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Sample records for hip dislocation congenital

  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. Congenital hip dislocation: Radiological screening or diagnosis?

    International Nuclear Information System (INIS)

    Congenital hip dislocation is a perfect example of public health problems: its incidence is high 0.6, to 2% of newborns in France and an early detection allows an easy and successful treatment. The current situation in our country is not satisfactory for several reasons: - Too many children are treated without reasons because of misleading radiological pictures; - Conversely, some dislocations are discovered only at the walking age, the treatment becoming then more difficult and less effective; - Almost 300,000 radiological examinations of the hip for screening are performed each year and among them 100,000 in newborns. This is not satisfactory as it is commonly admitted now that radiological examination at birth is unreliable and frequently misleading. For all these reasons a special working group has been settled up by the General Direction of Health, including physicians of different practices, from different specialities. The conclusion of this group will be published in a special booklet and can be summarized as follows: The group recommends to perform detection of congenital hip dislocation mainly by the clinical examination. This examination may be difficult but it must be performed very early, the first day of life, repeated several times, at the end of the first week and during the first, second, and third month. Every baby in this country must undergo several clinical examinations up to one year of age

  3. CONGENITAL DISLOCATION OF RIGHT HIP JOINT: IMPORTANCE OF DYNAMIC ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Pranita viveki

    2014-11-01

    Full Text Available Congenital Dislocation of Hip (CDH, is one of the most common congenital diseases in the orthopedic field. It is also known as Developmental Dysplasia of Hip. The condition can be diagnosed by clinical, ultrasonographic and radiological examination. Here we are reporting two days old male baby with congenital dislocation of right hip joint. The goal of treatment is to obtain a reduction to provide an optimal environment for femoral head and acetabular development. Early diagnosis is the most crucial aspect of the treatment of children with congenital dislocation of hip. If dislocation remains undiagnosed or neglected, the secondary pathological changes take place. Education of primary care colleagues, in making the diagnosis and prompt referral for management is recommended.

  4. Neonatal screening in Vancouver for congenital dislocation of the hip.

    OpenAIRE

    Lehmann, E C; Street, D G

    1981-01-01

    After 20 years' experience throughout the Western world the effectiveness of screening newborns for congenital dislocation of the hip remains controversial. Is the clinical test for hip instability (the Ortolani or "jump" sing) reliable? Are other equally important physical signs frequently missed by inexperienced examiners? Do some dislocations develop after the newborn period when no abnormality was identifiable during the first week of life? In Vancouver, screening for this condition was i...

  5. Hip dislocation during lengthening of congenital short femur.

    Science.gov (United States)

    Dhawale, Arjun A; Johari, Ashok N; Nemade, Amit

    2012-05-01

    Hip dislocation is a serious but rarely reported complication of femoral lengthening in congenital short femora. We report a retrospective series of three hip dislocations that occurred during lengthening, analyze the factors contributing to the dislocation, and discuss the treatment of this difficult problem. The average lengthening achieved was 9 cm. We found progressive acetabular dysplasia and decreasing center edge angle. Closed reduction failed. Treatment included soft tissue release, open reduction with femoral shortening, and acetabular procedures. At a mean follow-up of 4.4 years, two patients had a good modified Mckay score and a modified Severin score of 3. Excessive lengthening should be avoided. PMID:22186706

  6. Incidence of selective ultrasound screening in congenital hip dislocation diagnosis

    International Nuclear Information System (INIS)

    For the purpose of reducing the number of cases of late-diagnosed congenital hip dislocations, of the 1149 infants born in the province of Segovia during 1992, ultrasound exploration of the hip was performed in 297 who presented risk factors or abnormalities detected at physical examination. Of these, 16(1.4%) presented femoral head instability (13 subluxated or dislocated, and 3 susceptible to subluxation). Among this group, only 3 infants, versus a mean of 8 cases in preceding years, in whom radiolography was performed as a complementary study, were over four months old at the time of the exploration. Thus, it can be concluded that the use of ultrasound as a selective screening method significantly reduces the age at which diagnosis is feasible

  7. Functional treatment of congenital dislocation of the hip

    OpenAIRE

    Visser, Jan Douwes,

    1984-01-01

    A prerequisite for the development of ongenital dislocation of the hip is ligamentous laxity of the hip-joint which is demonstrable shortly after birth when the hip can be easily dislocated and reduced. This situation is described as dislocatable hip. Ligamentous laxity naturally tends to dissappear, and 90% of all dislocatable hips in fact stabilize spontaneously. No dislocation develops unless an exogenous factor is involved. In infants born in breech presentation the hyperextension of the ...

  8. Hip and knee dislocation during femoral lengthening in congenital short femur: a rare case report.

    Science.gov (United States)

    Hazra, Sunit; Song, Hae-Ryong; Jajodia, Nirmal; Biswal, Sandeep; Modi, Hitesh N; Srinivasalu, S

    2009-04-01

    Congenital short femur is a rare and complex deformity that is often associated with other anomalies. There are few reports of either hip or knee dislocations during femoral lengthening in congenital short femur predisposed by associated anomaly. However, there are probably no case reports of both hip and knee joint dislocation occurring in same case during femoral lengthening in congenital short femur. We have this case of congenital short femur, where both hip and knee dislocation occurs during femoral lengthening. We reviewed different article to understand the cause and avoid such unwanted complications in future. PMID:18600335

  9. Unilateral congenital dislocation of the knee and hip: a case report.

    Science.gov (United States)

    Tajdar, Farhad; Victor, Jan

    2012-02-01

    We report our experience with a unilateral congenital dislocation of the knee associated with a developmental dysplasia of the hip on the same side. Our case is a good example of congenital dislocation of the knee caused by abnormal intrauterine pressure leading to this type of congenital postural deformity. To our knowledge this is the first case of congenital dislocation of the knee reported after cervical cerclage of an incompetent cervix to prevent a pre-term delivery. The Pavlik Harness was used to treat the knee and the hip at the same time with a satisfactory result after 20 months of follow-up. PMID:22523942

  10. Total hip replacement in congenital high hip dislocation following iliofemoral monotube distraction

    OpenAIRE

    Holinka, Johannes; Pfeiffer, Martin; Jochen G. Hofstaetter; Lass, Richard; Kotz, Rainer I.; Giurea, Alexander

    2010-01-01

    The aim of this study was to prospectively evaluate our single-centre one- and five-year results of anatomically correct cementless total hip arthroplasty in unilateral and bilateral Crowe type IV high hip dislocations in ten hips following iliofemoral monotube soft tissue distraction. Six consecutive patients (five females and one male) with unilateral and two female patients with bilateral high hip dislocation with an average age of 46 years and height of dislocation up to 110 mm were treat...

  11. Use of the Pavlik harness in nonoperative management of congenital dislocation of the hip1

    OpenAIRE

    SMITH, M.A.

    1981-01-01

    The Pavlik harness and its application are described. A series is reported of 25 patients with congenital dislocation of the hip, aged between one day and eight months, all of whom were successfully treated in the harness. Since the harness was found to be effective in treating older infants, it is suggested that treatment of the newborn could be delayed until the age of two or three months, thus avoiding unnecessary treatment of those hips which will reduce spontaneously.

  12. A national survey of screening for congenital dislocation of the hip.

    OpenAIRE

    Dezateux, C.; Godward, S

    1996-01-01

    OBJECTIVE: To identify current screening and management practices for congenital dislocation of the hip (CDH), and determine the extent to which ultrasound imaging of the hips is practised throughout the United Kingdom and the Irish Republic. METHODS: Postal questionnaire to paediatricians responsible for the routine neonatal care of infants in all maternity units in the UK and the Irish Republic. RESULTS: Questionnaires were returned for 254 maternity units (92% response rate). By 1994, 69% ...

