sarwark, John

2014-09-01

67

Palliative surgery for acetabular metastasis with pathological central dislocation of the hip joint after radiation therapy. A case report  

International Nuclear Information System (INIS)

Orthopedic surgery for bone metastases is mainly a palliative treatment. Pathological central dislocation of the hip joint secondary to osteonecrosis of acetabular metastasis after radiation therapy brings severe suffering to cancer patients. We performed minimally invasive palliative surgery for an elderly woman, and excellent pain relief was achieved. An 80-year-old female suffering from right hip pain was referred to our hospital. She had undergone surgery for lung cancer 5 years previously and her right acetabulum was subsequently affected by metastasis. With the aim of controlling the metastasis, radiation therapy was performed. Two years later, pathological central dislocation of the hip joint occurred with sudden onset of severe pain, and she was unable to maintain a sitting position and became bedridden. After she was referred to our hospital, we created an intentional pseudarthrosis in the femoral neck for palliation. After the surgery, excellent pain relief and remarkably improved mobility were achieved during her limited remaining lifetime. In this report, we introduce a novel method of producing a pseudarthrosis in the femoral neck for pathological dislocation. This procedure is a minimally invasive treatment and an alternative option for palliative surgery for pathological dislocation of the hip joint due to osteonecrosis after radiation therapy. (author)

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A 4 year-old child with posterior hip dislocation and simultaneous subtrochanteric and anterior column fracture  

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Full Text Available Traumatic hip dislocation is an uncommon injury in children and consists of less than 5% of their dislocations; but it’s one of the real orthopedic urgency. Its mechanism is low energy trauma in below 6 years old and high energy trauma above it.One of the common associated complications with hip dislocation is posterior wall injuries but column fractures are very rare. We reported an uncommon case of posterior hip dislocation with simultaneous subtrochanteric fracture and anterior column fracture, in which close reduction was impossible. Because of sever associated injuries surgery was done with 48 hours delay including open reduction of dislocation and fracture, and internally fixation of the subtrochanteric fracture with 3.5mm locked plate.In 6 month follow up that was done in ICU, range of motion and stability was good and union sign was visible on radiography. After 15 months the patient general conditions was good and no sign of avascular necrosis was seen

Mousavian Alireza

2013-09-01

69

Femoral shortening in the congenital dislocation of the knee joint: results of mid-term follow-up.  

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Femoral shortening has an advantage of gaining reduction in severe grades of congenital dislocation of the knee joint without release or lengthening of the quadriceps tendon, thereby reducing the incidence of extensor lag. We report our mid-term functional results in six patients (10 knees) with grade III congenital dislocation of the knee joint who were treated with femoral shortening. At an average follow-up of 4.1 years, the mean active range of motion was -0.5 to 107° and none of the patients had extensor lag. The results in arthrogryposis multiplex congenita were noteworthy for the absence of extensor weakness, postoperative deformity, or recurrence. PMID:23744083

Sud, Alok; Kumar, Nishikant; Mehtani, Anil

2013-09-01

70

C1-C2 rotary subluxation following posterior stabilization for congenital atlantoaxial dislocation.  

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Full Text Available The authors report a rare complication of C1-C2 rotary subluxation in two children following posterior stabilization for congenital atlantoaxial dislocation (AAD. A patient, with mobile AAD, underwent Brook?s C1-C2 fusion while the other, with fixed AAD, underwent transoral decompression followed by Jain?s occipitocervical fusion. A pre-existing ligamentous laxity associated with an asymmetrical wire tightening or slippage of the wires due to rotation of the neck in the former, and the drilling of the C1-C2 lateral joints during the transoral procedure in the latter, could have contributed to the rotary subluxation. Both patients presented with persistent torticollis due to fusion in an asymmetrical position with dislocated facet joints. Rotary C1-C2 subluxation, when coexisting with anterior dislocation, has the potential to cause severe and occasionally fatal cord compression. Well defined criteria to diagnose this entity by conventional radiology exist, however, due to the overlap of anatomy, the condition is often overlooked. In the present study, three dimensional reconstruction images using helical computerized tomography were very useful in delineating the subluxation and in planning its surgical reduction and arthrodesis.

Behari S

2000-04-01

71

Redução cirúrgica da luxação do quadril em pacientes com artrogripose múltipla congênita: acesso anteromedial Open reduction of hip dislocation in patients with arthrogryposis multiplex congenita: an anteromedial approach  

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Full Text Available OBJETIVO: Avaliar os resultados do tratamento cirúrgico da luxação do quadril através do acesso anteromedial em pacientes com artrogripose múltipla congênita (AMC. MÉTODOS: Retrospectivamente foram revisados os prontuários e radiografias de sete crianças com AMC que apresentavam luxação do quadril, totalizando 10 quadris luxados. Foi avaliada a mobilidade articular pré e pós-operatória através da somatória do arco de mobilidade articular em flexão e abdução. Radiograficamente foram avaliados, no pré-operatório, o ângulo acetabular e a altura do colo do fêmur e, no pós-operatório, a continuidade do arco de Shenton, ângulo de Sharp e ângulo CE (centro borda. Quando foi identificada a necrose avascular, esta foi classificada segundo Ogden e Bucholz. RESULTADOS: A média de idade das crianças na ocasião da cirurgia era de 5,5 meses (três a 11 meses. O seguimento médio dos pacientes foi de 9,5 anos (dois a 13 anos. A média de amplitude de movimento da somatória do arco de mobilidade articular em flexão e abdução no exame pré-operatório foi de 108° (70 a 155° e no pós-operatório foi de 125° (75° a 175°. Na última avaliação, oito quadris estavam centrados e dois subluxados. Dois quadris foram submetidos a uma osteotomia de ilíaco do tipo Salter. Dois quadris apresentaram sinais significativos de necrose avascular Ogden tipo IV. Oito quadris foram considerados como bons resultados e dois como regulares. CONCLUSÃO: Consideramos a via anteromedial uma boa opção para tratamento da luxação de quadril em pacientes de baixa idade com artrogripose múltipla congênita.OBJECTIVE: To evaluate the results of the surgical treatment of hip dislocation through the anteromedial approach in patients with arthrogryposis multiplex congenita (AMC. METHODS: A retrospective review of the charts and radiographs of 7 children with AMC that presented dislocation of the hiprevised, totalling 10 dislocated hips. : Pre and postoperative articular mobility, was evaluated by summing the joint range-of-motion arc of flexion and abduction. , Pre-operatively, the acetabular angle and height of the neck of femur were evaluated radiographically and postoperatively, the continuity of the arc of Shenton, acetabular angle, Sharp angle and CE angle. The presence of avascular necrosis was classified according to Ogden and Bucholz. RESULTS: The average of age of the children at the time of the surgery was 5.5 months (3 to 11 months. The average follow-up time for the patients was 9.5 years (2 to 13 years. The average of the amplitude of movement of the sum of the joint mobility arc in flexion and abduction in the pre-operative examination was 108° (70° to 155 ° and postoperatively it was 125° (75° 175°. In the last evaluation, eight hips were centered and two were subluxated. Two hips had been submitted to a Salter iliac osteotomy. Two hips (20% had presented significant signs of Ogden type IV avascular necrosis . Eight hips had good results while two were fair. CONCLUSION: We consider the antero-medial approach a good option for the treatment of the dislocation of the hip in patients of low congenital age with arthrogryposis multiplex congenita.

Luis Eduardo Munhoz da Rocha

2010-01-01

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Redução cirúrgica da luxação do quadril em pacientes com artrogripose múltipla congênita: acesso anteromedial / Open reduction of hip dislocation in patients with arthrogryposis multiplex congenita: an anteromedial approach  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar os resultados do tratamento cirúrgico da luxação do quadril através do acesso anteromedial em pacientes com artrogripose múltipla congênita (AMC). MÉTODOS: Retrospectivamente foram revisados os prontuários e radiografias de sete crianças com AMC que apresentavam luxação do quadril, [...] totalizando 10 quadris luxados. Foi avaliada a mobilidade articular pré e pós-operatória através da somatória do arco de mobilidade articular em flexão e abdução. Radiograficamente foram avaliados, no pré-operatório, o ângulo acetabular e a altura do colo do fêmur e, no pós-operatório, a continuidade do arco de Shenton, ângulo de Sharp e ângulo CE (centro borda). Quando foi identificada a necrose avascular, esta foi classificada segundo Ogden e Bucholz. RESULTADOS: A média de idade das crianças na ocasião da cirurgia era de 5,5 meses (três a 11 meses). O seguimento médio dos pacientes foi de 9,5 anos (dois a 13 anos). A média de amplitude de movimento da somatória do arco de mobilidade articular em flexão e abdução no exame pré-operatório foi de 108° (70 a 155°) e no pós-operatório foi de 125° (75° a 175°). Na última avaliação, oito quadris estavam centrados e dois subluxados. Dois quadris foram submetidos a uma osteotomia de ilíaco do tipo Salter. Dois quadris apresentaram sinais significativos de necrose avascular Ogden tipo IV. Oito quadris foram considerados como bons resultados e dois como regulares. CONCLUSÃO: Consideramos a via anteromedial uma boa opção para tratamento da luxação de quadril em pacientes de baixa idade com artrogripose múltipla congênita. Abstract in english OBJECTIVE: To evaluate the results of the surgical treatment of hip dislocation through the anteromedial approach in patients with arthrogryposis multiplex congenita (AMC). METHODS: A retrospective review of the charts and radiographs of 7 children with AMC that presented dislocation of the hiprevis [...] ed, totalling 10 dislocated hips. : Pre and postoperative articular mobility, was evaluated by summing the joint range-of-motion arc of flexion and abduction. , Pre-operatively, the acetabular angle and height of the neck of femur were evaluated radiographically and postoperatively, the continuity of the arc of Shenton, acetabular angle, Sharp angle and CE angle. The presence of avascular necrosis was classified according to Ogden and Bucholz. RESULTS: The average of age of the children at the time of the surgery was 5.5 months (3 to 11 months). The average follow-up time for the patients was 9.5 years (2 to 13 years). The average of the amplitude of movement of the sum of the joint mobility arc in flexion and abduction in the pre-operative examination was 108° (70° to 155 °) and postoperatively it was 125° (75° 175°). In the last evaluation, eight hips were centered and two were subluxated. Two hips had been submitted to a Salter iliac osteotomy. Two hips (20%) had presented significant signs of Ogden type IV avascular necrosis . Eight hips had good results while two were fair. CONCLUSION: We consider the antero-medial approach a good option for the treatment of the dislocation of the hip in patients of low congenital age with arthrogryposis multiplex congenita.

Luis Eduardo Munhoz da, Rocha; Fábio Koiti, Nishimori; Daniel Carvalho de, Figueiredo; Dulce Helena, Grimm; Luiz Antonio Munhoz da, Cunha.

73

Posterior dislocation of the elbow as an unusual presentation after a total hip replacement: a case report  

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Full Text Available Abstract Introduction Posterior dislocation of the elbow is usually associated with trauma to the joint with a reported incidence of 3%to 6%. Chronic instability is usually symptomatic following the initial injury. Case presentation We report a case of posterior dislocation of the elbow occurring in a patient while using her arm to lift herself using a monkey pole on the second day following a total hip replacement. The dislocation was reduced under sedation in the ward. There were no signs or symptoms suggesting any joint hypermobility syndrome in the patient. Follow up 4 months following the injury revealed a complete recovery in the range of motion and a pain free elbow. There were no signs and symptoms of any instability. Conclusion This is the first time such a case is reported in the literature. It certainly demonstrates that even in the absence of instability a patient can be predisposed to low energy dislocation of the elbow.

Periasamy Kumar

2008-02-01

74

Prevention of dislocation of the hip in children with cerebral palsy: 20-year results of a population-based prevention programme.  

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In 1994 a cerebral palsy (CP) register and healthcare programme was established in southern Sweden with the primary aim of preventing dislocation of the hip in these children. The results from the first ten years were published in 2005 and showed a decrease in the incidence of dislocation of the hip, from 8% in a historical control group of 103 children born between 1990 and 1991 to 0.5% in a group of 258 children born between 1992 and 1997. These two cohorts have now been re-evaluated and an additional group of 431 children born between 1998 and 2007 has been added. By 1 January 2014, nine children in the control group, two in the first study group and none in the second study group had developed a dislocated hip (p < 0.001). The two children in the first study group who developed a dislocated hip were too unwell to undergo preventive surgery. Every child with a dislocated hip reported severe pain, at least periodically, and four underwent salvage surgery. Of the 689 children in the study groups, 91 (13%) underwent preventive surgery. A population-based hip surveillance programme enables the early identification and preventive treatment, which can result in a significantly lower incidence of dislocation of the hip in children with CP. Cite this article: Bone Joint J 2014; 96-B:1546-52. PMID:25371472

Hägglund, G; Alriksson-Schmidt, A; Lauge-Pedersen, H; Rodby-Bousquet, E; Wagner, P; Westbom, L

2014-11-01

75

Evaluation of the effect of the reduction of the hip spastic dislocation in adolescent and young adult with cerebral paralysis  

International Nuclear Information System (INIS)

We present the results obtained in the Instituto de Ortopedia Infantil Roosevelt for the treatment of the hip dislocation in adolescent patients and young adults with spastic cerebral palsy with the open reduction of the hip, accompanied by femoral osteotomy and, if as necessary, pelvic osteotomy. 14 hips (10 patients) were intervened from January of 1996 to July of 2003. Pain was completely released in 54 percent and improved in 36 percent of cases. Abduction improved in 63 percent of patients allowing the perinea cleaning in 63 percent and better tolerance to scar in 64% of the cases. Our complications were one patient developed a sacred pressure ulcer with the spica cast treated with a free flap transposition; one hip had redislocation at 31 months from surgery; another hip had instability without clinical repercussion; one patient had a not displaced supracondylar femoral fracture treated with immobilization. The results of our study showed that the open reduction of the spastic hip in adolescents and young adults is a procedure that improves, in most of the cases, the stability, mobility and pain of the hip and provides better quality life for these patients

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Traumatic anterior dislocation of the hip associated with ipsilateral femoral shaft fracture in a child: A case report.  

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Full Text Available Traumatic anterior dislocation of the hip joint in children is rare, and only one case with ipsilateral femoral fracture has been reported in Japan. We report a case of such dislocation and a review of the literature. The patient was a 31-month-old girl who was injured in a car accident while asleep on a tilted front passenger seat. Radiographic examination showed dislocation of the right obturator foramen and transverse fracture of the ipsilateral femoral shaft. The dislocation of the right hip was easily reduced without anaesthesia during radiography. We applied Bryant traction after reduction for 4 weeks, followed by cast application for 3 weeks. Walking with support and full weightbearing were permitted 14 weeks and 16 weeks after the injury, respectively. Radiography at 4.5 years after the injury showed a mildly enlarged right femoral head and femur overgrowth of approximately 8 mm. Magnetic resonance imaging showed no evidence of suspected avascular necrosis of the femoral head. The patient has no subjective or objective symptoms, and is able to engage in all usual activities. The detailed mechanism of the injury is unknown. We assume that the lower leg was dislocated through abduction during flexion, or abducent, external flexion, considering that the child was sleeping at the time of the accident. Since she was hurled to the back seat, it was assumed that strong external force was vertically added to the femur, which caused the abducent force.

Yamamoto K

2004-06-01

77

Simultaneous Shoulder and Hip Dislocation in a 12-Year-Old Girl with Hutchinson-Gilford Progeria Syndrome  

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Full Text Available Hutchinson-Gilford progeria syndrome (HGPS is a rare premature ageing disorder that is characterized by accelerated degenerative changes of the cutaneous, musculoskeletal and cardiovascular systems. Mean age at diagnosis is 2.9 years and generally leading to death at approximately 13 years of age due to myocardial infarction or stroke. Orthopedic manifestations of HGPS are multiple and shoulder dislocation is a rare skeletal trauma in progeria syndrome. Our patient had simultaneous shoulder and hip dislocation associated with a low energy trauma. This subject has not been reported. Treatment accomplished as close reduction under general anesthesia and immobilization.

Shirin Mardookhpour

2012-06-01

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Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case  

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Full Text Available Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. Keywords: Hip dislocation; acetabular fractures; intertrochanteric fracture; operative treatment.

Skand Sinha

2013-10-01

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Asymmetric traumatic bilateral dislocation of hip. Case report Luxación asimétrica traumática bilateral de cadera. Presentación de un caso  

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A male (26 years) suffered an asymmetric bilateral dislocation of hip as a result of a car accident. The patient was treated with closed reduction and bone traction for six weeks. We present this report since the reviewed literature only include six cases with this kind of lesion and because this is a medical emergency resulting from high impact trauma, being the aseptic osteonecrosis the most significant and serious complication.

Tamara Elizabeth Morales Perez; Pedro Gonzalo González González

2009-01-01

80

Congenital Deficiency of Distal Ulna and Dislocation of the Radial Head Treated by Single Bone Forearm Procedure  

Science.gov (United States)

Congenital deficiency of part of distal ulna affecting the distal radio-ulnar joint is a rare disorder. It is even rarer to find the association of proximal radio-ulnar joint dislocation along with distal ulnar deficiency. This type of congenital forearm anomaly is difficult to treat. Conversion to a single bone forearm in the expense of pronation-supination movement is a viable option. By doing so the elbow and wrist can be stabilized; however movement is possible in only one plane. We are describing here a girl of 8 years having proximal radio-ulnar joint dislocation along with deficiency of distal ulna treated by converting into a single bone forearm. PMID:25254127

Dutta, Anshuman; Sipani, Arun Kumar; Daolagupu, Arup Kumar

2014-01-01

 
 
 
 
81

Congenital irreducible atlantoaxial dislocation associated with cervical intramedullary astrocytoma causing progressive spastic quadriparesis  

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Full Text Available Simultaneous presence of congenital irreducible atlantoaxial dislocation (AAD and cervical intramedullary astrocytoma has not been previously described and may cause disabling myelopathy. This 55-year-old lady presented with suboccipital pain, spastic quadriparesis, Lhermitte?s phenomenon and sphincteric disturbances. Lateral radiographs and magnetic resonance imaging showed irreducible AAD, occipitalized atlas, C2-3 fusion, and,an intramedullary tumor from C2-5 level iso-to-hypointense, non-enhancing, except in a small segment in the dorsal C2 level. A suboccipital craniectomy with C2-5 laminectomy revealed a greyish-white tenacious tumor. The tumor was decompressed using a C2-5 midline myelotomy and duroplasty. An occipitocervical lateral mass fixation was performed. Histopathology revealed a low-grade astrocytoma. At three-month follow-up, her spasticity had decreased and quadriparesis and sphincteric disturbances were persisting. Postoperative lateral radiographs and intrathecal contrast CT scan showed a stable occipitocervical construct. Thus, the suboccipital craniectomy and laminectomy with midline myelotomy and duroplasty facilitated space for progressively expanding intramedullary astrocytoma with irreducible AAD; the lateral mass fixation provided stability at the craniovertebral junction.

Chatley Anooj

2008-01-01

82

Radiographic Prediction of the Results of Long-term Treatment with the Pavlik Harness for Developmental Dislocation of the Hip  

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Full Text Available In 1957, Pavlik introduced the Pavlik harness as a useful treatment for developmental dislocation of the hip (DDH, and subsequent studies have documented favorable outcomes among patients treated with this device. However, there are only a few articles reporting how early radiographic measurements can be used to determine the prognosis after treatment with the Pavlik harness. In this study, 217 hips from 192 patients whose DDH treatment with the Pavlik harness was initiated before they were 6 months old and whose follow-up lasted at least 14 years (rate, 63.8% were analyzed using measurements from radiographs taken immediately before and after harness treatment, and at 1, 2, and 3 years of age. Severin's classification at the final follow-up was I or II in 71.9% and III or IV in 28.1% of the hips, respectively. Avascular necrosis of the femoral head (AVN was seen in 10% of the hips. Stepwise multiple regression analysis was performed to retrospectively determine whether any radiographic factors were related to the final classification as Severin I/II or III/IV. Receiver opera-ting characteristic (ROC curves were drawn for these factors, and a Wiberg OE angle (Point O was the middle point of the proximal metaphyseal border of the femur of 2 degrees on the 3-year radiographs was found to be the most useful screening value for judging the acetabular development of DDH cases after treatment with a Pavlik harness, with a sensitivity of 71% a specificity of 93%, and a likelihood ratio of 10.1.

Tetsunaga,Tomonori

2009-06-01

83

Comparison of different treatments of hip dislocation in dog and cat  

International Nuclear Information System (INIS)

Over a period of three years 145 dogs and 51 cats were treated because of hip luxation. Besides closed reduction various surgical procedures were performed. Follow-up examinations were done between 6 month and 4 years after treatment or by questionnaire. Closed reduction was the method of choice in most cases. Postoperative treatment with an EHMER sling was advantageous to prevent reluxation. Under certain circumstances such as degenerative joint disease, long lasting hip luxation, concomitant fracture and reluxation surgical intervention was preferred

84

Some effects of position on the roentgenographic diagnosis of dislocation at the infant hip  

International Nuclear Information System (INIS)

X-ray findings in the examination of the hips in infants depend upon the position of the infant during the examination. Each of three variables of position, (1) pelvic tilt, (2) abduction of the femurs, and (3) external rotation of the femurs, affects the apparent relation but not the real relation between the acetabulum and the femur. (orig.)

85

Hip Replacement - Physical Therapy  

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Full Text Available ... been used for months or years due to pain. The risk of dislocating a new hip joint ... normal hip. However, there might be lots of pain and stiffness in the hip at first. Your ...

86

Histomorphologic Characteristics of Newly Formed Cavity of a Hip Joint in Dislocation in Experiment  

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Full Text Available The aim of the investigation was to study in experiment the head of femur dislocation, which is a variety of transchondral damages, and the process of chondro- and osteogenesis in articular surface formation to create optimal conditions for their reparation and new formation.Materials and Methods. The experiment was carried out on 20 reproductive chinchilla rabbits. The head of femur was dislocated in experiment after joint capsule transaction, and exposed to dosing impact and force effect in the area of its upper pole. A blow was stricken by the device looking like an impact machine. The blow energy was regulated by changing load weight and the pendulum height. The animals were removed from the experiment 3, 7, 14, 30 days and 3 months after the injury.Results. For the initial few days in the dislocation area there were found fibrin effusions, hemorrhage, periosteal edema, and granulation tissue. In 2 weeks in fibrous tissue there were determined focal clusters of chondroblasts. By the end of the first month, near the head of femur, connective tissue was underlaid by newly formed fibrous cartilage with the areas of young hyaline cartilage forming a free margin. In 3 months a submarginal zone was formed of hyaline cartilage with ordered cytoarchitectonics of chondrocytes. Different-sized margins of the newly formed hyaline cartilage with the foci of complete osteogenesis in the wall of forming cavity (in the form of osseous tissue of sponge structure with the blood-forming bone marrow in interjoist were observed in close connection with periosteum of acetabular roof.Conclusion. A joint cavity forms on the basis of the mechanisms of pluripotent development of cambial cell elements towards chondro- and osteogenesis. Its successful formation can be accompanied by the mass of well blood-supplied muscles surrounding the dislocated head, periosteum of acetabular roof, as well as the capability of active movements the head of femur dislocated into supra-acetabular area in the absence of axial bearing on the operated extremity during the whole postoperative period. Thus, an articular cartlage has significant potential for recovery, and the obtained results enable to help lay down optimal conditions for such a recovery.

I.Y. Ezhov

2013-06-01

87

Luxación asimétrica traumática bilateral de cadera. Presentación de un caso / Asymmetric traumatic bilateral dislocation of hip. Case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta el caso de un paciente masculino de 26 años de edad que en un accidente de transito sufrió una luxación asimétrica bilateral de cadera. Fue tratado con reducción a cielo cerrado y tracción esquelética por seis semanas. Porque la literatura revisada solo reconoce 6 casos publicados con es [...] te tipo de lesión y por ser una emergencia médica resultado de traumatismos de alta energía, con la osteonecrosis aséptica como la complicación más frecuente y más grave, se decidió publicar este caso. Abstract in english A male (26 years) suffered an asymmetric bilateral dislocation of hip as a result of a car accident. The patient was treated with closed reduction and bone traction for six weeks. We present this report since the reviewed literature only include six cases with this kind of lesion and because this is [...] a medical emergency resulting from high impact trauma, being the aseptic osteonecrosis the most significant and serious complication.

Pedro, González González; Tamara, Morales Perez.

88

Luxación asimétrica traumática bilateral de cadera. Presentación de un caso / Asymmetric traumatic bilateral dislocation of hip. Case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta el caso de un paciente masculino de 26 años de edad que en un accidente de transito sufrió una luxación asimétrica bilateral de cadera. Fue tratado con reducción a cielo cerrado y tracción esquelética por seis semanas. Porque la literatura revisada solo reconoce 6 casos publicados con es [...] te tipo de lesión y por ser una emergencia médica resultado de traumatismos de alta energía, con la osteonecrosis aséptica como la complicación más frecuente y más grave, se decidió publicar este caso. Abstract in english A male (26 years) suffered an asymmetric bilateral dislocation of hip as a result of a car accident. The patient was treated with closed reduction and bone traction for six weeks. We present this report since the reviewed literature only include six cases with this kind of lesion and because this is [...] a medical emergency resulting from high impact trauma, being the aseptic osteonecrosis the most significant and serious complication.

Pedro, González González; Tamara, Morales Perez.

2009-04-01

89

Congenital Dislocation of Knee: Results of the Treatment in 29 Cases Between 1970 and 2010 Years at Shafa Yahyaian Hospital in Tehran  

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Full Text Available Background: There are not many reports regarding the treatment approaches of congenital dislocation of the knee in the literature. Therefore, the preferred method of treatment of this rare congenital disease is still controversial. Hereby, we report the treatment outcome of 29 patients admitted in Shafa Yahyaian Hospital during 40 years. Methods: In this retrospective study done in Shafa Yahyaian Hospital in Tehran, Iran during 2010, we retrospectively reviewed the medical records of 29 patients treated conservatively or surgically for congenital dislocation of the knee. Patients had been evaluated for an average follow-up of 8.5 years. Results: Overall, 54 knee dislocations had been treated surgically (58% or conservatively (42%. Range of knee motion, persistent recurvatum, instability, valgus deformity after treatment and limping were the more important factors reported in the two surgically or conservatively treated groups. Knee function was satisfactory in patients with conservative treatment. Despite 80% of instability in the operated knees, patients could ambulate with or without braces and had a range of motion equal to 80 degrees. Knee function was also good after quadricepsplasty with transarticular pins in selected cases. Conclusion: We recommend a conservative approach to the disease, regardless of the patients age at the time of treatment and subsequent surgery in patients with dissatisfactory recovery. Quadricepsplasty with transarticular fixation is recommended as a good option in treating these patients. Posterior capsulorrhaphy for patients with CDK and ligamentous laxity is also recommended.

M Jabalameli

2012-08-01

90

A influência da via de acesso na luxação das artroplastias totais do quadril The influence of the surgical approach concerning dislocation in total hip arthroplasty  

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Full Text Available OBJETIVO: Avaliar a ocorrência de luxação nas artroplastias totais do quadril não cimentadas, comparando-se os acessos posterior e lateral direto. Métodos: Estudo retrospectivo comparativo com 232 pacientes submetidos à artroplastia total do quadril não cimentada, por diagnóstico de osteoartrose primária e secundária, sendo 105 submetidos ao acesso posterior e 127 ao acesso lateral. O modelo protético utilizado foi único, assim como o protocolo de reabilitação e cuidados pós-operatórios. Foram verificados ocorrência de luxação, posicionamento acetabular e componentes utilizados. RESULTADOS: Ocorreu um caso isolado de luxação no grupo do acesso lateral direto (0,8% contra 0% no grupo de pacientes submetidos ao acesso posterior, sem diferença significativa (p = 1. A luxação ocorreu em uma paciente de 47 anos de idade, que foi tratada com redução incruenta sem recidiva da luxação após três anos e um mês de seguimento. O tempo de seguimento dos dois grupos variou entre seis e 42 meses, com média de 23,7 meses. CONCLUSÃO: Os autores concluem que a prevalência de luxação nas artroplastias totais do quadril é similar nos dois acessos estudados e que medidas educativas, técnica cirúrgica adequada e utilização de próteses com offsets maiores podem diminuir o risco dessa complicação.OBJECTIVES: Our primary aim was to evaluate the occurrence of dislocation of non-cemented total hip arthroplasty, when using the posterior and the direct lateral approaches. METHODS: We performed a comparative retrospective study with 232 patients submitted to non-cemented total hip arthroplasty, due to the diagnosis of primary or secondary osteoarthritis. The posterior approach was used in 105 patients while direct lateral approach was used in 127 patients. There was only one prosthesis model and the same rehabilitation program and post-operative care was used for all patients. We checked the occurrence of dislocation, the acetabular positioning and also the size of the components. RESULTS: There was only one case of dislocation, treated with closed reduction successfully. This was a 47 year-old female, submitted to direct lateral approach. The mean follow-up time for both groups was 23.7 months, ranging from six to 42 months. Conclusion: The authors conclude that the prevalence of total hip arthroplasty dislocation is similar for both approaches, and educational measures besides the use of a higher femoral offset seem to reduce the risk of this complication.

José Ricardo Negreiros Vicente

2009-01-01

91

Luxação traumática posterior do quadril em crianças: relato de cinco casos Traumatic posterior dislocation of the hip in children: report of five cases  

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Full Text Available OBJETIVO: Avaliar uma série de casos de luxação traumática posterior em crianças, o tratamento e os resultados, e revisar os aspectos relacionados à sua epidemiologia, diagnóstico clínico e radiográfico, tratamento, complicações e prognóstico. MÉTODOS: Foram avaliados retrospectivamente cinco pacientes com luxação traumática do quadril com média idade de 4,6 ± 0,9 anos e tempo de seguimento de 19,8 ± 7,0 meses. Foram avaliados o tempo entre a luxação e a redução, o tipo de tratamento, as lesões associadas e as complicações tardias. RESULTADOS: O tratamento inicial foi a redução incruenta com tempo médio de 5,2 ± 3,6 horas após o trauma inicial, sendo que todos foram submetidos à redução sob anestesia. O tratamento complementar incluiu imobilização gessada e tração. Não foi observada necessidade de cirurgias adicionais ou sequelas a longo prazo. CONCLUSÃO: A luxação traumática do quadril deve ser tratada com redução incruenta rápida, controle adequado da redução e observação rigorosa para diagnóstico e tratamento de complicações tardias.OBJECTIVE: To evaluate a series of cases of traumatic posterior dislocations in children, the treatment and the results, and to revise aspects such as the epidemiology, clinical and radiographic diagnosis, treatment, complications and prognosis. METHODS: Five patients with traumatic hip dislocation, with an average age of 4.6 ± 0.9 years, and an ongoing follow-up period of 19.8 ± 7.0 months, were evaluated retrospectively. The time between dislocation and reduction, the type of treatment, associated injuries, and subsequent complications were also evaluated. RESULTS: The initial treatment was closed reduction, in an average time of 5.2 ± 3.6 hours after the initial trauma, in which the patients were subjected to the reduction under anesthesia. Complementary treatment included immobilization with casts and traction. No needs for additional surgeries or long-term side effects were observed. CONCLUSION: Traumatic dislocation of the hip should be treated by quick closed reduction, with appropriate control of the reduction and careful observation of the patient for diagnosis and treatment of subsequent complications.

Gilberto Francisco Brandão

2010-01-01

92

Fratura-luxação traumática do quadril no futebol: relato de caso / Traumatic hip fracture-dislocation in soccer: a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese De ocorrência rara no futebol, esporte coletivo mais praticado no mundo, as fraturas de acetábulo que se associam às luxações da articulação do quadril são lesões com grande potencial de gerar seqüelas graves e limitantes. O rápido atendimento, a precisão do diagnóstico e procedimentos de salvamento [...] da articulação pela redução e correta fixação são essenciais para perspectiva de retomar a atividade física regular praticada anteriormente ou outra que se adapte à nova situação. Abstract in english Uncommon in soccer, the world's most popular sport, the acetabular fractures with hip dislocation are injuries with high incidence of long-term serious sequelae. Prompt attending with accurate diagnosis and reduction and fixation are important to produce a stable and congruent joint for returning to [...] the usual sports practice prior the injury.

Ricardo Munir, Nahas; Eliseu, Netto; Takechi, Chikude; Roberto, Ikemoto.

93

Fratura-luxação traumática do quadril no futebol: relato de caso Traumatic hip fracture-dislocation in soccer: a case report  

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Full Text Available De ocorrência rara no futebol, esporte coletivo mais praticado no mundo, as fraturas de acetábulo que se associam às luxações da articulação do quadril são lesões com grande potencial de gerar seqüelas graves e limitantes. O rápido atendimento, a precisão do diagnóstico e procedimentos de salvamento da articulação pela redução e correta fixação são essenciais para perspectiva de retomar a atividade física regular praticada anteriormente ou outra que se adapte à nova situação.Uncommon in soccer, the world's most popular sport, the acetabular fractures with hip dislocation are injuries with high incidence of long-term serious sequelae. Prompt attending with accurate diagnosis and reduction and fixation are important to produce a stable and congruent joint for returning to the usual sports practice prior the injury.

Ricardo Munir Nahas

2007-08-01

94

Hip Replacement - Physical Therapy  

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Full Text Available ... little less than normal. The muscles of the legs keep artificial hips in place and do not allow them to slide out of place or dislocate. This is why it is very important to strengthen leg muscles in the hip area after a hip ...

95

Congenital dislocation of the deep digital flexor tendon associated with hypoplasia of the sustentaculum tali in a Thoroughbred colt  

International Nuclear Information System (INIS)

An 11-month-old Thoroughbred colt was presented with a hard swelling at the proximal third of the right 4th metatarsal bone. A medial dislocation of the deep digital flexor tendon (flexor digitorum profundus) was also observed on the same leg. On the plantaroproximal-plantarodistal projection of the calcaneus, there was flattening and shortening of the sustentaculum tali. The smooth bony proliferation at the proximal third of the right 4th metatarus was compatible with a chronic splint bone fracture. This report describes a medial deep digital flexor dislocation associated with hypoplasia of the sustentaculum tali

96

Simultaneous Shoulder and Hip Dislocation in a 12-Year-Old Girl with Hutchinson-Gilford Progeria Syndrome  

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Hutchinson-Gilford progeria syndrome (HGPS) is a rare premature ageing disorder that is characterized by accelerated degenerative changes of the cutaneous, musculoskeletal and cardiovascular systems. Mean age at diagnosis is 2.9 years and generally leading to death at approximately 13 years of age due to myocardial infarction or stroke. Orthopedic manifestations of HGPS are multiple and shoulder dislocation is a rare skeletal trauma in progeria syndrome. Our patient had simultaneous shoulder ...

Shirin Mardookhpour; Amir Sobhani Eraghi; Ramin Espandar

2012-01-01

97

Small Incision Total Hip Arthroplasty  

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Full Text Available ... the hip in. At Mercy Hospital, our dislocation rate is less than 1 in 50,000. In ... What's the -- what is the risk or the rate of transfusions needed after surgery of a hip ...