  13. Comparing the rate of femoral head necrosis of two different treatments of congenital dislocation of the hip.

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    Naumann, T; Zahniel, K

    1990-01-01

    We examined 120 patients with 140 congenital dislocations of the hip joint for femoral head necrosis. Of these, 77 hips were reduced with a Hoffmann-Daimler brace and the patients were subsequently placed in a spica cast in Lange position after a period in the Lorenz position. The hips of 43 patients were reduced the same way but were retained in a spica as described by Fettweis. The Lorenz group showed 10 grade II and III femoral head necroses, whereas there was only one grade III necrosis in the Fettweis group. The results were compared with the collected statistics of the German survey of congenital dislocation of the hip. PMID:2250065

  14. Ultrasound screening and follow-up of congenital hip dislocation

    International Nuclear Information System (INIS)

    US screening for hip dysplasia was performed on 1421 full-term newborns. The study was aimed at: 1) evaluating US feasibility in an unselected maternity ward population; 2) determining the frequency of the different types of hips, and correlating ours with literature data; 3) evaluating the efficacy of both an early prevention and treatment. All US examination were performed within the first week of life and the 2842 hips classified according to Graf. At birth, normal hips (Ia, Ib) were 2064 (72.6%) (group I); Physiologically immature hips (IIa) were 721 (25.4%) (group II); pathological hips (group III) were: 43 (1.5%) IIc, 8 (o.3%) IId, 6 (0.2%) III. Hips in group B were cheked at 3 months: 502 were normal, 51 were type IIb, and 1 was type IId: the latter 52 hips were treated and normalized in the following months. Hips in group C (types IIc, IId, and III=57 hips) were treated and cheked every seventh week until normalization. Our experience confirm US value in the evaluation of hip dysplasia in the newborn. In our opinion, the use of this method shoul be encouraged, although US screening of all newborns remains controversial on a cost-benefit ratio. Multicentric studies will better define US sensitivity, specificity and reliability. The correlation of ours results with literature data was difficult, because study populations are not always homogeneous. As for therapy, we found the plastic splint very effective and easy to use: In 2 cases, Milgram devices were used for a few months

  15. The application of MRI in the infantile congenital dislocation of the hip

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of MRI in infantile congenital dislocation of the hip (CDH), and to provide a reasonable basis for clinical examination. Methods: Forty-seven infants (< 3 years) with untreated CDH were examined by using MR imaging. Three types were classified according to the standard of Ogden and Dunn, and then the bony and cartilaginous hip parameters of all hips, including the bony acetabular index (BAI), cartilaginous acetabular index (CAI), bony acetabular quotient (BAQ), and cartilaginous acetabular quotient (CAQ), were measured except in the type III hips. Results: For the normal hips, dislocated hips, the type I hips, and the type II hips, BAI was (25.24 ± 3.70) degree, (38.12 ± 4.07) degree, (35.59 ± 2.86) degree, and (39.64 ± 3.97) degree, respectively, CAI was (8.49 ± 2.15) degree, (17.25 ± 2.41) degree, (15.85 ± 2.00) degree, and (18.08 ± 2.26) degree, respectively, BAQ was 0.199 ± 0.026, 0.126 ± 0.028, 0.131 ± 0.028, and 0.124 ± 0.028, respectively, CAQ was 0.195 ± 0.027, 0.120 ± 0.027, 0.120 ± 0.023, and 0.121 ± 0.030, respectively. The BAI and CAI of the type II hips were higher than those of the type I, and BAQ and CAQ were lower. There was a linear correlation between BAI and CAI (r=0.876) and between BAQ and CAQ (r=0.706), respectively. MRI demonstrated that bony changes as loss of sphericity and diminished aperture of the acetabulum, and cartilage changes as the distortion and overgrowth in CDH. Conclusion: MR imaging is not only a very useful imaging modality for assessment of the bony, cartilaginous, and soft-tissue structures of the infantile hip, but also an excellent tool in the diagnosis and treatment of CDH. (author)

  16. Factors leading to hip subluxation and dislocation in femoral lengthening of unilateral congenital short femur.

    Science.gov (United States)

    Bowen, J R; Kumar, S J; Orellana, C A; Andreacchio, A; Cardona, J I

    2001-01-01

    Congenital short femur is a rare and complex deformity. For it to be treated in the most accurate way, we must know of every possible complication. The purpose of this study was to determine the factors leading to hip subluxation or dislocation in patients with an unilateral congenital short femur who underwent a femoral lengthening procedure. Forty-four patients with congenital unilateral short femora types I, II, and IIIA were seen between 1981 and 1993 at Alfred I. duPont Hospital for Children. Seventeen patients had type I, 9 patients had type II, and 18 patients had type IIIA. Twenty patients underwent simultaneous lengthening of the femur and tibia, and 24 patients had primary lengthening of the femur. Eleven patients had an epiphysiodesis of the contralateral femur for residual leg length discrepancies of congenital short femur in association with an acetabular dysplasia prior to the lengthening. We recommend correction of the varus bow of the femur and the neck-shaft angle to 120 degrees and the acetabular index to <25 degrees prior to lengthening of type IIIA femora. PMID:11371820

  17. Differentiated method of physiotherapy for patients with congenital hip dislocation in postoperative rehabilitation period

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    Pozdniakova ?.N.

    2011-06-01

    Full Text Available The aim of the research was to develop a new rehabilitation method for patients with congenital dislocation of hip in the late postoperative period. It is based on anatomical, physiological, pathogenetic, functional and ontogenetic foundations and prevents coxarthrosis development and progress. Materials. The data from examination and treatment of 71 patients are presented. The main group consisted of 48 children and the comparison group consisted of 23 children. Methods. Data processing was made by «Statistica 6,0» programme. Normalcy of distribution was estimated by the Shapiro-Wilktest. Hypothesis proof of two means equality was provided by the Wilcoxon signed-ranktest. Correlation analysis was made by definition of the Pearson correlation coefficient and the Spearman»s rank correlation coefficient. Rate difference was considered as a reliable rate if p<0,05. Results. According to the results, a proper short-term gait stereotype formation has been attained as opposed to the routine rehabilitation methods. Conclusion. Due to advantages of the new method, therapy efficiency is extended and reoperation risks are decreased

  18. Ranking of computed tomography in congenital hip dysplasia and hip dislocation

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    Lingg, G.; Nebel, G.; Thomas, W.; Hering, L.

    1983-12-01

    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.

  19. 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.)

  20. 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)

  1. Aetiology and interrelationship of some common skeletal deformities. (Talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile idiopathic scoliosis).

    OpenAIRE

    Wynne-Davies, R; Littlejohn, A; Gormley, J.

    1982-01-01

    The Edinburgh Register of the Newborn 1964-1968 and the Edinburgh Scoliosis Clinic 1964-1971 have been used to establish the population frequency in the city of the idiopathic forms of talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile scoliosis. A survey of 165 patients now aged 7 to 11 years showed an aetiological relationship, but with differing environmental factors. These factors were established by comparison with the Edinburgh Reg...

  2. Cost-benefit evaluation of systematic radiological diagnosis of congenital dislocated hip

    International Nuclear Information System (INIS)

    The interest of radiological mass screening of congential dislocated hip is still debated. We have tried to evaluate the cost-benefit ratio of radiological detection at the age of 3-4 months, taking into account the socio-economic cost and radiation risk. Assuming a frequency of this disorder of 1% the average cost of treatment of one case detected by X-ray screening at the age of 3-4 months, including the price of X-ray examinations of 99 normal babies is 23.374 FF. The average cost of treatment of a case detected at walking-age, i.e. after 9 months, is 84.230 FF. The cost-benefit ratio is 3.6. In countries where the frequency reaches 2% the cost benefit ratio is 4.57. It also appears from our study that the irradiation of the patient is much smaller when the diagnosis is made earlier. Comparing the slight irradiation delivered to normal infants by this mass screening to the heavy irradiation received by a few individuals whose treatment is started after 9 months, the calculated risk of leukemia or of genetic disorder for the whole population still favours a systematic X-ray film of the pelvis at age 3-4 months. However, if it were decided to make obligatory this mass radiological detection programme during the fourth month of life, this would necessitate a serious effort to train all radiologists to obtain adequate films with the best radiation protection. (orig.)

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

    OpenAIRE

    Koshimune,Gisaburo

    1985-01-01

    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 degr...

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

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    Koshimune,Gisaburo

    1985-06-01

    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.

  5. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

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    Iulian ICLEANU

    2015-11-01

    Full Text Available Congenital hip luxation is a disorder which evolves in time. Teratological hip dislocation is a distinct form of hip luxation, which usually appears with other disorders. These hips are dislocated before birth. In this thesis we will try to elaborate a recovery program, through physical exercises, which will help us realize our treatment objectives: diminishing articular stiffness, increasing articular mobility, increasing muscle strength, recalibration of agonist and antagonist balances and reeducating gait. The specific objectives of the study consist of the particularization of the recovery programs based on age, illness stage (dysplasia or luxation and either surgical or non-surgical intervention. To show the importance of physiotherapy in gait rehabilitation of a child with hip dislocation we started from the hypothesis: using an adequate rehabilitation program after an individualized methodology, optimizes the functional recovery and ensures the gains of hip stability and the formation of an engram of gait as close as it could be to the normal one. We present a case of neurological congenital hip dislocation where the treatment initiated early is showing good results. Results obtained are significantly different and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient has better biomechanical results for the hip.

  6. The surgical treatment of established congenital dislocation of the hip: results of surgery after planned delayed intervention following the appearance of the capital femoral ossific nucleus.

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    Clarke, Nicholas M P; Jowett, Andrew J L; Parker, Lee

    2005-01-01

    It has been proposed that the presence of the capital femoral ossific nucleus confers protection against ischemic injury or avascular necrosis (AVN) at the time of reduction of a congenitally dislocated hip. The current literature is contradictory. A prospective study was undertaken of the clinical and radiologic outcomes following closed or open reduction. Fifty hips were included in the study. These cases had presented late or had failed conservative treatment. In 28 hips treatment was intentionally delayed until the appearance of the ossific nucleus (but not beyond 13 months) and in 22 the ossific nucleus was present at clinical presentation. Six hips reached the age of 13 months without an ossific nucleus appearing and progressed to treatment. The significant AVN rate (more than grade 1) was 7% for closed reduction and 14% for open. However, the amended rate if hips were excluded that had failed Pavlik harness treatment was 0.0% and 9%, respectively (4% overall). Further surgical procedures were necessary in 57% of hips undergoing closed reduction and 41% after open, which compares favorably with other series. The authors conclude that the presence of the ossific nucleus is an important factor in the prevention of AVN, particularly after late closed reduction. Intentional delay in the timing of surgery does not condemn a hip to open surgery, but there is a comparable rate of secondary procedures becoming necessary, particularly after closed reduction. A simultaneous pelvic procedure may be appropriate after late closed reduction. The delayed strategy to await the appearance of the ossific nucleus for previously untreated dislocation allows a simple treatment algorithm to be employed that produces good clinical and radiologic outcomes. PMID:15958890

  7. Acetabular development in the infant's dislocated hips.

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    Cherney, D L; Westin, G W

    1989-05-01

    The course of development of acetabulae after the reduction of congenitally dislocated hips was investigated to identify factors that might predict the need for acetabuloplasty. One hundred five congenitally dislocated hips in 83 children were followed roentgenographically for an average of eight years after reduction. While the percentage of children requiring later acetabuloplasty increased somewhat with advancing age at the time of reduction, numerous acetabulae in the older groups developed satisfactorily without later surgery. The prereduction acetabular index proved a much more reliable predictor of the need for later acetabuloplasty. Sixty percent of those with an acetabular index greater than 37 degrees required later pelvic surgery, compared with 17% of those with a prereduction index less than 30 degrees. The major acetabular response occurred in the first year after reduction in children whose hips were reduced before the age of three years, whereas the maximal response in children whose hips were reduced after three years of age occurred in the second through fourth years. A further drop can be expected in all reduced hips of children between the ages of eight and 11 years. PMID:2706864

  8. [Frequency of necroses of the head of the femur in the treatment of the so-called congenital dislocation of the hip joint according to Hoffmann-Daimler (author's transl)].

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    Weseloh, G; Legal, H; Schorr, H; Probst, K J

    1978-01-01

    The article reports on the results which can be obtained with the method described by Hoffmann-Daimler regarding the functional treatment of the so-called congenital dislocation of the hip joint. The report is based on a patient material of 110 children with 159 dislocated hips treated at the Orthopaedic University Clinic at Erlangen between 1971 and 1976. Observation of the course of the disease revealed a much lower rate of incidence of necrosis of the head of the femur than stated in literature, using the Hoffmann-Daimler method. The incidence of necrosis on pre-treatment of most children with other therapeutic methods, was 2.3% at the beginning of the Hoffmann-Daimler treatment, and increased to 12.7% up to the end of the treatment, dropping to 9.3% at the time of the follow-up examination. PMID:726573

  9. Missed or developmental dislocation of the hip.

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    Ilfeld, F W; Westin, G W; Makin, M

    1986-02-01

    In 15 documented cases, subluxation or dislocation of the hip was discovered months or years after previous multiple normal physical examinations. The examiners were unique in that six were professors specializing in childrens' orthopedics, four were board-certified orthopedists, and five were pediatricians. An increased acetabular index, subluxation, and early dislocation may not always be detected on physical examination. Delayed diagnosis of dislocation is not evidence that an inadequate physical examination was performed. An increased acetabular index may allow the femoral head to move laterally out of the acetabulum and become a delayed dislocation. The delayed subluxed or dislocated hip constitutes an entity not necessarily related to the neonatal subluxable or dislocatable hip. PMID:3955990

  10. Septic hip dislocations in children in a developing country

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    Gabriel Ngom

    2011-01-01

    Full Text Available Purpose: To report on a radiological issue and therapeutic aspects encountered in septic hip dislocations in a developing country. Patients and Methods: Nineteen children among whom 11 boys and 8 girls aged on average 5.3-years old presented 7 recent and 12 late hip dislocations. Those dislocations were distributed into in category 1: dislocations without associated lesion; category 2: dislocations associated with minor lesions; category 3: dislocations associated with major lesion. Ten children who presented an elevated erythrocyte sedimentation rate (ESR received antibiotics. An arthrotomy was performed in children with a recent dislocation. Traction was performed in all children with an average duration of 5 weeks. The results were considered good, intermediate or bad using two parameters: ESR and reduction of dislocation. Results: 2 category 1 dislocations, 6 category 2 dislocations and 11 category 3 dislocations were noted. As concerns the recent dislocations, there were 2 category 1 dislocations and 5 category 2 dislocations. For late dislocations, 1 category 2 and 11 category 3 dislocations were recorded. There were 8 good results and 11 bad results. The good results concerned 7 recent dislocations and one late dislocation. The bad results concerned exclusively late dislocations. Conclusion: In children with septic hip dislocations, the good results concern almost exclusively recent dislocations but arthrotomy and immobilization must be done early.

  11. Early Reduction for Congenital Dislocation of the Knee within Twenty-four Hours of Birth

    OpenAIRE

    Chun-Chien Cheng; Jih-Yang Ko

    2010-01-01

    Background: Congenital dislocation of the knee (CDK) is a very rare condition that comprisesa spectrum of deformities from subluxation to complete dislocation.The incidence of CDK is estimated at 1 per 100,000 live births, which is 1%of the incidence of developmental dysplasia of the hip (DDH). Moreover,40–100% of patients with CDK have additional musculoskeletal anomalies,the most common being DDH and clubfoot. In general, the diagnosis isestablished immediately after birth according to the ...

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

    LENUS (Irish Health Repository)

    Galbraith, John G

    2011-01-01

    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.

  13. Developmental hip dysplasia and dislocation: Part II.

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    Weinstein, Stuart L; Mubarak, Scott J; Wenger, Dennis R

    2004-01-01

    Both nonsurgical and surgical options are available for the treatment of developmental hip dysplasia and dislocation. The advantages, pitfalls, and techniques for using the Pavlik harness should be thoroughly examined before treatment. Other closed and open treatments are aimed at concentric reduction and prevention of residual subluxation and dysplasia. Early diagnosis and treatment lead to the best long-term results for these conditions. PMID:15116642

  14. [Ways of surgical technique optimization and prevention of hip endoprosthesis dislocation following total hip arthroplasty].

    Science.gov (United States)

    Voloshin, V P; Zubikov, V S; Martynenko, D V

    2005-01-01

    The article presents experience concerning intraoperative prevention of hip endoprosthesis dislocation, gained in the orthopedic surgical clinic of Moscow Regional Research Clinical Institute. The results of 1208 total articular replacements allowed the development of intraoperative dislocation-preventive measures, taking into account the approach to the hip joint, necessary mobilization of articular ends, the relative position of total endoprosthesis components. The cases of hip endoprosthesis dislocation were analyzed. The offered preventive measure system allowes reduction in total endoprosthesis dislocation rate down to 1.5%. PMID:15960202

  15. Posterior dislocation of the hip while playing basketball

    OpenAIRE

    Tennent, T. D.; Chambler, A. F.; Rossouw, D J

    1998-01-01

    Injuries in basketball are usually to the ankles and knees. Dislocation of the hip is usually associated with severe trauma--for example, road traffic accidents. A case is reported here in which a 22 year old club basketball player slipped on landing from a jump shot, forcing him into a side splits position from which he sustained a posterior dislocation of the hip resulting in a sciatic nerve palsy. ?????

  16. Total Hip Arthroplasty after Treatment of Pseudojoint Infection in a Patient with a Highly Dislocated Hip

    OpenAIRE

    Taek-Rim Yoon; Kyung-Soon Park; Seon-Yoon Nah; Jong-Keun Seon

    2013-01-01

    Infection at the pseudoacetabulum in a patient with a high hip dislocation has not been reported previously in the English literature. We report a case of total hip arthroplasty in a 28-year-old female who presented to us with hip pain following debridement of the infected pseudojoint in a case of neglected developmental dysplasia of the hip. The infection was treated with thorough debridement and drainage. However, even after achieving complete infection control, this patient complained of d...

  17. Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer Calov; Kjaersgaard-Andersen, Per; Solgaard, Søren; Kehlet, Henrik

    2014-01-01

    STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors. METHODS: Prospective data on preoperative patient characteristics from six Danish arthroplasty departments with similar fast-track approaches were cross-referenced with the Danish National Patient Registry for complete 90-day follow-up on readmission...