98

Aqueductal stenosis and mental retardation associated with O S odontoideum, "hypermobile" atlantoaxial dislocation and congenital stenosis of atlas leading to spastic quadriparesis  

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Full Text Available Background: The authors report a unique concomitant occurrence of mental retardation, hydrocephalus due to aqueductal stenosis, a freely floating atlas (having anterior, posterior and transverse atlantoaxial dislocation [AAD] consequent to an orthotopic os odontoideum and stenosis of atlantal ring. There were no features of coexisting chondroskeletal dysplasias or other systemic diseases. To the best of the authors? knowledge, this is the first reported case of its type in the literature. Case Report: This 17-year-old girl with delayed milestones had enlarging head with vomiting at 1 year of age. Her CT scan revealed hydrocephalus with aqueductal stenosis, and she underwent a ventriculoperitoneal shunt. She subsequently had progressive quadriparesis. A minor fall led to transient unconsciousness and aggravation of her symptoms. Radiology of the craniovertebral junction revealed os odontoideum with anterior, posterior and transverse C1-2 subluxation and atlantal ring stenosis with marked cervical compression. A C1 laminectomy with occipitocervical contoured rod fusion with onlay autologous bone graft under guidance of intraoperative image intensifier was performed. Conclusion: The concomitant presence of hydrocephalus due to aqueductal stenosis, mental retardation and congenital stenosis of the atlantal ring points towards a congenital origin for the os odontoideum. The free floating atlantal ring on the axis led to anteroposterior and transverse AAD, necessitating intubation and occipitocervical stabilization in absolutely neutral position of the neck since both flexion as well as extension movements would have been deleterious. Congenital stenosis of atlas is an extremely rare entity; it contributed to cervical canal compromise even in neutral position of the cervical spine when the AAD had been adequately reduced, requiring an additional C1 laminectomy. The simultaneous presence of all these anomalies merited unique management considerations.

Das Rupant

2007-01-01

99

Humoral immunodeficiency in congenital insensitivity to pain with anhidrosis.  

Science.gov (United States)

Congenital insensitivity to pain with anhidrosis (CIPA) is an autosomal recessive disorder caused by mutations in the neurotrophic tyrosine receptor kinase 1 (NTRK1) gene, which encodes the receptor for nerve growth factor. We report the clinical course of a 7-year-old girl with CIPA and proven NTRK1 mutation. In addition to recurrent dislocation of the left hip joint and avascular necrosis of the left talus, the patient also presented with recurrent infections secondary to hypogammaglobulinemia, a feature not previously known to be associated with CIPA. The patient was treated with regular administration of intravenous immunoglobulins. Conservative treatment of the recurrent left hip dislocation by cast immobilization and bracing was implemented to stabilize the joint. The implication of the immune system of the reported patient broadens the clinical phenotype associated with NTRK1 mutations. PMID:19089473

Kilic, Sara Sebnem; Ozturk, Rifatcan; Sarisozen, Bartu; Rotthier, Annelies; Baets, Jonathan; Timmerman, Vincent

2009-04-01

100

Tratamiento quirúrgico de la luxación congénita de rótula con técnica de Stanisavljevic / Congenital dislocation of the patella: surgical treatment with Stanislavljevic technique  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Introducción: La luxación congénita de la rótula (LCR) es una entidad infrecuente que produce diversos grados de discapacidad de rodilla en los niños. Existe cierta controversia con respecto a su tratamiento; mientras algunos autores apoyan la realineación quirúrgica del aparato extensor, otros reco [...] miendan sólo la observación afirmando que los resultados quirúrgicos suelen ser malos. Materiales y métodos: Se analizaron 8 pacientes consecutivos (8 rodillas) con luxación congénita permanente irreducible de rótula tratados en el período 1993-2006. El promedio de edad fue de 7,8 años. El seguimiento promedio fue de 67 meses (r, 7-173 meses). Cinco casos presentaron asociaciones sindrómicas. Los resultados funcionales subjetivos fueron evaluados con la Tegner-Lysholm Knee Scoring Scale y el score de Kujala. Resultados: Todos los pacientes poseen un buen centrado de la rótula, mejoraron la amplitud de movimiento y la capacidad para la deambulación. Seis de los 8 pacientes recuperaron la extensión completa. Siete pacientes presentaron resultados funcionales entre buenos y excelentes y uno, regular. No se observaron infecciones de la herida ni lesiones neurovasculares en el posoperatorio. Ninguno de los pacientes presentó recidiva de la luxación ni requirió cirugías adicionales en la rodilla tratada. Conclusiones: En nuestra serie la técnica de Stanisavljevic permitió una marcada mejoría de la amplitud de movimiento y de la capacidad para la deambulación. En los casos de deformidad moderada podría ser suficiente un procedimiento más limitado. El tratamiento quirúrgico debe realizarse de manera precoz para obtener los mejores resultados. Abstract in english Background: Congenital dislocation of the patella is a rare condition. Controversy exists regarding treatment. Some authors recommend observation alone while others recommend early surgical intervention. Methods: We analyzed retrospectively 8 consecutive patients (8 knees) surgically treated for con [...] genital dislocation of the patella between 1993 and 2006, followed up for at least 12 months post-op. Mean age was 7.8 years. Mean follow-up was 67 months (range: 7-173 months). All patients had fixed painful lateral dislocation of the patella that could not be reduced by closed means, associated with valgus and fixed flexion contracture of the knee. Five patients presented associated syndromes. Results: In the last follow-up, all patients had increased tolerance to activity and pain relief. The extension lag improved in all but two patients (oldest patients in the series). There were no postoperative complications or redislocation of the patella. Conclusions: Stanisavljevic's surgical technique of extensive quadriceps release and derotation yielded satisfactory results. A more limited procedure may suffice in moderately severe cases. Surgical treatment should be approached early to achieve better results.

Julio Javier, Masquijo; Sergio, Innocenti; Eduardo, Baroni.

 
 
 
 
101

Hip Replacement - Physical Therapy  

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Full Text Available ... discuss this with your doctor, nurse, and physical therapist. A dislocation usually happens if: • The operated leg ... hip. The surgeon, the nurse and the physical therapist will guide and help you after your surgery. ...

102

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... as well. Please discuss this with your doctor, nurse, and physical therapist. A dislocation usually happens if: • ... motion in your new hip. The surgeon, the nurse and the physical therapist will guide and help ...

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Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... couple weeks after surgery. Using a high-rise toilet seat also helps prevent dislocation. Over time, as ... not sit on the floor, low stools or toilet seats; this bends the hip more than 90 ...

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Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... operated leg is turned or rotated inwards To prevent a new hip from dislocating, it is a ... to put a pillow between the legs to prevent them from getting too close together. This document ...

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Total hip replacement through a posterior approach using a 22 mm diameter femoral head : the role of the transverse acetabular ligament and capsular repair in reducing the rate of dislocation.  

Science.gov (United States)

Despite a lack of long-term follow-up, there is an increasing trend towards using femoral heads of large diameter in total hip replacement (THR), partly because of the perceived advantage of lower rates of dislocation. However, increasing the size of the femoral head is not the only way to reduce the rate of dislocation; optimal alignment of the components and repair of the posterior capsule could achieve a similar effect. In this prospective study of 512 cemented unilateral THRs (Male:Female 230:282) performed between 2004 and 2011, we aimed to determine the rate of dislocation in patients who received a 22 mm head on a 9/10 Morse taper through a posterior approach with capsular repair and using the transverse acetabular ligament (TAL) as a guide for the alignment of the acetabular component. The mean age of the patients at operation was 67 years (35 to 89). The mean follow-up was 2.8 years (0.5 to 6.6). Pre- and post-operative assessment included Oxford hip, Short Form-12 and modified University of California Los Angeles and Merle D'Aubigne scores. The angles of inclination and anteversion of the acetabular components were measured using radiological software. There were four dislocations (0.78%), all of which were anterior. In conclusion, THR with a 22 mm diameter head performed through a posterior approach with capsular repair and using the TAL as a guide for the alignment of the acetabular component was associated with a low rate of dislocation. PMID:25183591

Kumar, V; Sharma, S; James, J; Hodgkinson, J P; Hemmady, M V

2014-09-01

106

Bilateral inverted vertebral arteries (V3 segment) in a case of congenital atlantoaxial dislocation: Distinct entity or a lateral variant of persistent first intersegmental artery?  

Science.gov (United States)

Background: Anomalous vertebral arteries (VAs), commonly involving the persistent first intersegmental artery (FIA), are often seen with congenital atlantoaxial dislocations (AAD). Here we describe an unusual variant consisting of bilateral VAs with normal loops but passing below the C1 (inverted VA) arch, distinctly different from the FIA. Case Description: A 9-year-old boy presented with a spastic quadriparesis. Preoperative radiographic studies showed an irreducible AAD with an occipitalized CO-C1 and C2-3 fusion. Although both VAs exhibited proximal and distal loops like normal VA, the distal loops did not pass through the C1 transverse foramina and coursed inferior to the C1 arch instead. With this critical preoperative information, both VAs could be better safeguarded during dissection of the C1-2 facets. Conclusion: In the case presented, although the course of the inverted VAs is similar, the norm, they coursed inferior to both C1 arches. Careful evaluation of the preoperative radiological studies allowed for careful dissection of the inverted VA (horizontal loop) while opening the C1-2 joint for subsequent alignment (e.g. reduction) and bony fusion. This information also facilitates safer insertion of lateral mass screws (e.g. choosing the appropriate C1 screw length to gain adequate bony purchase without compromising anomalous VA). PMID:25024882

Salunke, Pravin; Sahoo, Sushanta K.; Ghuman, Mandeep S.

2014-01-01

107

Luxação anterior exposta do quadril em um adulto: relato de caso e revisão da literatura / Open anterior dislocation of the hip in an adult: a case report and review of literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A luxação anterior exposta do quadril é condição rara e resulta de trauma de alta energia. Até o momento, foram descritos na literatura 10 casos. Sua raridade deve-se à estabilidade inerente da articulação e à posição profunda na pelve, com fortes ligamentos e musculatura volumosa ao seu redor. Infl [...] uenciam o prognóstico dessa lesão diversos fatores, tais como grau de contaminação, lesões de partes moles, idade do paciente e, principalmente, atraso na redução. As principais complicações são: artrose do quadril, com incidência que pode chegar a 50% dos casos, quando associada a fraturas da cabeça femoral; e osteonecrose da cabeça do fêmur, com incidência entre 1,7% e 40% (nos casos de luxação anterior fechada). Por causa da raridade e da potencial incapacidade funcional decorrente dessa lesão, relatamos o caso de um homem de 46 anos vítima de acidente automobilístico. Foi feita redução do quadril (luxação do tipo anterior alta) nas primeiras três horas pós-trauma. O paciente foi mantido sem carga até a sexta semana, com carga total após a 10ª semana. Após um ano de seguimento, observou-se resultado funcional pobre (Harris Hip Score: 52), provavelmente por causa de lesão labral associada, porém sem sinais na ressonância nuclear magnética de osteonecrose da cabeça femoral. Abstract in english Open anterior hip dislocation is a rare condition and results from high-energy trauma. Ten cases of open anterior dislocation have been described in the literature so far. Its rarity is due to the inherent stability of the joint, its deep position in the pelvis, with strong ligaments and bulky muscl [...] es around the articulation. Several factors influence the prognosis, such as the degree of compounding, the associated soft tissue injuries, the age of the patient and, mainly, the delay in reduction. The main complications are: arthrosis of the hip, with incidence of 50% of cases, when associated with fractures of the femoral head; and osteonecrosis of the femoral head, with incidence between 1.7 and 40% (in closed anterior dislocation). Because of the rarity and the potential disability of this lesion, we report a case in a 46-year-old man, involved in an automobile accident. The hip was reduced (anterior superior dislocation)in the first three hours of the trauma. The patient was kept non-weight bearing until sixth week, with complete weight bearing after 10th week. After one year follow-up, the functional result was poor (Harris Hip Score: 52), probably because of the associated labral tear, but without signs of osteonecrosis of the femoral head in magnetic resonance imaging.

Anderson Luiz de, Oliveira; Eduardo Gomes, Machado.

2014-01-01

108

Luxação anterior exposta do quadril em um adulto: relato de caso e revisão da literatura / Open anterior dislocation of the hip in an adult: a case report and review of literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A luxação anterior exposta do quadril é condição rara e resulta de trauma de alta energia. Até o momento, foram descritos na literatura 10 casos. Sua raridade deve-se à estabilidade inerente da articulação e à posição profunda na pelve, com fortes ligamentos e musculatura volumosa ao seu redor. Infl [...] uenciam o prognóstico dessa lesão diversos fatores, tais como grau de contaminação, lesões de partes moles, idade do paciente e, principalmente, atraso na redução. As principais complicações são: artrose do quadril, com incidência que pode chegar a 50% dos casos, quando associada a fraturas da cabeça femoral; e osteonecrose da cabeça do fêmur, com incidência entre 1,7% e 40% (nos casos de luxação anterior fechada). Por causa da raridade e da potencial incapacidade funcional decorrente dessa lesão, relatamos o caso de um homem de 46 anos vítima de acidente automobilístico. Foi feita redução do quadril (luxação do tipo anterior alta) nas primeiras três horas pós-trauma. O paciente foi mantido sem carga até a sexta semana, com carga total após a 10ª semana. Após um ano de seguimento, observou-se resultado funcional pobre (Harris Hip Score: 52), provavelmente por causa de lesão labral associada, porém sem sinais na ressonância nuclear magnética de osteonecrose da cabeça femoral. Abstract in english Open anterior hip dislocation is a rare condition and results from high-energy trauma. Ten cases of open anterior dislocation have been described in the literature so far. Its rarity is due to the inherent stability of the joint, its deep position in the pelvis, with strong ligaments and bulky muscl [...] es around the articulation. Several factors influence the prognosis, such as the degree of compounding, the associated soft tissue injuries, the age of the patient and, mainly, the delay in reduction. The main complications are: arthrosis of the hip, with incidence of 50% of cases, when associated with fractures of the femoral head; and osteonecrosis of the femoral head, with incidence between 1.7 and 40% (in closed anterior dislocation). Because of the rarity and the potential disability of this lesion, we report a case in a 46-year-old man, involved in an automobile accident. The hip was reduced (anterior superior dislocation)in the first three hours of the trauma. The patient was kept non-weight bearing until sixth week, with complete weight bearing after 10th week. After one year follow-up, the functional result was poor (Harris Hip Score: 52), probably because of the associated labral tear, but without signs of osteonecrosis of the femoral head in magnetic resonance imaging.

Anderson Luiz de, Oliveira; Eduardo Gomes, Machado.

109

Hip fusion as hip salvage procedure in cerebral palsy.  

Science.gov (United States)

The treatment of the spastic hip in Cerebral Palsy (CP) remains a challenge especially in cases of advance changes. Many options are available and the key for a good outcome is to find the best surgical procedure to an individualized patient. The hip fusion is one of the surgical options. The authors presented a group of spastic CP with painful chronic hip subluxation and dislocation treated with hip fusion with a mean follow-up period of 14.5 years. Surgical technique, post-operative management and outcomes were shown, also with the observations done regarding the evolution of the contralateral hip after the hip fusion. They concluded that the hip arthrodesis is an option for patients with spastic CP with painful subluxation or dislocated hips with the goal of pain relief maintain or improve functional status, and facilitating the care. The best candidate is a young ambulatory patient with normal contralateral hip and normal spinal alignment. PMID:25207734

Fucs, Patricia M De Moraes Barros; Yamada, Helder H

2014-01-01

110

Imaging of hip arthroplasty  

Energy Technology Data Exchange (ETDEWEB)

The imaging evaluation of the prosthetic hip begins with radiography, but arthrography, aspiration, scintigraphy, sonography, CT and MR imaging all have roles in the evaluation of the painful prosthesis. This article will review the appearance of normal hip arthroplasty including hemiarthroplasty, total arthroplasty, and hip resurfacing, as well as the appearances of potential complications such as aseptic loosening and osteolysis, dislocation, infection, periprosthetic fracture, hardware failure, and soft tissue abnormalities.

Miller, Theodore T., E-mail: millertt@hss.edu [Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 (United States)

2012-12-15

111

Imaging of hip arthroplasty  

International Nuclear Information System (INIS)

The imaging evaluation of the prosthetic hip begins with radiography, but arthrography, aspiration, scintigraphy, sonography, CT and MR imaging all have roles in the evaluation of the painful prosthesis. This article will review the appearance of normal hip arthroplasty including hemiarthroplasty, total arthroplasty, and hip resurfacing, as well as the appearances of potential complications such as aseptic loosening and osteolysis, dislocation, infection, periprosthetic fracture, hardware failure, and soft tissue abnormalities.

112

Congenital Anomalies in Infant with Congenital Hypothyroidism  

Directory of Open Access Journals (Sweden)

Full Text Available bjective: Congenital hypothyroidism is characterized by inadequate thyroid hormone production in newborn infants. Many infants with CH have co-occurring congenital malformations. This is an investigation on the frequency and types of congenital anomalies in infants with congenital hypothyroidism born from May 2006-2010 in Hamadan, west province of Iran.Methods: The Iranian neonatal screening program for congenital hypothyroidism was initiated in May 2005. This prospective descriptive study was conducted in infants diagnosed with congenital hypothyroidism being followed up in Pediatric Endocrinology Clinicof Besat Hospital, a tertiary care centre in Hamadan. Cases included all infants with congenital hypothyroidism diagnosed through newborn screening program or detected clinically. Anomalies were identified by clinical examination, echocardiography, and X-ray of the hip during the infant’s first year of life.Results: A total of 150 infants with biochemically confirmed primary congenital hypothyroidism (72 females and 78 males were recruited during the period between May 2006-2010. Overall, 30 (20% infants had associated congenital anomalies. The most common type of anomaly was Down syndrome. Seven infants (3.1% had congenital cardiac anomalies such as: ASD (n=3, VSD (n=2, PS (n =1, PDA (n=1. Three children (2.6% had developmental displasia of the hip (n=3.Conclusion: The overall frequency of Down syndrome, cardiac malformation and other birth defect was high in infants with CH. This reinforces the need to examine all infants with congenital hypothyroidism for the presence of associated congenital anomalies.

Zahra Razavi

2012-09-01

113

Tratamento cirúrgico de displasia de desenvolvimento do quadril de apresentação tardia depois da idade da marcha / Surgical treatment of late-presenting developmental dislocation of the hip after walking age  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Os casos de displasia de desenvolvimento do quadril (DDQ) ainda ocorrem depois da idade da marcha devido ao diagnóstico tardio ou ausente e à falha do tratamento conservador. A escolha do tratamento da DDQ depois da idade da marcha continua controversa e uma das opções é a redução a céu ab [...] erto combinada com osteotomia do inominado. MÉTODOS: Vinte pacientes com 26 quadris com DDQ tratados cirurgicamente foram avaliados de 2005 a 2008, usando-se a osteotomia do inominado pela técnica de Salter depois de redução e capsulorrafia a céu aberto. A idade dos pacientes no momento da cirurgia variou de 12 a 18 meses (média de idade 14,7 meses). De 15 pacientes do sexo feminino e cinco do masculino, seis tiveram luxação bilateral e dos restantes, nove tiveram luxação do quadril esquerdo e cinco, do direito. RESULTADOS: Os resultados foram avaliados de acordo com os critérios modificados de McKay e dos critérios radiológico de Severin, depois de acompanhamento médio de 46,7 meses. Oitenta e nove por cento dos quadris foram classificados como excelentes ou bons pelos critérios de McKay. Não houve resultados ruins. De acordo com os critérios de Severin, 77% eram do tipo I e II, enquanto 23% eram do tipo III e IV; nenhum quadril foi classificado nos tipos V ou VI. Houve um caso (3,8%) de reluxação, mas a cirurgia de revisão resultou em redução estável, concêntrica e permanente. Não há relato de casos de infecções, fratura do enxerto e lesão vacular ou nervosa. CONCLUSÃO: A redução a céu aberto combinada com a osteotomia de Salter não afeta o quadril com relação à remodelação em crianças entre 12 e 18 meses de idade. Nível de Evidência IV, Série de Casos. Abstract in english OBJECTIVE: Cases of developmental dysplasia of the hip (DDH) still occur after walking age because of late or missed diagnosis and failed conservative treatment. The choice of treatment for DDH after walking age continues to be controversial and one of the options is open reduction combined with inn [...] ominate osteotomy. METHODS: Twenty patients with 26 surgically treated hips with DDH, were evaluated from 2005 to 2008, using innominate osteotomy by Salter's technique after open reduction and capsulorraphy. The age of patients at time of surgery ranged from 12 to 18 months (mean age 14.7 months). Fifteen were females and five males, six patients had bilateral dislocation and among the remaining, nine had their left hip dislocated and five had their right hip dislocated. RESULTS: The results were evaluated according to the modified McKay criteria and the Severin radiological criteria, after a mean follow-up of 46.7 months. Eighty nine percent of the hips were rated as excellent or good by McKay criteria. There were no poor results. According to Severin criteria 77% were type I and II while 23% showed type III and IV; no hip was rated as Severin's group V or VI. There was one case (3.8%) of re-dislocation but revision surgery resulted in stable, concentric, and permanent reduction. No cases of infection, graft fracture and vascular or nervous injury were reported. CONCLUSION: Open reduction combined with Salter osteotomy does not jeopardize the hip with regard to acetabular remodeling in children between 12 and 18 months of age. Level of Evidence IV, Case Series.

Enan, Ahmed; Abo-hegy, Mohamed; Hammad, Wael.

114

Congenital contractures and distinctive phenotypic features consistent with Stuve-Wiedmann syndrome in a male infant  

Science.gov (United States)

Introduction Expressionless face associated with multiple contractures has been encountered in an infant. There is a wide range of misconception regarding the categorization of children with multiple contractures among different pediatric disciplines. The fundamental element in categorizing children with multiple contractures is "the etiological understanding". In the absence of concomitant neuromuscular disease, however, the search for other reasons is mandatory. Our present paper signifies the necessity of proper interpretations of unusual clinical and radiographic features. Case presentation We describe a 3-months-old-infant presented with the phenotypic and the radiographic features consistent with the diagnosis of Stüve-Wiedemann syndrome. We report what might be the first clinical report of Stüve-Wiedemann syndrome from a consanguineous family in Austria. Conclusion Congenital limitations of the hips in a newborn infant raise the possibility of " Congenital Hip Dislocation". As congenital hip dislocation is a dysplastic process. Here further knowledge by the pediatrician and the orthopaedic surgeon is needed. Our present patient appears to constitute a distinct pathological entity consistent with Stüve-Wiedemann syndrome (SWS). Superti-Furga et al, and Cormier-Daire et al, also suggest that Stüve-Wiedemann syndrome and Schwartz-Jampel syndrome type 2 are allelic conditions. We wish to stress that, given the rarity of syndromic malformation complex, our impression is that it is more common than it is reported. PMID:18718019

Al Kaissi, Ali; Rumpler, Monika; Csepan, Robert; Grill, Franz; Klaushofer, Klaus

2008-01-01

115

Total Hip Arthroplasty for Hip Fractures  

Science.gov (United States)

Introduction: This study aimed to determine the dislocation and reoperation rate, functional outcomes, and the survival rate of the unique subset of very old but lucid and independent patients with hip fractures following a total hip arthroplasty (THA) and geriatric team-coordinated perioperative care. Method: Between 2000 and 2006, previously independent ambulatory patients ?80 years old presenting with an intracapsular hip fracture were given THAs under the care of an integrated orthopedic surgery–geriatric service. Their fracture-related complications, ambulation, mental status, and survival were followed for 5 to 11 years postinjury. Results: Five years postinjury, 57 (61.3%) patients of the original study group were living. In all, 3 (3.2%) patients had postoperative hip dislocations (and 2 patients had dislocation twice) and 2 reoperations were needed within the first postoperative month. There were no hip dislocations or reoperations after the first year. Radiographs obtained on 88% of the surviving patients at 5 years postoperatively showed that all remained unchanged from their immediate postoperative images. Nearly half of the patients were still able to ambulate as they did preoperatively and their mixed-model equation was statistically unchanged. Conclusion: This study of patients >80 years old with previously good functional status demonstrates that with appropriate surgical (best prosthesis, good operating technique, and regional anesthesia) and geriatric (pre- and postoperative assessments, close follow-up, medication adjustments, and fall-prevention instruction) care, they have few hip dislocations and reoperations, survive postfracture at least as long as their noninjured contemporaries, and continue to function and ambulate as they did prior to their injury. PMID:24660092

Monzon, Daniel Godoy; Iserson, Kenneth V.; Jauregui, Jose; Musso, Carlos; Piccaluga, Francisco; Buttaro, Martin

2014-01-01

116

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... a little rough on the dislocation of the hip, you can actually cause a fracture. And that's a disaster when you break the ... are around 5-6%. The chances of a fracture of the hip that's left with this operation is nil because ...

117

Proximal femoral resection without post-operative traction for the painful dislocated hip in young patients with cerebral palsy: a review of 79 cases.  

Science.gov (United States)

Proximal femoral resection (PFR) is a proven pain-relieving procedure for the management of patients with severe cerebral palsy and a painful displaced hip. Previous authors have recommended post-operative traction or immobilisation to prevent a recurrence of pain due to proximal migration of the femoral stump. We present a series of 79 PFRs in 63 patients, age 14.7 years (10 to 26; 35 male, 28 female), none of whom had post-operative traction or immobilisation. A total of 71 hips (89.6%) were reported to be pain free or to have mild pain following surgery. Four children underwent further resection for persistent pain; of these, three had successful resolution of pain and one had no benefit. A total of 16 hips (20.2%) showed radiographic evidence of heterotopic ossification, all of which had formed within one year of surgery. Four patients had a wound infection, one of which needed debridement; all recovered fully. A total of 59 patients (94%) reported improvements in seating and hygiene. The results are as good as or better than the historical results of using traction or immobilisation. We recommend that following PFR, children can be managed without traction or immobilisation, and can be discharged earlier and with fewer complications. However, care should be taken with severely dystonic patients, in whom more extensive femoral resection should be considered in combination with management of the increased tone. PMID:24788508

Dartnell, J; Gough, M; Paterson, J M H; Norman-Taylor, F

2014-05-01

118

Anesthesia for a patient with Fanconi anemia for developmental dislocation of the hip: a case report / Anestesia en paciente con anemia de Fanconi y displasia del desarrollo de la cadera: caso clínico / Anestesia em paciente com anemia de Fanconi e displasia do desenvolvimento do quadril: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A anemia de Fanconi é uma síndrome hereditária autossômica recessiva rara, caracterizada por deficiência da medula óssea e anomalias congênitas e hematológicas. A literatura sobre o manejo anestésico dos pacientes é limitada. O manejo de uma displasia do desenvolvimento do quadril foi descrito em um [...] paciente com anemia de Fanconi. Por causa da natureza heterogênea, um paciente com anemia de Fanconi deve ser submetido à avaliação pré-operatória para diagnosticar as características clínicas. Em conclusão, o bloqueio caudal foi a nossa escolha para esse paciente com anemia de Fanconi, sem trombocitopenia, para evitar o N2O, reduzir a quantidade de anestésico, a microcefalia existente, o hipotireoidismo e o aumento das enzimas hepáticas, proporcionar analgesia pós-operatória e reduzir a quantidade de analgésico usada no pós-operatório. Abstract in spanish La anemia de Fanconi es un síndrome hereditario autosómico recesivo raro, caracterizado por deficiencia de la médula ósea y por anomalías congénitas y hematológicas. La literatura sobre el manejo anestésico de esos pacientes es limitada. El manejo de una displasia del desarrollo de la cadera fue des [...] crito en un paciente con anemia de Fanconi. Debido a la naturaleza heterogénea, un paciente con anemia de Fanconi debe ser sometido a la evaluación preoperatoria para diagnosticar las características clínicas. En conclusión, el bloqueo caudal fue nuestra elección para ese paciente con anemia de Fanconi sin trombocitopenia para evitar el N2O, reducir la cantidad de anestésico, microcefalia existente, hipotiroidismo y aumento de las enzimas hepáticas, proporcionar analgesia postoperatoria y reducir la cantidad de analgésico usado en el postoperatorio. Abstract in english Fanconi anemia is a rare autosomal recessive inherited bone marrow failure syndrome with congenital and hematological abnormalities. Literature regarding the anesthetic management in these patients is limited. A management of a developmental dislocation of the hip was described in a patient with fan [...] coni anemia. Because of the heterogeneous nature, a patient with fanconi anemia should be established thorough preoperative evaluation in order to diagnose on clinical features. In conclusion, we preferred caudal anesthesia in this patient with fanconi anemia without thrombocytopenia, because of avoiding from N2O, reducing amount of anesthetic, existing microcephaly, hypothyroidism and elevated liver enzymes, providing postoperative analgesia, and reducing amount of analgesic used postoperatively.

Zafer, Dogan; Huseyin, Yildiz; Ismail, Coskuner; Murat, Uzel; Mesut, Garipardic.

119

Anesthesia for a patient with Fanconi anemia for developmental dislocation of the hip: a case report / Anestesia en paciente con anemia de Fanconi y displasia del desarrollo de la cadera: caso clínico / Anestesia em paciente com anemia de Fanconi e displasia do desenvolvimento do quadril: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A anemia de Fanconi é uma síndrome hereditária autossômica recessiva rara, caracterizada por deficiência da medula óssea e anomalias congênitas e hematológicas. A literatura sobre o manejo anestésico dos pacientes é limitada. O manejo de uma displasia do desenvolvimento do quadril foi descrito em um [...] paciente com anemia de Fanconi. Por causa da natureza heterogênea, um paciente com anemia de Fanconi deve ser submetido à avaliação pré-operatória para diagnosticar as características clínicas. Em conclusão, o bloqueio caudal foi a nossa escolha para esse paciente com anemia de Fanconi, sem trombocitopenia, para evitar o N2O, reduzir a quantidade de anestésico, a microcefalia existente, o hipotireoidismo e o aumento das enzimas hepáticas, proporcionar analgesia pós-operatória e reduzir a quantidade de analgésico usada no pós-operatório. Abstract in spanish La anemia de Fanconi es un síndrome hereditario autosómico recesivo raro, caracterizado por deficiencia de la médula ósea y por anomalías congénitas y hematológicas. La literatura sobre el manejo anestésico de esos pacientes es limitada. El manejo de una displasia del desarrollo de la cadera fue des [...] crito en un paciente con anemia de Fanconi. Debido a la naturaleza heterogénea, un paciente con anemia de Fanconi debe ser sometido a la evaluación preoperatoria para diagnosticar las características clínicas. En conclusión, el bloqueo caudal fue nuestra elección para ese paciente con anemia de Fanconi sin trombocitopenia para evitar el N2O, reducir la cantidad de anestésico, microcefalia existente, hipotiroidismo y aumento de las enzimas hepáticas, proporcionar analgesia postoperatoria y reducir la cantidad de analgésico usado en el postoperatorio. Abstract in english Fanconi anemia is a rare autosomal recessive inherited bone marrow failure syndrome with congenital and hematological abnormalities. Literature regarding the anesthetic management in these patients is limited. A management of a developmental dislocation of the hip was described in a patient with fan [...] coni anemia. Because of the heterogeneous nature, a patient with fanconi anemia should be established thorough preoperative evaluation in order to diagnose on clinical features. In conclusion, we preferred caudal anesthesia in this patient with fanconi anemia without thrombocytopenia, because of avoiding from N2O, reducing amount of anesthetic, existing microcephaly, hypothyroidism and elevated liver enzymes, providing postoperative analgesia, and reducing amount of analgesic used postoperatively.

Zafer, Dogan; Huseyin, Yildiz; Ismail, Coskuner; Murat, Uzel; Mesut, Garipardic.

2014-06-01

120

Congenital transverse deficiency of the tibia and fibula: a report of two cases  

International Nuclear Information System (INIS)

We report two similar, but unrelated, patients with congenital bilateral partial deficiencies of the tibia and fibula associated with intact feet. In both patients, the tibia and fibula were absent on initial radiographs, while the femur and the tarsal bones were well developed and there was bilateral teratologic dislocation of the hips. Ultrasound and magnetic resonance imaging (MRI) studies suggested the presence of cartilaginous remnants of the tibia and fibula. There were multidirectional instabilities in the knees and ankles. The clinical and radiological features of these cases are distinct from those of congenital longitudinal deficiency of the tibia, in which the fibula is always preserved, and from longitudinal deficiency of the fibula, in which the tibia is present and the foot is usually involved. We suggest that the bilateral partial deficiencies of the tibia and fibula associated with the intact foot and teratologic dislocation of the hips is a single-entity disorder, possibly categorized as an intercalary transverse deficiency of the lower limb. (orig.)

 
 
 
 
121

Congenital insensitivity to pain with anhidrosis: a case report of a 33-year-old patient.  

Science.gov (United States)

Congenital insensitivity to pain with anhidrosis is a type IV hereditary sensory and autonomic neuropathy, presenting early in life. This disorder results from defective neural crest differentiation with loss of the first-order afferent system, which is responsible for sensations of pain and temperature; a neuronal loss in the sympathetic ganglia is also present. A case of a 33-year-old patient with congenital insensitivity to pain with anhidrosis is presented. From the time of birth, he did not sweat and did not respond to painful stimuli, although unexplained bouts of fever were often observed in infancy; an extensive workup during childhood helped establish the diagnosis. Throughout childhood and adulthood, the patient presented multiple infections and fractures in various sites of his body, growth disturbances, and avascular necrosis, and Charcot arthropathies and joint dislocations mainly affected his elbow and hip joint. At the final follow-up, at the age of 33 years, he was found to be obese, with a limited social life. A Charcot elbow restricted the activity of his left upper limb, and the dislocated hips combined with the instability of the ankle joints limited the ambulation distance. A specific treatment protocol has not been established in the literature; the main principles that can be applied in patients with normal intelligence include training programs to prevent self-mutilation and accidental injuries and an early diagnosis and treatment of the infections. PMID:22422007

Kosmidis, Ilias; Krallis, Panagiotis; Tsiamasfirou, Damiani; Filiopoulos, Konstantinos

2013-01-01

122

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... on ice. Through either an injury mechanism, an infection, or disease process, the lubrication characteristics are lost, ... a little rough on the dislocation of the hip, you can actually cause a fracture. And that's a disaster when you break the ...

123

Evaluation of the patient with hip pain.  

Science.gov (United States)

Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Lateral hip pain occurs with greater trochanteric pain syndrome. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses; however, a rational approach to the hip examination can be used. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance arthrography is the diagnostic test of choice for labral tears. PMID:24444505

Wilson, John J; Furukawa, Masaru

2014-01-01

124

Screening programmes for developmental dysplasia of the hip in newborn infants  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english BACKGROUND Uncorrected developmental dysplasia of the hip (DDH) is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. OBJECTIVE To determine the effect of different screening programmes for DDH on the incidence of l [...] ate presentation of congenital hip dislocation. METHODS Search methods: Searches were performed in CENTRAL (The Cochrane Library), MEDLINE and EMBASE (January 2011) supplemented by searches of clinical trial registries, conference proceedings, cross references and contacting expert informants. Selection criteria: Randomized, quasi-randomized or cluster trials comparing the effectiveness of screening programmes for DDH. Data collection and analysis: Three independent review authors assessed study eligibility and quality, and extracted data. MAIN RESULTS No study examined the effect of screening (clinical and/or ultrasound) and early treatment versus not screening and later treatment. AUTHORS' CONCLUSIONS There is insufficient evidence to give clear recommendations for practice. There is inconsistent evidence that universal ultrasound results in a significant increase in treatment compared to the use of targeted ultrasound or clinical examination alone. Neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. The studies are substantially underpowered to detect significant differences in the uncommon event of late detected DDH or surgery. For infants with unstable hips or mildly dysplastic hips, use of delayed ultrasound and targeted splinting reduces treatment without significantly increasing the rate of late diagnosed DDH or surgery.

Damon, Shorter; Timothy, Hong; David A., Osborn.