  18. Bilateral posterior hip dislocations with femoral head fractures.

    Science.gov (United States)

    Meislin, R J; Zuckerman, J D

    1989-01-01

    An unusual case of bilateral posterior fracture-dislocation of the hip (Pipkin Type IV) occurred in a 63-year-old man with Paget's disease of the pelvis. Other injuries included a displaced humeral shaft fracture and patellar ligament disruption. Bilateral cemented total hip arthroplasty was performed to avoid the need for prolonged immobilization. Postoperative low-dose irradiation was used because of the risk of heterotopic ossification. PMID:2600708

  19. Differentiating subluxation from developmental dislocation of the hip

    Directory of Open Access Journals (Sweden)

    Joao O. Tavares

    2012-02-01

    Full Text Available The radiological and clinical picture of a developmental hip dislocation and a severe subluxation are identical. According to Leveuf and Wiberg the diagnosis can only be made by arthrography. The differential diagnosis is critical, as treatment differs dependent on the diagnosis. In this study, the diagnosis of subluxation was based on a plain radiograph of the pelvis. A radiograph of the pelvis with the hips abducted at least 45° and internally rotated (AIR view was used to differentiate these two entities. In subluxations, the femoral head will relocate into the acetabulum with perfect or near perfect reconstitution of the Shenton’s line. It will fail to do so in true dislocations. Five patients, mean age 14.6 months (range 9 to 20 months, presented with delayed diagnosis of hip dysplasia. The examination revealed minimal or no limitation of hip abduction, a leg length discrepancy, and a Trendelenburg gait in the three walking age girls. The radiograph suggested a hip dislocation. The diagnosis of hip subluxation was based on the relocation of the femoral head with the abduction/internal rotation radiograph. All were successfully treated with an Ilfeld abduction splint. None had examination with general anesthesia, arthrograms, traction or immobilization in spica cast. Avoiding over diagnosis of hip dislocation in cases of subluxation is important. This is necessary to prevent overtreatment and to accurately assess the results of treatment. The abduction/internal rotation view may achieve this goal while avoiding diagnostic and therapeutic procedures, such as arthrograms, cast immobilization and surgery.

  20. Developmental Dislocation (Dysplasia) of the Hip (DDH)

    Science.gov (United States)

    ... placed in a so positioning device, called a Pavlik harness, for 1 to 2 months to keep the ... of the legs and easy diaper care. The Pavlik harness helps tighten the ligaments around the hip joint ...

  1. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

    Directory of Open Access Journals (Sweden)

    Kumar Sunil

    2014-02-01

    Full Text Available ?Abstract?Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.

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

    Directory of Open Access Journals (Sweden)

    K Karthik

    2011-01-01

    Conclusions: Intra-articular loose bodies were identified by nonconcentric reduction in 12 out of 117 patients with simple hip dislocation. Careful evaluation by fluoroscopy and good quality radiographs are indicated following reduction of hip dislocations.

  3. X-ray, anatomical and biomechanical features in patients with developmental hip dislocation

    Directory of Open Access Journals (Sweden)

    Yusupov K.S.

    2014-03-01

    Full Text Available The Pupose: to analyze X-ray, anatomical and biomechanical features in patients with developmental hip dislocation. Material and Methods. The study included 73 patients (57 women and 16 men with the developmental hip dislocation at the age of 31 to 76 years. The clinical method, X-ray, gait analysis and visual analogue scale VAS, McGill inquiry. Results. The comparative analysis of X-ray, anatomic and biomechanical features in patients with different severity of developmental hip dislocation. Conclusion. Features of the functional status of patients with different severity of developmental hip dislocation enable to predict the tactics of surgical treatment and individual rehabilitation program.

  4. [Two siblings with bilateral congenital knee dislocations: case report].

    Science.gov (United States)

    Kubinec, V; Polakovi?ová, L; Kantarská, D

    2015-01-01

    Congenital dislocation of the knee and congenital permanent dislocation of the patella are rare disorders usually associated with complex syndromes. Two cases of siblings, girl and boy, who had the same clinical phenotype of this disorder are presented. The diagnosis of Desbuquois dysplasia was made and its autosomal recessive heredity was confirmed by genetic analysis. DNA samples were sent for a molecular genetic analysis of the skeletal dysplasia. The girl was surgically treated for a complete (grade 3) anterior dislocation of the tibia on the femur in the first year of life. Redressing casts had not previously been applied to avoid the risk of damaging the epiphysis. The left knee was operated on by the method, as described by Curtis and Fisher, at the age of six months. The Kirschner wire was removed after one month and a plaster cast was applied to maintain the flexion required. At seven post-operative weeks physiotherapy was started with temporary use of a knee brace. The right knee was managed by a similar procedure at four months after the first surgery. Normal walking was achieved at the age of 21 months. Knee motion was symmetrically restricted, with 5 to 90 degrees of flexion. The boy was first seen at our out-patient department after his sister had achieved full walking ability. He was 10 years old at that time and presented with walking problems due to nearly 30 degrees of bilateral knee contractures. Permanent dislocation of both patellae was treated by the surgical technique described by Stanisavljevic. Revision surgery of the right knee due to patellar lateralization was required two years after the primary surgery; it was performed using the Campbell's technique. A corrective osteotomy of the left proximal tibia because of progressive genu valgum was carried out at four years following the first operation. At the last follow-up, the boy was 16 years old and the knee range of motion bilaterally was 0 to 120 degrees with good alignment of both knees. As a result of surgical treatment the two patients gained ability to walk without problems. Key words: bilateral congenital knee dislocation, patella, Desbuquois dysplasia, siblings, skeletal dysplasia, case report. PMID:26317189

  5. 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

  6. A rare fracture-dislocation of the hip in a gymnast and review of the literature

    OpenAIRE

    Mitchell, J. C.; Giannoudis, P. V.; Millner, P. A.; Smith, R. M.

    1999-01-01

    Posterior fracture-dislocation of the hip is an uncommon injury in athletics and leisure activities. It is more commonly seen in high energy motor vehicle accidents and occasionally in high energy sporting activities. A rare case is reported of posterior fracture-dislocation of the hip joint that occurred in a young athlete during gymnastics. This unusual mechanism of injury illustrates the great forces sustained by the hip joint of gymnasts. Early reduction and operative treatment led ...

  7. Early Reduction for Congenital Dislocation of the Knee within Twenty-four Hours of Birth

    Directory of Open Access Journals (Sweden)

    Chun-Chien Cheng

    2010-06-01

    Full Text Available Background: Congenital dislocation of the knee (CDK is a very rare condition that comprisesa spectrum of deformities from subluxation to complete dislocation.The incidence of CDK is estimated at 1 per 100,000 live births, which is 1%of the incidence of developmental dysplasia of the hip (DDH. Moreover,40–100% of patients with CDK have additional musculoskeletal anomalies,the most common being DDH and clubfoot. In general, the diagnosis isestablished immediately after birth according to the position of the kneerecurvatum. Treatment with conservative methods at an early stage is mostlikely to yield successful results. We report here successful treatment of aseries of CDK patients with early reduction.Methods: From July 1990 to June 2007, 19 patients with CDK (affecting 25 kneeswere treated with early reduction. Of these, 6 knees had dislocation, and 19had subluxation. Since 1990, treatment has been guided by a protocol thatconsiders patient age and the severity of the condition. In patients examinedwithin 24 hours of birth, early, direct reduction under gentle, persistent manualtraction was attempted. Birth history and perinatal course were obtainedfrom medical records. Associated musculoskeletal anomalies were observedand treated after reduction of the knee joint. A Pavlik harness was used for atleast 4 months in the concomitant treatment of DDH and CDK. Knee functionwas graded as excellent, good, fair, or poor. Radiographs were used toassess DDH during follow-up.Results: After an average follow-up duration of 4.3 years, 18 patients showed anexcellent or good outcome. One patient, whose knee could not be reduced,had severe multiple anomalies and died 16 days after birth. Fifteen of thenineteen patients had associated musculoskeletal anomalies, including DDHand foot deformity. Two cases of residual hip dysplasia after Pavlik harnessapplication required an acetabular osteotomy.Conclusions: For CDK patients, early and direct closed reduction within 24 hours of birthaffords outcomes graded as either excellent or good.

  8. Purulent Necrotic Dislocation of the Hip Joint Associated with Umbilical Infection in a Foal

    OpenAIRE

    Magata, Fumie; ISHII, Mitsuo; OIKAWA, Eri; Furuoka, Hidefumi; Yamada, Kazutaka; SASAKI, NAOKI; SHIMIZU, Syo; Inokuma, Hisashi

    2010-01-01

    A 42-day-old heavy draft horse fell into sudden astasia. Significant swelling and heat sensation of the left femoral region were observed. Because of a friction sound in the left hip, we supposed that the hip joint was dislocated or the hip bone was fractured. Computed Tomography (CT) examination showed that the left hip joint was dislocated and the left femoral head was disjunct. We carried out a pathological autopsy, and made a diagnosis of the foal as fracture of the hip bon...