2013-04-01

125

Tratamento da luxação paralítica do quadril na paralisia cerebral tetraparética espástica com osteotomia do fêmur e do ilíaco sem abertura da cápsula articular (capsuloplastia Hip dislocation treatment in cerebral palsy patients with spastic quadriplegia with femoral and pelvic osteotomies, without opening of the joint capsule (capsuloplasty  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Mostrar o planejamento pré-operatório, e os resultados do tratamento cirúrgico da luxação paralítica do quadril em pacientes com paralisia cerebral. A técnica utilizada foi a osteotomia derrotatória e varizante do fêmur proximal, associada à osteotomia do ilíaco tipo Dega, sem abertura da cápsula articular. MÉTODOS: Realizamos um estudo retrospectivo de 10 quadris em oito pacientes com paralisia cerebral tipo tetraparesia espástico, submetidos a tratamento cirúrgico entre 2003 e 2005 com a mesma técnica cirúrgica. Foram avaliados parâmetros clínicos e radiográficos pré e pós-operatórios, bem como o planejamento pré-operatório com uso do intensificador de imagem. Os parâmetros clínicos analisados foram: dor, dificuldade de higiene e dificuldade de posicionamento. Os parâmetros radiológicos foram os índices de Reimers, índice acetabular e ângulo cervicodiafisário. Estes resultados foram submetidos a análise estatística. RESULTADOS: Obtivemos bons resultados com esta técnica. Com um seguimento médio de três anos, todos os quadris estavam reduzidos na última consulta, com alto grau de satisfação dos familiares, em relação ao tratamento. Além disso, mostramos que o planejamento pré-operatório com uso do intensificador de imagem nos permite a redução e estabilização desses quadris sem a necessidade de capsuloplastia. CONCLUSÃO: Os autores concluíram que no tratamento da luxação do quadril dos pacientes com paralisia cerebral tetraparéticos espásticos com o planejamento pré-operatório, não é necessária a capsuloplastia para estabilização da articulação coxofemoral.OBJECTIVES: To show the preoperative planning and the results of surgical treatment for paralytic hip dislocation in children with cerebral palsy. The techniques used were proximal femoral varus derotation osteotomy and Dega osteotomy without opening of the joint capsule. METHODS: We performed a retrospective review of ten hips in eight patients with cerebral palsy with spastic quadriplegia treated with surgery from 2003 to 2005, by the same surgical technique. Were assessed clinical and radiological outcomes before and after surgery, as well as the preoperative planning with the use of fluoroscope. The clinical parameters analyzed were: pain, difficulty performing personal hygiene, and sitting balance. The radiological parameters were Reimer's index, acetabular index and neck-shaft angle. These results were submitted to statistical analysis. RESULTS: We obtained good results with this technique. After an average follow-up of three years, all hips were stable in the last assessment, and there was a high level of satisfaction among the families in relation to the treatment. We also show that preoperative planning with fluoroscopy enables the reduction and stabilization of the hips without the need for capsuloplasty. CONCLUSION: The authors conclude that in the treatment of hip dislocation in patients with Cerebral Palsy with spastic quadriplegia, it is not necessary to open the joint capsule to stabilize the coxofemoral joint.

Fernando Farcetta Junior

2010-01-01

126

Hip Replacement  

Medline Plus

Full Text Available ... arthritis in the hip can lead to severe pain and inability to walk. Doctors may recommend surgery ... severe arthritis in the hip to relieve their pain and help them move more easily. If your ...

127

Hip Replacement  

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Full Text Available ... surgery is also yours. This reference summary will review the benefits and risks of this surgery. HipJoint ... to decrease the inflammation in the hip joint. Physical therapy may also help keep the joint as ...

128

Hip Revision  

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Full Text Available Hip Revision Featuring the ZMR® Hip System Tapered Distal Stem Zimmer, Inc. Winfield, Illinois September 3, 2009 Welcome to this OR Live webcast presentation, brought to you by Zimmer. ...

129

Hip Revision  

Medline Plus

Full Text Available ... Revision Featuring the ZMR® Hip System Tapered Distal Stem Zimmer, Inc. Winfield, Illinois September 3, 2009 Welcome ... a hybrid hip arthroplasty with a cemented femoral stem and an acetabular shell. You can see the ...

130

Mechanical complications and reconstruction strategies at the site of hip spacer implantation  

Directory of Open Access Journals (Sweden)

Full Text Available Over the past two decades antibiotic-impregnated hip spacers have become a popular procedure in the treatment of hip joint infections. Besides infection persistence and/or reinfection, major complications after hip spacer implantation include spacer fracture, -dislocation, and bone fracture. Moreover, in cases with extensive loss of femoral and/or acetabular bone alternative reconstructive techniques should be used for a stable spacer fixation and prevention of fractures or dislocations. The present article reviews the different types of spacer fractures and dislocations and offers some suggestions about reconstructive techniques for management of extensive loss of femoral and/or acetabular bone at the site of hip spacer implantation.

Konstantinos Anagnostakos, Jochen Jung, Nora Verena Schmid, Eduard Schmitt, Jens Kelm

2009-01-01

131

Importancia de la Relación Anatómica entre el nervio Isquiático y el Margen Posterior del Acetábulo en la Luxación Posterior de la Cadera Anatomic Value of the Sciatic Nerve with the Posterior Margin of the Acetabulum in Posterior Dislocation of the Hip  

Directory of Open Access Journals (Sweden)

Full Text Available La luxación posterior de la articulación de la cadera es un trauma que puede sufrir una buena parte de la población, donde se puede comprometer el nervio isquiático, produciendo serios problemas en la vida del individuo afectado. El conocimiento de la relación anatómica entre el nervio isquiático y el margen posterior del acetábulo propiciará um diagnóstico preciso y precoz de esta lesión. Con el objetivo de estudiar la relación topográfica del nervio isquiático con el margen posterior del acetábulo y entregar antecedentes anatómicos para las cirugías ortopédicas en caso de luxaciones posteriores de la cadera, se estudiaron 40 miembros inferiores formolizados, de cadáveres humanos, adultos y de ambos sexos, localizados en los laboratorios de anatomía topográfica de la Universidad Estadual de Ciencias de la Salud de Alagoas, Brasil. En 19 miembros inferiores (47,7% el nervio isquiático pasó directamente sobre el margen posterior del acetábulo y en los 21 restantes (53,3%, el nervio estuvo distante del margen mencionado, distancia que varió de 6 a 49 mm. Los resultados obtenidos muestran la estrecha relación entre el nervio isquiático y el margen acetabular, lo que acrecienta la posibilidad de lesión del nervio em los casos de luxación posterior de la cadera.The posterior dislocation of the hip joint is a trauma that can undergo a large part of the population, which may compromise the sciatic nerve, causing serious problems in the life of the affected individual. Knowledge of the anatomical relationship between the sciatic nerve and the posterior margin of the acetabulum will facilitate accurate diagnosis and early um this injury. In order to study the topographical relationship of the sciatic nerve with the posterior margin of the acetabulum and provide background for orthopedic anatomical in posterior dislocations of the hip were studied 40 lower limbs formolized human cadavers, adults of both sexes , located in the topographical anatomy laboratories of the Universidade Estadual de Ciencias da Saude, Alagoas, Brasil. In 19 limbs (47.7% sciatic nerve passed directly over the posterior margin of the acetabulum and the remaining 21 (53.3%, the nerve passed distal to the acetabular margin, distance ranging from 6-49 mm. The results show the close relationship between the sciatic nerve and the acetabular margin, which increases the possibility of nerve injury in posterior dislocation of the hip.

A. C da Rocha

2012-09-01

132

Importancia de la Relación Anatómica entre el nervio Isquiático y el Margen Posterior del Acetábulo en la Luxación Posterior de la Cadera / Anatomic Value of the Sciatic Nerve with the Posterior Margin of the Acetabulum in Posterior Dislocation of the Hip  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La luxación posterior de la articulación de la cadera es un trauma que puede sufrir una buena parte de la población, donde se puede comprometer el nervio isquiático, produciendo serios problemas en la vida del individuo afectado. El conocimiento de la relación anatómica entre el nervio isquiático y [...] el margen posterior del acetábulo propiciará um diagnóstico preciso y precoz de esta lesión. Con el objetivo de estudiar la relación topográfica del nervio isquiático con el margen posterior del acetábulo y entregar antecedentes anatómicos para las cirugías ortopédicas en caso de luxaciones posteriores de la cadera, se estudiaron 40 miembros inferiores formolizados, de cadáveres humanos, adultos y de ambos sexos, localizados en los laboratorios de anatomía topográfica de la Universidad Estadual de Ciencias de la Salud de Alagoas, Brasil. En 19 miembros inferiores (47,7%) el nervio isquiático pasó directamente sobre el margen posterior del acetábulo y en los 21 restantes (53,3%), el nervio estuvo distante del margen mencionado, distancia que varió de 6 a 49 mm. Los resultados obtenidos muestran la estrecha relación entre el nervio isquiático y el margen acetabular, lo que acrecienta la posibilidad de lesión del nervio em los casos de luxación posterior de la cadera. Abstract in english The posterior dislocation of the hip joint is a trauma that can undergo a large part of the population, which may compromise the sciatic nerve, causing serious problems in the life of the affected individual. Knowledge of the anatomical relationship between the sciatic nerve and the posterior margin [...] of the acetabulum will facilitate accurate diagnosis and early um this injury. In order to study the topographical relationship of the sciatic nerve with the posterior margin of the acetabulum and provide background for orthopedic anatomical in posterior dislocations of the hip were studied 40 lower limbs formolized human cadavers, adults of both sexes , located in the topographical anatomy laboratories of the Universidade Estadual de Ciencias da Saude, Alagoas, Brasil. In 19 limbs (47.7%) sciatic nerve passed directly over the posterior margin of the acetabulum and the remaining 21 (53.3%), the nerve passed distal to the acetabular margin, distance ranging from 6-49 mm. The results show the close relationship between the sciatic nerve and the acetabular margin, which increases the possibility of nerve injury in posterior dislocation of the hip.

A. C, da Rocha; R. F, Monte Bispo; R. D, da Cruz; F. T. A, dos Santos; T. F. A, dos Santos; E, Olave; C. F, Sousa-Rodrigues.

133

Importancia de la Relación Anatómica entre el nervio Isquiático y el Margen Posterior del Acetábulo en la Luxación Posterior de la Cadera / Anatomic Value of the Sciatic Nerve with the Posterior Margin of the Acetabulum in Posterior Dislocation of the Hip  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La luxación posterior de la articulación de la cadera es un trauma que puede sufrir una buena parte de la población, donde se puede comprometer el nervio isquiático, produciendo serios problemas en la vida del individuo afectado. El conocimiento de la relación anatómica entre el nervio isquiático y [...] el margen posterior del acetábulo propiciará um diagnóstico preciso y precoz de esta lesión. Con el objetivo de estudiar la relación topográfica del nervio isquiático con el margen posterior del acetábulo y entregar antecedentes anatómicos para las cirugías ortopédicas en caso de luxaciones posteriores de la cadera, se estudiaron 40 miembros inferiores formolizados, de cadáveres humanos, adultos y de ambos sexos, localizados en los laboratorios de anatomía topográfica de la Universidad Estadual de Ciencias de la Salud de Alagoas, Brasil. En 19 miembros inferiores (47,7%) el nervio isquiático pasó directamente sobre el margen posterior del acetábulo y en los 21 restantes (53,3%), el nervio estuvo distante del margen mencionado, distancia que varió de 6 a 49 mm. Los resultados obtenidos muestran la estrecha relación entre el nervio isquiático y el margen acetabular, lo que acrecienta la posibilidad de lesión del nervio em los casos de luxación posterior de la cadera. Abstract in english The posterior dislocation of the hip joint is a trauma that can undergo a large part of the population, which may compromise the sciatic nerve, causing serious problems in the life of the affected individual. Knowledge of the anatomical relationship between the sciatic nerve and the posterior margin [...] of the acetabulum will facilitate accurate diagnosis and early um this injury. In order to study the topographical relationship of the sciatic nerve with the posterior margin of the acetabulum and provide background for orthopedic anatomical in posterior dislocations of the hip were studied 40 lower limbs formolized human cadavers, adults of both sexes , located in the topographical anatomy laboratories of the Universidade Estadual de Ciencias da Saude, Alagoas, Brasil. In 19 limbs (47.7%) sciatic nerve passed directly over the posterior margin of the acetabulum and the remaining 21 (53.3%), the nerve passed distal to the acetabular margin, distance ranging from 6-49 mm. The results show the close relationship between the sciatic nerve and the acetabular margin, which increases the possibility of nerve injury in posterior dislocation of the hip.

A. C, da Rocha; R. F, Monte Bispo; R. D, da Cruz; F. T. A, dos Santos; T. F. A, dos Santos; E, Olave; C. F, Sousa-Rodrigues.

2012-09-01

134

Severe congenital RYR1-associated myopathy  

Science.gov (United States)

Objective: To report a series of 11 patients on the severe end of the spectrum of ryanodine receptor 1 (RYR1) gene–related myopathy, in order to expand the clinical, histologic, and genetic heterogeneity associated with this group of patients. Methods: Eleven patients evaluated in the neonatal period with severe neonatal-onset RYR1-associated myopathy confirmed by genetic testing were ascertained. Clinical features, molecular testing results, muscle imaging, and muscle histology are reviewed. Results: Clinical features associated with the severe neonatal presentation of RYR1-associated myopathy included decreased fetal movement, hypotonia, poor feeding, respiratory involvement, arthrogryposis, and ophthalmoplegia in 3 patients, and femur fractures or hip dislocation at birth. Four patients had dominant RYR1 mutations, and 7 had recessive RYR1 mutations. One patient had a cleft palate, and another a congenital rigid spine phenotype—findings not previously described in the literature in patients with early-onset RYR1 mutations. Six patients who underwent muscle ultrasound showed relative sparing of the rectus femoris muscle. Histologically, all patients with dominant mutations had classic central cores on muscle biopsy. Patients with recessive mutations showed great histologic heterogeneity, including fibrosis, variation in fiber size, skewed fiber typing, very small fibers, and nuclear internalization with or without ill-defined cores. Conclusions: This series confirms and expands the clinical and histologic variability associated with severe congenital RYR1-associated myopathy. Both dominant and recessive mutations of the RYR1 gene can result in a severe neonatal-onset phenotype, but more clinical and histologic heterogeneity has been seen in those with recessive RYR1 gene mutations. Central cores are not obligatory histologic features in recessive RYR1 mutations. Sparing of the rectus femoris muscle on imaging should prompt evaluation for RYR1-associated myopathy in the appropriate clinical context. PMID:23553484

Bharucha-Goebel, Diana Xerxes; Santi, Mariarita; Medne, Livija; Zukosky, Kristin; Dastgir, Jahannaz; Shieh, Perry B.; Winder, Thomas; Tennekoon, Gihan; Finkel, Richard S.; Dowling, James J.; Monnier, Nicole

2013-01-01

135

Analysis of the acetabulum by CT scan in Japanese with osteoarthritis of the hip  

International Nuclear Information System (INIS)

The morphology of the acetabulum was analyzed by CT scan in 66 Japanese patients with osteoarthritis of the hip mainly following congenital dislocation or dysplasia. The CT scan data was analyzed to standardize the pelvic inclination in all directions. In these patients, the acetabular floor had thickened and the acetabulum was located in the anterolateral portion. The bilateral difference in the acetabular anteversion angle was not different between patients and normal individuals, but the acetabular sector angle in patients was smaller than in the normal subjects. As the stage of osteoarthritis of the hip advanced, the thickness of the acetabular floor in the center and posterior portions and the anterior sector angle increased, and the lateralization of the acetabulum advanced, but the anteversion angle decreased. A bone-forming change is characteristic of the anterior acetabulum and acetabular fossa in the center and posterior portions in Japanese patients with osteoarthritis of the hip. In comparison with data obtained by standard radiography, these changes detected by CT scan corresponded to an increase of the width of a tear drop, the lateralization of the femoral head and the lack of the support of the femoral head from the acetabulum. (author)

136

Total hip arthroplasty following failed fixation of proximal hip fractures  

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Full Text Available Background: Most proximal femoral fractures are successfully treated with internal fixation but a failed surgery can be very distressing for the patient due to pain and disability. For the treating surgeon it can be a challenge to perform salvage operations. The purpose of this study was to evaluate the short-term functional outcome and complications of total hip arthroplasty (THA following failed fixation of proximal hip fracture. Materials and Methods: In a retrospective study, 21 hips in 20 patients (13 females and seven males with complications of operated hip fractures as indicated by either established nonunion or fracture collapse with hardware failure were analysed. Mean age of the patients was 62 years (range 38 years to 85 years. Nine patients were treated for femoral neck fracture, 10 for intertrochanteric (I/T fracture and two for subtrochanteric (S/T fracture of the hip. Uncemented THA was done in 11 cases, cemented THA in eight hip joints and hybrid THA in two patients. Results: The average duration of follow-up was four years (2-13 years. The mean duration of surgery was 125 min and blood loss was 1300 ml. There were three dislocations postoperatively. Two were managed conservatively and one was operated. There was one superficial infection and one deep infection. Only one patient required a walker while four required walking stick for ambulation. The mean Harris Hip score increased from 32 preoperatively to 79 postoperatively at one year interval. Conclusion: Total hip arthroplasty is an effective salvage procedure after failed osteosynthesis of hip fractures. Most patients have good pain relief and functional improvements inspite of technical difficulties and high complication rates than primary arthroplasty.

Srivastav Shekhar

2008-01-01

137

Neonatal hip dysplasia: Differental diagnosis  

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Full Text Available Introduction. Hip dysplasia is the elementary form of the developmental dysplasia of the hip (DDH. The diagnosis may be made by the ultrasound examination (types II a-, II b. Objective. The aim of the authors was to define the congenital structural neonatal hip dysplasia, and to differentiate hip hypoplasia, hip dysplasia and teratogenic anomalies. Methods. In all the cases, the uniform clinical and ultrasound tests were performed. All the patients were examined in the neonatal period of life (the first six weeks. The following clinical tests were used: Le Damany-Ortolany, Coleman-Barlow-Palmen and Weissman-Strinovi?. For the ultrasound examination, the Graph’s method was used. Results. The investigation was performed in the period 2007- 2008. 2,878 neonates were included. The distribution of the sonotypes, according to Graph, was as follows: Ia in 16.17%. Ib in 65.08%; IIa+ in 18.17%, IIc in 0.28%, IId in 0.19%; IIIa in 0.009%, IIIb in 0.02%; and IV in 0.01%. It was found that DDH was 8 times more frequent in girls; located more frequently at the left side than bilaterally. Conclusion. Hip sonoscreening has to be performed in all newborns in the first 72 hours. The suggested follow-up period is six weeks: for the diagnosis - the first three weeks, and for the prevention and treatment - all six weeks.

Vukašinovi? Zoran

2010-01-01

138

Unilateral hip osteoarthritis: can we predict the outcome of the other hip?  

International Nuclear Information System (INIS)

The objective of this study was to define, in unilateral hip osteoarthritis (OA), factors predicting the outcome of the other hip. We examined the anteroposterior radiographs of the pelvis of 95 white patients with unilateral idiopathic (56 patients) or secondary to congenital hip diseases (39 patients) OA. The other hip was free from symptoms (pain or limping) at the initial examination and without radiographic evidence of OA; it was what we call a ''normal'' hip. Two parameters were evaluated: (1) the type of osteoarthritis of the involved hip and (2) the range of four radiographic indices of the contralateral hip: the sourcil inclination (weight-bearing surface), the acetabular angle, the Wiberg's center-edge angle, and the neck-shaft angle. Follow-up radiographs for the hips that remained OA-free were available for 10 to 35 years and for those that developed OA, at the time of initial symptoms, range 2 to 31 years. Logistic regression analysis showed that the presence of idiopathic OA in one hip had a statistically significant effect on the development of OA on the other hip (p<0.001). Minor deviations of radiographic indices of the contralateral hip is not a predictive factor for its outcome. When the radiographic indices are examined together with the pathology of the involved hip, only WBS was shown to have a significant effect to the development of OA and its type (p < 0.001). The following conclusions can be drawn from this study: 1. Patient with idiopathic OA of one hip is at increased risk of developing OA in the other hip. 2. The outcome of the other hip cannot be predicted only on the basis of the evaluation of its radiographic indices. 3. Among the different indices, WBS seems to have a strong influence toward the development of OA. (orig.)

139

Unilateral hip osteoarthritis: can we predict the outcome of the other hip?  

Energy Technology Data Exchange (ETDEWEB)

The objective of this study was to define, in unilateral hip osteoarthritis (OA), factors predicting the outcome of the other hip. We examined the anteroposterior radiographs of the pelvis of 95 white patients with unilateral idiopathic (56 patients) or secondary to congenital hip diseases (39 patients) OA. The other hip was free from symptoms (pain or limping) at the initial examination and without radiographic evidence of OA; it was what we call a ''normal'' hip. Two parameters were evaluated: (1) the type of osteoarthritis of the involved hip and (2) the range of four radiographic indices of the contralateral hip: the sourcil inclination (weight-bearing surface), the acetabular angle, the Wiberg's center-edge angle, and the neck-shaft angle. Follow-up radiographs for the hips that remained OA-free were available for 10 to 35 years and for those that developed OA, at the time of initial symptoms, range 2 to 31 years. Logistic regression analysis showed that the presence of idiopathic OA in one hip had a statistically significant effect on the development of OA on the other hip (p<0.001). Minor deviations of radiographic indices of the contralateral hip is not a predictive factor for its outcome. When the radiographic indices are examined together with the pathology of the involved hip, only WBS was shown to have a significant effect to the development of OA and its type (p < 0.001). The following conclusions can be drawn from this study: 1. Patient with idiopathic OA of one hip is at increased risk of developing OA in the other hip. 2. The outcome of the other hip cannot be predicted only on the basis of the evaluation of its radiographic indices. 3. Among the different indices, WBS seems to have a strong influence toward the development of OA. (orig.)

Vossinakis, I.C. [General Hospital of Volos, Orthopaedic Department, Volos (Greece); Georgiades, G. [General Hospital of Tripoli, Tripoli Greece, Orthopaedic Department, Athens (Greece); Hartofilakidis, G. [University of Athens Medical School, Department of Orthopaedics, Athens (Greece); Kafidas, D.

2008-10-15

140

Hip Replacement  

Medline Plus

Full Text Available ... inability to walk. When appropriate, a hip replacement can replace the ball on the femur and socket in the pelvis. The artificial replacement parts are called “prostheses.” Hip replacement is very successful in helping decrease your pain and improve your quality of life. This operation is safe, ...

 
 
 
 
141

Tratamento da luxação paralítica do quadril na paralisia cerebral tetraparética espástica com osteotomia do fêmur e do ilíaco sem abertura da cápsula articular (capsuloplastia) / Hip dislocation treatment in cerebral palsy patients with spastic quadriplegia with femoral and pelvic osteotomies, without opening of the joint capsule (capsuloplasty)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Mostrar o planejamento pré-operatório, e os resultados do tratamento cirúrgico da luxação paralítica do quadril em pacientes com paralisia cerebral. A técnica utilizada foi a osteotomia derrotatória e varizante do fêmur proximal, associada à osteotomia do ilíaco tipo Dega, sem abertura da [...] cápsula articular. MÉTODOS: Realizamos um estudo retrospectivo de 10 quadris em oito pacientes com paralisia cerebral tipo tetraparesia espástico, submetidos a tratamento cirúrgico entre 2003 e 2005 com a mesma técnica cirúrgica. Foram avaliados parâmetros clínicos e radiográficos pré e pós-operatórios, bem como o planejamento pré-operatório com uso do intensificador de imagem. Os parâmetros clínicos analisados foram: dor, dificuldade de higiene e dificuldade de posicionamento. Os parâmetros radiológicos foram os índices de Reimers, índice acetabular e ângulo cervicodiafisário. Estes resultados foram submetidos a análise estatística. RESULTADOS: Obtivemos bons resultados com esta técnica. Com um seguimento médio de três anos, todos os quadris estavam reduzidos na última consulta, com alto grau de satisfação dos familiares, em relação ao tratamento. Além disso, mostramos que o planejamento pré-operatório com uso do intensificador de imagem nos permite a redução e estabilização desses quadris sem a necessidade de capsuloplastia. CONCLUSÃO: Os autores concluíram que no tratamento da luxação do quadril dos pacientes com paralisia cerebral tetraparéticos espásticos com o planejamento pré-operatório, não é necessária a capsuloplastia para estabilização da articulação coxofemoral. Abstract in english OBJECTIVES: To show the preoperative planning and the results of surgical treatment for paralytic hip dislocation in children with cerebral palsy. The techniques used were proximal femoral varus derotation osteotomy and Dega osteotomy without opening of the joint capsule. METHODS: We performed a ret [...] rospective review of ten hips in eight patients with cerebral palsy with spastic quadriplegia treated with surgery from 2003 to 2005, by the same surgical technique. Were assessed clinical and radiological outcomes before and after surgery, as well as the preoperative planning with the use of fluoroscope. The clinical parameters analyzed were: pain, difficulty performing personal hygiene, and sitting balance. The radiological parameters were Reimer's index, acetabular index and neck-shaft angle. These results were submitted to statistical analysis. RESULTS: We obtained good results with this technique. After an average follow-up of three years, all hips were stable in the last assessment, and there was a high level of satisfaction among the families in relation to the treatment. We also show that preoperative planning with fluoroscopy enables the reduction and stabilization of the hips without the need for capsuloplasty. CONCLUSION: The authors conclude that in the treatment of hip dislocation in patients with Cerebral Palsy with spastic quadriplegia, it is not necessary to open the joint capsule to stabilize the coxofemoral joint.

Fernando, Farcetta Junior; Fabio Peluzo, Abreu; Daniella Lins, Neves; Paulo Facciola, Kertzman; Alexandre, Zuccon; Simone de Oliveira, Bittencourt; Davi Moshe Leopold, Lopes.

142

A Single Centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Ceramic-on-ceramic Bearing in Primary Total Hip Replacement  

Science.gov (United States)

Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

2014-08-13

143

A Two Centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Metal-on-Metal Bearing in Primary Total Hip Replacement  

Science.gov (United States)

Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

2014-04-29

144

Tight fit technique in primary hybrid total hip arthroplasty for patients with hip dysplasia.  

Science.gov (United States)

This article presents the midterm results of hybrid total hip arthroplasty for patients with hip dysplasia by use of a tight fit technique for the femoral component. We followed up 113 hips in 99 patients for a mean of 11 years. All final femoral rasps used in this study overrasped by 0.5 to 1.0 mm for stem insertion, resulting in relatively thin cement mantles. Both components of one hip were removed because of infection. The other 5 acetabular components were revised for osteolysis, recurrent dislocation, or dislodgement of the polyethylene liner. No femoral component was revised for aseptic loosening. We conclude that the tight fit technique using a canal-filling stem may produce good long-term results for patients with hip dysplasia. PMID:17197309

Ito, Hiroshi; Hirayama, Teruhisa; Tanino, Hiromasa; Matsuno, Takeo; Minami, Akio

2007-01-01

145

Hip Replacement  

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Full Text Available ... and the socket is prepared to accept an artificial surface known as a “prosthesis.” This document is ... the femur and socket in the pelvis. The artificial replacement parts are called “prostheses.” Hip replacement is ...

146

Hip Revision  

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Full Text Available ... initial preoperative x-ray, where we see a hybrid hip arthroplasty with a cemented femoral stem and ... every single time. But the nature of this design of the stem is that doesn't always ...

147

Hip Replacement  

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Full Text Available ... to decrease the inflammation in the hip joint. Physical therapy may also help keep the joint as mobile ... walk without any aid. Because of the extensive physical therapy program and because initially the patient has difficult ...

148

Hip Replacement  

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Full Text Available ... overweight patients, losing weight may help relieve the stress on the hip joint. If an operation is ... variety of causes, such as arthritis or an injury. This can cause pain and the inability to ...

149

Hip Replacement  

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Full Text Available ... Femur Pelvis Anatomy The hip joint joins the leg to the pelvis. The head of the femur, ... attacks, strokes, pneumonia, and blood clots in the legs. These risks will be discussed with you in ...

150

Hip Revision  

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Full Text Available ... initial preoperative x-ray, where we see a hybrid hip arthroplasty with a cemented femoral stem and ... well. Well, I mean obviously I didn't train on this stem and didn't believe in ...

151

Hip Revision  

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Full Text Available ... an acetabular shell. You can see the lucent lines behind the acetabular shell, and there are some ... the next radiograph, unfortunately, three years down the line, this patient was developing increasing hip pain. And ...

152

Hip Replacement  

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Full Text Available ... painless movement. Symptoms and Their Causes Arthritis, or inflammation of the joint, causes the surfaces to become ... to walk. Hip arthritis can result from chronic inflammation of the joint or may be caused by ...

153

Hip Replacement  

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Full Text Available ... inability to walk. Hip arthritis can result from chronic inflammation of the joint or may be caused by a previous injury. The pain may interfere with normal work and activities. Walking ...

154

Hip pain  

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... be a serious and lead to major problems. Hip fractures are more common as people get older because falls are more likely and your bones become weaker. Infection in the bones or joints Osteonecrosis of the ...

155

Hip Replacement  

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Full Text Available ... a cane or walker may help when walking. Injections of steroids in the hip joint may also ... anterior approach requires a smaller incision and less post operative precautions. Your surgeon will discuss with you ...

156

Hip Revision  

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Full Text Available ... your hip construct stability? I would agree one hundred percent with that. Well, do you want to ... and cut this. I agree with you a hundred percent though. There's times, this \\INAUDIBLE\\ patient is ...

157

Hip Replacement  

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... of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences. Where Can People Find More Information About Hip ...

158

Hip Replacement  

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Full Text Available ... the side. The other way is from the front and is known as the ‘anterior’ approach. The ... help of a walker initially to take the pressure off of your new hip. Eventually, you will ...

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Hip Revision  

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Full Text Available ... hip construct stability? I would agree one hundred percent with that. Well, do you want to just ... cut this. I agree with you a hundred percent though. There's times, this \\INAUDIBLE\\ patient is not ...

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Hip Revision  

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Full Text Available ... initial preoperative x-ray, where we see a hybrid hip arthroplasty with a cemented femoral stem and ... it in and out, but you can completely control its position. So, Todd, once the stem's in ...

 
 
 
 
161

Hip Replacement  

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Full Text Available ... Severe arthritis in the hip can lead to severe pain and inability to walk. Doctors may recommend surgery ... surfaces to become rough. This can result in severe pain and may even lead to the inability to ...

162

Hip Replacement  

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Full Text Available ... cemented to the bone. However, some types of prostheses do not need to be cemented. Instead, the ... the pelvis. The artificial replacement parts are called “prostheses.” Hip replacement is very successful in helping decrease ...

163

Hip ultrasound  

Energy Technology Data Exchange (ETDEWEB)

In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up.

Martinoli, Carlo, E-mail: carlo.martinoli@libero.it [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Valle, Maura [Radiologia, Gaslini Children Hospital, Genova (Italy); Tagliafico, Alberto [Radiologia, National Institute for Cancer Research, Genoa (Italy)

2012-12-15

164

Hip ultrasound  

International Nuclear Information System (INIS)

In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up.

165

Hip ultrasound.  

Science.gov (United States)

In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up. PMID:21571471

Martinoli, Carlo; Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa; Valle, Maura; Tagliafico, Alberto

2012-12-01

166

Hip Replacement  

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Full Text Available ... overweight patients, losing weight may help relieve the stress on the hip joint. If an operation is ... anterior approach requires a smaller incision and less post operative precautions. Your surgeon will discuss with you ...

167

Hip Revision  

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Full Text Available ... re going to initially look at Scott's preoperative x-rays and just kind of describe the situation ... up to that time. Here's Scott's initial preoperative x-ray, where we see a hybrid hip arthroplasty ...

168

Capsular replacement with synthetic mesh: effectiveness in preventing postoperative dislocation after wide resection of proximal femoral tumors and prosthetic reconstruction.  

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We describe a surgical technique for replacing the hip joint capsule using synthetic mesh after oncological resections of the proximal femur that resulted in gross intraoperative instability of the prosthetic reconstruction. The results of its use in 13 patients, 6 of whom also had pelvic resections, are described. These patients were selected from a total group of 88 patients undergoing proximal femoral replacement, 75 of whom did not require capsular replacement (none of these 75 patients have experienced dislocation). In the group requiring capsular reconstruction, 1 of 4 patients with bipolar hemiarthroplasty and 4 of 9 patients with total hip replacements experienced dislocation after operation. Of the dislocated total hip replacements, 1 remains chronically dislocated, and 3 were successfully stabilized by open reduction with further capsular augmentation. Given that the resections involved removal of most of the soft tissues stabilizing the hip joint, we believe that the technique of capsular reconstruction is useful in this difficult group of patients. PMID:9880176

Masterson, E L; Ferracini, R; Griffin, A M; Wunder, J S; Bell, R S

1998-12-01

169

Congenital insensitivity to pain with anhidrosis (CIPA): the spectrum of radiological findings  

International Nuclear Information System (INIS)

Background: Congenital insensitivity to pain with anhidrosis (CIPA) is an exceedingly rare, hereditary, sensory autonomic neuropathy (HSAN). Aim: To evaluate the various skeletal manifestations and cranial CT features in children affected by CIPA. Materials and methods: In the semidesert area of the Negev, the Bedouin tribes constitute a closed society where consanguineous marriages are the custom. This has resulted in a group of 20 children being affected by this rare autosomal recessive HSAN. The skeletal surveys and CT scans of these 20 Bedouin patients, 12 girls and 8 boys, ages ranging between 1 month and 8 years, were retrospectively analysed. Cranial CT scans were performed in ten children because of neonatal hypotonia and psychomotor retardation. The skeletal findings were classified as follows: fractures, joint deformities, joint dislocations, osteomyelitis, avascular necrosis and acro-osteolysis. Results: All 20 patients had fractures of the extremities and acro-osteolysis of the fingers. Six had joint deformities. Three children had recurrent hip joint dislocations and another three had avascular necrosis. Ten patients presented with osteomyelitis of the limbs, acetabulum and scapula. The cranial CT scans disclosed mild brain volume loss with some ventriculomegaly. Conclusions: CIPA is a severe autosomal recessive condition that leads to self-mutilation early in life and to fractures, osteomyelitis and limb amputation in older children. Mental retardation is common. Death from hyperpyrexia occurs in almost 20 % of patients in the first 3 years of life. (orig.)

170

Congenital insensitivity to pain with anhidrosis (CIPA): the spectrum of radiological findings  

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Background: Congenital insensitivity to pain with anhidrosis (CIPA) is an exceedingly rare, hereditary, sensory autonomic neuropathy (HSAN). Aim: To evaluate the various skeletal manifestations and cranial CT features in children affected by CIPA. Materials and methods: In the semidesert area of the Negev, the Bedouin tribes constitute a closed society where consanguineous marriages are the custom. This has resulted in a group of 20 children being affected by this rare autosomal recessive HSAN. The skeletal surveys and CT scans of these 20 Bedouin patients, 12 girls and 8 boys, ages ranging between 1 month and 8 years, were retrospectively analysed. Cranial CT scans were performed in ten children because of neonatal hypotonia and psychomotor retardation. The skeletal findings were classified as follows: fractures, joint deformities, joint dislocations, osteomyelitis, avascular necrosis and acro-osteolysis. Results: All 20 patients had fractures of the extremities and acro-osteolysis of the fingers. Six had joint deformities. Three children had recurrent hip joint dislocations and another three had avascular necrosis. Ten patients presented with osteomyelitis of the limbs, acetabulum and scapula. The cranial CT scans disclosed mild brain volume loss with some ventriculomegaly. Conclusions: CIPA is a severe autosomal recessive condition that leads to self-mutilation early in life and to fractures, osteomyelitis and limb amputation in older children. Mental retardation is common. Death from hyperpyrexia occurs in almost 20 % of patients in the first 3 years of life. (orig.)