  9. Frequency of Developmental Dislocation of the Hip in Icteric Newborns Detected by Graf 's Ultrasonographic Method

    Directory of Open Access Journals (Sweden)

    Amin Foroughi

    2009-01-01

    Full Text Available "nIntroduction: A prospective detection of developmental dislocation of the hip (DDH in icteric newborns and comparison with the frequency of DDH in other newborns. "nMaterials and Methods: During a one year period all icteric newborns who were referred to Nemazi hospital’s neonatal emergency room for bilirubin checking were screened by Graf"s ultrasonographic method for DDH.300 newborns (600 hips were screened during this period. Any newborn with other problems such as congenital anomalies was excluded from this study. "nResults: Of the 600 hips a total of 20 newborns (3.3% had a dysplastic hip (class IIa that needed follow-up .A total of 11 from class IIa came back for a follow-up hip ultrasonography. All of them had become normal (class Ia without treatment. Only 1 (16% hip had sever dysplasia (class IIc that needed treatment at the time of discovery "nConclusion: The rate of DDH seems to not increase in newborns how develop physiologic jaundice.  

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

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2012-09-01

    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).

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

    Scientific Electronic Library Online (English)

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

    Full Text Available 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.

  12. Superior dislocation hip with anterior column acetabular fracture - open reduction and internal fixation using a twin incision technique

    OpenAIRE

    Jindal, Nipun; Sankhala, Sohan S

    2012-01-01

    Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin incision technique. The course to recovery has been uneventful.

  13. Can posterior hip fracture-dislocation occur in indoor football (futsal)? A report of two cases

    OpenAIRE

    Yasin, Faissal Nor; Singh, Vivek Ajit

    2009-01-01

    Hip fracture-dislocation is extremely rare in sports and is most frequently seen after road traffic accidents. This injury is associated with considerable long-term disability and rapidly progressive joint degeneration. This case report illustrates two cases of hip fracture dislocation that occurred while playing recreational indoor football (futsal). Futsal is a fast-emerging recreational sport in Malaysia and we are now beginning to see high-impact injuries rarely encountered in recreationa...

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

    LENUS (Irish Health Repository)

    Forde, James C

    2012-02-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Venkatachalam Santosh

    2009-12-01

    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.

  16. Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties : incidence, circumstances and predisposing factors

    DEFF Research Database (Denmark)

    JØrgensen, Christoffer C; Kjaersgaard-Andersen, Per

    2014-01-01

    STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors. METHODS: Prospective data on preoperative patient characteristics from six Danish arthroplasty departments with similar fast-track approaches were cross-referenced with the Danish National Patient Registry for complete 90-day follow-up on readmissions, including emergency-room contacts. Complete patient files and postoperative radiographs were reviewed in case of dislocations. Unadjusted comparisons were made using t test/Chi-square analyses, while evaluation of risk factors potentially predisposing to dislocations was done using uni- and multivariate regression analysis. RESULTS: A total of 2,734 consecutive unselected procedures were available for analysis, of which 65 (2.4 %) had dislocations. Of these, eight were during index admission and five were treatedand discharged from the emergency room. Mechanisms of dislocation were most often movement while supine or sitting for the first 30 days and due to squatting/bending from day 31 to 90. The 65 patients with dislocations had suboptimal cup placement in 34 (52.3 %), and a femoral head size of <36 mm in 20 (30.8 %) cases. Predisposing factors of dislocation were age ?75 [OR:1.96 (1.18-3.38)], pharmacologically treated psychiatric disease [OR:2.37 (1.29-4.36)] and department of surgery [OR:2.27 (1.31-3.40)] but not hospital stay of <4 days. Departments with recommendations for activity restrictions had fewer dislocations than a department without restrictions. CONCLUSIONS: Patients ?75 years and with pharmacologically treated psychiatric disease may be at increased risk of dislocations after fast-track total hip arthroplasty. Further studies including detailed information on patient and prosthesis characteristics, and activity restrictions are needed to reduce the risk of dislocation.

  17. Flexion reminder device to discourage recurrent posterior dislocation of a total hip replacement: a case report

    Directory of Open Access Journals (Sweden)

    Wong King

    2008-07-01

    Full Text Available Abstract Introduction Recurrent dislocation of a total hip replacement prosthesis is a frustrating complication for both the surgeon and the patient. For positional dislocations with no indications for revision surgery, the current best treatment is physiotherapy, the use of abduction braces and avoidance of unsafe hip positions. Abduction braces can be cumbersome and have poor compliance. We report the successful use of a new lightweight flexion reminder device that can be used to treat people with this condition. Case presentation A 64-year-old British woman experienced recurrent positional posterior dislocation after primary hip replacement, particularly when involved in activities involving unsafe flexion of the operated hip. She disliked using an abduction brace and hence was given a simple 'flexion reminder device' that could be strapped to the thigh. Beyond the safe flexion limit, the padded top end of the device hitched against the groin crease and reminded her not to flex further, to avoid dislocation. She experienced no discomfort in wearing the device continuously throughout the day and was very satisfied. She has had no further dislocations in the 2 years since she began using it. Conclusion In cases of arthroplasty dislocation caused mainly by an unsafe hip position, and with no indication for revision surgery, this new lightweight and easily worn flexion reminder device may be a good option for avoiding such positional dislocations, particularly those caused by unsafe flexion.

  18. Management of the bilateral congential dislocation of the hip and knee: a case report.

    Science.gov (United States)

    Mahirogullari, Mahir; Pehlivan, Ozcan; Kiral, Ahmet; Cakmak, Selami

    2006-11-01

    Congenital dislocation of the knee (CDK) is a rare disease and may be associated with other congenital and musculoskeletal disorders. We report our result in the treatment of a patient with CDK and DDH that treated with serial casting and Pavlik harness. Early diagnosis of the CDK is very important non operative treatment usually provides more stabile, greater range of motion and much more quadriceps strength than the surgical treatment. Early reduction of dislocation prevents formation of the knee contracture. PMID:16273376

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

    DEFF Research Database (Denmark)

    Jakobsen, Thomas; Kappel, Andreas; Hansen, Flemming; Krarup, Niels

    2014-01-01

    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 ...

  20. Chronic asymptomatic dislocation of a total hip replacement: a case report

    Directory of Open Access Journals (Sweden)

    Lidder Surjit

    2009-08-01

    Full Text Available Abstract Introduction Dislocation of a prosthetic hip is the second most common complication after thromboembolic disease in patients undergoing total hip arthroplasty, with an incidence reported as 0.5 to 20%. Although the period of greatest risk for dislocation has been reported to be within the first few months after surgery, late dislocation occurs more commonly then previously thought. Case presentation A 60-year-old man underwent a right Exeter cemented total hip replacement and was subsequently discharged after appropriate follow-up. He next presented 8 years later complaining of pain in the left groin. An anterioposterior radiograph of the pelvis revealed degenerative changes in the left hip and a dislocated right total hip replacement. The dislocated femoral component had formed a neoacetabulum within the ilium, in which it was freely articulating. He remained pain-free on this side, had 5 cm of true leg length shortening with a good range of movement and was very pleased with his hip replacement. He was later placed on the waiting list for a left total hip replacement. Conclusion This case illustrates that a dislocated total hip replacement may occasionally not cause symptoms that cause significant discomfort or reduction in range of movement. The prosthetic femoral head can form a neoacetabulum allowing a full range of pain-free movement. Furthermore it emphasises that with an increased trend to earlier hospital discharge and shorter follow-up, potential complications may be missed. We urge a low index of suspicion for potential complications and suggest that regular review with radiographic follow-up should be made.

  1. The effect of posterior capsule repair upon post-operative hip dislocation following primary total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Wang Chen-Ti

    2008-02-01

    Full Text Available Abstract Background Herein, we evaluated, retrospectively, the effect of posterior capsular repair upon postoperative hip dislocation subsequent to total hip arthroplasty (THA incorporating a posterolateral approach. Methods A total of 181 patients undergoing 204 primary non-complicated THA surgical procedures in the period from January 2000 to October 2005 inclusively were included in this study. The patients were separated into two groups by whether the posterior capsular repair had been incorporated in the surgical procedure. For the surgeon did not commence repairing the posterior capsule until July, 2003, all members in the group that did not undergo posterior capsular repair (142 hips from 131 patients were collected since January, 2000 to July, 2003, while the members in the group that underwent posterior capsular repair (62 hips from 52 patients were followed since July, 2003, to October, 2005. With a minimum follow-up period of 12 months, we evaluated the early post-operative dislocation rate. Results The early postoperative hip-dislocation rate for the group who did not undergo posterior capsular repair appeared to be substantially greater (6.38% versus 0% than the corresponding figure for the group the members of which underwent posterior capsular repair. In addition, patient demographics and the orientation of acetabular components for the replaced hip joints, as presented in postoperative radiographs, did not differ between the two groups. Conclusion Thus, surgeons should include posterior capsular repair as an important step in the surgical procedures of posterolateral approach for all THA in order to reduce the likelihood of early hip dislocation subsequent to THA.