Schulman, H.; Tsodikow, V.; Hertzanu, Y. [Dept. of Radiology, Soroka University Medical Centre, Beer-Sheva (Israel); Einhorn, M.; Levy, Y.; Shorer, Z. [Dept. of Pediatrics, Soroka University Medical Centre, Beer-Sheva (Israel)

2001-10-01

171

Vascular injuries during total hip revision  

International Nuclear Information System (INIS)

Although most patients undergoing a revision total hip replacement (THR) will have an uneventful procedure, in others the potential of serous vascular injuries is real. Migrating prosthesis or excessive cement may be in compromising positions adjacent or adherent to vessels and pose a particular danger at surgery with inadvertent lacerations of vessels such as the internal and external iliac arteries. In out study of 20 patients with THR, CT with two-dimensional reconstructions is used to define vessel position. In eight of these patients, the hip prosthesis or displaced cement lies within 5 mm of major vessels. In patients with dislocation of the acetabular cup, the potential of vascular injury is highest

172

Dislocations in icosahedral quasicrystals.  

Science.gov (United States)

Dislocations in quasicrystals, as a direct result of the lack of translational symmetry in these materials, possess various salient features. The Burgers vector of a dislocation in an icosahedral quasicrystal is a 6-dimensional vector, which reflects the fact that the dislocation, besides the phonon-type strain field analogous to dislocations in ordinary crystals, is associated inseparably with a further type of defect, the phasons. Phasons are critically involved in the formation and motion of dislocations in quasicrystals and govern the macroscopic plastic behaviour of these materials. In this article the properties of dislocations in icosahedral quasicrystals are comprehensively reviewed, starting from a continuum-mechanical description, via core-structure simulation, to their full experimental characterization. The experimental results presented address the icosahedral phases in the well explored systems Al-Pd-Mn and Zn-Mg-Dy. PMID:22760204

Feuerbacher, Michael

2012-10-21

173

The Dislocation Bias  

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Bias factors for dislocations quantify the preferential diffusion of self-interstitials relative to the diffusion of vacancies to dislocations. These parameters are essential for rate theory computer codes that model nucleation and growth of voids, helium bubbles, dislocation loops, and the evolution of microstructures in materials subject to high dose irradiations. Compact formulae for these factors are derived and the accuracy of several approximations is explored.

Wolfer, W. G.

2007-10-01

174

Hip Replacement  

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Full Text Available ... can result in severe pain and may even lead to the inability to walk. Hip arthritis can result from chronic inflammation of the joint or may be caused by a previous injury. The pain may interfere with normal work and ...

175

Hip Replacement  

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Full Text Available ... The following organs in the thigh and hip area are close to the surgical area and may be damaged: • Arteries and veins going ... in helping decrease your pain and improve your quality of life. This operation is safe, with good ...

176

Hip Revision  

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Full Text Available ... With axle, I'm not aware of any fracture that's occurred with this type of junction. What my point is, it's a Morris taper. And we use a Morris taper in every hip we do at the head/neck junction. I ...

177

Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty  

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Full Text Available Background: The purpose of this study was to assess the clinical outcome and complicationsof megaprostheses for massive proximal femoral bone loss after failedtotal hip arthroplasty.Methods: Between June 1997 and December 2002, 12 patients (12 hips with massiveproximal femoral deficiencies had reconstruction of the hip using proximalfemoral megaprostheses. The average age of the patients was 59 years (range25 to 75.Results: At an average of 5.7 years (range 3.3 to 9 after surgery, eight patients (67%had a satisfactory result, one had fair and three had poor results. The complicationsincluded dislocation in 5 (42%, deep infection in 4 (33%, ectopicossification in 1 (8%, leg shortening > 3 cm in 2 (16.7%, displacement ofthe greater trochanter in 3 (25% and aseptic loosening of the megaprosthesisin 1 (8%. The early dislocation rate was 75% but this was subsequentlyreduced to 14% in the later period after use of an abduction brace postoperatively.The average Harris hip score of the 12 patients preoperatively was 30points (range 16-42. The average Harris hip score of the 9 patients with aretained megaprosthesis was 83 points (range 68 to 92.Conclusion: Patients with a failed total hip arthroplasty and massive proximal femoralbone loss can be salvaged with a proximal femoral megaprosthesis if there isno other alternative. However, this procedure is technically demanding andhas a high rate of complications. The routine use of an abduction brace postoperativelyis advised to reduce the dislocation rate.

Shu-Tai Shih

2007-02-01

178

Congenital duplication.  

Science.gov (United States)

Almost all types of congenital duplication described in humans have been observed in food animals, and a number are illustrated in this article. Congenital duplications, especially conjoined symmetric twins, are relatively common defects in cattle. The incidence is less in sheep and in hogs, and they appear to be rare in goats. In cattle, cranial duplication is predominant; this is in contrast to caudal duplication in sheep and hogs. These differences among species are interesting and may explain why congenital duplications appear more frequently in cattle than in other domestic animals. Based on the number of eyes and ears, classification criteria for cranial duplications are proposed. The cause of congenital duplications is not known. PMID:8457924

Hiraga, T; Dennis, S M

1993-03-01

179

Congenital toxoplasmosis  

Science.gov (United States)

Congenital toxoplasmosis is a group of symptoms that occur when an unborn baby (fetus) is infected with the parasite ... Toxoplasmosis infection can be passed to a developing baby if the mother becomes infected while pregnant. The ...

180

Congenital Leukemia  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital leukemia is a rare disease that can manifest soon after birth. Cutaneous involvement consistsof red, brown or purple papules or nodules and purpura. We present a case of congenital myelomonblasticleukemia in a seven week old infant who had petechiae and subcutaneous nodules. Diagnosis was establishedby the presence of leukemic cells in bone marrow and involved skin along with cytochemical characterizationof these cells.

Rupali Bargotra , Jyotsna Suri, Yudhvir Gupta

2010-10-01

 
 
 
 
181

[Congenital diarrhoea].  

Science.gov (United States)

Congenital diarrhoea of heterogenic etiology is a rare cause of chronic diarrhoea. Characteristic features are: onset in the first weeks of life, life-threatening severe dehydratation and electrolyte disorders leading to a necessity of long-term parenteral nutrition. The clinical onset may be delayed and the degree of diarrhoea may be modest, making the diagnosis difficult. The main causes of congenital diarrhoea such as intestine electrolytes, carbohydrates, lipid and protein transport disorders and congenital enzymatic deficiencies, enterocyte polarization disorders, hormonal, immunological, metabolic, genetic and congenital anatomic disorders are presented in the paper. Some of them, such as: microvillus inclusion disease, tufting enteropathy, intestinal anedocrynosis, IPEX syndrome (immunodysregulation polyendocrinopathy enteropathy X-linked syndrome) have been described recently. One of the basic investigations, when congenital diarrhea is suspected, is general examination of the stool, its electrolyte concentration and serum electrolytes and blood gas analysis. Often, small bowel biopsy with histological examination (with the use of electronic microscopy and PAS staining) is indicated. In some cases molecular examination is possible and indicated. In differential diagnosis other, more frequent causes of chronic diarrhea of infancy, have to be excluded. In most of the cases of congenital diarrhoea there is no casual treatment available - usually long-term parenteral nutrition is necessary. PMID:22516705

Buda, Piotr; Friedman-Gruszczy?ska, Joanna; Ksi??yk, Janusz

2011-01-01

182

Hip Replacement - Physical Therapy  

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Full Text Available ... Hip Replacement – Physical Therapy Reference Summary Introduction Hip replacement surgery is a very successful and safe operation. Long-term success mostly depends on the patient, though. The muscles around the hip joint must ...

183

Hip Replacement - Physical Therapy  

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Full Text Available ... the patient, though. The muscles around the hip joint must be strengthened after surgery and the patient ... out of a new hip. Anatomy The hip joint joins the pelvis to the femur, or thighbone. ...

184

Hip Replacement - Physical Therapy  

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Full Text Available ... new hip joint. Start slow and progress gradually. Set achievable goals for yourself and discuss them with ... your hip joint more flexible. Hip Extension – Gluteal Set Lie down flat and squeeze your buttock muscles ...

185

Hip Replacement - Physical Therapy  

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Full Text Available ... and make your hip joint more flexible. Hip Extension – Gluteal Set Lie down flat and squeeze your ... 1-2 seconds; repeat 10-20 times. Hip Extension – Bridging While lying down with knees bent and ...

186

Bursitis of the Hip  

Science.gov (United States)

... I prevent hip bursitis? You can avoid getting bursitis by not putting too much strain on your hips. Avoid activities that are especially difficult or painful, and take breaks to rest your hips. When you exercise, remember to warm ...

187

Hip Replacement - Physical Therapy  

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Full Text Available ... hip area after a hip replacement. It is best to strengthen ALL of the muscles of the legs. ... the chair when you sit are helpful practices that keep the hip from bending too far. ...

188

Hip Replacement - Physical Therapy  

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Full Text Available ... it moves in the hip socket. Unlike the knee joint, the hip joint moves in many directions. ... for 5-10 seconds; repeat 15-20 times. Knee & Hip Flexion While lying down flat, slide one ...

189

Clinical Outcomes of Total Hip Arthroplasty in Patients with Ankylosed Hip  

Science.gov (United States)

Background: Hip ankylosis includes the limitation of hip motion and hip arthroplasty is the recommended treatment. This study aimed to evaluate the clinical and radiographic outcomes in the treatment of ankylosis of the hip joint by the Harris Hip Score (HHS). Methods: This interventional study was performed on patients with ankylosis in one or both hip joints, who were referred to Sina Hospital, Tehran, Iran from 2011-13. Electromyogram and nerve conduction studies were taken from the hip abductor muscles before surgery and HHS was calculated. Type of surgery and prosthesis, osteotomy required for the neck and trochanteric region of the femur, periprosthetic fracture and the need to restore the acetabulum were studied in the patients. Postoperative complications such as infection and dislocation at 3, 6 and 12 months after surgery were examined and then the HHS was calculated. Results: Six patients were excluded after six month and two patients were excluded after 12 month due to surgery complications. The mean HHS of patients before surgery was 48.53±6.28 and it progressed to 88.22±3.78 after 12 month (Pjoint motion, especially in the long-term follow-up. However, good results should be considered in the absence of pre- and post-operative complications.

Siavashi, Babak; Mohseni, Nima; Zehtab, Mohammad J; Ramim, Tayeb

2014-01-01

190

Relative head size increase using an anatomic dual mobility hip prosthesis compared to traditional hip arthroplasty: impact on hip stability.  

Science.gov (United States)

Smaller head sizes and head/cup ratios make cups smaller than 50mm and larger than 58mm, more prone to dislocation. Using computer modeling, we compared average head sizes and posterior horizontal dislocation distance (PHDD) in two 78-patient matched cohorts. Cup sizes were small (?50mm) or large (?58mm). The control cohort had conventional fixed bearing prostheses, while the experimental cohort had anatomical dual mobility (ADM) hip prostheses. ADM cups have larger average head sizes and PHDD than traditional fixed bearing prostheses by 11.5mm and 80% for cups ?50mm, and 16.3mm and 90% for cups ?58mm. Larger head sizes and increased head/cup ratio may allow the ADM prosthesis to reduce the incidence of dislocation. PMID:24997653

D'Apuzzo, Michele R; Nevelos, Jim; Yeager, Alyssa; Westrich, Geoffrey H

2014-09-01

191

Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture  

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Full Text Available Abstract Background Hip dislocation after arthroplasty for femoral neck fractures remains a serious complication. The aim of our study was to investigate the dislocation rate in acute femoral neck fracture patients operated with a posterior approach with cemented conventional or dual articulation acetabular components. Methods We compared the dislocation rate in 56 consecutive patients operated with conventional (single mobility cemented acetabular components to that in 42 consecutive patients operated with dual articulation acetabular components. All the patients were operated via posterior approach and were followed up to one year postoperatively. Results There were 8 dislocations in the 56 patients having conventional components as compared to no dislocations in those 42 having dual articulation components (p = 0.01. The groups were similar with respect to age and gender distribution. Conclusions We conclude that the use of a cemented dual articulation acetabular component significantly reduces the dislocation rates in femoral neck fracture patients operated via posterior approach.

Robertsson Otto

2010-08-01

192

Dislocation of preformed antibiotic-loaded cement spacers (Spacer-G): etiological factors and clinical prognosis.  

Science.gov (United States)

This study assesses the factors associated with the dislocation of the Spacer-G and its clinical prognosis. Seventy-four spacers were reviewed. Acetabular bone defects, proximal femoral cementation of the spacer and its relationship to the size of the head spacer were not associated with dislocation. The only variable that it was possible to associate with dislocation was when the previous stem, prior to the spacer placement, was a cemented stem. In patients who experienced a dislocation, infection was not cured during the interim period more frequently than patients who had not experienced a dislocation (P = 0.001) and the final clinical hip evaluation was also worse (P < 0.001). The study concludes that the surgeon should assess different surgical aspects in order to avoid mechanical complications such as dislocation and its consequences. PMID:24269066

Bori, Guillem; García-Oltra, Ester; Soriano, Alex; Rios, José; Gallart, Xavier; Garcia, Sebastian

2014-05-01

193

Evaluation of Surgical Treatment of Developmental Dysplasia of Hip for Avascular Necrosis of Femoral Head in Children  

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Full Text Available Developmental Dysplasia of the Hip (DDH is a common congenital malformation. Avascular necrosis of femoral head is the major complication of both close and open reduction of the dislocated joint. Aim of this study was to determine the incidence and influencing factors in different types of a vascular necrosis of femoral head, following surgical treatment of developmental dysplasia of hip in 1-7 years patients. In this study, 120 patients aged from 1 to 7 years old with DDH who had been undergone open surgery, entered to the study. All of these patients followed up for at least 1 year. Surgery procedures divided to 4 groups: open reduction, open reduction+salter osteotomy, open reduction+femur shortening and open reduction+salter osteotomy+femur shortening. The presence of Avascular Necrosis (AVN had been appraised. 27.5% of surgeries performed on male and 72.5 on female patients. 35.0% of DDH cases were unilateral and remaining was bilateral. 36 patients (30% shows radiologic findings of AVN, although all of them placed at group I of Bucholz-Ogden classification. 40% of group A patients, 25% of group B, 14.3% of group C and 36.4% of group D patients developed this findings. Open reduction of DDH in older children is effective in the management of DDH and if all of the contrivance considered in the surgery, the rate of AVN would be low and mild (at least in short term follow ups.

O.A. Aghdam

2012-01-01

194

Quantitative assessment of bone scintigraphy in the hip joint disease  

International Nuclear Information System (INIS)

Quantitative assessment of bone scintigraphy was performed in fifty-six patients with hip joint disease including femoral neck fracture, aseptic necrosis of the femoral head, traumatic dislocation of the hip, Perthes disease, and transient synovitis of the hip. In the static study, bone scintigraphy was obtained 3 hours after injection of sup(99m)Tc-MDP by gamma camera equipped with a computer and uptake ratios were calculated. In the dynamic study, bone scintigraphy was performed in one, 3 and 5 hours after injection of radionuclide. Femoral head uptake ratio was markedly decreased in osteonecrosis following femoral neck fracture and characteristically increased in aseptic necrosis of the femoral head but prolonged retention of sup(99m)Tc-MDP could be observed. Uptake ratios of epiphysis were decreased in Perthes disease but normal in transient synovitis of the hip. Static and dynamic study of bone scintigraphy may be useful for early diagnosis and treatment in the hip joint disease. (author)

195

Case-control study of congenital malformations and occupational exposure to low-level ionizing radiation  

International Nuclear Information System (INIS)

In a case-control study, the authors investigated the association of parental occupational exposure to low-level external whole-body penetrating ionizing radiation and risk of congenital malformations in their offspring. Cases and controls were ascertained from births in two counties in southeastern Washington State, where the Hanford Site has been a major employer. A unique feature of this study was the linking of quantitative individual measurement of external whole-body penetrating ionizing radiation exposure of employees at the Hanford Site, using personal dosimeters, and the disease outcome, congenital malformations. The study population included 672 malformation cases and 977 matched controls from births occurring from 1957 through 1980. Twelve specific malformation types were analyzed for evidence of association with employment of the parents at Hanford and with occupational exposure to ionizing radiation. Two defects, congenital dislocation of the hip and tracheoesophageal fistula, showed statistically significant associations with employment of the parents at Hanford, but not with parental radiation exposure. Neural tube defects showed a significant association with parental preconception exposure, on the basis of a small number of cases. Eleven other defects, including Down syndrome, for which an association with radiation was considered most likely, showed no evidence of such an association. When all malformations were analyzed as a group, there was no evidere analyzed as a group, there was no evidence of an association with employment of the parents at Hanford, but the relation of parental exposure to radiation before conception was in the positive direction (one-tailed p value between 0.05 and 0.10). Given the number of statistical tests conducted, some or all of the observed positive correlations are likely to represent false positive findings. 30 references

196

Knee in congenital short femur.  

Science.gov (United States)

The abnormalities of the knee associated with congenital short femur (CSF) and proximal femoral focal deficiency (PFFD), have been recognized for many years. The emergence of new and more effective lengthening techniques that can correct major congenital leg length discrepancies has made the abnormalities of the knee much more relevant. Some investigators have reported a high incidence of knee subluxation and dislocation during lengthening procedures in patients with CSF, attributing the incidence to knee anomalies. We assessed knee function in a group of 24 patients with CSF. Detailed evaluation of knee stability showed that not all knees were unstable; even when knees were unstable, the degree of instability was highly variable. No patient complained of knee pain or other knee symptoms. PMID:7670984

Sanpera, I; Fixsen, J A; Sparks, L T; Hill, R A

1995-01-01

197

Dura arhtroplasty of the hip a case report with follow up to 10 years  

International Nuclear Information System (INIS)

Freeze-dried human dura allograft was used to cover the dislocated femoral head of a 9 years old with left hip dislocation. The left hip was dislocated as a consequence of pyogenic arthritis of the hipjoint afterbirth. After medical treatment the child regained his health and began to walk at the age of one year. At the age of 9 years old, limping was clearly obvious with 2.5 cms of limb length discrepancy. The dislocated hip was surgically reduced and the joint was stabilized by Chiari medial displacement osteotomy. The child was kept in a 1 1/2 hip spica for 4 weeks, after which the Yirschner wires were removed. Two years after surgery, the hip joint was mobiled, stable and pain free, leg length discrepancy was 1 cm. Ten years follow up, the child (1 9 years old) becomes a normal developed adult with nearly full range hip motion. The thigh circumference of the affected limb is smaller than the other, leg length discrepancy is 2 cms but he can walk, run and participate in sports. Follow up X-rays show a well located hip with deformed femoral head

198

Imaging of the hip and bony pelvis. Techniques and applications  

Energy Technology Data Exchange (ETDEWEB)

This is a comprehensive textbook on imaging of the bony pelvis and hip joint that provides a detailed description of the techniques and imaging findings relevant to this complex anatomical region. In the first part of the book, the various techniques and procedures employed for imaging the pelvis and hip are discussed in detail. The second part of the book documents the application of these techniques to the diverse clinical problems and diseases encountered. Among the many topics addressed are congenital and developmental disorders including developmental dysplasia of the hip, irritable hip and septic arthritis, Perthes' disease and avascular necrosis, slipped upper femoral epiphysis, bony and soft tissue trauma, arthritis, tumours and hip prostheses. Each chapter is written by an acknowledged expert in the field, and a wealth of illustrative material is included. This book will be of great value to musculoskeletal and general radiologists, orthopaedic surgeons and rheumatologists. (orig.)

Davies, A.M. [Royal Orthopaedic Hospital, Birmingham (United Kingdom). MRI Centre; Johnson, K.J. [Princess of Wales Birmingham Children' s Hospital (United Kingdom); Whitehouse, R.W. (eds.) [Manchester Royal Infirmary (United Kingdom). Dept. of Clinical Radiology

2006-07-01

199

congenital anomalies  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital anomalies in conjunction with intrauterine growth restriction account for 50-60% of fetal mortality. This article describes major birth defects by systems; most can be diagnosed by ultrasound while others cannot. Some anomalies develop later in pregnancy and in some cases sonographic examination may suggest the presence of a nonexistent abnormality. Incidence, etiology and risk factors of congenital malformations are described, as well as the importance and characteristics of prenatal diagnosis and prevention through folic acid supplementation in the diet.

Bernardita Donoso Bernales

2012-10-01

200

Luxatio erecta: Inferior glenohumeral dislocation  

Directory of Open Access Journals (Sweden)

Full Text Available Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form of the otherwise common shoulder dislocation. It accounts for less than 0.5% of all shoulder dislocations. A case involving the inferior dislocation of the shoulder is reported. A brief review of the presentation and management of the condition is described.

Baba Asif

2007-01-01

 
 
 
 
201

Degeneration in dysplastic hips. A computer tomography study  

DEFF Research Database (Denmark)

BACKGROUND: Hip dysplasia is considered pre-osteoarthritic, causing degeneration in young individuals. OBJECTIVE: To determine the pattern of degenerative change in moderate to severely dysplastic hips in young patients. DESIGN AND PATIENTS: One hundred and ninety-three consecutively-referred younger patients with hip pain believed to be caused by hip dysplasia constituted the study cohort. The average age was 35.5 years (range, 15-61 years). They were examined by close-cut transverse pelvic and knee computed tomography and antero-posterior radiographs (CT). We identified 197 hips with moderate to severe dysplasia, and 78 hips with normal morphology in the study cohort, whilst 111 hip joints were borderline dysplastic according to preset definitions. Comparative analyses of anatomy and distribution of degeneration between dysplastic and normal hips in the study cohort were performed. RESULTS: In dysplastic hips the anterior acetabular sector angle was significantly and inversely associated to femoral anteversion (p < 0.001). The center-edge (CE) angle, the acetabular angle (AA), and the acetabular depth ratio (ADR) were significantly interrelated (p < 0.001; correlation coefficients ranging from -0.8 to 0.7). Fifty-one hips were subluxated (24R/27L). There were no cases of complete dislocation. The formation of subchondral cysts or osteophytes in dysplastic hips was significantly associated with reduced minimum joint space width (p ranging from 0.005 to 0.02). However, in 67 hips with acetabular cysts, only 6 hips had minimum joint space widths = 2.0 mm (8.9%) in the coronal plane. In 96 cases with acetabular cysts found in the sagittal plane, 43 cases had minimum joint space widths = 2.0 mm (44.7%). Bony rim detachment at the site of labral insertion was recorded in 30 hips. Twenty-three of these were dysplastic (p = 0.01). CONCLUSIONS: Degeneration was most often found in the anterolateral part of the dysplastic hip joints. Most cysts were located above the transition zone between the bony and the fibrocartilaginous acetabulum, and we found a significantly- increased number of cases with avulsed bony fragments at the antero-lateral labral insertion in dysplastic hips compared to normal hips. It seems likely that the early degenerative process in dysplastic hips originates at the watershed zone between the acetabular labrum and the acetabular cartilage in response to subluxation and femoroacetabular impingement.

Jacobsen, Steffen; RØmer, Lone

2005-01-01

202

Using the Graf method of ultrasound examination to classify hip dysplasia in neonates Using the Graf method of ultrasound examination to classify hip dysplasia in neonates  

Directory of Open Access Journals (Sweden)

Full Text Available Developmental dysplasia of the hip (DDH is one of the most common congenital orthopedic anomalies. Ultrasound examination employing the Graf method is used to diagnose DDH. We conducted a retrospective cross?sectional study of 222 neonatal patients (140 females and 82 males submitted to ultrasound examination of the right and left hips between January of 2009 and May of 2011. The mean age was 5.0 days. The patients were grouped by laterality, mean alpha (? and beta (? angles (in degrees, and hip type (as determinedby the Graf classification. The data collected were statistically correlated.Mean ? angle values were higher in males than in females, as well as being higher for right hips than for left hips (p in both genders and on both sides, having been found in 82.32% of the examinations of males and in 71.09% of those of females. The right hip was classified as type Ia in 78.38% of the examinations, and the left hip was classified as type Ia in 72.07%. Type IIa hips (i.e., immature hips were found in 12.8% of the examinations of males and in 20% of those of females. The right hip was classified as type IIa in 13.96% of the examinations, and the left hip was classified as type IIa in 20.72%. The remaining hip types were less common. We emphasize the importance of ultrasound as a standard methodof screening for DDH.nulo

Bruno de Castro Paixão Jacobino

2012-08-01

203

[Congenital epulis].  

Science.gov (United States)

Congenital epulis or gingival granular cell tumor is an uncommon benign tumor, usually diagnosed at birth as a pediculated maxilar gingival mass. Although some cases of spontaneous regression have been described, most of the lesions are surgically removed with excelent prognosis and cosmetic final result. The authors describe a case report as well as a short revision on this pathology. PMID:19323084

Braga-Tavares, H; Santos, H; M-Pinto, I; Ramos, M; de Sousa, P

2009-01-01

204

Total hip replacement in patients with Down syndrome and degenerative osteoarthritis of the hip.  

Science.gov (United States)

Dysplasia of the hip, hypotonia, osteopenia, ligamentous laxity, and mental retardation increase the complexity of performing and managing patients with Down syndrome who require total hip replacement (THR). We identified 14 patients (six males, eight females, 21 hips) with Down syndrome and degenerative disease of the hip who underwent THR, with a minimum follow-up of two years from 1969 to 2009. In seven patients, bilateral THRs were performed while the rest had unilateral THRs. The mean clinical follow-up was 5.8 years (standard deviation (sd) 4.7; 2 to 17). The mean Harris hip score was 37.9 points (sd 7.8) pre-operatively and increased to 89.2 (sd 12.3) at final follow-up (p = 1x10(-9)). No patient suffered a post-operative dislocation. In three patients, four hips had revision THR for aseptic loosening at a mean follow-up of 7.7 years (sd 6.3; 3 to 17). This rate of revision THR was higher than expected. Our patients with Down syndrome benefitted clinically from THR at mid-term follow-up. Cite this article: Bone Joint J 2014;96-B:1455-8. PMID:25371456

Amanatullah, D F; Rachala, S R; Trousdale, R T; Sierra, R J

2014-11-01

205

Is Cup Positioning Challenged in Hips Previously Treated With Periacetabular Osteotomy?  

DEFF Research Database (Denmark)

After periacetabular osteotomy (PAO), some patients develop osteoarthritis with need of a total hip arthroplasty (THA). We evaluated the outcome of THA following PAO and explored factors associated with inferior cup position and increased polyethylene wear. Follow-up were performed 4 to 10years after THA in 34 patients (38 hips) with previous PAO. Computer analysis evaluated cup position and wear rates. No patient had dislocations or revision surgery. Median scores were: Harris hip 96, Oxford hip 38 and WOMAC 78. Mean cup anteversion and abduction angles were 22(o) (range 7°-43°) and 45° (range 28°-65°). Outliers of cup abduction were associated with persisting dysplasia (CE

Hartig-Andreasen, Charlotte; Stilling, Maiken

2013-01-01

206

Effective dislocation lines in continuously dislocated crystals II. Congruences of effective dislocations  

CERN Document Server

The notion of a congruence of effective dislocation lines endowed with the nonvanishing local Burgers vector is introduced. Particularly, the class of congruences of principal Volterra-type effective dislocation lines associated with the dislocation densities (tensorial as well as scalar) is distinguished in order to investigate the geometry of continuized defective crystals in terms of these densities. It is shown that effective dislocation lines can be endowed with the dislocation line tension and with a finite self-energy.

Trzesowski, Andrzej

2007-01-01

207

Total hip arthroplasty in developmental dysplasia of the hip: Review of anatomy, techniques and outcomes  

Directory of Open Access Journals (Sweden)

Full Text Available Total hip arthroplasty (THA in developmental dysplasia of the hip (DDH presents many challenges to the reconstructive surgeon. The complex femoral and acetabular anatomy makes standard reconstruction technically challenging. Acetabular coverage can be improved by medialization of the component or augmentation of the deficient areas with bone graft. Femoral shortening osteotomies are considered in cases of severe dysplasia and frankly dislocated hips. Each patient’s unique anatomy dictates what options of reconstruction are available. The functional outcomes of THA in DDH are generally excellent, though higher rates of mechanical failure have been reported in this group. This article reviews the anatomy, classification, technical considerations, and outcomes of THA in patients with DDH.

Scott Yang

2012-01-01

208

Dislocations Jam At Any Density  

CERN Document Server

Crystalline materials deform in an intermittent way via dislocation-slip avalanches. Below a critical stress, the dislocations are jammed within their glide plane due to long-range elastic interactions and the material exhibits plastic response, while above this critical stress the dislocations are mobile (the unjammed phase) and the material fails. We use dislocation dynamics and scaling arguments in two dimensions to show that the critical stress grows with the square root of the dislocation density. Consequently, dislocations jam at any density, in contrast to granular materials, which only jam below a critical density.

Tsekenis, Georgios; Dahmen, Karin A

2011-01-01

209

Dislocation Dynamics During Plastic Deformation  

CERN Document Server

The book gives an overview of the dynamic behavior of dislocations and its relation to plastic deformation. It introduces the general properties of dislocations and treats the dislocation dynamics in some detail. Finally, examples are described of the processes in different classes of materials, i.e. semiconductors, ceramics, metals, intermetallic materials, and quasicrystals. The processes are illustrated by many electron micrographs of dislocations under stress and by video clips taken during in situ straining experiments in a high-voltage electron microscope showing moving dislocations. Thus, the users of the book also obtain an immediate impression and understanding of dislocation dynamics.

Messerschmidt, Ulrich

2010-01-01

210

Radiographic observation of congenital diaphragmatic hernia  

International Nuclear Information System (INIS)

Five cases of congenital diaphragmatic hernia. Case 1: A female infant, birth weight 2.25 kg, Apgar score 10, normal delivery at 11:33 P.M. on Feb.8, 1972. Lt side congenital diaphragmatic hernia. Case 2: A female infant, birth weight 1.48 kg, Apgar score 5, normal delivery at 11:20 A.M. on Oct.14, 1972. Lt. side congenital diaphragmatic hernia. This infant was twin. this infant's mother was toxemia. Case 3; A 33 years old women was admitted to the our hospital because of Lt.hip joint pain without other symptoms. Date of admission: Jan. 8, 1973. Rt side congenital diaphragmentic hernia. Case 4: A 4 month infant male was admitted to the our hospital because of vomiting, dyspnea and abdominal pain. He had cyanosis intermittently after one month ago. This infant was normal delivered. The family history was not contributory. Date of admission: This infant was normal delivered. The family history was not contributory. Date of admission: Aug. 30, 1971. Rt side congenital diaphragmatic hernia. Case 5: A 13 years old girl was admitted to our hospital because of general weakness without other symptoms. This patient was normal delivered. The family history was not contributory. Date of admission: March. 15, 1973. Lt. side congenital diaphragmentic hernia

211

Radiographic observation of congenital diaphragmatic hernia  

Energy Technology Data Exchange (ETDEWEB)

Five cases of congenital diaphragmatic hernia. Case 1: A female infant, birth weight 2.25 kg, Apgar score 10, normal delivery at 11:33 P.M. on Feb.8, 1972. Lt side congenital diaphragmatic hernia. Case 2: A female infant, birth weight 1.48 kg, Apgar score 5, normal delivery at 11:20 A.M. on Oct.14, 1972. Lt. side congenital diaphragmatic hernia. This infant was twin. this infant's mother was toxemia. Case 3; A 33 years old women was admitted to the our hospital because of Lt.hip joint pain without other symptoms. Date of admission: Jan. 8, 1973. Rt side congenital diaphragmentic hernia. Case 4: A 4 month infant male was admitted to the our hospital because of vomiting, dyspnea and abdominal pain. He had cyanosis intermittently after one month ago. This infant was normal delivered. The family history was not contributory. Date of admission: This infant was normal delivered. The family history was not contributory. Date of admission: Aug. 30, 1971. Rt side congenital diaphragmatic hernia. Case 5: A 13 years old girl was admitted to our hospital because of general weakness without other symptoms. This patient was normal delivered. The family history was not contributory. Date of admission: March. 15, 1973. Lt. side congenital diaphragmentic hernia.

Rhee, Chung Sik [Ewha Women' s University College of Medicine, Seoul (Korea, Republic of)

1973-12-15

212

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... to help thousands of people suffering from hip pain. A small-incision total hip arthroplasty and arthroscopic hip femoroacetabular impingement resection. Hip pain is not limited to senior citizens. It can ...

213

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... increasingly being recognized as a cause of hip osteoarthritis. Arthroscopy of the hip is a mainstream surgical ... hip replacement because he has a disease called osteoarthritis, which is essentially a destruction of the hip ...

214

Complications after total hip replacement  

International Nuclear Information System (INIS)

Complications seen after long-term follow-up examinations of total hip replacement should be treated immediately and completely. In the past decade a considerable increase in revisions has been noted. Radiographic assessment may be regarded as an effective means in diagnosing prosthetic complications from the surgeon's point of view. Examples are given. The difficulties in radiographic assessment of complications after cementless implanation or cemented prostheses without contrast media are mentioned. Prosthesis-related complications, such as mechanical loosening, infection with and without loosening, fatigue fractures and wear, fractures of the femur or pelvis, dislocations and surgical failures, are illustrated, as are clinical courses with gross loss of bone stock after repeated surgery and delayed revisions. Complications not related to the prosthesis such as periarticular ossification, muscle deficiencies, and nervous and vascular lesions are also explained using examples. (orig.)

215

Total hip arthroplasty for arthrodesed hips.  

Directory of Open Access Journals (Sweden)

Full Text Available The benefits of converting an ankylosed or arthrodesed hip to total hip arthroplasty have been reported in the literature as have the technical difficulties associated with this procedure. This review, however, outlines the experience of a single surgeon (WJMB at a single institution using uncemented prostheses. Between November 1991 and June 1996, 5 arthrodesed hips underwent uncemented total hip arthroplasty in 4 males and 1 female. Clinical and radiological follow-up review was for at least three years in all patients. In general, patients were satisfied with the outcome of their surgery with Harris Hip scores improving from an average of 62 preoperatively to an average of 72 postoperatively. The surgical outcome in these difficult cases was not as satisfactory as for routine total hip arthroplasty. Meticulous preoperative planning is required to aim toward leg length restoration and restoration of the abductor moment arm. A modular prosthesis allows versatility at surgery.

Howard MB

2002-06-01

216

Congenital CMV Infection  

Science.gov (United States)

... CMV) and Congenital CMV Infection Share Compartir Congenital CMV Infection Español: Infección congénita por CMV On this ... Top of Page Treatment for Babies Born with CMV If your baby is diagnosed with congenital CMV ...

217

Can pelvic tilting be ignored in total hip arthroplasty?  

Science.gov (United States)

INTRODUCTION The orientation of acetabular component is influenced by pelvic tilt, body position and individual variation in pelvic parameters. Most post-operative adverse events may be attributed to malposition of the component in the functional position. There is evidence that orientation of the pelvis changes from the supine to standing position. Authors report a case of recurrent dislocation after total hip arthroplasty due to excessive pelvic tilting. PRESENTATION OF CASE A 69-year old female with coxarthrosis had undergone total hip replacement with recurrent dislocation of the hip on bearing weight in spite of using constrained acetabular component. DISCUSSION Our case report substantiates the influence of pelvic tilt, incurred by a sagittal deformity of spine, on dynamic orientation of the acetabular cup which was positioned in accordance with the anatomic landmarks alone. If the reference is only bony architecture and dynamic positions of the pelvis are not taken into account, improper functional orientation of the acetabular cup can result in sitting and standing positions. These can induce instability even in anatomically appropriately oriented acetabular component. CONCLUSION The sagittal position of pelvis is a key factor in impingement and dislocation after total hip arthroplasty. Pelvic tilting affects the position of acetabular component in the sagittal plane of the body as compared with its anatomic position in the pelvis. We suggest a preoperative lateral view of spine-pelvis, in upright and supine position for evaluation of a corrective adaptation of the acetabular cup accordingly with pelvic balance. PMID:25128730

Shon, Won Yong; Sharma, Vivek; keon, Oh jong; Moon, Jun Gyu; Suh, Dong Hun

2014-01-01

218

Behavior of dislocations in silicon  

Energy Technology Data Exchange (ETDEWEB)

A review is given of dynamic behavior of dislocations in silicon on the basis of works of the author`s group. Topics taken up are generation, motion and multiplication of dislocations as affected by oxygen impurities and immobilization of dislocations due to impurity reaction.

Sumino, Koji [Nippon Steel Corp., Chiba Prefecture (Japan)

1995-08-01

219

Neglected irreducible posterolateral knee dislocation  

Directory of Open Access Journals (Sweden)

Full Text Available Knee dislocations are rare injuries. Posterolateral knee dislocations are only a small subset of them. There is a paucity of literature regarding the management of such neglected cases. We report here, a case of neglected irreducible posterolateral knee dislocation treated with open reduction and isolated posterior cruciate ligament reconstruction followed by gradual rehabilitation with good outcome at 3 years followup.

Saini Raghav

2010-01-01

220

Effective dislocation lines in continuously dislocated crystals. III. Kinematics  

CERN Document Server

A class of congruences of principal Volterra-type effective dislocation lines associated with a dislocation density tensor is distinguished in order to investigate the kinematics of continuized defective crystals in terms of their dislocation densities (tensorial as well as scalar). Moreover, it shown, basing oneself on a formula defining the mean curvature of glide surfaces for principal edge effective dislocation lines, that the considered kinematics of continuized defective crystals is consistent with some relations appearing in the physical theory of plasticity (e.g. with the Orowan-type kinematic relations and with the treatment of shear stresses as driving stresses of moving dislocations).

Trzesowski, Andrzej

2007-01-01

 
 
 
 
221

On the permanent hip-stabilizing effect of atmospheric pressure.  

Science.gov (United States)

Hip joint dislocations related to total hip arthroplasty (THA) are a common complication especially in the early postoperative course. The surgical approach, the alignment of the prosthetic components, the range of motion and the muscle tone are known factors influencing the risk of dislocation. A further factor that is discussed until today is atmospheric pressure which is not taken into account in the present THA concepts. The aim of this study was to investigate the impact of atmospheric pressure on hip joint stability. Five joint models (Ø 28-44 mm), consisting of THA components were hermetically sealed with a rubber capsule, filled with a defined amount of fluid and exposed to varying ambient pressure. Displacement and pressure sensors were used to record the extent of dislocation related to intraarticular and ambient pressure. In 200 experiments spontaneous dislocations of the different sized joint models were reliably observed once the ambient pressure was lower than 6.0 kPa. Increasing the ambient pressure above 6.0 kPa immediately and persistently reduced the joint models until the ambient pressure was lowered again. Displacement always exceeded half the diameter of the joint model and was independent of gravity effects. This experimental study gives strong evidence that the hip joint is permanently stabilized by atmospheric pressure, confirming the theories of Weber and Weber (1836). On basis of these findings the use of larger prosthetic heads, capsular repair and the deployment of an intracapsular Redon drain are proposed to substantially decrease the risk of dislocation after THA. PMID:24938930

Prietzel, Torsten; Hammer, Niels; Schleifenbaum, Stefan; Kaßebaum, Eric; Farag, Mohamed; von Salis-Soglio, Georg

2014-08-22

222

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available X-Plain Hip Replacement – Physical Therapy Reference Summary Introduction Hip replacement surgery is a very successful and safe operation. Long-term success mostly depends on the patient, though. The muscles around ...

223

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available X-Plain Hip Replacement – Physical Therapy Reference Summary Introduction Hip replacement surgery is a very successful and safe operation. Long-term success mostly depends on the patient, though. The ...

224

Taper Hip Prosthesis  

Medline Plus

Full Text Available ... the minimally invasive anterial lateral approach to the right hip in this gentleman. We're going to ... the anterior superior at the spine of the right hip. And at this point we'll begin. ...

225

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... new hip. Anatomy The hip joint joins the pelvis to the femur, or thighbone. It is similar ... to move, it is the muscles of the pelvis and legs that make moving possible. There are ...

226

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... advice or help at any time! Exercises This section will explain some exercises that will help strengthen your leg and make your hip joint more flexible. Hip Extension – Gluteal Set Lie down ...

227

Taper Hip Prosthesis  

Medline Plus

Full Text Available ... OR Live" Webcast on the Kinectiv Total Hip System. At this time, let’s join Dr. Maltry in ... going to be installing the Zimmer Kinectiv Hip System today and we'll walk you through that. ...

228

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... running • going up and down stairs Socket Anchor • sitting down Artificial Hips Artificial hips have improved significantly ... between the legs to prevent them from getting too close together. This document is for informational purposes ...

229

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... walking • running • going up and down stairs Socket Anchor • sitting down Artificial Hips Artificial hips have improved ... anchored in the pelvis 2. a ball-type anchor that looks like a deformed ice cream cone ...

230

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... more flexible. Hip Extension – Gluteal Set Lie down flat and squeeze your buttock muscles together without holding ... 20 times. Knee & Hip Flexion While lying down flat, slide one heel at a time towards your ...

231

Strategies of hip management in neuromuscular disorders: Duchenne Muscular Dystrophy, Spinal Muscular Atrophy, Charcot-Marie-Tooth Disease and Arthrogryposis Multiplex Congenita.  

Science.gov (United States)

Joint contractures, subluxation and dislocation are common problem in children with neuromuscular disorders. Medical, surgical and rehabilitative approaches can be used to maintain patient function and comfort. Contracture release, hip dysplasia correction and procedures to address or prevent hip subluxation or dislocation, are not always necessary since patients can be asymptomatic and surgical treatment will not always be successful in maintaining a reduced hip. In fact, controversy surrounds the management of hip disorder in children with Duchenne Muscular Dystrophy, Spinal Muscular Atrophy, Charcot-Marie-Tooth Disease and Arthrogryposis Multiplex Congenita. Patients with neuromuscular disorders also frequently develop a progressive scoliosis with pelvic obliquity which may affect sitting balance and become painful. Most subluxations and dislocations have the tendency to occur on the high side of a tilted pelvis. Spinal stabilisation is sometimes necessary to improve the pelvic tilt and to prevent further increase. The present article provides an overview of the current strategies of hip management in neuromuscular disorders. PMID:19306247

Canavese, F; Sussman, M D

2009-01-01

232

Congenital epulis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Congenital epulis of the newborn is a very rare and unique tumor first described in 1871 by Neuman. It has a female predilection. It is a tumor with no tendency to recur after excision. The histogenesis of the lesion is unknown, but it is believed to be of mesenchymal origin. We report a 2-day-old female with tumor mass on the anterior mandibular alveolar ridge, which demonstrated immunoreactivity for vimentin, S-100 and neuron-specific enolase; thus, suggesting a similar histogenesis with gr...

Adeyemi Bukola; Oluwasola Abideen; Adisa Akinyele

2010-01-01

233

Congenital epulis  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital epulis of the newborn is a very rare and unique tumor first described in 1871 by Neuman. It has a female predilection. It is a tumor with no tendency to recur after excision. The histogenesis of the lesion is unknown, but it is believed to be of mesenchymal origin. We report a 2-day-old female with tumor mass on the anterior mandibular alveolar ridge, which demonstrated immunoreactivity for vimentin, S-100 and neuron-specific enolase; thus, suggesting a similar histogenesis with granular cell tumor.

Adeyemi Bukola

2010-01-01

234

Inflatable hip protectors  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Falls and fall-related injuries are crucial health problems among older adults, and hip protectors are designed to reduce fall-related injuries in this population. This thesis explores the technology of inflatable hip protectors with the aim to provide insight for future designers and manufacturers of these devices. The thesis comprises two studies. In the first, a mathematical model of an inflatable hip protector is developed. For system identification, a prototype of an inflatable hip prote...

Arjmand Boroujeni, Seyed Ehsan

2012-01-01

235

Delocalized dislocations in quantum points  

International Nuclear Information System (INIS)

The theoretical model, describing the generation of the dislocations of incompatibility with the delocalized nuclei in the island film is proposed. The evaluation of the nanoislands (quantum dots) parameters with the delocalized dislocations of incompatibility in the Ge/Si system is carried out. It is shown within the frames of the proposed model, that generation of the delocalized dislocations of incompatibility in the quantum dots within the wide interval of their parameters is energetically more efficient than the generation of the ideal dislocations (usually considered in the models of the quantum dots with dislocations)

236

Minimally-incision total hip arthoplasty: Complications  

Directory of Open Access Journals (Sweden)

Full Text Available Minimaly invasive hip surgery techniques have been proposed as an alternative to conventional soft tissue exposure total hip arthroplasty. Purpored advantages of the technique included less blood loss, faster recovery, shoter stay in hospital and better cosmetical result. During the years good results have been presented by many authors, and serious complications have been found only in a few articles. But, some papers reported a catastrofic complications of the MIS procedures. Our intention is to present complication which had occurred in our experience with MIS total hip replacement. Retrospective study involved 215 patients (230 hips. All patients, of mean age 55.7 years, obtained fiber metal midcoated or fiber metal taper femoral stem and identical fiber metal coated acetabular shell with polyethylene or ceramic insert. The goal of the study was to evaluate intraoperative and early postoperative complications: bone fractures and/or implant, blood loss, dislocations, prolonged bleeding, loss of component position in 6 week postop. period, infections, and thromboembolism. The complications we had may occur with any type of operating technique. The purpose of the study was not either to condone or condemn MIS techniques but to show the complications that had occurred in our experience.

Baš?arevi? V.

2010-01-01

237

The radiology of total hip replacement  

International Nuclear Information System (INIS)

The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included. (orig.)

238

[Patella dislocation in athletes].  

Science.gov (United States)

Most dislocations of the patella occur during sports activities. The entities instability, maltracking and loss of tracking should be defined by patient history, clinical examination and radiological evaluation including magnetic resonance imaging (MRI). Based on these criteria a new classification of patella dislocations (5 types) was established which allows a standardized treatment algorithm. Type 1 is a simple (traumatic) dislocation without maltracking and without instability. Type 2 has a high redislocation risk (defined as instability) without maltracking. An isolated stabilizing surgical procedure, such as medial patellofemoral ligament (MPFL) augmentation is successful in most cases. Type 3 is characterized by instability and maltracking. Maltracking can be caused by soft tissue contracture or muscular deficits (type 3a), patella alta (type 3b), pathological tibial tuberosity to trochlear groove (TT-TG) distance (type 3c), genu valgum (type 3d) and torsional deformities (type 3e). In these types an isolated soft tissue procedure is usually not sufficient. The bony pathologies additionally need to be addressed to regain physiological patella tracking. Type 4 includes severe trochlea dysplasia with loss of patella tracking. Usually trochleaplasty is needed to stabilize the patella and to prevent redislocation. Type 5 is based on patella maltracking without instability and can be found in patients with a pathological knee baseline or special forms of torsional deformities. Although patella dislocations in trained athletes are seldom due to the stabilizing muscular status, the treatment strategy is similar to that of normal persons. Additional cartilage injuries, type of sports and time for rehabilitation have to be considered for optimal treatment. PMID:25182007

Frosch, K H; Akoto, R; Schmeling, A

2014-10-01

239

Arthrography of the hip in children  

International Nuclear Information System (INIS)

A method by which bilateral hip arthrography was performed under general anaesthesia in 130 infants and children 1 month to 7 years of age is described. Significant contractures of the adductor muscles had been corrected before the examination. Most of the children were girls with unilateral congenital idiopathic hip instability detected before the age of one year. From films exposed in standardized projections valuable information was obtained about the configuration of the joint cavity and the size and shape of the femoral head. Criteria for normal appearance in infants of ages 2 to 12 months are presented. More reliable details on the relation between the articular surfaces, the radiographic anatomy of the acetabulum and the distribution of the contrast medium were yielded by stereoradiography. Closed reduction was usually accomplished successfully during the arthrography, which made beginning of definitive treatment under the same anaesthesia possible. (Auth.)

240

Effective dislocation lines in continuously dislocated crystals. I. Material anholonomity  

CERN Document Server

A continuous geometric description of Bravais monocrystals with many dislocations and secondary point defects created by the distribution of these dislocations is proposed. Namely, it is distinguished, basing oneself on Kondo and Kroner Gedanken Experiments for dislocated bodies, an anholonomic triad of linearly independent vector fields. The triad defines local crystallographic directions of the defective crystal as well as a continuous counterpart of the Burgers vector for single dislocations. Next, the influence of secondary point defects on the distribution of many dislocations is modeled by treating these local crystallographic directions as well as Burgers circuits as those located in such a Riemannian material space that becomes an Euclidean 3-manifold when dislocations are absent. Some consequences of this approach are discussed.

Trzesowski, Andrzej

2007-01-01

 
 
 
 
241

INTERACTION OF DISLOCATIONS WITH GRAIN BOUNDARIES  

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Dislocations interact with grain boundaries during yielding, creep, and recrystallization. It will be assumed that the dislocation model for grain boundary structure is valid generally. Consequently, Burgers vectors are conserved and dislocation lines can end only on other dislocations or free surfaces. The following phenomena will be considered : (1) grain boundary dislocation sources, (2) movement of a dislocation in and through a grain boundary dislocation network, (3) transmission of a cr...

Smith, D.

1982-01-01

242

Bilateral anterior glenohumeral fracture dislocation  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Bilateral anterior dislocation of the glenohumeral (shoulder) joint is uncommon. Incidences of bilateral anterior fracture dislocation of the shoulder are relatively rare. About 16 cases are reported in the world literature. We report a case of bilateral anterior dislocation of the shoulder with bil [...] ateral avulsion fractures of the greater tuberosities of the humerus following seizure or convulsion due to electric shock.

MS, Moloto; BE, Mungulu; SS, Golele.

243

Congenital hypothyroidism  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Congenital hypothyroidism (CH occurs in approximately 1:2,000 to 1:4,000 newborns. The clinical manifestations are often subtle or not present at birth. This likely is due to trans-placental passage of some maternal thyroid hormone, while many infants have some thyroid production of their own. Common symptoms include decreased activity and increased sleep, feeding difficulty, constipation, and prolonged jaundice. On examination, common signs include myxedematous facies, large fontanels, macroglossia, a distended abdomen with umbilical hernia, and hypotonia. CH is classified into permanent and transient forms, which in turn can be divided into primary, secondary, or peripheral etiologies. Thyroid dysgenesis accounts for 85% of permanent, primary CH, while inborn errors of thyroid hormone biosynthesis (dyshormonogeneses account for 10-15% of cases. Secondary or central CH may occur with isolated TSH deficiency, but more commonly it is associated with congenital hypopitiutarism. Transient CH most commonly occurs in preterm infants born in areas of endemic iodine deficiency. In countries with newborn screening programs in place, infants with CH are diagnosed after detection by screening tests. The diagnosis should be confirmed by finding an elevated serum TSH and low T4 or free T4 level. Other diagnostic tests, such as thyroid radionuclide uptake and scan, thyroid sonography, or serum thyroglobulin determination may help pinpoint the underlying etiology, although treatment may be started without these tests. Levothyroxine is the treatment of choice; the recommended starting dose is 10 to 15 mcg/kg/day. The immediate goals of treatment are to rapidly raise the serum T4 above 130 nmol/L (10 ug/dL and normalize serum TSH levels. Frequent laboratory monitoring in infancy is essential to ensure optimal neurocognitive outcome. Serum TSH and free T4 should be measured every 1-2 months in the first 6 months of life and every 3-4 months thereafter. In general, the prognosis of infants detected by screening and started on treatment early is excellent, with IQs similar to sibling or classmate controls. Studies show that a lower neurocognitive outcome may occur in those infants started at a later age (> 30 days of age, on lower l-thyroxine doses than currently recommended, and in those infants with more severe hypothyroidism.

LaFranchi Stephen H

2010-06-01

244

Ceramic liner fatigue fracture: 3-D CT findings in a late recurrent THA dislocation.  

Science.gov (United States)

Dislocation is one of the most common complications of total hip arthroplasty (THA). To the authors' knowledge, late recurrent dislocation of a THA with a ceramic-on-ceramic coupling secondary to fatigue fracture of the ceramic liner has never been described. A 76-year-old woman with right hip osteoarthritis underwent cementless modular THA with a ceramic-on-ceramic coupling. Approximately 10 years postoperatively, she experienced right hip pain with no trauma, which resolved in 14 days. Family members reported that the patient had shown a progressive cognitive and muscular decline in the previous months. Six months later, the patient was admitted for THA dislocation, which was immediately reduced. Computed tomography revealed that the right acetabular component had a retroversion of 4° and an inclination angle of 45°. An orthopedic brace was applied, but dislocation recurred 2 days after discharge. A 3-dimensional CT reconstruction showed a fracture of the ceramic liner in the posterolateral region. The patient underwent revision surgery, and the ceramic liner breakage was confirmed. After removal of the acetabular components, a cemented polyethylene cup was implanted. The stability of the stem was verified. The existing modular neck was replaced with a chromium-cobalt neck, and a new ceramic head was applied. At 7-month follow-up, the patient had good functional recovery with no hip instability. Fatigue failure of a ceramic liner should be considered as responsible for late dislocation after ceramic-on-ceramic THA. As part of the diagnostic strategy, 3-dimensional CT reconstruction should be used to evaluate ceramic liner breakage. PMID:23276339

Trivellin, Giacomo; Sandri, Andrea; Bizzotto, Nicola; Marino, Marco Andrea; Mezzari, Silvio; Sambugaro, Elena; Regis, Dario

2013-01-01

245

Preformed antibiotic-loaded cement spacers for two-stage revision of infected total hip arthroplasty. Long-term results.  

Science.gov (United States)

Two-stage revision is the most widely accepted and performed intervention for chronically infected hip prosthesis and different interim spacers have been proposed. In recent years, antibiotic-loaded preformed spacers have become available on the market. The aim of this retrospective study was to assess the long-term results of two-stage revision with preformed spacers and uncemented hip prosthesis for the treatment of septic hip prosthesis. From 2000 to 2010, 183 consecutive patients underwent two-stage revision of septic hip prosthesis, with a same protocol, including preformed antibiotic-loaded cement spacer and a cementless modular hip revision prosthesis and four to six weeks antibiotic administration. Clinical and radiologic assessment at a minimum follow-up of two years was performed. At a minimum two years follow-up, 10 patients (5.4%) had had an infection recurrence, four (2.2%) an aseptic loosening and four more required partial revision of the modular components of the prosthesis, because of hip instability/dislocation; 21 patients died or were lost to follow-up. Considering all the reasons for revision, survivorship at eleven years was 93.9%. Harris Hip Score improved from 29.1 ± 14.6 pre-operatively to 41.1 ± 15.9 after spacer implant and 81.7 ± 17.6 after hip revision. The main complications after spacer implant included: spacer dislocation (16.4%), intra-operative femoral fractures (2.7%), and thromboembolism (2.1%). Complications after hip revision were: instability/dislocation (4,3%), intra-operative femoral fractures (1.6%), and thromboembolism (3.3%). Two-stage revision of septic hip prosthesis with preformed antibiotic-loaded spacers and cementless hip prosthesis provides satisfactory long-term results, with reduced complications. PMID:22956370

Romanò, Carlo L; Romanò, Delia; Albisetti, Alessandra; Meani, Enzo

2012-01-01

246

Hip joint replacement - series (image)  

Science.gov (United States)

... pain that limits what you can do. Hip joint replacement is usually done in people age 60 and ... Hip joint replacement is surgery to replace all or part of the hip joint with a man-made or artificial ...

247

Fracture After Total Hip Replacement  

Science.gov (United States)

... osteolysis. Symptoms The most common symptoms of periprosthetic hip fracture include: • Pain around the hip or thigh • Swelling ... o en very painful, someone with a periprosthetic hip fracture will most likely go directly to the emergency ...

248

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... question that patients may have is what about ceramic hips? Because most likely you have seen on the internet or heard advertised ceramic hips. Well, in my opinion, ceramic hips are -- ...

249

Ipsilateral Fracture Shaft Femur with Neglected Dislocation of Prosthesis: A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Neglected hip dislocation is rare in today’s world and after prosthesis replacement even rarer finding. However such patients may not report to surgeons until they develop secondary complications. Management of such patient’s is a challenge to the treating surgeon and need to be tailored suiting to patient’s demands, expectations and constraints of financial resources. We did not find a similar case in the electronic and print media and therefore report this case which was innovatively managed. Case Report: A 60 year farmer presented with fracture shaft femur and ipsilateral dislocation prosthesis of right hip. He had a hemiarthroplasty done for fracture neck of femur in the past but used to walk with a lurch since he started to ambulate after discharge. However he was satisfied despite “some problems” which had caused shortening of his limb. The patient was informed of the various treatment options and their possible complications. He expressed his inability to afford a Total Hip Arthroplasty (THA at any stage and consented for other options discussed with him. The patient was positioned supine and adductor tenotomy done. Next he was positioned laterally and the fracture was fixed with heavy duty broad dynamic compression plate and screws. The wound was temporarily closed. Now through the previous scar via posterior approach the hip was exposed. The prosthesis was found to be firmly fixed to the proximal femur. The acetabulum was cleared with fibrous tissue. All attempts the prosthesis to relocate the prosthesis failed after several attempts and it was best decided to leave alone. Post operatively period was uneventful. At follow up he refused for any further manoeuvre in future inform of heavy traction and attempts to reduce the same. At one year when he was walking unaided and his X-rays showed that fracture had well united his SF-36 score was PCS – 49.6 and MCS – 51.9. Conclusion: Ipsilateral shaft femur fracture in chronically dislocated prosthesis, done for fracture neck of femur is a rare clinical entity. Increased stress transfers due to dislocation compounded with osteoporosis makes the shaft vulnerable to fracture even with low velocity injury as in our case. Though fixation of fracture shaft femur is clear and straightforward; management of neglected prosthesis dislocation have to be guided by patient’s level of expectations and subjective contentment to adaptation to the altered hip state which influence the overall functional outcome. Keywords: Neglected dislocation, ipsilateral femoral fracture, hip arthroplasty.

Mantu Jain

2013-10-01

250

Hip Arthroscopy Update  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The management of hip injuries in the athlete has evolved significantly in the past few years with theadvancement of arthroscopic techniques. The application of minimally invasive surgical techniques has facilitated relatively rapid returns to sporting activity in recreational and elite athletes alike. Recent advancements in both hip arthroscopy and magnetic resonance imaging have elucidated several sources of intraarticular pathology that result in chronic and disabling hip symptoms. Many of...

Kelly, Bryan T.; Buly, Robert L.

2005-01-01

251

Hip Conditioning Program  

Science.gov (United States)

... thigh should be lifted toward the ceiling. 6. Hip Adduction ___________________________________________________________________ Main muscles worked: Adductors You should feel this exercise at your inner thigh Equipment needed: Begin with ...

252

Hip fracture - discharge  

Science.gov (United States)

Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - ...

253

Annealing of dislocation loops in dislocation dynamics simulations  

International Nuclear Information System (INIS)

We report of 3-dimensional discrete dislocation dynamics (DDD) simulations of dislocation loops coarsening by vacancy bulk diffusion. The calculation is based upon a model which couples the diffusion theory of vacancies to the DDD in order to obtain the climb rate of the dislocation segments. Calculation of isolated loops agrees with experimental observations, i.e. loops shrink or expand, depending on their type and vacancy supersaturation. When an array of dislocation loops of various sizes is considered, and the total number of vacancies in the simulation is maintained constant, the largest dislocations are found to increase in size at the expense of small ones, which disappear in a process known as Ostwald ripening.

254

Congenital heart disease  

Science.gov (United States)

Congenital heart disease is a problem with the heart's structure and function that is present at birth. ... Congenital heart disease (CHD) can describe a number of different problems affecting the heart. It is the most common ...

255

Congenital Heart Information Network  

Science.gov (United States)

... heart defects. Important Notice The Congenital Heart Information Network website is temporarily out of service. Please join ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright © ...

256

Congenital distal humeral dysplasia: a case report  

International Nuclear Information System (INIS)

Congenital dysplasia of the humerus is very rare. It is characteristically seen in omodysplasia and has also been reported as one of the associated features of Larsen's syndrome. We report a 4-year-old girl with bilateral humero-ulnar dysplasia, with dislocation of the elbows, facial dysmorphism, ball-and-socket ankles and foot deformities. Although the elbow dysplasia is similar to that seen in Larsen's syndrome, other pathognomic features of Larsen's syndrome were absent. The changes seen in the elbows in this patient are also different from those encountered in omodysplasia. We believe that this condition may be a distinct form of skeletal dysplasia hitherto undescribed. (orig.)

257

Formation of a large rice body-containing cyst following total hip arthroplasty  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background There are several well-described causes of a painful mass following total hip arthroplasty including polyethylene and metal wear debris, infection, expanding hematoma, dislocation, and synovial cysts. In addition to causing pain, these lesions, when large enough, may cause neurologic and vascular compromise. Rapid growth of the mass may clinically and radiographically resemble a sarcoma. Here, we report a case of a large painful hip mass which developed after total hip arthroplasty. The well-circumscribed mass was overlying and extending into the hip joint containing thousands of highly organized fibrin-containing “rice bodies”. To our knowledge, this is the first report of a large, highly organized (rice-body-containing cyst complicating total hip arthroplasty. Case presentation A 55-year old Caucasian woman developed a large, slowly enlarging, painful hip mass 2 1/2?years after primary total hip arthroplasty. Clinically and radiographically, the lesion resembled a soft tissue sarcoma. Surgical removal identified a well-circumscribed mass extending into the hip joint containing thousands of highly organized fibrin-containing “rice bodies”. Conclusion Identification and excision of this “pseudotumor” following hip arthroplasty is important for obtaining a definitive diagnosis, ruling out malignancy or infection and relieving any potential compression on surrounding neurovascular structures.

Issack Paul S

2012-06-01

258

Primary abductor hip contracture as diagnostic, prognostic and therapeutic problem in child hip pathology  

Directory of Open Access Journals (Sweden)

Full Text Available Coxa obliqua represents a special functional entity in the pathology of the child hip. Authors have confirmed the results of S.L. Weissman and B. Strinovic which claimed that the abductor contracture of the hip was a primary congenital condition that developed as a result of intrauterine malposition, leading later to the contralateral adductor contracture. Critical period for the development of complications was between 6 and 8 month after birth, adductor contracture might keep persisting together with the development of acetabular dysplasia, and later on with ipsilateral subluxation. This malformation has usually been diagnosed within 3 and 6 months of age. It could be connected with some other signs of malposition, such as plagiocephaly, torticollis or infantile thoracic C scoliosis. For the diagnosis of coxa obliqua, the examination of hips in the prone position was very important and the ultrasonic and radiological examinations were crucial. The applied treatment used to be exclusively physical rehabilitation. Wide diapering has been contraindicated. In this study, we included 2,500 newborns, 1,300 boys and 1,200 girls (5,000 hips. In 22 cases of coxa obliqua (10‰, the excellent results were obtained in 96% of cases. In two unsuccessfully treated cases, a contralateral dysplasia developed, and in one untreated, subluxation. The authors are advocating a systematic and early detection and treatment of the primary coxa obliqua. .

Paji? Miloš

2007-01-01

259

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... over the years. Artificial hips are made of 2 parts: 1. a socket anchored in the pelvis 2. a ... straight and the toes pointed up. Hold for 1-2 seconds; repeat 10-20 times. Hip Extension – Bridging ...

260

Hip Implant Systems  

Science.gov (United States)

... femur) slips out of its socket in the hip bone (pelvis) Bone fracture Joint infection Local nerve damage with numbness/weakness Device loosening or breakage Difference in leg lengths Bone loss (osteolysis) Patients who have hip implants should be aware of potential symptoms that ...

 
 
 
 
261

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... also look at the hip often while using heat to make sure you are not burning the skin! Do’s & Don’ts This section shows what you should and should NOT do, especially in the first few months after your surgery. This is specific to a traditional hip replacement surgery. If you ...

262

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available X-Plain Hip Replacement – Physical Therapy Reference Summary Introduction Hip replacement surgery is a very successful and ... 1995-2010, The Patient Education Institute, Inc. www.X-Plain.com pt030105 Last reviewed: 11/10/2010 ...

263

The Warwick Hip Trauma Evaluation Two - an abridged protocol for the WHiTE Two Study  

Science.gov (United States)

Fractures of the proximal femur are one of the greatest challenges facing the medical community, constituting a heavy socioeconomic burden worldwide. Controversy exists regarding the optimal treatment for independent patients with displaced intracapsular fractures of the proximal femur. The recognised alternatives are hemiarthroplasty and total hip replacement. At present there is no established standard of care, with both types of arthroplasty being used in many centres. The principal advantages of total hip replacement are a functional benefit over hemiarthroplasty and a reduced risk of revision surgery. The principal criticism is the increased risk of dislocation. We believe that an alternative acetabular component may reduce the risk of dislocation but still provide the functional benefit of total hip replacement in these patients. We therefore propose to investigate the dislocation risk of a dual-mobility acetabular component compared with standard polyethylene component in total hip replacement for independent patients with displaced intracapsular fractures of the proximal femur within the framework of the larger WHiTE (Warwick Hip Trauma Evaluation) Comprehensive Cohort Study. Cite this article: Bone Joint Res 2013;2:210–13. PMID:24089291

Griffin, X. L.; McArthur, J.; Achten, J.; Parsons, N.; Costa, M. L.

2013-01-01

264

Comparison between 28 mm and 32 mm ceramic-on-ceramic bearings in total hip replacement.  

Science.gov (United States)

Large femoral heads have become popular in total hip replacement (THR) as a method of reducing the risk of dislocation. However, if large heads are used in ceramic-on-ceramic THR, the liner must be thinner, which may increase the risk of fracture. To compare the rates of ceramic fracture and dislocation between 28 mm and 32 mm ceramic heads, 120 hips in 109 patients (51 men and 58 women, mean age 49.2 years) were randomised to THR with either a 28 mm or a 32 mm ceramic articulation. A total of 57/60 hips assigned to the 28 mm group and 55/60 hips assigned to the 32 mm group were followed for at least five years. No ceramic component fractures occured in any patient in either group. There was one dislocation in the 32 mm group and none in the 28 mm group (p = 0.464). No hip had detectable wear, focal osteolysis or prosthetic loosening. In our small study the 32 mm ceramic articulation appeared to be safe in terms of ceramic liner fracture. Cite this article: Bone Joint J 2014;96-B:1459-63. PMID:25371457

Lee, Y K; Ha, Y C; Koo, K H

2014-11-01

265

Perilunate Injuries, Not Dislocated (PLIND).  

Science.gov (United States)

Purpose?We reviewed a series of equivalents of perilunate dislocations and fracture-dislocations (PLDs-PLFDs) in which there was no dislocation of the capitate from the lunate on the initial radiographs. We propose to include these injuries as a variant of perilunate dislocations that we have termed a perilunate injury, not dislocated (PLIND) lesion in a modified classification of perilunate injuries. Methods?A review of the records of all acute perilunate injuries and displaced carpal fractures was done in a single-center university hospital wrist surgery unit over a 5-year period. All cases presenting at the acute stage with displaced fractures of scaphoid, lunate, triquetrum, or capitate along with scapholunate and/or lunotriquetral dissociation but no dislocation of the capitate from the lunate in the sagittal or coronal plane were reviewed and considered as PLIND lesions. Results?We identified 11 patients with PLIND lesions. Three cases with clinical and radiological follow-up are presented. Discussion?Equivalents of PLDs-PLFDs presenting without dislocation of the capitate from the lunate do exist. These injuries may be overlooked despite their severity. They require both osseous and ligamentous repair. Including them into an existing perilunate injuries classification highlights their recognition and enables a better understanding and treatment of both acute and chronic nondislocated perilunate injuries. Level of Evidence?Level IV, retrospective case series. PMID:24436839

Herzberg, Guillaume

2013-11-01

266

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available SMALL INCISION TOTAL HIP REPLACEMENT ARTHROPLASTY MERCY HOSPITAL MIAMI, FLORIDA May 3, 2007 00:00:08 ANNOUNCER: Welcome to Mercy Hospital ... people suffering from hip pain. A small-incision total hip arthroplasty and arthroscopic hip femoroacetabular impingement resection. ...

267

Congenital contractural deformities of the fingers and arthropathy.  

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Four patients are described who presented with congenital finger contractures and arthropathy. There was synovial cell hyperplasia and giant cells but no inflammatory process. Radiographs showed flattening of the metacarpal and metatarsal heads and the proximal femoral ossification centres. In the oldest patient the process had subsided leaving slight contractures but severe impairment of hip mobility. In another the arthropathy was still prominent in the early teens. In a third, finger contr...

Martin, J. R.; Huang, S. N.; Lacson, A.; Payne, R. H.; Bridger, S.; Fraser, F. C.; Neary, A. J.; Maclaughlin, E. A.; Hobeika, C.; Lawton, L. J.

1985-01-01

268

Graphitization at diamond dislocation cores  

International Nuclear Information System (INIS)

We examine possible mechanisms for graphitization at dislocation cores in diamond, both as an explanation for brown coloration in natural brown diamond and as a model for annealing in amorphous carbon materials. We find a metastable structure for the 90 deg. partial dislocation core where bonds are broken in both single- and double-period structures leading to a row of paired sp2 C atoms. We examine the effect of hydrogen and other impurities on this core structure both through direct interaction and potential charging effects. We also investigate a mechanism for progressive aromatization through the migration and aggregation of 30 deg. partial dislocations. (author)

269

Dislocations of the sternoclavicular joint  

Energy Technology Data Exchange (ETDEWEB)

Dislocations of the sternoclavicular joint are uncommon, with the posterior variety having a potential for considerable morbidity. Radiologic management and diagnosis can be difficult. In this review article, the joint anatomy and mechanisms of dislocation are discussed and the incidence and clinical manifestations described. Six case reports are presented to illustrate causative mechanisms, diagnoses, and radiologic appearances. Computed tomography is the best method of demonstrating the sternoclavicular joint, but a number of specialized plain film projections are also described and illustrated; these should be more widely known. Treatment of the joint dislocations is briefly discussed. (orig.)

Cope, R. (Dept. of Radiology, Univ. of Missouri Hospital and Clinics, Colombia, MO (United States))

1993-05-01

270

Dislocations of the sternoclavicular joint  

International Nuclear Information System (INIS)

Dislocations of the sternoclavicular joint are uncommon, with the posterior variety having a potential for considerable morbidity. Radiologic management and diagnosis can be difficult. In this review article, the joint anatomy and mechanisms of dislocation are discussed and the incidence and clinical manifestations described. Six case reports are presented to illustrate causative mechanisms, diagnoses, and radiologic appearances. Computed tomography is the best method of demonstrating the sternoclavicular joint, but a number of specialized plain film projections are also described and illustrated; these should be more widely known. Treatment of the joint dislocations is briefly discussed. (orig.)

271

Dislocation Evolution During Plastic Deformation: Equations vs. Discrete Dislocation Simulations  

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Explaining the work hardening behavior of metals has been a big challenge over the past eighty years. Although individual processes are well understood, the study of the overall effects of these processes was difficult before the emergence of computer modeling. In this paper, we employ discrete dislocation dynamics to establish a continuum-based model for the evolution of the dislocation structure in polycrystalline thin films. The Taylor equation is evaluated and expression...

Davoudi, Kamyar M.; Vlassak, Joost J.

2014-01-01

272

Transient osteoporosis of the hip  

International Nuclear Information System (INIS)

Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain. (author)

273

Transient osteoporosis of the hip.  

Directory of Open Access Journals (Sweden)

Full Text Available Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain.