  2. Surgical dislocation of the hip in patients with femoroacetabular impingement: Surgical techniques and our experience

    Directory of Open Access Journals (Sweden)

    Mladenovi? Marko

    2015-01-01

    Full Text Available Background/Aim. Arthrosis of the hip is the most common cause of a hip joint disorders. The aim of this study was to present our experience in the application of a safe surgical dislocation of the hip in patients with minor morphological changes in the hip joint, which, through the mechanism of femoroacetabular impingement, cause damage to the acetabular labrum and adjacent cartilage as an early sign of the hip arthrosis. Methods. We have operated 51 patients with different morphological bone changes in the hip area and resultant soft tissue damage of the acetabular labrum and its adjacent cartilage. Surgical technique that we applied in this group of patients, was adapted to our needs and capabilities and it was minimaly modified compared to the original procedure. Results. The surgical technique presented in this paper, proved to be a good method of treatment of bone and soft tissue pathomorphological changes of the hip in patients with femoroacetabular impingement. We had no cases with avascular necrosis of the femoral head, and two patients had nonunion of the greater trochanter, 9 patients developed paraarticular ossification, without subjective symptoms, while 3 patients suffered from postoperative pain in the groin during more energetic physical activities. Conclusion. Utilization of our partly modified surgical technique of controlled and safe dislocation of the hip can solve all the bone and soft tissue problems in patients with femoroacetibular impingement to stop already developed osteoarthritis of the hip or to prevent mild form of it.

  3. Risk of dislocation using large- vs. small-diameter femoral heads in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Plate Johannes F

    2012-10-01

    Full Text Available Abstract Background Dislocation remains a difficult problem in total hip arthroplasty. Large-diameter femoral heads may lower the incidence of dislocation by enhancing the jump distance and decreasing impingement, but their performance against small-diameter heads has not been assessed. This study compared the mid-term radiographic and functional outcomes of two matched cohorts of patients undergoing total hip arthroplasty who had a high pre-operative risk for dislocation and who received either small-diameter (26- or 28-millimeters or large-diameter (?36-millimeters femoral heads. Methods All patients who received large-diameter heads (?36-millimeter between 2002 and 2005, and who had pre-operative risk factors for dislocation, were identified in the institution’s joint registry. Forty-one patients (52 hips who received large-diameter heads were identified, and these patients were matched to 48 patients (52 hips in the registry who received small-diameter femoral heads. Results At mean final follow-up of 62 months (range, 49 to 101 months, both groups achieved excellent functional outcomes as measured by Harris Hip scores, with slightly better final scores in the large-diameter group (90 vs. 83 points. No patient showed any radiographic signs of loosening. No patient dislocated in the large-diameter femoral head group; the smaller-diameter group had a greater rate of dislocation (3.8%, 2 out of 52. Conclusions Large-diameter femoral head articulations may reduce dislocation rates in patients who have a high pre-operative risk for dislocation while providing the same functional improvements and safety as small-diameter bearings.

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

    Directory of Open Access Journals (Sweden)

    Sutsungkokla Imchen

    2013-01-01

    Full Text Available 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.

  5. Delayed cementless total hip arthroplasty for neglected dislocation of hip combined with complex acetabular fracture and deficient bone stock

    Directory of Open Access Journals (Sweden)

    Gavaskar Ashok S

    2012-12-01

    Full Text Available ?Abstract?Total hip arthroplasty (THA for an un-treated acetabular fracture is technically challenging and the long-term result is not so favorable. A 45-year-old fe-male patient with untreated column and comminuted poste-rior wall fracture of the acetabulum was treated in our insti-tution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior col-umn with cancellous grafting and cementless THA in a single stage. At 3 years’ follow-up, the patient was independently mobile without limb length discrepancy. Radiological evalu-ation showed well integrated components and bone grafts. No evidence of aseptic loosening or osteolysis was found. This report aims to emphasize that bony acetabular recon-struction allows the use of primary hip components, which improves prosthesis longevity and preserves bone stock for a future revision. Key words: Acetabulum; Fractures, bone; Hip dislocation; Arthroplasty, replacement, hip

  6. Can posterior hip fracture-dislocation occur in indoor football (futsal)? A report of two cases.

    Science.gov (United States)

    Yasin, Faissal Nor; Singh, Vivek Ajit

    2009-01-01

    Hip fracture-dislocation is extremely rare in sports and is most frequently seen after road traffic accidents. This injury is associated with considerable long-term disability and rapidly progressive joint degeneration. This case report illustrates two cases of hip fracture dislocation that occurred while playing recreational indoor football (futsal). Futsal is a fast-emerging recreational sport in Malaysia and we are now beginning to see high-impact injuries rarely encountered in recreational sports. Therefore, futsal cannot be taken lightly and it is important to take adequate precautions to prevent serious injuries when participating in such sports. PMID:21686368

  7. Surgical hip dislocation in symptomatic cam femoroacetabular impingement: what matters in early good results?

    OpenAIRE

    Jäger M; Bittersohl B; Zilkens C; Hosalkar HS; Stefanovska K; Kurth S.; Krauspe R

    2011-01-01

    Abstract In order to assess outcome and possible predictors of early good results, a prospective study on 22 patients who were treated with save surgical hip dislocation for symptomatic isolated cam-type femoroacetabular impingement (FAI) was performed. After a follow-up of 6 and 12 months, standard clinical and radiographic parameters were recorded. A statistically significant improvement of the clinical status according to the Harris hip score could be assessed at six months (p-value = 0.00...

  8. Implant survival after primary total hip arthroplasty due to childhood hip disorders: results from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Thillemann, Theis; Pedersen, Alma B; Johnsen, Søren P; Søballe, Kjeld

    2008-01-01

    BACKGROUND: Childhood hip disorders including acetabular dysplasia, congenital hip dislocation, epiphysiolysis, and morbus Calve-Legg-Perthes are well-established risk factors for the development of early osteoarthritis of the hip. These patients have an increased risk of undergoing a total hip arthroplasty (THA) operation early in their life. However, there are very few data on implant survival in such patients. METHODS: We used data from the Danish Hip Arthroplasty Registry to identify patient...

  9. TRAUMATIC HIP DISLOCATION IN CHILDREN YOUNGER THAN 3 YEARS : A SERIES OF 3 CASES

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    Navin

    2015-03-01

    Full Text Available The musculoskeletal anatomy of children is qui te different from that of adults. The capsule, periosteum and other soft tissues surrounding the joints is very pliable and dislocations can occur even following trivial injuries . However dislocation occurring in a child population is a rare entity. There are a few case reports of hip dislocations in children < 3 years. We present here a series of 3 cases of paediatric hip dislocations which presented to us for management. The age of the children were between 24 - 27 months. Incidentally all 3 patients were b oys and all 3 were right sided dislocations. None of them had any associated fractures. Two of them had a fall from height and one child fell off a slide. All 3 patients presented within 5 hours following injury. Closed reduction under anaesthesia was perf ormed and post reduction the children were immobilized in a broom - stick plaster for 6 weeks. All children were followed up with serial x - rays and a MRI done immediately following reduction then at 6 and 18 months. There was no evidence of chondrolysis or a vascular necrosis in any of the children at the last follow - up. They all had full range of movements with no limitation of function. We conclude that with early recognition and early reduction of the hip within the golden period (6 hours the occurrence of complications can be prevented.

  10. Acetabular dysplasia following closed reduction of developmental dislocation of the hip.

    Science.gov (United States)

    Carney, Brian T

    2005-01-01

    The purpose of this study was to determine the incidence of acetabular dysplasia following closed reduction of developmental dislocation of the hip, particularly as it relates to the age at reduction and the presence of the ossific nucleus. Thirty-five children with unilateral developmental dislocation of the hip underwent closed reduction. Medical records were reviewed for gender, side, age at reduction, use of Pavlik harness, prereduction traction, presence/absence of the ossific nucleus, and whether adductor longus tenotomy was performed. Acetabular index was measured. The mean age at reduction was 10 months. The mean length of follow-up was 91 months. Following closed reduction, the incidence of acetabular dysplasia was 69% (24 hips). No statistically significant relationship between acetabular dysplasia and age at reduction or presence of the ossific nucleus was demonstrated. PMID:16216178

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

    DEFF Research Database (Denmark)

    Jakobsen, Thomas; Kappel, Andreas

    2014-01-01

    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.

  12. Luxación congénita de rodilla, a propósito de un caso / Congenital dislocation of the Knee, a case report

    Scientific Electronic Library Online (English)

    Rolando, Azurduy Ance; Rodrigo, Peña Orozco; Diego, Salinas Emcinas; Rossy, Quimbert Montes.

    Full Text Available La luxación congénita de rodilla es una entidad de muy baja incidencia (0.017 casos por mil nacidos vivos) y 1 por 100.000 casos en relación con la displasia de cadera y que puede presentarse en forma aislada o como parte de algunas entidades teratológicas (síndrome de Down, artrogriposis, mielomeni [...] ngocele, etc.). Describimos a un neonato, de sexo femenino, que presenta una rodilla izquierda en hiper-extensión, asociado a genu valgo, pie plano valgo y displasia de cadera del mismo lado. De inicio, el manejo fue conservador, pero frente al fracaso terapéutico tuvo que ser intervenido quirúrgicamente para lograr la rehabilitación del paciente. Concluimos que la intervención quirúrgica debe ser precoz y oportuna en esta afección. Abstract in english Congenital dislocation of the knee is a very rare disease (0.017 cases/1000 live newborns and 1/100.000 in relation to hip dysplasia). Usually is an isolated finding, but some times it is associated to other entities (Down syndrome, arthrogriposis, myelomeningocele, etc). We describe a female newbor [...] n who presented at birth hyperextend left knee, genu valgo, flat foot and hip dysplasia of the same side. She was treated conservatively with no improvement, so she underwent surgery and later rehabilitation. We conclude that surgery should be early and the first line of treatment of this condition.