McWalter Patricia

2009-01-01

274

Metal-on-metal hip resurfacings. A radiological perspective  

International Nuclear Information System (INIS)

It is important to be aware of the various complications related to resurfacing arthroplasty of the hip (RSA) and the spectrum of findings that may be encountered on imaging. The bone conserving metal-on-metal (MOM) hip resurfacing has become increasingly popular over the last ten years, especially in young and active patients. Initial reports have been encouraging, but long-term outcome is still unknown. Early post operative complications are rare and have been well documented in the literature. Medium and long term complications are less well understood. A rare but important problem seen at this stage is the appearance of a cystic or solid periarticular reactive mass, which occurs predominately in women and usually affects both hips when seen in patients with bilateral RSAs. The following imaging findings are illustrated and their significance discussed; Uncomplicated hip resurfacing arthroplasty, radiolucency around the femoral peg, femoral neck fracture, loosening and infection, suboptimal component position, femoral notching, dislocation, heterotopic ossification, femoral neck thinning and reactive masses. The radiologist should be aware of the normal radiographic appearances and the variety of complications that may occur following RSA and should recommend ultrasound or MRI in patients with an unexplained symptomatic hip and normal radiographs. (orig.)

275

Metal-on-metal hip resurfacings. A radiological perspective  

Energy Technology Data Exchange (ETDEWEB)

It is important to be aware of the various complications related to resurfacing arthroplasty of the hip (RSA) and the spectrum of findings that may be encountered on imaging. The bone conserving metal-on-metal (MOM) hip resurfacing has become increasingly popular over the last ten years, especially in young and active patients. Initial reports have been encouraging, but long-term outcome is still unknown. Early post operative complications are rare and have been well documented in the literature. Medium and long term complications are less well understood. A rare but important problem seen at this stage is the appearance of a cystic or solid periarticular reactive mass, which occurs predominately in women and usually affects both hips when seen in patients with bilateral RSAs. The following imaging findings are illustrated and their significance discussed; Uncomplicated hip resurfacing arthroplasty, radiolucency around the femoral peg, femoral neck fracture, loosening and infection, suboptimal component position, femoral notching, dislocation, heterotopic ossification, femoral neck thinning and reactive masses. The radiologist should be aware of the normal radiographic appearances and the variety of complications that may occur following RSA and should recommend ultrasound or MRI in patients with an unexplained symptomatic hip and normal radiographs. (orig.)

Chen, Zhongbo [University of Oxford, Medical School, Oxford (United Kingdom); Pandit, Hemant; Taylor, Adrian; Gill, Harinderjit; Murray, David [University of Oxford, Nuffield Department of Orthopaedic Surgery, Oxford (United Kingdom); Ostlere, Simon [Nuffield Orthopaedic Centre, Department of Radiology, Oxford (United Kingdom)

2011-03-15

276

Can Vacancies Lubricate Dislocation Motion in Aluminum?  

Science.gov (United States)

The interaction of vacancy with dislocations in Al is studied using the semidiscrete variational Peierls-Nabarro model with ab initio determined ? surface. For the first time, we confirm theoretically the so-called vacancy lubrication effect on dislocation motion in Al, a discovery that can settle a long-standing controversy in dislocation theory for fcc metals. We provide insights into the lubrication effect by exploring the connection between dislocation mobility and its core width. We predict an increased dislocation splitting in the presence of vacancy. We find that on average there is a weak repulsion between vacancies and dislocations which is independent of dislocation character.

Lu, Gang; Kaxiras, Efthimios

2002-08-01

277

Can vacancies lubricate dislocation motion in aluminum?  

CERN Document Server

The interaction of vacancy with dislocations in Al is studied using the Semidiscrete Variational Peierls-Nabarro model with ab initio determined gamma surface. For the first time, we confirm theoretically the so-called vacancy lubrication effect on dislocation motion in Al, a discovery that can settle a long-standing controversy in dislocation theory for fcc metals. We provide insights on the lubrication effect by exploring the connection between dislocation mobility and its core width. We predict an increased dislocation splitting in the presence of vacancy. We find that on average there is a weak repulsion between vacancies and dislocations which is independent of dislocation character.

Lu, G; Lu, Gang; Kaxiras, Efthimios

2002-01-01

278

Anterior Hip Subluxation due to Lumbar Degenerative Kyphosis and Posterior Pelvic Tilt.  

Science.gov (United States)

Nontraumatic anterior subluxation and dislocation of the hip joint are extremely rare. A 58-year-old woman presented to our outpatient clinic with left hip pain with a duration of 15 years. There was no history of trauma or other diseases. Her hip pain usually occurred only on walking and not at rest. Physical examinations demonstrated no tenderness in the hip joint. The range of motion of both hip joints was almost normal. Laxity of other joints was not observed. The bone mineral density of the lumbar spine and proximal femur confirmed a diagnosis of osteoporosis. A plain radiograph showed osteoarthritic changes of the hip joints, severe posterior pelvic tilt, and superior displacement of both femoral heads, especially in a standing position. Three-dimensional computed tomography (3DCT) revealed anterior subluxation of both femoral heads. Seven years after the initial visit, both hip joints showed progression to severe osteoarthritis. Although the exact cause remains unclear, lumbar kyphosis, posterior pelvic tilt, and a decrease in acetabular coverage may have influenced the current case. We should be aware of these factors when we examine patients with hip osteoarthritis. PMID:24592346

Tsuchie, Hiroyuki; Yamada, Shin; Tazawa, Hiroshi; Kijima, Hiroaki; Shimada, Yoichi

2014-01-01

279

Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty: design of a randomized controlled trial  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, but can increase systemic cobalt and chromium ion concentrations. The objective of this study is to compare two cementless total hip arthroplasties: a conventional 28 mm metal-on-polyethylene articulation and a large head metal-on-metal articulation. We hypothesize that the latter arthroplasties show less bone density loss and higher serum metal ion concentrations. We expect equal functional scores, greater range of motion, fewer dislocations, fewer periprosthetic radiolucencies and increased prosthetic survival with the metal-on-metal articulation. Methods A randomized controlled trial will be conducted. Patients to be included suffer from non-inflammatory degenerative joint disease of the hip, are aged between 18 and 80 and are admitted for primary cementless unilateral total hip arthroplasty. Patients in the metal-on-metal group will receive a cementless titanium alloy acetabular component with a cobalt-chromium liner and a cobalt-chromium femoral head varying from 38 to 60 mm. Patients in the metal-on-polyethylene group will receive a cementless titanium alloy acetabular component with a polyethylene liner and a 28 mm cobalt-chromium femoral head. We will assess acetabular bone mineral density by dual energy x-ray absorptiometry (DEXA, serum ion concentrations of cobalt, chromium and titanium, self reported functional status (Oxford hip score, physician reported functional status and range of motion (Harris hip score, number of dislocations and prosthetic survival. Measurements will take place preoperatively, perioperatively, and postoperatively (6 weeks, 1 year, 5 years and 10 years. Discussion Superior results of large head metal-on-metal total hip arthroplasty over conventional hip arthroplasty have been put forward by experts, case series and the industry, but to our knowledge there is no randomized controlled evidence. Conclusion This randomized controlled study has been designed to test whether large head metal-on-metal cementless total hip arthroplasty leads to less periprosthetic bone density loss and higher serum metal ion concentrations compared to 28 mm metal-on-polyethylene cementless total hip arthroplasty. Trial registration Netherlands Trial Registry NTR1399

van Raaij Jos JAM

2008-10-01

280

Congenital diaphragmatic hernia.  

Science.gov (United States)

Congenital diaphragmatic hernia is an uncommon congenital anomaly of the diaphragm with pulmonary hypoplasia and persistent pulmonary hypertension as serious consequences. Despite recent advances in therapy, congenital diaphragmatic hernia remains a challenging condition. Best treatment strategies are still largely unknown, and practice strategies vary widely among different centres. Additionally, as congenital diaphragmatic hernia is a relatively uncommon condition, it is difficult to recruit sufficient numbers of patients for clinical trials. In recent years, survival rates of congenital diaphragmatic hernia patients appear to have increased. With the progressively improved survival rates, the long-term prognosis and quality of life of patients have become an increasingly important issue. Survivors have been shown to be at risk for many long-term morbidities, which highlights the importance of long-term follow-up of these children. The aim of this review is to give an overview of the current knowledge regarding congenital diaphragmatic hernia. PMID:24528549

Leeuwen, Lisette; Fitzgerald, Dominic A

2014-09-01

 
 
 
 
281

Hip Replacement - Physical Therapy  

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Full Text Available ... a very successful and safe operation. Long-term success mostly depends on the patient, though. The muscles ... function a lot like a ball and socket device. Artificial hips allow a very wide range of ...

282

Taper Hip Prosthesis  

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Full Text Available ... Now in terms of patient positioning for acetabular orientation, anything special you do in that arena? Yeah, ... a very stiff hip and you're having problems mobilizing the femoral portion of the patient out ...

283

Taper Hip Prosthesis  

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Full Text Available ... right hip. And at this point we'll begin. All right, the incision starts from the superior ... the capsule, the greater trochanter. And I'll begin my incision though the capsule at the tip ...

284

Hip Replacement - Physical Therapy  

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Full Text Available ... your hip surgery. If you need to have dental or surgical procedures, you should make sure to ... for any particular treatment plan. Like any printed material, it may become out of date over time. ...

285

Imaging of hip arthroplasty  

International Nuclear Information System (INIS)

Hip arthroplasty has become a common and still increasing procedure for the treatment of osteoarthritis, advanced head necrosis, post-inflammatory arthritis or rheumatoid arthritis.Radiography is the most important imaging modality for monitoring the normal, asymptomatic hip arthroplasty. Radiographs are obtained at the end of a surgical treatment, to exclude complications like fracture or component misplacement. In the follow-up radiographs are used for the diagnosis of loosening and infection of the hip arthroplasty as well as soft tissue ossification. Together with the history and clinical information, the analysis of morphological findings allows to find the grade of loosening. MRI has been advocated in the diagnosis of infection, in particular in the localisation of soft tissue involvement.Imaging, especially by radiographs, is used for the evaluation of the normal and complicated follow-up of hip arthroplasty. (orig.)

286

Total Hip Replacement  

Science.gov (United States)

... Post-traumatic arthritis. This can follow a serious hip injury or fracture. The cartilage may become damaged and lead to ... occur they can prolong or limit full recovery. Infection Infection may occur super? cially in the wound ...

287

Hip joint replacement  

Science.gov (United States)

... cane or walker. Other reasons for replacing the hip joint are: Fractures in the thigh bone. Older adults often have ... can make you more likely to get an infection. This includes methotrexate, Enbrel, and other medicines that ...

288

Hip Replacement - Physical Therapy  

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Full Text Available ... doctor or a healthcare professional for your specific condition. ©1995-2010, The Patient Education Institute, ... the body does. Common activities that use the hip include: • ...

289

The pelvis and hips  

International Nuclear Information System (INIS)

Fractures of the pelvis and hips are often associated with significant morbidity and mortality. Complete evaluation of the complex anatomy and potential complications requires proper diagnostic techniques, including computed tomography and angiography, to determine the best approach to treatment

290

Taper Hip Prosthesis  

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Full Text Available Zimmer M/L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome to this "OR Live" Webcast presentation brought to you by Zimmer. During ...

291

Hip Replacement - Physical Therapy  

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Full Text Available ... may cause decreased sensation in the hip; therefore, check the temperature of anything you put on your ... sure it would be safe. You should also check with your surgeon before having sexual intercourse after ...

292

Taper Hip Prosthesis  

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Full Text Available ... up a size by looking at our tissue tension in the hip. And I generally know that ... test -- go ahead -- to see if our tissue tension looks reasonable too, okay. There you go. And ...

293

Ultrasound: Infant Hip  

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... the internal structures of the hip, including the ball-shaped top of the thighbone (femoral head) and ... is specially trained in reading and interpreting X-ray and ultrasound images) will interpret the ultrasound results ...

294

Hip Replacement - Physical Therapy  

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Full Text Available ... together without holding your breath. Hold together for 5-10 seconds; repeat 15-20 times. Knee & Hip ... lift up the buttock and hold it for 5 seconds. Repeat 10-20 times. Quadriceps Setting While ...

295

Hip Replacement - Physical Therapy  

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Full Text Available ... to bend forward. The gluteal muscles allow the hip to bend backward. The abductor muscles allow the leg to be pushed out. The adductor muscles allow the leg to be pulled in ...

296

Luxación carpometacarpiana Carpometacarpal dislocation  

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Full Text Available Se presenta el caso clínico de un paciente de 18 años de edad que acude a consulta a los 30 días de haber sufrido un traumatismo en la mano derecha, al cual se le diagnosticó una luxación carpometacarpiana del 5 rayo. Se inició el tratamiento con la implantación del mini fijador externo HVP para transportar el hueso hasta su posición anatómica, se comenzó desde el primer día a razón de un milímetro diario, 15 días después fue colocada la base del metacarpiano en su posición anatómica normal, manteniendo el aparato durante 3 semanas más. Se logró que el paciente recobrara la movilidad y la función normal del dedo, tras un período de tratamiento fisioterapéutico. Se demostró que este método puede ser utilizado en casos no recientes y de urgencia, pues elimina la inmovilización con yeso y facilita los movimientos.The clinical case of a 18 year-old patient is reported, who went to the outpatient department after 30 days of suffering a trauma in the right hand and he was diagnosed with carpometacarpal dislocation of ray 5. The treatment was initiated with the implant of an external mini-fixer HVP to transport the bone to its anatomical position. It was started from the first day with a daily millimeter, 15 days later the metacarpal base was placed in its normal anatomical position, and the apparatus was left for 3 more weeks. The patient was able to recover mobility and the finger normal function after a period of physyotherapeutic treatment. It was demonstrated that this method can be used in emergency and non recent cases, because it eliminates the immobilization with plaster and facilitates movements.

Humberto Villalobos Pedroso

2009-04-01

297

Osteoarthritis of the hip  

International Nuclear Information System (INIS)

Magnetic resonance imaging (MRI) is the modality of choice for evaluation of joint disease. Forty-one hips in 33 patients with osteoarthritis of the hip joint were examined by MRI and the features were analyzed. MR examinations were performed on a 1.5 T superconducting unit using the spin echo (SE) technique with short TR (600 ms)/short TE (23, 28, 35 ms) and short TR (600 ms)/long TE (70, 75 ms) sequences. MRI revealed deformity of the femoral head in all hips. Some outgrowths, which were isointense with normal bone marrow, were shown on the periphery of the femoral head in 22 hips (54%). These outgrowths represented marginal osteophytes. Short TE images showed hypointense areas, which varied in size, in the superior or supero-anterior aspect of the femoral head in all hips, and in the opposite position of the acetabulum in 38 hips (93%). These lesions showed a heterogenous signal with predominant low signal on long TE images. These images may indicate the presence of several components including subchondral cysts, bony sclerosis and fibrous tissue. In the joint space, areas of low signal intensity were shown on short TE images, which were high to intermediate signal intensity on long TE images in 16 hips (39%). These areas were presumably consistent with synovial proliferation, cartilageous hypertrophy or joint effusion. Both MR images revealed a mass locating just anterior to the femoral head in 2 hips (5%). The mass showed a low signal on short TE images and a high signal on long TE images, representing the distended iliopsoas bursa. (author)

298

Genetics Home Reference: Congenital hypothyroidism  

Science.gov (United States)

... Research studies OMIM Genetic disorder catalog Conditions > Congenital hypothyroidism On this page: Description Genetic changes Inheritance Diagnosis ... Glossary definitions Reviewed May 2006 What is congenital hypothyroidism? Congenital hypothyroidism is a condition that affects infants ...

299

Hip Replacement - Physical Therapy  

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Full Text Available ... approach the risk of dislocation is lessened. Your precautions and exercises may be different than listed in ... had a surgery using an anterior approach your precautions will be different. Please consult with your doctor, ...

300

The role of arthroscopic thermal capsulorrhaphy in the hip.  

Science.gov (United States)

Arthroscopic thermal modification of collagen in the hip capsular tissue appears to be a treatment option for patients with hip instability. Traumatic hip instability is associated with frank dislocation or a subluxation, and labral tears. Atraumatic hip instability is associated with evidence of generalized ligament laxity. It can be associated with bone-collagen type disorders, including Ehlers-Danlos syndrome, Down syndrome, arthrochalasis multiplex congenita, developmental dysplastic hip, and idiopathic type. As previously discussed by Bellabarba et al, capsular laxity may be the underlying cause of dynamic hip instability. The capsule is a fibrous, thick, and strong structure that encircles the proximal femur and the acetabulum. The capsule is thicker anteriorly than posteriorly, and consists of two sets of fibers, circular and longitudinal. The capsule ligaments play a very important role in hip stability. The hip joint capsule is reinforced by the iliofemoral, pubofemoral, and ischiofemoral ligaments. It remains sensitive to stretch and serves as a mechanism for muscular feedback and pain. The iliofemoral ligament limits hyperextension and lateral rotation of the hip joint and is taut in full extension. Full extension of the hip exposes the capsule and ligaments to a twisting and shortening effect that forces the head onto the acetabulum. We are currently studying the effect of iliofemoral ligament deficiency and its relationship to instability. Many of the properties of synovial lubrication depend on contact with articular surfaces, and incongruency due to instability may have some functional role in distribution of synovial fluid, leading to stresses from weightbearing and eventually to rapid deterioration of the articular surfaces. The high-level athletes in this series include two professional baseball players, three professional golfers (PGA), one professional football player (NFL), one figure skater (Olympic gold medalist), one gymnast (Olympic level, bilateral hips), and one ballet dancer; they returned to their pre-injury level of activity. The other patients returned to their pre-injury functional lifestyle. Hip instability appears to present consistently with stable gait abnormalities and painful sensation of instability. Recognizing the various patterns of hip instability is complicated, and therefore management and outcome of these disorders are quite variable. Bellabarba et al concluded that physical therapy alone had been unsuccessful and that temporary success of a posterior capsular "plication" in one patient showed promise. Arthroscopic thermal modification of collagen in the hip capsular tissue appears to be a treatment option for patients with hip instability. The hip joint capsule is predominantly type 1 collagen, and the mechanism of tissue shrinkage through type 1 collagen alteration is well documented in the literature. Short-term results appear promising, however, more studies are required to determine the long-term efficacy of this procedure in the treatment of this challenging disorder. PMID:11675889

Philippon, M J

2001-10-01

 
 
 
 
301

The behaviour of dislocations inside the dislocation channels in neutron-irradiated Ni  

International Nuclear Information System (INIS)

Neutron-irradiated Ni foil specimens were stretched at room temperature under observation in a high voltage electron microscope (HVEM). When the Ni specimens were stretched, the so-called dislocation channels, in which defect clusters introduced by neutron-irradiation were swept out, were formed and the deformation was concentrated in the dislocation channels. The behaviour of dislocation channels and that of dislocations inside the dislocation channels were directly observed. The formation of each dislocation channel occurred with an interval shorter than 1/60 sec. by fast and simultaneous motion of many dislocations; the dislocation channels were hardened by trapping of dislocations due to interactions between moving dislocations and defect clusters remaining near the edge of dislocation channels. The strain imposed on the crystal was accommodated by the repeated process of formation and hardening of dislocation channels. (auth.)

302

Use of ceramics in total hip replacement.  

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Ceramics have been used as a bearing surface in total hip arthroplasty (THA) for more than 30 years. Properties of this material which make it particularly attractive for this application include its hardness, high compression strength, and excellent wettability. The low incidence of biologically significant particle generation and clinically significant osteolysis with the use of ceramics in THA reflects these properties. However, low fracture toughness and linear elastic behavior demonstrated by ceramic make it prone to breakage under stress. Improvements in the processing of ceramic as well as advances in engineering of head-neck articulations and liner design have led to an overall decrease in the incidence of ceramic fracture and dislocation. This article reviews the science behind the use of ceramics in THA, the clinical results of ceramics in THA, including complications unique to this bearing surface, and future directions for the application of ceramics in THA. PMID:18284905

Lang, Jason E; Whiddon, David R; Smith, Eric L; Salyapongse, Aaron K

2008-01-01

303

Preformed gentamicin spacers in two-stage revision hip arthroplasty: functional results and complications.  

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Two-stage revisions with antibiotic-loaded spacers have gained popularity for treating infected hip-joint arthroplasties. The aim of this prospective study was to assess patient functionality between stages and treatment impact on duration of hospital stay and to describe related complications. Sixty-one consecutive patients with infected hip arthroplasties underwent two-stage revision with preformed spacer implantation. Mean Harris Hip and Merle d'Aubigné scores between the two stages were 39.9 and 7.6, respectively. Forty-six patients (75.4%) were able to leave hospital between stages. Spacer dislocation occurred in 16.4%. No cases of spacer breakage were noted. Preformed cement spacers provide acceptable functional outcome between revision hip arthroplasty stages and facilitate the surgical procedure without increasing mechanical complication rates. PMID:21116817

Pattyn, Christophe; De Geest, Thomas; Ackerman, Pieter; Audenaert, Emmanuel

2011-10-01

304

Torcicolo congênito: avaliação de dois tratamentos fisioterapêuticos Congenital torticollis: evaluation of two physiotherapeutic approaches  

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Full Text Available OBJETIVO: Avaliar a evolução clínica e comparar a eficácia do tratamento fisioterapêutico intensivo ou mínimo, em neonatos e lactentes com torcicolo congênito. MÉTODOS: Foram atendidas no Ambulatório de Fisioterapia e Cirurgia Pediátrica do Hospital de Clínicas da Universidade Estadual de Campinas 47 crianças com torcicolo congênito. Analisaram-se, retrospectivamente, antecedentes maternos, neonatais, apresentação clínica e tratamento fisioterapêutico, classificado de acordo com a freqüência das sessões. O tratamento intensivo foi definido como sessões de fisioterapia realizadas pelo fisioterapeuta no ambulatório, acrescidas de exercícios diários realizados pelos pais em domicílio. O tratamento mínimo foi considerado quando apenas o fisioterapeuta realizava as sessões semanalmente no ambulatório, sem a participação dos pais. RESULTADOS: Quanto às características demográficas da população, observou-se: idade média materna=26 anos; parto normal=40 (85%; mães primigestas=35 (75%; idade média ao diagnóstico=50 dias. A presença de nódulo intramuscular foi notada em 46 (98% pacientes. As seguintes doenças estiveram associadas: luxação congênita de quadril igual=4 (8%; fratura de clavícula=2 (4%; pé torto congênito=1 (2%. O tratamento intensivo foi realizado em 34 (72% pacientes e a cura observada em 100%, após 74 dias, em média. O tratamento mínimo foi aplicado em 13 (28% pacientes e a cura observada em dez (77%, tratados em média por 130 dias. CONCLUSÕES: O torcicolo congênito apresentou evolução clínica favorável em ambos os grupos. O tratamento intensivo propiciou maior índice de cura em menor tempo de tratamento.OBJECTIVE: To evaluate the clinical course and to compare the effectiveness of physiotherapeutic treatment performed daily or once a week in newborns and infants with congenital torticollis. METHODS: 47 patients with congenital torticollis were assisted at the Physiotherapy and Pediatric Surgery Services of the Clinical Hospital of Campinas University. The following data were retrospectively collected: maternal and neonatal history, clinical presentation and physiotherapeutic treatment classified according to the frequency of the exercises. Intensive treatment was defined as sessions performed at the daycare clinic by the physiotherapist plus daily sessions performed by parents at home. Minimal treatment was defined as weekly sessions performed only by the physiotherapist at the daycare clinic, without participation of the parents. RESULTS: The demographic characteristics of the studied patients were: mean maternal age=26 years; first gestation=35 (75%; vaginal delivery=40 (85%; mean age at diagnosis =50 days. A sternomastoid nodule was felt seen in 46 (98% patients. Diseases associated with congenital torticollis were: congenital hip dislocation=4 (8%; fracture of clavicles=2 (4%; and club feet=1 (2%. Intensive treatment was performed in 34 (72% patients for an average of 74 days and the cure was achieved in 100%. Minimal treatment was performed in 13 (28% for an average of 130 days and ten (77% patients achieved cure. CONCLUSIONS: Congenital torticollis had favorable outcome in both groups. The intensive treatment was followed by higher rates of cure in smaller period of time.

Luciane Zanusso Pagnossim

2008-09-01

305

Torcicolo congênito: avaliação de dois tratamentos fisioterapêuticos / Congenital torticollis: evaluation of two physiotherapeutic approaches  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar a evolução clínica e comparar a eficácia do tratamento fisioterapêutico intensivo ou mínimo, em neonatos e lactentes com torcicolo congênito. MÉTODOS: Foram atendidas no Ambulatório de Fisioterapia e Cirurgia Pediátrica do Hospital de Clínicas da Universidade Estadual de Campinas 4 [...] 7 crianças com torcicolo congênito. Analisaram-se, retrospectivamente, antecedentes maternos, neonatais, apresentação clínica e tratamento fisioterapêutico, classificado de acordo com a freqüência das sessões. O tratamento intensivo foi definido como sessões de fisioterapia realizadas pelo fisioterapeuta no ambulatório, acrescidas de exercícios diários realizados pelos pais em domicílio. O tratamento mínimo foi considerado quando apenas o fisioterapeuta realizava as sessões semanalmente no ambulatório, sem a participação dos pais. RESULTADOS: Quanto às características demográficas da população, observou-se: idade média materna=26 anos; parto normal=40 (85%); mães primigestas=35 (75%); idade média ao diagnóstico=50 dias. A presença de nódulo intramuscular foi notada em 46 (98%) pacientes. As seguintes doenças estiveram associadas: luxação congênita de quadril igual=4 (8%); fratura de clavícula=2 (4%); pé torto congênito=1 (2%). O tratamento intensivo foi realizado em 34 (72%) pacientes e a cura observada em 100%, após 74 dias, em média. O tratamento mínimo foi aplicado em 13 (28%) pacientes e a cura observada em dez (77%), tratados em média por 130 dias. CONCLUSÕES: O torcicolo congênito apresentou evolução clínica favorável em ambos os grupos. O tratamento intensivo propiciou maior índice de cura em menor tempo de tratamento. Abstract in english OBJECTIVE: To evaluate the clinical course and to compare the effectiveness of physiotherapeutic treatment performed daily or once a week in newborns and infants with congenital torticollis. METHODS: 47 patients with congenital torticollis were assisted at the Physiotherapy and Pediatric Surgery Ser [...] vices of the Clinical Hospital of Campinas University. The following data were retrospectively collected: maternal and neonatal history, clinical presentation and physiotherapeutic treatment classified according to the frequency of the exercises. Intensive treatment was defined as sessions performed at the daycare clinic by the physiotherapist plus daily sessions performed by parents at home. Minimal treatment was defined as weekly sessions performed only by the physiotherapist at the daycare clinic, without participation of the parents. RESULTS: The demographic characteristics of the studied patients were: mean maternal age=26 years; first gestation=35 (75%); vaginal delivery=40 (85%); mean age at diagnosis =50 days. A sternomastoid nodule was felt seen in 46 (98%) patients. Diseases associated with congenital torticollis were: congenital hip dislocation=4 (8%); fracture of clavicles=2 (4%); and club feet=1 (2%). Intensive treatment was performed in 34 (72%) patients for an average of 74 days and the cure was achieved in 100%. Minimal treatment was performed in 13 (28%) for an average of 130 days and ten (77%) patients achieved cure. CONCLUSIONS: Congenital torticollis had favorable outcome in both groups. The intensive treatment was followed by higher rates of cure in smaller period of time.

Luciane Zanusso, Pagnossim; Augusto Frederico S., Schmidt; Joaquim Murray, Bustorff-Silva; Sérgio Tadeu M., Marba; Lourenço, Sbragia.

306

The climb of dissociated dislocations  

International Nuclear Information System (INIS)

The weak-beam technique of electron microscopy has been used to directly study the climb of dissociated dislocations under conditions of high supersaturation of point defects introduced by electron irradiation. In a Cu-13%Al alloy irradiated at room temperature, prismatic loops (assumed to be of interstitial type because of the dislocation bias) are nucleated on the individual partials. The loop Burgers vectors are a function of partial orientation and are such as to minimize the elastic energy of the resultant configuration of partial plus loop, and to maximize the edge component of the loops. In Cu-13%Al irradiated at temperatures in excess of 2000C complex dislocation configurations are observed which are quite different from those observed at room temperature. These results may be understood in terms of the nucleation of prismatic loops, followed by their growth in directions controlled by the climb force on the parts of the prismatic loops not lying in the glide plane of the dislocations and their interaction with the non-parent partial. In this paper the mechanisms of climb of dissociated dislocations in Cu-13%Al are explained. The results are compared with preliminary observations carried out on a Cu-10%Al alloy and on pure Si. (author)

307

Yielding, mobile dislocations and chaos  

International Nuclear Information System (INIS)

Plastic deformation involves the motion and generation of dislocations. These defects interact through their stress fields, resulting in the collective motion of dislocations. Collective motion can be incisively evaluated and measured by obtaining the auto-correlation function, r(u). The auto-correlation function measures how an event at a time t affects an event at a time t+u, where u is the time interval between events. In the present case the authors measure the mobile dislocation density, ?m, during deformation, and analyze the observed fluctuations in pm. Analysis of the fluctuations in ?m gives directly the degree of correlation of the dislocations during deformation. The experimental determinations of ?m are carried out as follows: the authors deform lead 10 wt% indium crystals at 4.2 K while in the mixed, superconducting state. When dislocations move then there is a change in flux which is detected with a D.C. bridge, which includes a low noise, high gain amplifier; the signal from the amplifier is sent to a computer w1 here statistical analyses are performed

308

Indications, cost and safety implications of traditional post-operative radiography following total hip replacement  

International Nuclear Information System (INIS)

Purpose: As routine check radiographs obtained in the recovery room following total hip arthroplasty present issues of concern regarding quality, cost and safety of both staff and patient, we wished to determine the usefulness and indications for this investigation as a screening tool for post-operative dislocation. MethodsA 10-year retrospective analysis of all total hip replacements performed in a single Regional Orthopaedic Hospital, considering the total number of hip arthroplasties performed and the number of acute recovery room dislocations using theatre records and patient notes. We then randomly selected the recovery room and departmental radiographs of 100 patients and compared them with regard to the need for repeat radiographs and subsequent costs generated. ResultsRecovery room radiographs were not statistically superior to clinical assessment in the diagnosis of acute post-operative dislocations (P=0.7), and these were associated with increased costs because it was necessary to repeat poor quality films (P=0.008). The use of recovery room radiography was also therefore associated with significant safety implications for patients and staff. ConclusionsThe conclusion was that recovery room radiographs are neither a safe, effective nor economical method of screening for dislocation. Furthermore, they fail to provide reliable or reproducible information and expose patients and staff to extra radiation. It is recommended therefore that recovery room radiographs should only be obtained for clinical indications, with most routine post-operative radiography being performed in a standardised fashion in the radiology department

309

Congenital proximal radioulnar synostosis  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital proximal radio-ulnar synostosis is a rare anomaly and is often part of syndromes such as Crouzon, Apert's and Poland's. We have successfully managed one such case with bilateral involvement not associated with any other congenital deformity. He has been managed by performing derotation osteotomy through the synostosis mass with gratifying results.

Dogra B

2003-01-01

310

Small Incision Total Hip Arthroplasty  

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Full Text Available ... last couple minutes here -- for patients who have osteoporosis, are they candidates for hip replacement surgery? 00: ... CARLOS J. LAVERNIA, MD, FAAOS: Great question. Absolutely. Osteoporosis is not a contraindication to getting your hip ...

311

Small Incision Total Hip Arthroplasty  

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Full Text Available ... receptors right before I get started. This patient needs a hip replacement because he has a disease ... that has just a hip damaged and that needs just a replacement. That kind of patient, with ...

312

Small Incision Total Hip Arthroplasty  

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Full Text Available ... hip femoroacetabular impingement resection. Hip pain is not limited to senior citizens. It can begin to affect ... surgery. Yes, it has been done. There's very limited indications, but for some patients who have -- maybe ...

313

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... surgical instrumentation and techniques. In addition to the live hip replacement, you will see footage of an arthroscopic hip femoroacetabular impingement resection. Remember, OR-Live makes it easy for you to learn more. ...

314

Small Incision Total Hip Arthroplasty  

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Full Text Available ... to walk and have to be in a wheelchair. So the spectrum of the hip disease varies ... HOMMEN, MD: Another question. How long is the rehabilitation after a hip replacement surgery? 00:25:10 ...

315

Hip Fractures among Older Adults  

Science.gov (United States)

... Communications Press Room Social Media Publications Injury Center Hip Fractures Among Older Adults On this Page How big ... 9 billion. 7 What outcomes are linked to hip fractures? A large proportion of fall deaths are due ...

316

Small Incision Total Hip Arthroplasty  

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Full Text Available ... and he's going to wake up with a brand-new hip. Go up. 00:38:44 PIETER ... could tell us a little bit about your experience with hip replacement surgery using a computer or ...

317

Anterior Approach Total Hip Replacement  

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Full Text Available ... valgus inclination to her hips and her slightly dysplastic joint; otherwise having excellent and relatively normal anatomy. ... see the severe arthritic changes within this mildly dysplastic hip. Switch these. Come on out. Again, like ...

318

Small Incision Total Hip Arthroplasty  

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Full Text Available ... to receive the actual replacement hip, the femoral component of that hip. And what I'm doing ... a second. I have an actual size 10 component here, so we can show you exactly what ...

319

Small Incision Total Hip Arthroplasty  

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Full Text Available ... going to do right now is try the mechanics of the hip, okay? So we're going ... doing research on computer-assisted orthopedic surgery in general, not just in hips and knees but we' ...

320

[Rehabilitation and sport following total hip replacement].  

Science.gov (United States)

The number of total hip replacement (THR) surgeries has increased significantly over the last few years and patients undergoing surgery are of decreasing age. In consequence the question of the influencing factors for the survival of artificial hip joints becomes more and more urgent. The expected survival time of an implant is nowadays 15-20 years and it seems that factors for a shorter lifetime are female gender, overweight, younger age and certain indications which led to surgery, such as rheumatoid arthritis or fractures. In the early phase of rehabilitation, measures against dislocation including training of the abductor muscles are most important. Starting rehabilitation programs early after surgery has positive effects on outcome, especially when strengthening programs are included. There are different opinions concerning the question how the lifetime of a THR is influenced by sports activities. However, it seems to have been demonstrated that suitable sports activities have a positive effect and do not necessarily correlate with higher loosening rates after THR. In general, high-impact sports should be avoided. Recommended activities are cycling, swimming, aquajogging, hiking, rowing and dancing. PMID:21607538

Schmitt-Sody, M; Pilger, V; Gerdesmeyer, L

2011-06-01

 
 
 
 
321

Chondrofibrosis of adolescent hip  

Directory of Open Access Journals (Sweden)

Full Text Available Authors present 420 hips with slipped capital epiphysis treated in the IOHB "Banjica", during the period between 1970 and 2005. Research includes the analysis of incidence, diagnostics and causes which contribute to the genesis of hip chondrofibrosis. Risk factors are shown, as well as the approach to eliminate them. 39 hips in which this complication occurred were individually analyzed. Every hip was separately studied with intent to determine the cause of the condition’s genesis, it’s evolution, treatment and it’s final functionality result. Synovia biopsy was performed in 7 cases, as well as the biopsy of the capsule, articular hyaline cartilage and subchondral bone of the femoral head, which enabled detailed description of both microscopic and macroscopic changes that follow this condition. Regardless of still hypothetical comprehension of the inception of chondrofibrosis, authors clearly state all the risky procedures during treatment that can contribute to the development of chondrofibrosis. The importance of early diagnostics and well-timed treatment are highlighted in this article, for they are crucial. Results of treated hip chondrofibrosis presented here give hope for the destiny of the ill joint, which was considered highly uncertain for a long time.

Tomi? S.

2006-01-01

322

Contiguous bifacet cervical fracture dislocations  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Bifacet dislocations of the cervical spine are severe debilitating injuries often associated with complete cord injury. Contiguous bilateral facet dislocations are extremely rare and, to the best of our knowledge, have only been described once before. We present a patient who was involved in a road [...] traffic accident. Pre-operative radiographs suggested contiguous bifacet injury and this was confirmed intra-operatively. This should alert physicians to the possibility of contiguous injuries to the cervical spine.

JWM, Kigera; M, Nyati.

323

Cartilage restoration of the hip using fresh osteochondral allograft: Resurfacing the Potholes.  

Science.gov (United States)

Cartilage defects of the hip cause significant pain and may lead to arthritic changes that necessitate hip replacement. We propose the use of fresh osteochondral allografts as an option for the treatment of such defects in young patients. Here we present the results of fresh osteochondral allografts for cartilage defects in 17 patients in a prospective study. The underlying diagnoses for the cartilage defects were osteochondritis dissecans in eight and avascular necrosis in six. Two had Legg-Calve-Perthes and one a femoral head fracture. Pre-operatively, an MRI was used to determine the size of the cartilage defect and the femoral head diameter. All patients underwent surgical hip dislocation with a trochanteric slide osteotomy for placement of the allograft. The mean age at surgery was 25.9 years (17 to 44) and mean follow-up was 41.6 months (3 to 74). The mean Harris hip score was significantly better after surgery (p hip replacement and two patients are awaiting hip replacement. Fresh osteochondral allograft is a reasonable treatment option for hip cartilage defects in young patients. Cite this article: Bone Joint J 2014;96-B(11 Supple A):11-16. PMID:25381401

Khanna, V; Tushinski, D M; Drexler, M; Backstein, D B; Gross, A E; Safir, O A; Kuzyk, P R

2014-11-01

324

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... ORLive.com for a live webcast of a total hip arthroplasty surgery. This is a very special program. Not only ... a total hip arthroplasty live. So that's a total hip replacement surgery. Actually, I think right here we can pan ...

325

Modular hybrid total hip arthroplasty. Experimental study in dogs  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background This prospective experimental study evaluated the surgical procedure and results of modular hybrid total hip arthroplasty in dogs. Methods Ten skeletally mature healthy mongrel dogs with weights varying between 19 and 27 kg were used. Cemented modular femoral stems and uncemented porous-coated acetabular cups were employed. Clinical and radiographic evaluations were performed before surgery and at 30, 60, 90, 120, 180 and 360 days post-operation. Results Excellent weight bearing was noticed in the operated limb in seven dogs. Dislocation followed by loosening of the prosthesis was noticed in two dogs, which were therefore properly treated with a femoral head osteotomy. Femoral fracture occurred in one dog, which was promptly treated with full implant removal and femoral osteosynthesis. Conclusions The canine modular hybrid total hip arthroplasty provided excellent functionality of the operated limb.

Ranzani José JT

2011-07-01

326

A new Ehlers-Danlos syndrome with craniofacial characteristics, multiple congenital contractures, progressive joint and skin laxity, and multisystem fragility-related manifestations.  

Science.gov (United States)

We previously described two unrelated patients showing characteristic facial and skeletal features, overlapping with the kyphoscoliosis type Ehlers-Danlos syndrome (EDS) but without lysyl hydroxylase deficiency [Kosho et al. (2005) Am J Med Genet Part A 138A:282-287]. After observations of them over time and encounter with four additional unrelated patients, we have concluded that they represent a new clinically recognizable type of EDS with distinct craniofacial characteristics, multiple congenital contractures, progressive joint and skin laxity, and multisystem fragility-related manifestations. The patients exhibited strikingly similar features according to their age: craniofacial, large fontanelle, hypertelorism, short and downslanting palpebral fissures, blue sclerae, short nose with hypoplastic columella, low-set and rotated ears, high palate, long philtrum, thin vermilion of the upper lip, small mouth, and micro-retrognathia in infancy; slender and asymmetric face with protruding jaw from adolescence; skeletal, congenital contractures of fingers, wrists, and hips, and talipes equinovarus with anomalous insertions of flexor muscles; progressive joint laxity with recurrent dislocations; slender and/or cylindrical fingers and progressive talipes valgus and cavum or planus, with diaphyseal narrowing of phalanges, metacarpals, and metatarsals; pectus deformities; scoliosis or kyphoscoliosis with decreased physiological curvatures of thoracic spines and tall vertebrae; cutaneous, progressive hyperextensibility, bruisability, and fragility with atrophic scars; fine palmar creases in childhood to acrogeria-like prominent wrinkles in adulthood, recurrent subcutaneous infections with fistula formation; cardiovascular, cardiac valve abnormalities, recurrent large subcutaneous hematomas from childhood; gastrointestinal, constipation, diverticula perforation; respiratory, (hemo)pneumothorax; and ophthalmological, strabismus, glaucoma, refractive errors. PMID:20503305

Kosho, Tomoki; Miyake, Noriko; Hatamochi, Atsushi; Takahashi, Jun; Kato, Hiroyuki; Miyahara, Teruyoshi; Igawa, Yasuhiko; Yasui, Hiroshi; Ishida, Tadao; Ono, Kurahito; Kosuda, Takashi; Inoue, Akihiko; Kohyama, Mohei; Hattori, Tadashi; Ohashi, Hirofumi; Nishimura, Gen; Kawamura, Rie; Wakui, Keiko; Fukushima, Yoshimitsu; Matsumoto, Naomichi

2010-06-01

327

Hip supporting device  

DEFF Research Database (Denmark)

The present invention relates to a device for limiting movements in one or more anatomical joints, such as a device for limiting movement in the human hip joint after hip replacement surgery. This is provided by a device for limiting movement in the human hip joint, said device comprising: at least a first member (1) adapted to conform to a leg, a second member (2) adapted to engage at least one shoulder, and a third member (3) connecting said at least first member and said second member, wherein the third member is substantially soft and/or flexible and adapted to limit one or more specific movements of said leg by anchoring the tensile load of said movement (s) in the shoulder (s).

BrØndsted, Povl Technical University of Denmark,

328

Intermittent dislocation flow in viscoplastic deformation  

CERN Document Server

The viscoplastic deformation (creep) of crystalline materials under constant stress involves the motion of a large number of interacting dislocations. Analytical methods and sophisticated `dislocation-dynamics' simulations have proved very effective in the study of dislocation patterning, and have led to macroscopic constitutive laws of plastic deformation. Yet, a statistical analysis of the dynamics of an assembly of interacting dislocations has not hitherto been performed. Here we report acoustic emission measurements on stressed ice single crystals, the results of which indicate that dislocations move in a scale-free intermittent fashion. This result is confirmed by numerical simulations of a model of interacting dislocations that successfully reproduces the main features of the experiment. We find that dislocations generate a slowly evolving configuration landscape which coexists with rapid collective rearrangements. These rearrangements involve a comparatively small fraction of the dislocations and lead ...

Miguel, M C; Zapperi, S; Weiss, J; Grasso, J R; Vespignani, Alessandro; Zapperi, Stefano; Weiss, Jerome; Grasso, Jean-Robert

2001-01-01

329

14 CFR 314.6 - Qualifying dislocation.  

Science.gov (United States)

...Qualifying dislocation. A qualifying dislocation is a bankruptcy or major contraction of a carrier, the major cause of which is the change in regulatory structure provided by the Airline Deregulation Act of...

2010-01-01

330

CT to delineate hip pathology in cerebral palsy  

International Nuclear Information System (INIS)

Surgical intervention for cerebral palsy hip dislocation or subluxation is frequently undertaken without a full comprehension of the three-dimensional aspects of the femoral-acetabular complex. CT with a modified technique allows more accurate measurement of the angle of femoral anteversion. In this exhibit the authors compare the modified technique with the old technique. Details of femoral had deficits, acetabular configuration, the arc of the acetabulum, the relative position of the femoral head within the acetabulum, and the soft tissue interposed between the femoral head and the acetabulum are well demonstrated with the new technique

331

Adult hip dysplasia and osteoarthritis. Studies in radiology and clinical epidemiology  

DEFF Research Database (Denmark)

Osteoarthritis (OA) presupposes the interaction of systemic and/or local factors. In hip joint OA, congenital or developmental malformation is believed to constitute an individual risk factor for premature degeneration. Hip dysplasia (HD) is such a malformation. The radiological and epidemiological studies had several aims: To critically evaluate the radiological source material of the Copenhagen Heart Study: The Osteoarthritis Substudy, consisting of 4,151 standardized, weight bearing pelvic radiographs recorded 1991-1994. To qualify or disqualify the radiological source material for further studies. To develop a comprehensible and reproducible radiographic discriminator of hip OA with as close an association to self reported hip pain as possible. To identify prevalences of hip OA and HD in a Caucasian, urban background population and investigate the influence of sex, age, physical and occupational parameters on these prevalences. To evaluate the influence of HD on hip OA development relative to other potential risk factors. To evaluate degeneration in dysplastic hips over time. To evaluate the three dimensional anatomy of HD and the distribution of degenerative features in severely dysplastic hips, and To evaluate risk factors for total hip replacement surgery. In the course of the studies we found that assessments of classic indices of HD were significantly influenced by pelvic orientation during x-ray recording and identified exclusion limits of rotation and inclination/reclination of pelvic radiographs to stay inside a measurement error of +/- 3 degrees. We found that minimum joint space width (JSW) /= 60 years of age, and HD prevalence was 4-10%, depending on the radiographic criteria applied. Age and HD were significant risk factors for hip OA development in women, and HD was found to be a significant risk factor for hip OA in men. However, only obesity was found to determine an event of hip replacement surgery. In a longitudinal study of 81 subjects and with mild or moderate hip dysplasia followed for a decade we did not document a tendency for radiological degeneration compared to 136 control subjects. In a computerized tomographic study of severely dysplastic hips we found a close relationship between insufficient anterior, acetabular containment and proximal femoral anteversion. The primary area of degeneration in dysplastic hips was in the antero-lateral quadrant of the joint.

Jacobsen, Steffen

2006-01-01

332

Malformaciones invalidantes en Chile.: Estudio ECLAMC, 1982-1997 / Disabling congenital defects in Chile  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Background: The ECLAMC (Estudio Colaborativo Latinoamericano de Malformaciones Congénitas) is an epidemiological surveillance program for congenital defects that operates in Chile since 1969. Aim: To communicate the frequency of disabling congenital defects in Chile in the period 1982-1997. Material [...] and methods: A review of the ECLAMC registry, choosing 12 congenital defects: amelia, limb amputations, limb reductions, arthrogryposis, hip luxation and subluxation, spina bifida, hydrocephaly, microcephaly, cephalocele, talipes equinovarus, Down syndrome and multiple abnormalities. Results: In the study period, 283,403 births occurred and 7,917 newborns were malformed (7,654 born alive and 263 stillbirths). The congenital defects prevalence rates appeared higher in Chile than in other Latin American countries, specially among stillbirths. Among the studied maternity hospitals, the Clinical Hospital of the University of Chile, showed the higher prevalence of congenital defects. Rancagua and the Navy Hospital in Valparaiso have a high frequency of Down syndrome. Global rates in Chile and in the rest of ECLAMC for specific defects, do not have significant differences, except for hip subluxation, that has a lower incidence in Chile. Conclusions: The ECLAMC allows to have a good knowledge of the prevalence of congenital malformations in Latin America (Rev Méd Chile 2001; 129: 67-74).

Julio, Nazer H; Juan, Margozzini R; Mariela, Rodríguez C; Mildred, Rojas N; Lucía, Cifuentes O.

333

Giant congenital melanocytic nevus.  

Science.gov (United States)

Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ? 20 cm in adulthood. Its incidence is estimated in congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion. PMID:24474093

Viana, Ana Carolina Leite; Gontijo, Bernardo; Bittencourt, Flávia Vasques

2013-01-01

334

Scattering of phonons by dislocations  

International Nuclear Information System (INIS)

By 1950, an explicit effort had been launched to use lattice thermal conductivity measurements in the investigation of defect structures in solids. This technique has been highly successful, especially when combined with the measurements of other properties such as optical absorption. One exception has been the study of dislocations. Although dislocations have a profound effect on the phonon thermal conductivity, the mechanisms of the phonon-dislocation interaction are poorly understood. The most basic questions are still debated in the literature. It therefore is pointless to attempt a quantitative comparison between an extensive accumulation of experimental data on the one hand, and the numerous theoretical models on the other. Instead, this chapter will attempt to glean a few qualitative conclusions from the existing experimental data. These results will then be compared with two general models which incorporate, in a qualitative manner, most of the proposed theories of the phonon-dislocation interaction. Until very recently, measurement of thermal conductivity was the only means available to probe the interaction between phonons and defects at phonon frequencies above the standard ultrasonic range of approx. = 109 Hz. The introductory paragraphs provide a brief review of the thermal-conductivity technique and the problems which are encountered in practice. There is also a brief presentation of the theoretical models and the complications that may occur in more realistic situations

335

Studies of the Dislocation Glass  

Science.gov (United States)

We report the large scale simulations of 2D dislocation systems with overdamped dynamics. 40,000-1,000,000 dislocations were studied with a combination of coarse graining, Fast Fourier Transform and stochastic methods. Both glide and climb processes were considered, as well as the local rotation of crystal axes. Simulations were performed at zero and finite temperatures, with and without dislocation annihilation. When climb processes were included, the system exhibited the formation of dislocation cells/patterns even in equilibrium, without the application of shear. This is in close correspondence with recent experiments on GaAs by P. Rudolph et al. (2005). The distribution function of cell sizes can exhibit a fractal dimension. At long times the system shows glassy dynamics. In particular, aging was observed through the waiting time dependence of the correlations and the effective diffusion. In certain parameter ranges the formation of cells leads to an initial exponential decay of correlations. This is followed by the growth of cells, generating a power law temporal decay in the long time domain. Data for both time domains and for all waiting times can be collapsed onto a single master curve when a t/tw scaling is applied.

Zimanyi, Gergely; Bako, Botond; Groma, Istvan; Gyorgyi, Geza

2006-03-01

336

Tomographic index as auxiliary criteria for surgery indication in fracture dislocation of acetabulum posterior wall  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract There are situations which the tomographic exam is done on the affected hip or situations where the contralateral hip presents abnormalities that make it impossible to compare. In this study we aimed to evaluate a tomographic index that does not require comparison between the both hips. Twenty two patients with unilateral acetabular fracture dislocation with fracture of posterior wall were studied. We established the relationship between the remaining posterior wall and the femoral head diameter (head/wall index-H/W index. We evaluated 45 two-dimensional computed tomography scan in normal hips and established the H/W index. In 45 normal hips we simulated a posterior wall fracture with involvement of 25% and 30% of the posterior wall and calculated the H/W index. We divided into five groups with five different H/W index (fractured group with non surgical treatment; fractured group; normal group; normal group with simulated fracture of 25% and; 30% of the posterior wall. 2.4 was the lowest limit of confidence interval of the group with 25% of the posterior wall fracture. When we analyzed the confidence interval of the 30% fracture group the upper limit of the confidence interval was 2.7, close to the lower limit of the surgical group that was 2.9. Thus, we suggest the 2.4 the H/W index limit as an auxiliary criteria to indicate whether or not to operate. H/W index is helpful to decide whether or not surgery indication in the fracture dislocation of the posterior wall of the acetabulum.

Fujiki Edison N

2012-06-01

337

[Hemi-arthroplasty of the hip joint: concentric or positive eccentric (self-centering) dual head prosthesis? A retrospective comparison].  

Science.gov (United States)

In femoral neck fractures in the elderly, the least traumatic operative treatment is hemiarthroplasty. In our Trauma Unit, from August 1986 to December 1986 we implanted 22 concentric bipolar cups. During follow-up this cup proved to be associated with an unjustifiably high failure rate: system-caused interprosthetic dislocation in 4 patients (18%), and extraprosthetic dislocation in a further 3 (13%). In one of the latter, interprosthetic disconnection occurred during closed reduction. In all of these, i.e., in 31% out of the 22 patients, conversion to a total hip arthroplasty became necessary. Since March 1987 we have used a positive eccentric, self-centering bipolar head. Up to September 1990 322 such prostheses were implanted. Bearing in mind the reduced general physical condition of the patients, the complication rate is considered to be low (dislocations 3.4%, conversion to total hip arthroplasty 0.9%, deep wound infections 3.1%). PMID:1604331

Möllers, M; Stedtfeld, H W; Paechtner, S; Wald, A

1992-05-01

338

The painful hip: new concepts  

Energy Technology Data Exchange (ETDEWEB)

Hip pain is a common condition, and the work-up often includes imaging. This article reviews the normal MR anatomy of the hip and the imaging findings of internal derangements, snapping hip, and femoral acetabular impingement. We will describe the role of MR arthrography in evaluating the patient with suspected labral and articular cartilage abnormalities, as well as the pitfalls in interpretation. We will review the causes of a snapping hip, and the role of sonography in evaluating and guiding treatment of the snapping iliopsoas tendon. We will also review the radiographic and MRI signs of femoroacetabular impingement (FAI), a cause of early degenerative joint disease and hip pain. (orig.)

Blankenbaker, Donna G.; Tuite, Michael J. [University of Wisconsin Medical School, Department of Radiology, Division of Musculoskeletal Imaging, Madison, WI (United States)

2006-06-15

339

The painful hip: new concepts  

International Nuclear Information System (INIS)

Hip pain is a common condition, and the work-up often includes imaging. This article reviews the normal MR anatomy of the hip and the imaging findings of internal derangements, snapping hip, and femoral acetabular impingement. We will describe the role of MR arthrography in evaluating the patient with suspected labral and articular cartilage abnormalities, as well as the pitfalls in interpretation. We will review the causes of a snapping hip, and the role of sonography in evaluating and guiding treatment of the snapping iliopsoas tendon. We will also review the radiographic and MRI signs of femoroacetabular impingement (FAI), a cause of early degenerative joint disease and hip pain. (orig.)

340

Medial subtalar dislocation: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Subtalar dislocation (SI is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.

Manojlovi? Radovan

2010-01-01

 
 
 
 
341

21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.  

Science.gov (United States)

...hemi-hip) acetabular metal cemented prosthesis. 888.3370 Section 888.3370...hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip...hemi-hip) acetabular metal cemented prosthesis is a device intended to be...

2010-04-01

342

21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.  

Science.gov (United States)

...femoral (hemi-hip) metallic resurfacing prosthesis. 888.3400 Section 888.3400...femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip...femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be...

2010-04-01

343

Talocalcaneal transfixation in total dislocation of the talus and subtalar dislocations.  

Science.gov (United States)

We present 4 cases of talus dislocation. In one case we had open total lateral dislocation of the talus and in 3 other cases we had closed subtalar dislocation (disruption of the talocalcaneal and talonavicular joints). Reposition of the dislocation was made and talocalcaneal transfixation completed with 3 Kirschner wires, placed like a spread fan, under fluoroscopic control. Reoccurring dislocations were not experienced nor were there signs of avascular necrosis in these 4 cases. PMID:19354102

Pavi?, Roman

2009-03-01

344

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... measures like these will not be as important. Physical Therapy With time and physical therapy, your new hip will work and feel like ... can put on the operated leg. As your physical therapy progresses, you will be able to put more ...

345

Taper Hip Prosthesis  

Medline Plus

Full Text Available ... L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome ... degrees of theta. So we're pretty well clean here, guys. Got a cup? Here’s our trabecular ...

346

Taper Hip Prosthesis  

Medline Plus

Full Text Available Zimmer M/L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome ... at the tip of the trochanter and I'm going to ultimately make an “H” shaped incision ...

347

Taper Hip Prosthesis  

Medline Plus

Full Text Available Zimmer M/L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome to this " ... ascertain that we're in the acetabulum -- I mean, excuse me, in the intermidulary canal. We'll ...

348

Taper Hip Prosthesis  

Medline Plus

Full Text Available Zimmer M/L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome to this "OR Live" ... close-up of the component? It’s a bi-taper design, which is proximally plasma sprayed. The very ...

349

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... you as you strengthen your new hip joint. Start slow and progress gradually. Set achievable goals for yourself and discuss them with your physical therapist. Examples of such goals include: • walking 100 yards • going up or down the stairs • taking a few trips ...

350

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... wear slip-on shoes at first. Your home health therapist can show you how to put your socks, pants and shoes on. You may need some help. Keep your kneecap pointing straight or slightly outward. Turning it inward can put significant stress on your new hip. This is important while ...

351

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... www.X-Plain.com pt030105 Last reviewed: 11/10/2010 1 The muscles that allow the hip ... www.X-Plain.com pt030105 Last reviewed: 11/10/2010 2 Immediately after surgery a large wedge, ...

352

A Rare Dislocation: Isolated Proximal Tibiofibular Joint Dislocation  

Directory of Open Access Journals (Sweden)

Full Text Available Isolated dislocation of proximal tibiofibular joint is one of the rarely encountered and easily overlooked traumas in ER departments. Injury mechanism can not be elucidated entirely; however it occurs commonly by sudden inversion of foot, concurrently knee is at flexion and foot is at plantar flexion. Diagnosis can be made by determining swelling and sensitivity increase at proximal tibia with comparing healthy side and radiological imaging techniques. Treatment is still a challenging and controversial issue and most of the cases are approached conservatively; for selected cases, it is possible to carry out surgical stabilization. We have reported the case, an isolated dislocation of the proximal tibiofibular joint in a football player.

ibrahim Arziman

2011-09-01

353

Congenital adrenal hyperplasia  

Science.gov (United States)

... to treat congenital adrenal hyperplasia do not usually cause side effects such as obesity or weak bones, because the doses replace the hormones that the child's body cannot make. It is important for parents ...

354

Congenital orbital teratoma.  

Science.gov (United States)

We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma. PMID:23619505

Aiyub, Shereen; Chan, Wengonn; Szetu, John; Sullivan, Laurence J; Pater, John; Cooper, Peter; Selva, Dinesh

2013-12-01

355

Giant congenital nevus  

Science.gov (United States)

... hairy nevus; Giant pigmented nevus; Bathing trunk nevus; Congenital melanocytic nevus - large ... cells (lipomas) Neurofibromatosis Other nevi Spina bifida Smaller ... cause problems most of the time. Larger or giant nevi are rare.

356

Revision hip arthroplasty using a modular revision hip system in cases of severe bone loss.  

Science.gov (United States)

We sought to identify outcomes of the Restoration Modular Hip System in cases of severe femoral bone stock deficiency. We performed a retrospective review of 55 revTHAs with a mean follow-up of 32 months (24-60 months). Outcomes included the WOMAC and HHS. Preoperative bone loss was categorized as Paprosky 3A (n = 13), 3B (n = 14), and 4 (n = 17). Periprosthetic fractures were classified as Vancouver B2 (n = 6) and B3 (n = 5). 53 of 55 stems were in situ at time of final review. WOMAC improved from 46 ± 18 to 70 ± 22 and HHS improved from 47 ± 15 to 78 ± 15. Complications were identified in 9 patients, which included dislocation (3), subsidence (2), infection (2), and periprosthetic fracture (2). In cases of significant proximal femoral bone deficiency, this stem demonstrated improvement in clinical outcomes with good results at short-term follow up. PMID:24768500

Dzaja, Ivan; Lyons, Matt C; McCalden, Richard W; Naudie, Douglas D D; Howard, James L

2014-08-01

357

Evolution of geometrically necessary dislocation density from computational dislocation dynamics  

International Nuclear Information System (INIS)

This paper presents a method for calculating GND densities in dislocation dynamics simulations. Evolution of suitably defined averages of GND density as well as maps showing the spatial nonuniform distribution of GNDs are analyzed under uniaxial loading. Focus is laid on the resolution dependence of the very notion of GND density, its dependence upon physical dimensions of plastically deformed specimens and its sensitivity to initial conditions. Acknowledgments Support from the National Science Foundation (CMMI-0748187) is gratefully acknowledged.

358

Pipe diffusion at dislocations in UO2  

Science.gov (United States)

We present the results of a combination of static and dynamic simulations employing empirical potentials, investigating the structures of dislocations in UO2 and show how the dislocation core structure influences the rate of O2- and U4+ diffusion along the dislocation (i.e. pipe diffusion). In the region immediately surrounding the dislocations there is a significant reduction in the activation energies and diffusion coefficients for O2- and U4+ diffusion, however only out to a cylindrical radius of ?20 Å from the dislocation centre. The contribution of pipe diffusion to the overall O2- and U4+ diffusion is also discussed.

Murphy, Samuel T.; Jay, Eleanor E.; Grimes, Robin W.

2014-04-01

359

Kinetic Monte Carlo simulation of dislocation dynamics  

Science.gov (United States)

A kinetic Monte Carlo simulation of dislocation motion is introduced. The dislocations are assumed to be composed of pure edge and screw segments confined to a fixed lattice. The stress and temperature dependence of the dislocation velocity is studied, and finite-size effects are discussed. It is argued that surfaces and boundaries may play a significant role in the velocity of dislocations. The simulated dislocations are shown to display kinetic roughening according to the exponents predicted by the Kardar-Parisi-Zhang equation.

Lin, Karin; Chrzan, D. C.

1999-08-01

360

Congenital adrenal hyperplasia.  

Science.gov (United States)

An autosomal recessive disorder, congenital adrenal hyperplasia, results from a deficiency in the activity of one of the five enzymes required for cortisol biosynthesis. More than 90% of cases are related to deficiency in 21-hydroxylase enzyme activity, which is required for the conversion of 17OH-progesterone to 11-deoxycortisol. Treatment of congenital adrenal hyperplasia consists of steroid replacement to ensure normal growth and reproductive potential. PMID:18411104

Hughes, I A

1990-01-01

 
 
 
 
361

Congenital chylous ascites  

International Nuclear Information System (INIS)

Congenital chylous ascites is a rare entity, conditioned by numerous factors and with changing dynamics of the disease. Because of the lack of therapeutic and diagnostic standards, this disease constitutes to be a medical challenge. This article presents current knowledge on pathogenesis, diagnostics and management of this disease, as well as a case of a newborn with primary congenital chylous ascites in the abdominal cavity. (authors)

362

The results of total hip arthroplasty for fractured neck of femur in octogenarians.  

Science.gov (United States)

The role of total hip arthroplasty (THA) for fracture in octogenarians remains unclear. Over a two-year period, 354 patients aged > 80 years were admitted with a displaced intracapsular hip fracture. Using defined clinical guidelines, 38 patients underwent THA with a median age of 84 years, mean follow-up of 20 months. Primary outcomes were dislocation, 30-day and one-year mortality, revision surgery and periprosthetic fracture. There were no dislocations or periprosthetic fractures and patient survival was 97% at 30 days and 87% at one year. There was one revision for deep infection. This study demonstrates that THA for selected octogenarians can be performed safely, allows the majority of patients to return to independent living and has a low complication rate. PMID:23958235

Kieffer, Will K M; Dawe, Edward J C; Lindisfarne, Edward A O; Rogers, Benedict A; Nicol, Stephen; Stott, Philip M

2014-03-01

363

MR imaging in congenital lower limb deformities  

Energy Technology Data Exchange (ETDEWEB)

Treatment for children with cogenital deformities of the lower extremities may vary, depending on the state of the unossified skeletal structures and surrounding soft tissues. The purpose of our study was to demonstrate the spectrum of the osteochondral and extrasosseous abnormalities as depicted with MR imaging. We retrospectively reviewed MR examinations of 13 limbs of ten children (aged 1 month-9 years, mean 2.1 years) with longitudinal and transverse deformities of the lower extremities. The lesions imaged were fibular hemimelia (n=5), tibial hemimelia (n=5), and congenital constriction bands (n=3). Each examination was assessed for abnormalities in the osteocartilaginous and extraosseous (articular or periarticular components such as ligaments, tendons, and menisci; the muscles and the arteries) structures. Abnormalities were seen in all patients. Osteocartilaginous abnormalities in the patients with longitudinal deformities included abnormal distal femoral epiphyses, abnormal proximal tribial physes, hypertrophied and dislocated proximal fibular epiphyses, unsuspected fibular and tibial remnants, and absence or coalition of the tarsal bones. No osteocartilaginous abnormalities were seen in the patients with congential constriction bands. Articular abormalities in patients with either form of hemimelia included absent cruciate ligaments and menisci, dislocated or absent cartilaginous patellae, absent patellar tendons, and abnormal collateral ligaments. All but one limb imaged had absent or attenuated muscle groups. Of the nine MR arteriograms performed at the level of the knee, eight were abnormal. The normal popliteal trifurcation was absent or in an abnormal location. We conclude that MR imaging of children with congenital lower extremity deformities shows many osteochondral and extraosseous abnormalities that are not depicted by conventional radiogrpahy. This information can help to plan early surgical intervention and prosthetic rehabilitation. (orig.)

Laor, T. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Jaramillo, D. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Hoffer, F.A. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Kasser, J.R. [Dept. of Orthopedics, Children`s Hospital and Harvard Medical School, Boston, MA (United States)

1996-06-01

364

Lattice dislocation in Si nanowires  

International Nuclear Information System (INIS)

Modified formulas were used to calculate lattice thermal expansion, specific heat and Bulk modulus for Si nanowires with diameters of 115, 56, 37 and 22 nm. From these values and Gruneisen parameter taken from reference, mean lattice volumes were found to be as 20.03 A3 for the bulk and 23.63, 29.91, 34.69 and 40.46 A3 for Si nanowire diameters mentioned above, respectively. Their mean bonding length was calculated to be as 0.235 nm for the bulk and 0.248, 0.269, 0.282 and 0.297 nm for the nanowires diameter mentioned above, respectively. By dividing the nanowires diameter on the mean bonding length, number of layers per each nanowire size was found to be as 230, 104, 65 and 37 for the diameters mentioned above, respectively. Lattice dislocations in 22 nm diameter wire were found to be from 0.00324 nm for the 1st central lattice to 0.2579 nm for the last surface lattice. Such dislocation was smaller for larger wire diameters. Dislocation concentration found to change in Si nanowires according to the proportionalities of surface thickness to nanowire radius ratios.

365

Misfit dislocation nucleation in heteroepitaxy  

Science.gov (United States)

We have studied atomic mechanisms of misfit dislocation nucleation in heteroepitaxy with semiempirical potentials. Many-body mechanisms of stress relaxation are systematically investigated with Lennard-Jones potential in 2D and 3D cases. Energy barriers for dislocation nucleation are estimated using modern methods for saddle point search (Nudged Elastic Band [1], Eigenvector Following [2] and others). Moreover, new simple and effective method for transition paths searching is proposed. Based on the data the critical thickness of film is estimated as a function of film-substrate lattice misfit. Moreover, to make the study more realistic we used EAM [3] potentials in simulations of Pd/Cu and Cu/Pd systems. We show that the dislocations nucleate more easily in compressive than tensile strained films, and in fcc(111) orientation rather than in fcc(100). These findings are in agreement with recent experimental and theoretical works. 1. H. Jonsson, G. Mills and K. W. Jacobsen, in Classical and Quantum Dynamics in Condensed Phase Simulations, ed. by B. J. Berne, G. Ciccotti, and D. F. Coker (World Scientific, Singapore, 1998). 2. L. J. Munro and D. J. Wales, Phys. Rev. B v59, 3969 (1999), and references therein. 3. S. M. Foiles, M. I. Baskes, and M. S. Daw, Phys. Rev. B v33, 7983 (1986).

Trushin, Oleg; Ying, See Chen; Granato, Enzo; Ala-Nissila, Tapio

2001-03-01

366

Transmission electron microscopy analysis of worn alumina hip replacement prostheses  

International Nuclear Information System (INIS)

Explanted worn alumina orthopaedic hip replacements show characteristic wear regions, ranging from severe wear, dominated by intergranular fracture, to regions in which minimal damage has occurred during articulation. The surface damage accumulation mechanisms are complex and not fully understood. This paper presents a detailed transmission electron microscopy (TEM) study of the surface damage accumulation mechanisms following in vitro tested worn alumina hip replacement prostheses. TEM of focused ion beam cross-section samples indicated extensive surface dislocation activity, which is restricted in the outer grain layer. Except for one example of basal slip, all slips were found to be on pyramidal planes. Both inter- and transgranular cracks were observed in regions of high wear. Grooves, largely associated with third-body abrasion, were generally associated with extensive dislocation activity. Three types of wear debris were seen from the worn surface, namely: granular wear debris, nanocrystalline wear debris and oblong wear debris. Wear debris were shown to arise from grain pull-out and severe plastic deformation at the surface. The observations allow a mechanistic model of the damage accumulations leading to wear and ultimately failure.

367

3D Dislocation dynamics modelling of interactions between prismatic loops and mobile dislocations in pure iron  

International Nuclear Information System (INIS)

3D Dislocation dynamics simulations have been carried out to model the interaction between prismatic loops and dislocations in pure iron subject to uniaxial loading conditions. The primary goal was to understand the mechanism of interaction of an a/2 interstitial loop and a mobile dislocation. The secondary goal was to investigate the dependence of the critical stress needed for dislocations to overcome the obstacles as a function of size of loops and their orientation with respect to the glide plane. The simulations have shown a complicated 3D interaction resulting in the mobile dislocation bowing around a loop, either reacting with the loop dislocation or leaving it behind unchanged.

368

Congenital contractural arachnodactyly with neurogenic muscular atrophy: case report  

Directory of Open Access Journals (Sweden)

Full Text Available We report the case of a 3-1/2-year-old girl with hypotonia, multiple joint contractures, hip luxation, arachnodactyly, adducted thumbs, dolichostenomelia, and abnormal external ears suggesting the diagnosis of congenital contractural arachnodactyly (CCA. The serum muscle enzimes were normal and the needle electromyography showed active and chronic denervation. The muscle biopsy demonstrated active and chronic denervation compatible with spinal muscular atrophy. Analysis of exons 7 and 8 of survival motor neuron gene through polymerase chain reaction did not show deletions. Neurogenic muscular atrophy is a new abnormality associated with CCA, suggesting that CCA is clinically heterogeneous.

Scola Rosana Herminia

2001-01-01

369

The association of congenital neuroblastoma and congenital heart disease  

International Nuclear Information System (INIS)

Several authors have reported an association between neuroblastoma and congenital heart disease; others contend that, unlike specific wellknown associations between malignancy and congenital defects (Wilm's tumor and aniridia, leukemia and Down's syndrome), no real relationship exists. We present three cases of cyanotic congenital heart disease in which subclinical neuroblastoma was found. We speculate that abnormal neural crest cell migration and development may be a common link between cardiac malformations and congenital neuroblastoma. (orig.)

370

Complications of hip arthroscopy.  

Science.gov (United States)

Complications associated with hip arthroscopy occur between 1.6% and 5%. Fortunately, with the greater understanding of the causes and advancements in techniques and equipment, the incidence is declining. Most of the complications were transient neuropraxias and fluid extravasations resulting in no permanent damage. Severe scuffing of two femoral heads and one case of avascular necrosis were considered serious and permanent, thereby resulting in a 0.5% rate in our series for significant complications. PMID:11675890

Sampson, T G

2001-10-01

371

Pediatric hip: pearls and pitfalls.  

Science.gov (United States)

Pediatric hip pathology varies depending on patient age. Newborns are often screened for developmental dysplasia of the hip, whereas toddlers and older children can present later with pain, leg length discrepancy, or limp. Young children may have hip pain related to transient synovitis, septic arthritis, or Legg-Calvé-Perthes disease. Older children are more likely to suffer from slipped capital femoral epiphysis or apophyseal avulsion fractures. Knowledge about how the growing skeleton differs from adults as well as the classic imaging findings in many of these diagnoses is paramount when taking care of pediatric patients with suspected hip pathology. PMID:23787987

Gill, Kara G

2013-07-01

372

Developmental dysplasia of the hip: definition, recognition, and prevention of late sequelae.  