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

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    Vukašinovi? Zoran

    2010-01-01

    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.

  14. Bilateral Staged Total Hip Replacement and the Natural Progress of an Untreated Case of Developmental Dysplasia (Dislocation of the Hip: A Clinical Case Report by the Surgeon and the Patient

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    Hamid Honarpisheh

    2015-07-01

    Full Text Available The natural history of an untreated case of a Developmental Dysplasia (Dislocation of the Hip (DDH associated with multiple congenital abnormalities is reported in a 55-years-old man. The patient’s complaints and the varieties of the typical manifestations emerged in other parts of the body throughout the life are reviewed and discussed as comorbidities of a dysplastic condition. Two-stage bilateral total hip replacement (THR operations were performed at the age of 55. In addition, to relieve the pain, the walking disabilities were overcome, hence gaining normal walking in swing and stances. The leg length discrepancy was corrected by anatomically positioned prostheses, examined by the knee bending test and characterized and evidenced by radiological features and indices.

  15. Treatment of a femoral shaft fracture in a patient with congenital hip disease: a case report

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    Koutsostathis Stefanos D

    2010-07-01

    Full Text Available Abstract Introduction We present a rare case of two concomitant morbidities treated in one operation. To our knowledge, this is the first report of its kind in the literature. Case presentation A 57-year-old Greek woman was admitted to the emergency department having sustained a spiral mid-shaft femoral fracture. She also suffered from an ipsilateral hip congenital dysplasia with ankylosed hip joint due to severe arthritis. She was treated with a total hip arthroplasty using a long stem performing as an intramedullary nail. Conclusion We undertook a complex operative treatment of both co-morbidities in a one stage procedure with a satisfactory clinical result.

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

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    Slavkovi? N.

    2006-01-01

    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.

  17. Early loosening and secondary dislocation due to a broken trochanteric osteotomy wire following a Charnley total hip arthroplasty: a case report

    OpenAIRE

    Shahin, Yousef; Choudhary, Rakesh; Al-Naser, Saeed; Mullins, Mark

    2009-01-01

    We report a case of interposition of a broken trochanteric wire in the hip joint. This caused early wear of the prosthesis and dislocation of the Charnley total hip arthroplasty. The patient was treated with a revision total hip arthroplasty. This rare complication should be taken into consideration when performing a trochanteric osteotomy fixation with wiring in Charnley total hip arthroplasty.

  18. A case of congenital unilateral hip dysplasia in a newborn calf.

    Science.gov (United States)

    Mann, S; Blutke, A; Brühschwein, A; Feist, M

    2011-10-01

    We describe the case of a Simmental calf with congenital unilateral hip dysplasia. In the initial physical exam, the calf was able to stand unsteady when helped and showed severe swinging lameness in the left hind limb. Unilateral hip laxity and a positive Ortolani sign indicated subluxation of the femur within the hip joint. This finding was further confirmed by radiographic examination which also showed malformation of the left femoral head and acetabulum. After a short period of clinical improvement the calf's health deteriorated and it was euthanized due to signs of severe coxarthrosis. Pathological examination of the affected hip joint revealed a severe acetabular and femoral dysplasia with an incomplete formation of the epiphysis of the femoral head and a chronic granulating coxarthritis without evidence of primary infectious events. PMID:21971673

  19. 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)

    Luísa Neiva, Araújo; Eduardo, Almeida.

    Full Text Available 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.

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

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    Sebastian S. Mukka

    2013-06-01

    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.

  1. Surgical hip dislocation in symptomatic cam femoroacetabular impingement: what matters in early good results?

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    Jäger M

    2011-05-01

    Full Text Available Abstract In order to assess outcome and possible predictors of early good results, a prospective study on 22 patients who were treated with save surgical hip dislocation for symptomatic isolated cam-type femoroacetabular impingement (FAI was performed. After a follow-up of 6 and 12 months, standard clinical and radiographic parameters were recorded. A statistically significant improvement of the clinical status according to the Harris hip score could be assessed at six months (p-value = 0.003 and 12 months (p-value = 0.001 post-surgery. By comparing standard clinical and radiographic preoperative parameters with various follow-up outcomes, we revealed no specific parameter with predictive value. These findings are important for centers that have just started to use this surgical technique and are still identifying their learning curve.

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

    Scientific Electronic Library Online (English)

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

    2012-03-01

    Full Text Available 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.

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

    Scientific Electronic Library Online (English)

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

    2014-04-01

    Full Text Available 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.

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

    OpenAIRE

    Tetsunaga,Tomonori; Minagawa,Hiroshi; Mitani, Shigeru; Endo,Hirosuke; Ohmori, Takao; Ozaki,Toshifumi

    2009-01-01

    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 ...

  5. Avascular necrosis as a complication of the treatment of dislocation of the hip in children with cerebral palsy.

    Science.gov (United States)

    Koch, A; Jozwiak, M; Idzior, M; Molinska-Glura, M; Szulc, A

    2015-02-01

    We investigated the incidence and risk factors for the development of avascular necrosis (AVN) of the femoral head in the course of treatment of children with cerebral palsy (CP) and dislocation of the hip. All underwent open reduction, proximal femoral and Dega pelvic osteotomy. The inclusion criteria were: a predominantly spastic form of CP, dislocation of the hip (migration percentage, MP > 80%), Gross Motor Function Classification System, (GMFCS) grade IV to V, a primary surgical procedure and follow-up of > one year. There were 81 consecutive children (40 girls and 41 boys) in the study. Their mean age was nine years (3.5 to 13.8) and mean follow-up was 5.5 years (1.6 to 15.1). Radiological evaluation included measurement of the MP, the acetabular index (AI), the epiphyseal shaft angle (ESA) and the pelvic femoral angle (PFA). The presence and grade of AVN were assessed radiologically according to the Kruczynski classification. Signs of AVN (grades I to V) were seen in 79 hips (68.7%). A total of 23 hips (18%) were classified between grades III and V. Although open reduction of the hip combined with femoral and Dega osteotomy is an effective form of treatment for children with CP and dislocation of the hip, there were signs of avascular necrosis in about two-thirds of the children. There was a strong correlation between post-operative pain and the severity of the grade of AVN. PMID:25628294

  6. Neurovascular lesion after total hip arthroplasty in congenital hip dysplasia: Case report

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    Stojkovi?-Jovanovi? Tatjana

    2013-01-01

    Full Text Available Introduction. Nowadays, the total hip arthroplasty is a very frequent surgical intervention. In some cases, vascular and nerve injuries may happen around the hip with total hip arthroplasty. Although they are very rare, they may be very dangerous for the patient in some cases. This paper presents a case of a female patient, in whom the nervous fibularis lesion was detected after the total hip arthroplasty, and the occlusion of the iliac femoral artery was revealed later during physical therapy. Case Report. We described a case of a 32-year-old female patient, in whom the nervous fibularis lesion was detected after the total hip arthroplasty. The patient was referred to a ward for physical therapy. On the 19th postoperative day, she felt a vigorous ache and numbness on the left operated leg during stimulation of the paretic fibular musculature. Clinically weak inguinal arterial pulse was detected. After the examination, iliac-femoral occlusion was diagnosed. The patient was referred to the vascular surgeon. In the next few months, she was treated conservatively and eventually underwent surgery. The revascularization was achieved with a satisfactory effect. A year after the total hip replacement, the patient continued with rehabilitation and physical treatment, which lasted one and a half month and had an incomplete functional result - the patient walked with a walking stick and had weak fibular musculature of a severe degree. The vascular status of the leg was good. Conclusion. In this case, neurovascular lesions led to an incomplete functional recovery of the patient and compromised the expected treatment outcome. According to the scoring system used to assess the functionality, the result was marked as poor.

  7. 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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    Luis Eduardo Munhoz da Rocha

    2010-01-01

    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.

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

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    Periasamy Kumar

    2008-02-01

    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.

  9. 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

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

    OpenAIRE

    Skand Sinha; Ananta k Naik; Rajendra K Arya; Vijay K Jain

    2013-01-01

    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...

  11. Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles

    Directory of Open Access Journals (Sweden)

    Sen Ramesh Kumar

    2011-06-01

    Full Text Available ?Abstract?This paper discussed the injury mecha- nism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture- dislocations of the left hip (Pipkin’s type IV and knee (Moore II joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin’s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabi- lized with lateral buttress plate and a transarticular span- ning fixator. The open fracture on the other leg was de- brided and fixed with an external fixator. There was no insta- bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appro- priate intervention can provide good functional outcome to the patient in this situation. Key words: Hip dislocation; Knee dislocation; Fractures, bone

  12. Tenomyoplasty of the flexor muscles in the surgical treatment of congenital recurvatum, subluxation and dislocation of the knee.