Science.gov (United States)

When a child presents with a dislocated hip after the walking age, parents are upset, pediatricians are distraught, and lawsuits often follow. The prevention of late presentation is a goal that all practitioners should strive for. However, at this time, using current diagnostic techniques, the late presentation of DDH can be minimized but not eliminated. The AAP Subcommittee on DDH has estimated that approximately 15% of DDH at birth is not detectible, even by experienced examiners or ultrasonographers. In addition to preventing the late presentation of a developmentally dislocated hip, the prevention of premature degenerative arthritis of the hip secondary to developmental subluxation and acetabular dysplasia is equally, if not more, important in terms or morbidity and cost. It is hoped that the identification and treatment of babies with DDH at birth will have the added benefit of decreasing the incidence of degenerative arthritis of the hip in adults. As the key to early detection remains repeated, careful examination of the infant in the first year of life, it is imperative for practitioners to become as skilled as possible in performing the exam. Unfortunately, medical school curricula and pediatric and family practice residency programs often are deficient in teaching the neonatal hip examination. Strategies for clinicians to improve their examination technique include asking a pediatric orthopedic surgeon to demonstrate the examination in their nursery or attending one of the AAP courses on DDH. Starting a formal DDH screening program in the nursery is another option, using few screeners to maximize their experience. Nurse practitioners, physician's assistants, and physiotherapists could be used in addition to physicians. Having a child present with a developmentally dislocated hip after the walking age is not malpractice if the child has had repeated careful examinations. It is important to document the examinations in writing, rather than placing a check mark next to "musculoskeletal" or "hips" on standard, pre-printed exam forms. The best documentation is a handwritten note that states "the hips are stable and there is wide symmetrical abduction" at every well-child visit. At this time, careful, repeated physical exam supplemented by ultrasonography or X-rays for babies with risk factors is our best strategy to minimize the late presentation of DDH. PMID:16493916

Cady, Robert B

2006-02-01

373

Bone scanning as a useful supplementary examination in the evaluation of hip prothesis  

International Nuclear Information System (INIS)

Although there are permanent improvements in material and in operation techniques the results of cement-anchored alloarthroplastic prothesis of the hip joint are effected by a remarkable rate of loosening. The diagnosis of the loosening of a hip endoprothesis is mainly based on the morphological findings in X-ray films. The only radiological sign of getting loose are unequivocal and drastic dislocations or fractures of the implant. Most of the other radiological signs and clinical findings are equivocal. In these cases the additionally performed bone scanning provides further and important information. The unstable and loosened hip prothesis is characterized by an abnormal, localized and increasing accumulation of the tracer. But a positive bone scan does not absolutely indicate an instability of the endoprothesis in each case. Therefore, static and dynamic scanning cannot replace the well-known, conventional X-ray techniques. Both methods complete each other. (orig.)

374

Plane-strain discrete dislocation plasticity with climb-assisted glide motion of dislocations  

International Nuclear Information System (INIS)

A small-strain two-dimensional discrete dislocation plasticity (DDP) framework is developed wherein dislocation motion is caused by climb-assisted glide. The climb motion of the dislocations is assumed to be governed by a drag-type relation similar to the glide-only motion of dislocations: such a relation is valid when vacancy kinetics is either diffusion limited or sink limited. The DDP framework is employed to predict the effect of dislocation climb on the uniaxial tensile and pure bending response of single crystals. Under uniaxial tensile loading conditions, the ability of dislocations to bypass obstacles by climb results in a reduced dislocation density over a wide range of specimen sizes in the climb-assisted glide case compared to when dislocation motion is only by glide. A consequence is that, at least in a single slip situation, size effects due to dislocation starvation are reduced. By contrast, under pure bending loading conditions, the dislocation density is unaffected by dislocation climb as geometrically necessary dislocations (GNDs) dominate. However, climb enables the dislocations to arrange themselves into lower energy configurations which significantly reduces the predicted bending size effect as well as the amount of reverse plasticity observed during unloading. The results indicate that the intrinsic plasticity material length scale associated with GNDs is strongly affected by thermally activated processes and will be a function of temperature. (paper)

375

Impact of Congenital Heart Defects  

Science.gov (United States)

... other learning difficulties. What is the social/financial impact of congenital heart defects? Successful treatment requires highly ... resources to achieve optimum functioning. What is the impact of congenital heart disease on families?

376

Dislocation interactions mediated by grain boundaries  

International Nuclear Information System (INIS)

The dynamics of dislocation assemblies in deforming crystals indicates the emergence of collective phenomena, intermittent fluctuations and strain avalanches. In polycrystalline materials, the understanding of plastic deformation mechanisms depends on grasping the role of grain boundaries on dislocation motion. Here the interaction of dislocations and elastic, low-angle grain boundaries is studied in the framework of a discrete dislocation representation. We allow grain boundaries to deform under the effect of dislocation stress fields and compare the effect of such a perturbation to the case of rigid grain boundaries. We are able to determine, both analytically and numerically, corrections to dislocation stress fields acting on neighboring grains, as mediated by grain boundary deformation. Finally, we discuss conclusions and consequences for the avalanche statistics, as observed in polycrystalline samples

377

Closed total talus dislocation: a case report.  

Science.gov (United States)

Total dislocation of the talus is caused by a high-energy trauma, that dislocates the talus from all its surrounding articulations. Most cases reported are open talus dislocations; closed dislocations are rarely seen. Complications include avascular necrosis, posttraumatic osteoarthritis and infection. The vascularisation of the talus is delicate and the soft tissue attachments surrounding the talus are important for the blood supply. Closed talus dislocations, closed reduction and careful surgical dissection in case of open reduction respect more soft tissue attachments and potentially reduce the incidence of avascular of necrosis. We describe the case of a 46-year old male patient who sustained a closed total dislocation of the right talus associated with small fractures of the lateral and medial malleolus. The talus could not be reduced by closed means. The malleolar fractures were treated by open reduction and internal fixation. PMID:22308633

Heylen, Steven; De Baets, Thierry; Verstraete, Patricia

2011-12-01

378

Dislocation climb in GaAs  

International Nuclear Information System (INIS)

The weak-beam technique of transmission-electron-microscopy is used to investigate dislocation climb in GaAs, a high supersaturation of point defects being introduced by electron irradiation in a high-voltage-electron-microscope. It is shown that, at room temperature, climb of dissociated a/2 dislocations proceeds by nucleation of both Frank and perfect interstitial loops on the individual partials. Irradiation carried out at higher temperature (4500C) showed evidence for the interaction of the new loops with the non-parent partial, leading to climb of the total dislocation. Dislocations of ? and ?-type, i.e. of opposite edge character, exhibit the same climb mechanism. In this paper, the microscopic mechanism of dislocation climb is analysed and the relevance of this study to the understanding of the degradation of GaAs devices by climbing dislocations is considered

379

Congenital Cardiology Today  

Science.gov (United States)

The mission of the monthly newsletter, Congenital Cardiology Today (CCT), "is to provide reliable and timely information on devices and procedures, patient therapy, drug therapy, supporting technologies, products and services, as well as training opportunities for pediatric cardiologists, hospitals and allied organizations which support their practice." The electronic publication in pdf format is available free-of-charge to qualified professionals around the world working in the fields of pediatric and congenital cardiology (or in a related field). The 21-page April 2005 issue contains such articles as "Congenital Heart Disease in the Developing World," and "Screening for Sudden Cardiac Death Using Pre-participation Physical Exam." The newsletter also provides a list of upcoming medical conferences. Information about requesting free, monthly subscriptions to the North American and-or International editions of the newsletter can be found on the final page of the April issue.

380

Congenital nonhemolytic hyperbilirubinemias.  

Science.gov (United States)

Congenital nonhemolytic hyperbilirubinemias (CNH) are quite rare pathology of liver. They occur most often in children, but are common in adults too. A common feature of congenital nonhemolytic hyperbilirubinemias is an abnormal serum bilirubin level without other abnormalities in routine liver functional tests. Liver histology on light microscopy is normal. Hereditary genetics defect of enzymes taking part in metabolism of bilirubin is the cause of CNH. They are divided into two groups: with unconjugated hyperbilirubinemia (Crigler-Najjar syndrome, Gilbert syndrome) and conjugated hyperbilirubinemia (Dubin-Johnson syndrome and Rotor syndrome). Because CNH in adults are benign disorders and the prognosis is excellent, patients do not require any specific therapy. Is important to take the differential diagnosis. Once the diagnosis of congenital nonhemolytic hyperbilirubinemia is confirmed, patients should be informed of the disease process and its benign nature to prevent needless work-up in the future. In present, CNH are treated as cosmetic defects and no therapy is applied. PMID:16146029

Cichoz-Lach, Halina; Celi?ski, Krzysztof; S?omka, Maria

2004-01-01

 
 
 
 
381

Identification of congenital deafblindness  

DEFF Research Database (Denmark)

For many reasons an accurate and straightforward identification of congenital deafblindness can be difficult. This article reports on the assessment procedures and experience in Denmark where medical examinations were combined with functional assessments performed through direct observation. The study evaluated the assessment procedure of 190 children and adults found to be congenitally deafblind. Among the 190 individuals 76 percent were determined using functional assessment in addition to medical examination. A case example involving a 12-year-old child is also presented to illustrate the complexity in identifying congenital deafblindness. It is concluded that determining deafblindness should not be limited to medical procedures (vision and hearing tests) alone, but may also involve a lengthy process to assess the level of sense functioning the individual possesses.

Dammeyer, Jesper Herup

2012-01-01

382

Congenital Rubella Infection  

Directory of Open Access Journals (Sweden)

Full Text Available Rubella, a mild viral infection in non-pregnant state, becomes a major public health problem when acquired in pregnancy. Infection during pregnancy is responsible for miscarriages, stillbirths and congenital malformation. Late sequelae are frequent. Since children with congenital Rubella do not usually progress toward independence in spite of extensive educational programs and support services, the emotional and economic impact on society remains high. From another point of view, in this country we do not perform therapeutic abortions because of malformed fetus, therefore, the preventive measures for Rubella has a very important role on controlling this highly contagious disease and preventing congenital Rubella syndrome. In this article we review the effects of Rubella virus on fetus, vaccination and serologic screening.

L Eslamian

1998-05-01

383

The epidemiology of shoulder dislocations in Oslo  

Digital Repository Infrastructure Vision for European Research (DRIVER)

There are few previous studies on the incidence of shoulder dislocation in the general population. The aim of the study was to report the incidence of acute shoulder dislocations in the capital of Norway (Oslo) in 2009. Patients of all ages living in Oslo, sustaining a dislocation of the glenohumeral joint, were identified using electronic diagnosis registers, patient protocols, radiological registers of the hospitals, and the Norwegian Patient Register (NPR). The overall incidence rate was 5...

Liavaag, S.; Svenningsen, S.; Reikera?s, O.; Enger, M.; Fjalestad, T.; Pripp, A. H.; Brox, J. I.

2011-01-01

384

Misfit dislocations in composites with nanowires  

International Nuclear Information System (INIS)

A theoretical model is suggested which describes the generation and evolution of misfit dislocations in composite solids containing nanowires with rectangular cross-section. In the framework of the model, the ranges of the geometric parameters (nanowire sizes, misfit parameter, interspacing between the nanowire and the free surface of the composite) are calculated at which the generation of various misfit dislocation configurations (loops, semi-loops and dipoles) is energetically favourable. Transformations of these dislocation configurations and their specific features are discussed

385

Nanoparticles as dislocation sources in nanocomposites  

International Nuclear Information System (INIS)

A new mechanism for nucleation of dislocation dipoles at nanoparticles (nanoinclusions) in nanocomposite solids is suggested and theoretically described. The mechanism represents the nucleation of a nanoscale dipole of 'non-crystallographic' partial dislocations whose Burgers vector magnitudes continuously grow during the nucleation process. It is shown that the dislocations nucleated at nanoparticles can be emitted into a matrix in nanocomposites deformed at high mechanical stresses. (letter to the editor)

386

Femoral head fractures: hemiarthroplasty or total hip arthroplasty?  

Science.gov (United States)

Most femoral neck fractures are osteoporotic fractures in the elderly. The one-year mortality after neck fracture in this group is 24%.For hemiarthroplasty (HA) the bipolar heads have a risk reduction for reoperation due to acetabular erosion compared with monoblock heads. Surprisingly, the bipolar head had an increased reoperation risk for dislocation, infection and for periprosthetic fracture.Total hip arthroplasty (THA) after fracture has a four-fold raised risk for dislocation compared with THA after osteoarthritis. A larger head on the same neck (head to neck ratio) results in a theoretically larger range of movement and hence less risk for dislocation. The dual mobility bearing has, theoretically, the largest range of movement and good clinical results.Functional results are better for THA compared with HA. Arthroplasty for fracture has much better results compared with arthroplasty after a failed internal fixation; the risk for reoperation is more than doubled for the latter.A Swedish hip arthroplasty register study found a 20-fold higher risk for periprosthetic fracture when comparing uncemented HA with matt cemented HA. Also a polished cemented stem had 13½-fold higher risks compared with a matt.The mortality during the first day after surgery is higher for cemented compared with uncemented arthroplasties, but lower after one week, one month and one year. Analysing the time points together resulted in no difference.A matt cemented THA with a maximum head size, maybe dual mobility, has the best results, and is also for the low-demanding elderly. PMID:25329978

Ullmark, Gösta

2014-01-01

387

The ScanHip total hip arthroplasty: radiographic assessment of 72 hips after 10 years.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We analyzed the radiographic and clinical outcome of the ScanHip total hip arthroplasty in 70 patients after 10 years. The Swedish National Hip Register, in which the end-point of the survival analysis is defined as revisions, reported a 10-year survival rate of 94% with the ScanHip, but in the present series 13% of the femoral stems and 29% of the sockets met the criteria for aseptic loosening. Focal osteolysis was found around 8 sockets (11%) and 23 stems (32%) and had occurred significantl...

Iwase, Toshiki; Wingstrand, Inga; Persson, Bjo?rn M.; Kesteris, Uldis; Hasegawa, Yukiharu; Wingstrand, Hans

2002-01-01

388

Congenital epulis. Case report.  

Science.gov (United States)

A newborn baby boy weighing 3100 g was found to have a pinky red solid mass 3 x 2.5 x 2 cm arising from the anterior ridge of the maxilla. This caused difficulty in feeding, and looked ugly. The mass was excised under local anaesthetic when he was 2 days old and histological examination showed congenital epulis. He also had a stage II congenital goitre. His hypothyroidism was treated with L-thyroxine sodium and he was well with no sign of recurrence of the tumour at the age of 1 year. PMID:7597396

Sarihan, H; Gedík, Y; Mocan, H; Kutlu, N; Yildiz, K

1995-03-01

389

Congenital hearing impairment  

International Nuclear Information System (INIS)

Establishing the etiology of congenital hearing impairment can significantly improve treatment for certain causes of hearing loss and facilitates genetic counseling. High-resolution CT and MRI have contributed to the evaluation and management of hearing impairment. In addition, with the identification of innumerable genetic loci and genetic defects involved in hearing loss, genetic testing has emerged as an invaluable tool in the assessment of hearing impairment. Some of the common forms of congenital hearing loss are reviewed and their imaging features illustrated. (orig.)

390

Congenital hearing impairment  

Energy Technology Data Exchange (ETDEWEB)

Establishing the etiology of congenital hearing impairment can significantly improve treatment for certain causes of hearing loss and facilitates genetic counseling. High-resolution CT and MRI have contributed to the evaluation and management of hearing impairment. In addition, with the identification of innumerable genetic loci and genetic defects involved in hearing loss, genetic testing has emerged as an invaluable tool in the assessment of hearing impairment. Some of the common forms of congenital hearing loss are reviewed and their imaging features illustrated. (orig.)

Robson, Caroline D. [Children' s Hospital and Harvard Medical School, Division of Neuroradiology, Department of Radiology, Boston, MA (United States)

2006-04-15

391

Ullrich Congenital Muscular Dystrophy  

Directory of Open Access Journals (Sweden)

Full Text Available ObjectiveUllrich congenital muscular dystrophy is a rather severe type of congenital muscular dystrophy with early onset features related to motor development.In general it is inherited in autosomal recessive principles, however in the Western world mostly seen with de novo dominant mutations in the collagen VI genes. Milder form of the condition is the Bethlem myopathy. There may be overlap forms in the clinic resembling the Ehler-Danlos syndrome. There has been some radical efforts for cure especially through the apoptosis cascades.

Goknur Haliloglu

2011-06-01

392

Complications of revision hip arthroplasty using fresh bone allografts  

Directory of Open Access Journals (Sweden)

Full Text Available General and specific complications of revision hip arthroplasty using fresh bone allografts may affect the postoperative functional outcome to different extent. The aim of this paper was to estimate the incidence and types of intraoperative and early postoperative complications after revision hip arthroplasty, and to clinically and radiographically evaluate their influence on the final postoperative outcome. The most frequent general intraoperative complications were: femoral fracture (6.7% and lesion of the superior gluteal artery. Anterior dislocation of the prosthesis (6.7% and superficial infection (3.3% were the two most frequent early postoperative complications. Of all general complications taken into account, femoral fracture, either intra or postoperative, has the worst prognosis. Bone allograft resorption, as the only specific complication encountered in this study, has a bad prognosis only if it is very extensive. The use of fresh bone allografts, prepared in a special manner, is clinically safe for revision total hip arthroplasty, if a bone bank is not available. .

Miljkovi? Nataša

2007-01-01

393

Indirect lateral surgical approach modified in hip arthroplasty  

International Nuclear Information System (INIS)

The authors show an another option to the surgical approach to the hip, a lateral indirect modified (ALIM) for the partial or total arthroplasty of primary hip replacement and for revision (RTC), in a retrospective study, series of cases, with average was 7,75 years of follow up (range 6 months-10 years); quick access, easy technically, provide a good orientation of the components of the placement of implants, and allow an excellent exhibition for the complex problems of the reconstruction of the acetabular and the femur. Leaves intact the greater trochanter, improving the rotational stability that is needed in its femoral implant, doesn't injured the gluteus medius and doesn't produces his deficit, reduce the time for the deambulation. This approach is designed for primary cases and complex cases of revision using the mini-incision, with better exposition and less morbid-mortality associated to the surgical technique due to the less bleeding, less incidence of dislocation, thromboembolism and infection because of the little damage and better control of the surrounding soft tissue; better stability, no paralysis or lesion of the sciatic or femoral nerve without incidence of heterotopic ossifications with a better range of external rotation in extension of the hip that with traditional approach of Hardinge, and greater versatility in its indications

394

Dislocations in LaBr3 crystals  

Science.gov (United States)

Using a many-body embedded ion method potential for La-Br system, molecular dynamics simulations have been performed to study dislocations in the UCl3 type of LaBr3 crystal including identification of dislocation line energy, core structure, migration mechanism, and mobility. We found that dislocations with the Burgers vector can move under shear stresses, but they retain perfect dislocations during the motion rather than dissociated partials as commonly seen in metal systems. Unlike the edge dislocations whose mobility increases with temperature, the screw dislocations may become sessile at high temperatures due to thermally activated dissociation of the core. Dislocations with the Burgers vector were found to be sessile due to non-planar dissociation at the core. Because the dislocations can only slip on the {1 1 00 } prism plane and often only the edge dislocations are operative, the stresses created during any thermal mechanical processes cannot be effectively relieved by the plastic deformation mechanism. Considering that LaBr3 tend to cleave along the {1 1 00 } prism plane, the simulations shed some lights on why this material is so brittle and how large LaBr3 crystals tend to fracture during growth.

Zhou, X. W.; Doty, F. P.; Yang, Pin

2009-08-01

395

Elasticity and dislocation anelasticity of crystals  

Science.gov (United States)

The book is concerned with the application of the results of physical acoustic studies of elasticity and dislocation anelasticity to the investigation of interatomic interactions and interactions between lattice defects. The analysis of the potential functions determining the energy of interatomic interactions is based on a study of the elastic properties of crystals over a wide temperature range; data on the dislocation structure and on the interaction between dislocations and point defects are based mainly on a study of inelastic effects. Particular attention is given to the relationship between microplastic effects and the initial stage of plastic deformation under conditions of elastic oscillations, when the multiplication of dislocations is negligible.

Nikanorov, S. P.; Kardashev, B. K.

396

Enabling Strain Hardening Simulations with Dislocation Dynamics  

Energy Technology Data Exchange (ETDEWEB)

Numerical algorithms for discrete dislocation dynamics simulations are investigated for the purpose of enabling strain hardening simulations of single crystals on massively parallel computers. The algorithms investigated include the /(N) calculation of forces, the equations of motion, time integration, adaptive mesh refinement, the treatment of dislocation core reactions, and the dynamic distribution of work on parallel computers. A simulation integrating all of these algorithmic elements using the Parallel Dislocation Simulator (ParaDiS) code is performed to understand their behavior in concert, and evaluate the overall numerical performance of dislocation dynamics simulations and their ability to accumulate percents of plastic strain.

Arsenlis, A; Cai, W

2006-12-20

397

Massively-Parallel Dislocation Dynamics Simulations  

Energy Technology Data Exchange (ETDEWEB)

Prediction of the plastic strength of single crystals based on the collective dynamics of dislocations has been a challenge for computational materials science for a number of years. The difficulty lies in the inability of the existing dislocation dynamics (DD) codes to handle a sufficiently large number of dislocation lines, in order to be statistically representative and to reproduce experimentally observed microstructures. A new massively-parallel DD code is developed that is capable of modeling million-dislocation systems by employing thousands of processors. We discuss the general aspects of this code that make such large scale simulations possible, as well as a few initial simulation results.

Cai, W; Bulatov, V V; Pierce, T G; Hiratani, M; Rhee, M; Bartelt, M; Tang, M

2003-06-18

398

Epidemiology of Isolated Acromioclavicular Joint Dislocation  

Science.gov (United States)

Background. Acromioclavicular (AC) joint dislocation is a common shoulder problem. However, information about the basic epidemiological features of this condition is scarce. The aim of this study is to analyze the epidemiology of isolated AC dislocation in an urban population. Materials and Methods. A retrospective database search was performed to identify all patients with an AC dislocation over a 5-year period. Gender, age, affected side and traumatic mechanism were taken into account. X-rays were reviewed by two of the authors and dislocations were classified according to the Rockwood's criteria. Results. A total of 108 patients, with a mean age of 37.5 years were diagnosed with AC dislocation. 105 (97.2%) had an isolated AC dislocation, and 3 (2.8%) were associated with a clavicle fracture. The estimated incidence was 1.8 per 10000 inhabitants per year and the male-female ratio was 8.5?:?1. 50.5% of all dislocations occurred in individuals between the ages of 20 and 39 years. The most common traumatic mechanism was sport injury and the most common type of dislocation was Rockwood type III. Conclusions. Age between 20 and 39 years and male sex represent significant demographic risk factors for AC dislocation. PMID:23431452

Dei Giudici, Luca; Alibardi, Ambra; Salate Santone, Francesco; Ramos Alday, Luis J.; Osimani, Marcello

2013-01-01

399

Dislocation-impurity interaction in Si  

International Nuclear Information System (INIS)

Dynamic dislocation-impurity interactions in CZ-Si doped with light impurity (N), acceptor (B), donor (P, As, Sb) and neutral (Ge) impurities were investigated in comparison with those in undoped CZ-Si. Dislocation generation was effectively suppressed in B-, P- and As-doped Si when the concentration was higher than 1019 cm-3, while Ge impurity did not strongly suppress dislocation generation. Dislocations were immobilized by the stable complexes formed through the impurity segregation and reaction. It was found that B and N impurities promptly form strong locking agents, while P and As impurities form highly dense locking agents along dislocations. Dislocation velocity in Si doped with electrically active impurities increased with increasing concentrations of not only the donor (P, As, Sb) but also the acceptor (B) impurities in the temperature range of 650-950 deg. C. N and Ge impurities had no or little effect on the velocity of dislocations in motion. Co-doping of Si with Ge and B was effective for suppression of dislocation generation and retardation of dislocation velocity at low temperatures

400

Dislocation-impurity interaction in Si  

Energy Technology Data Exchange (ETDEWEB)

Dynamic dislocation-impurity interactions in CZ-Si doped with light impurity (N), acceptor (B), donor (P, As, Sb) and neutral (Ge) impurities were investigated in comparison with those in undoped CZ-Si. Dislocation generation was effectively suppressed in B-, P- and As-doped Si when the concentration was higher than 10{sup 19} cm{sup -3}, while Ge impurity did not strongly suppress dislocation generation. Dislocations were immobilized by the stable complexes formed through the impurity segregation and reaction. It was found that B and N impurities promptly form strong locking agents, while P and As impurities form highly dense locking agents along dislocations. Dislocation velocity in Si doped with electrically active impurities increased with increasing concentrations of not only the donor (P, As, Sb) but also the acceptor (B) impurities in the temperature range of 650-950 deg. C. N and Ge impurities had no or little effect on the velocity of dislocations in motion. Co-doping of Si with Ge and B was effective for suppression of dislocation generation and retardation of dislocation velocity at low temperatures.

Yonenaga, I. [Institute for Materials Research, Tohoku University, Katahira 2-1-1, Aoba-ku, Sendai 980-8577 (Japan)]. E-mail: yonenaga@imr.tohoku.ac.jp

2005-12-05

 
 
 
 
401

Misfit dislocation loops in cylindrical quantum dots  

International Nuclear Information System (INIS)

A theoretical model is suggested which describes the generation of prismatic misfit dislocation loops surrounding cylindrical quantum dots. These dislocation loops partly accommodate misfit stresses in cylindrical quantum dots embedded in a film deposited onto a substrate. In the framework of the model, the ranges of geometric parameters (misfit parameter f, quantum dot radius a and its height H) are calculated at which the generation of misfit dislocation loops surrounding cylindrical quantum dots is energetically favourable. The exemplary cases of dislocation loop generation in InxGa1-xN/GaN and GaN/AlN systems are briefly discussed

402

Total hip arthroplasty for ankylosed hip secondary to heterotopic ossification.  

Science.gov (United States)

Heterotopic ossification (HO) secondary to traumatic brain injury occurs at various sites and most commonly at the elbow, shoulder, and hip. There are few published reports on the assessment and surgical resection techniques of HO. A complete preoperative physical examination and radiologic assessment with a computed tomographic scan are important for the thorough evaluation of a patient. We describe a patient with neurogenic HO of the hip secondary to traumatic brain injury who underwent a total hip arthroplasty (THA). In selected patients with hip HO, THA supplemented with postoperative radiotherapy and indomethacin prophylaxis can facilitate progressive functional movements of the hip. To our knowledge, there is no report in the English literature of a THA being preformed for HO. PMID:18358392

Kaliyaperumal, Kannan; Sathappan, Sathappan S; Peng, Low Yin

2008-04-01

403

Total hip and knee replacement in a patient with arthrogryposis multiplex congenita.  

Science.gov (United States)

Arthrogryposis multiplex congenita (AMC) is a complex disorder that leads to joint stiffness and deformities in 2 or more joints in afflicted children. Late manifestations of this disorder can include secondary degeneration of the abnormal joints with arthritic symptoms of pain and loss of function. There are few reports in the orthopedic literature on the use of total joint arthroplasty to improve the pain and function in patients with arthrogryposis. This case report presents one patient who underwent bilateral total hip and total knee arthroplasties for deteriorating function and pain in her hips and knees secondary to the congenital deformities created by arthrogryposis multiplex congenita. We discuss the intraoperative difficulties and techniques used to reconstruct her hips and knees, as well as the potential indications for joint arthroplasty in this challenging group of patients. PMID:24730009

Fisher, Kimberly A; Fisher, David A

2014-04-01

404

A mini-anterior approach to the hip for total joint replacement: optimising results: improving hip joint replacement outcomes.  

Science.gov (United States)

Direct anterior approaches to the hip have gained popularity as a minimally invasive method when performing primary total hip replacement (THR). A retrospective review of a single institution joint registry was performed in order to compare patient outcomes after THR using the Anterior Supine Intermuscular (ASI) approach versus a more conventional direct lateral approach. An electronic database identified 1511 patients treated with 1690 primary THRs between January 2006 and December 2010. Our results represent a summary of findings from our previously published work. We found that patients that underwent an ASI approach had faster functional recovery and higher Harris hip scores in the early post-operative period when compared with patients who had a direct lateral approach The overall complication rate in our ASI group was relatively low (1.7%) compared with other series using the same approach. The most frequent complication was early periprosthetic femoral fractures (0.9%). The dislocation rate in our series was 0.4% and the prosthetic joint infection rate was 0.1%. We suggest that the ASI approach is acceptable and safe when performing THR and encourages early functional recovery of our patients. Cite this article: Bone Joint J 2014;96- B(11 Suppl A):32-5. PMID:25381405

Mirza, A J; Lombardi, A V; Morris, M J; Berend, K R

2014-11-01

405

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... needs a hip replacement because he has a disease called osteoarthritis, which is essentially a destruction of the hip joint. Because the patient cannot tolerate the non-operative route, which means the pills and the shots and the therapy that was tried, he is unable to function. ...

406

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... okay? And that allows us to basically play video games and look inside the hip joint. So you can see here, that's the labrum of the hip, okay? That's that little capsule of ... looks like here? Show a little video snippet of that and then we'll pan ...

407

Biomechanics of the hip joint  

International Nuclear Information System (INIS)

The load and the stress of the hip joint are related to the density of bone, thickness of cartilage and pattern of the cancellous bone. The X-rays of the hip joint must provide all information for the calculation of the individual strain and stress. (orig.)

408

Discrete Dislocation Modeling of Fatigue  

Science.gov (United States)

In joint work with V.S. Deshpande of Cambridge University and E. Van der Giessen of the University of Groningen a framework has been developed for the analysis of crack growth under cyclic loading conditions where plastic flow arises from the motion of large numbers of discrete dislocations and the fracture properties are embedded in a cohesive surface constitutive relation. The material model is independent of the presence of a crack and the only distinction between an analysis of monotonic crack growth and fatigue crack growth is that in fatigue the remote loading is specified to be an oscillating function of time. Thus, a basic question is: within this framework, do cracks grow at a lower driving force under cyclic loading than under monotonic loading, and if so, what features of fatigue crack growth emerge? Fatigue does emerge from the calculations as a consequence of the evolution of internal stresses associated with the irreversibility of the dislocation motion. A fatigue threshold, Paris law behavior, striations and the accelerated growth of short cracks are outcomes of the simulations. Also, scaling predictions obtained for the fatigue threshold and the fatigue crack growth rate are discussed.

Needleman, Alan

2004-03-01

409

Transient Osteoporosis of the Hip  

Directory of Open Access Journals (Sweden)

Full Text Available Transient osteoporosis of the hip is often seen in middle-aged men and in women during the third trimester of pregnancy and is characterized by acute, spontaneous hip pain. In suspected cases magnetic resonance imaging shows bone marrow edema within 48 hours from the onset of pain. Transient osteoporosis is a diagnosis of exclusion and differential diagnosis with other diseases presented with hip pain and bone marrow edema should be considered. Although it is a self limiting condition it must be kept in mind that it may migrate and involve other joints in the lower extremities like knee, ankle and contralateral hip. The cornerstone of treatment is joint protection and limited weight bearing and antiresorptive medication may be of benefit. This review summarizes conditions defined with the terms of transient osteoporosis of the hip, migratory osteoporosis, pregnancy induced osteoporosis and transient bone marrow edema syndrome. Turk J Phys Med Rehab 2009; 55 Suppl 1: 41-5.

Rengin Güzel

2009-04-01

410

Congenital diaphragmatic hernia  

Energy Technology Data Exchange (ETDEWEB)

Three cases of congenital diaphragmatic hernia in the adult are reported. Strangulation of the large bowel was the presenting feature in 1 case and pancreatitis in another. The abnormality was discovered as a coincidental finding in a third case. The incidence, presentations, and diagnosis of this uncommon condition are discussed.

Cope, R.

1981-05-15

411

Congenital diaphragmatic hernia  

International Nuclear Information System (INIS)

Three cases of congenital diaphragmatic hernia in the adult are reported. Strangulation of the large bowel was the presenting feature in 1 case and pancreatitis in another. The abnormality was discovered as a coincidental finding in a third case. The incidence, presentations, and diagnosis of this uncommon condition are discussed. (orig.)

412

Bilateral Congenital Diaphragmatic Hernia  

Directory of Open Access Journals (Sweden)

Full Text Available Bilateral congenital diaphragmatic hernia (CDH is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension.

Anjan K Dhua

2012-08-01

413

Multiple congenital cranial hemangiomas  

International Nuclear Information System (INIS)

Though cranial hemangiomas are second only to vertebral hemangiomas in frequency, such lesions are rarely congenital and multiple. It is probable that the true incidence of congenital calvarial hemangiomas is higher than that reported in the literature, as they are unlikely to undergo imaging, most being asymptomatic and without a significant soft tissue component. We present a case of multiple congenital calvarial and skull base cavernous-type hemangiomas, diagnosed in a 4-day-old female, involving the right zygoma, maxilla, frontal and petrous temporal bones and contralateral squamous temporal bone. Surgical biopsy confirmed the radiological diagnosis as well as the concomitant multiple subcutaneous capillary-type hemangiomas which were identified clinically. No specific clinical syndrome or chromosomal abnormality was identified and the underlying cerebral parenchyma was normal with no intra-axial involvement. With conservative treatment, two lesions completely resolved and a further two lesions subsequently decreased in both size and degree of enhancement. To the best of our knowledge, this is the first case of multiple congenital hemangiomas involving the calvarium and skull base. Despite this, the radiological features, combined with the clinical findings of multiple capillary hemangiomas, were characteristic enough to permit an accurate preoperative diagnosis. Osseous hemangiomas should feature prominently in any differential diagnosis of multiple hypervascular lesions, as they are common, more so when limited to an anatomical region, irrespective of site or age. (orig.)

414

Congenital Absence of Tibia  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital absence of tibia is a rare anomaly. We repol1 a case who presented at the age of 3 years withabsence of tibia right side with associated anomolies and was managed by reconstruction of the kneeand ankle joints b transfer of fibula

Sudesh Sharma, Saleem Mir, Vikrant Sharma, Irshad Dar, Rafee

2002-10-01

415

Congenital Lumbar Hernia  

Directory of Open Access Journals (Sweden)

Full Text Available Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

Sanjay Sharma

2008-01-01

416

Hybrid dislocated control and general hybrid projective dislocated synchronization for the modified Lue chaotic system  

Energy Technology Data Exchange (ETDEWEB)

This paper introduces a modified Lue chaotic system, and some basic dynamical properties are studied. Based on these properties, we present hybrid dislocated control method for stabilizing chaos to unstable equilibrium and limit cycle. In addition, based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization (GHPDS) is proposed, which includes complete dislocated synchronization, dislocated anti-synchronization and projective dislocated synchronization as its special item. The drive and response systems discussed in this paper can be strictly different dynamical systems (including different dimensional systems). As examples, the modified Lue chaotic system, Chen chaotic system and hyperchaotic Chen system are discussed. Numerical simulations are given to show the effectiveness of these methods.

Xu Yuhua [College of Information Science and Technology, Donghua University, Shanghai 201620 (China) and Department of Maths, Yunyang Teacher' s College, Hubei 442000 (China)], E-mail: yuhuaxu2004@163.com; Zhou Wuneng [College of Information Science and Technology, Donghua University, Shanghai 201620 (China)], E-mail: wnzhou@163.com; Fang Jianan [College of Information Science and Technology, Donghua University, Shanghai 201620 (China)

2009-11-15

417

Stone-Wales defect as a dipole of dislocation and anti-dislocation  

International Nuclear Information System (INIS)

Stone-Wales defect in a single-walled carbon nanotube has been investigated theoretically by a fully discrete dislocation equation. It is found that Stone-Wales defect as a fundamental structure can be obtained from the basic dislocation equation, which is used to determine the structure of the dislocations. In addition, there are two possible equilibrium configurations for the Stone-Wales defect. -- Highlights: ? The nonlinear mode only existed in the discrete structure is studied. ? The dislocation equation that can deal with dislocation dipole is put forward. ? Stone