    Science.gov (United States)

    Dal Monte, A; Manes, E; Marchiodi, L; Rubbini, L

    1982-12-01

    The writers present eight cases of congenital recurvatum or dislocation of the knee in which tenomyoplasty of the flexor muscles of the knee was performed. The operation was the only one used in cases with flexion greater than 60 degrees, while in cases of more severe loss of flexion, it was supplementary to mobilisation of the quadriceps according to Judet's technique. The technique of tenomyoplasty is described and the results are reported. These are considered to be favourable. PMID:7183654

  13. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in Total Hip Replacement

    Directory of Open Access Journals (Sweden)

    Vasileios Sakellariou

    2014-09-01

    Full Text Available Developmental dysplasia of the hip (DDH or congenital hip dysplasia (CDH is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.

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

    Directory of Open Access Journals (Sweden)

    Chatley Anooj

    2008-01-01

    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.

  15. Dislocation

    Science.gov (United States)

    ... elderly. Wear protective gear when participating in contact sports. For all age groups: Keep a first aid ... ed. Philadelphia, Pa: Saunders Elsevier; 2008. Calandruccio JH. Fractures, dislocations, and ligamentous injuries. In: Canale ST, Beaty ...

  16. Treatment of Graf’s Ultrasound Class III and IV Hips Using Pavlik’s Method

    OpenAIRE

    Peled, Eli; Bialik, Viktor; Katzman, Alexander; Eidelman, Mark; Norman, Doron

    2008-01-01

    When Pavlik introduced his method of treating congenital dislocation of the hip, he emphasized reducing the rate of osteonecrosis. Graf’s method of sonographic evaluation afforded earlier accurate diagnosis and subsequent treatment of developmental dysplasia of the hip. To ascertain whether treatment duration, gender, age at diagnosis, clinical stability, and/or treatment onset correlate with the risk of osteonecrosis in Graf Type III or IV hips, we clinically and sonographically screened 18,...

  17. Is surgery recommended in adults with neglected congenital muscular torticollis? A prospective study

    OpenAIRE

    Sharifi Reza; Hasankhani Ebrahim G; Omidi-Kashani Farzad; Mazlumi Mahdi

    2008-01-01

    Abstract Background Congenital muscular torticollis is the third most common congenital musculoskeletal anomaly after dislocation of the hip and clubfoot. When diagnosed early, it is obvious that it can be managed with good or excellent results. The aim of this prospective study was to determine the efficacy of surgery in neglected adult cases. Methods From January 2003 to June 2007, 18 adult skeletally matured patients were surgically treated for neglected congenital muscular torticollis and...

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

    Directory of Open Access Journals (Sweden)

    Tetsunaga,Tomonori

    2009-06-01

    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.

  19. Radiographic prediction of the results of long-term treatment with the Pavlik harness for developmental dislocation of the hip.

    Science.gov (United States)

    Ohmori, Takao; Endo, Hirosuke; Mitani, Shigeru; Minagawa, Hiroshi; Tetsunaga, Tomonori; Ozaki, Toshifumi

    2009-06-01

    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 operating 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. PMID:19571898

  20. Patterns of postural deformity in non-ambulant people with cerebral palsy: what is the relationship between the direction of scoliosis, direction of pelvic obliquity, direction of windswept hip deformity and side of hip dislocation?

    OpenAIRE

    Porter, David; Michael, Shona; Kirkwood, Craig

    2008-01-01

    Objective: To investigate: (a) associations between the direction of scoliosis, direction of pelvic obliquity, direction of windswept deformity and side of hip subluxation/dislocation in non-ambulant people with cerebral palsy; and (b) the lateral distribution of these postural asymmetries.

  1. Inflammatory Pseudotumor Complicated by Recurrent Dislocations after Revision Total Hip Arthroplasty

    OpenAIRE

    John Ryan Quinn; Jason Lee; Ran Schwarzkopf

    2014-01-01

    A 71-year-old female with a history of right total hip arthroplasty presented with an enlarging pseudotumor. Pseudotumor is a known complication following metal-on-metal and metal-on-conventional polyethylene and metal-on-highly cross-linked polyethylene implants. Revision total hip arthroplasty following resection of pseudotumor has resulted in an increase in incidence of postoperative complications. Despite stable implants, these complications arise from the amount of soft tissue damage com...

  2. Seasonality of congenital anomalies in Europe

    DEFF Research Database (Denmark)

    Luteijn, Johannes Michiel; Dolk, Helen

    2014-01-01

    BACKGROUND: This study describes seasonality of congenital anomalies in Europe to provide a baseline against which to assess the impact of specific time varying exposures such as the H1N1 pandemic influenza, and to provide a comprehensive and recent picture of seasonality and its possible relation to etiologic factors. METHODS: Data on births conceived in 2000 to 2008 were extracted from 20 European Surveillance for Congenital Anomalies population-based congenital anomaly registries in 14 European countries. We performed Poisson regression analysis encompassing sine and cosine terms to investigate seasonality of 65,764 nonchromosomal and 12,682 chromosomal congenital anomalies covering 3.3 million births. Analysis was performed by estimated month of conception. Analyses were performed for 86 congenital anomaly subgroups, including a combined subgroup of congenital anomalies previously associated with influenza. RESULTS: We detected statistically significant seasonality in prevalence of anomalies previously associated with influenza, but the conception peak was in June (2.4% excess). We also detected seasonality in congenital cataract (April conceptions, 27%), hip dislocation and/or dysplasia (April, 12%), congenital hydronephrosis (July, 12%), urinary defects (July, 5%), and situs inversus (December, 36%), but not for nonchromosomal anomalies combined, chromosomal anomalies combined, or other anomalies analyzed. CONCLUSION: We have confirmed previously described seasonality for congenital cataract and hip dislocation and/or dysplasia, and found seasonality for congenital hydronephrosis and situs inversus which have not previously been studied. We did not find evidence of seasonality for several anomalies which had previously been found to be seasonal. Influenza does not appear to be an important factor in the seasonality of congenital anomalies.

  3. Magnetic resonance imaging of bilateral lateral congenital dislocations of unossified patellae

    Energy Technology Data Exchange (ETDEWEB)

    Calisir, Cuneyt; Yilmaz, Oguzhan [Osmangazi University, Medical Faculty, Department of Radiology, Eskisehir (Turkey); Inan, Ulukan [Osmangazi University, Medical Faculty, Department of Orthopaedic and Trauma Surgery, Eskisehir (Turkey)

    2006-06-15

    We describe our experience using magnetic resonance imaging (MRI) to evaluate the unossified dislocated cartilaginous patella in a 6-year-old male patient with restricted extension and flexion deformity of both knees. MRI is used widely in the visualization of cartilage since it can show cartilage directly. In addition, FS FLASH 3D sequence has recently been accepted as a suitable sequence in the evaluation of hyaline cartilage. MRI makes it possible to evaluate ligamentous, tendinous, muscular, and cartilaginous structures as well as the abnormalities related to them. We applied this technique in our case and found it very effective in locating the unossified dislocated cartilaginous patella. We also observed structural changes such as bilateral lateral displacement of short quadriceps tendon inserting into diminutive patella, insertion of bilateral patellar tendons into anterolateral tibia, and a stretching of the medial collateral ligament associated with valgus stress. (orig.)

  4. Imaging in the Surgical Management of Developmental Dislocation of the Hip

    OpenAIRE

    Grissom, Leslie; Harcke, H. T.; Thacker, Mihir

    2008-01-01

    Although the use of ultrasound in the diagnosis and early treatment of developmental dysplasia of the hip (DDH) has reduced the number of patients diagnosed late and decreased the number of operative procedures, surgical treatment is still needed in some patients. Late cases continue to occur as a result of missing the screening examination, being normal at initial screening and missing followup. Dysplasia may persist despite appropriate nonoperative or operative treatment. Many of these pati...

  5. Posterior fracture dislocation of the hip joint in motor vehicle occupants

    Scientific Electronic Library Online (English)

    DM, Selvey; GM, Siboto; J, Walters.

    Full Text Available Between July 1994 and January 2000 one hundred and ten posterior fracture dislocations in 109 patients presenting to Groote Schuur Hospital required open reduction and internal fixation. Motor vehicle accidents accounted for 88 (80%) of the injuries equally divided between drivers and passengers. Ei [...] ghty-one per cent of comminuted grade III injuries occurred on the right side. Of these, 71.5% occurred in vehicle drivers. Only 48% of the simple fractures were right-sided and 64% occurred in passengers. We concluded that the driver of a motor vehicle is more likely to sustain a right-sided fracture dislocation which is of greater severity than other occupants. These findings should alert the motor industry to take steps to minimise this injury.

  6. Dislocation and spontaneous reduction of the femoral implant against the femoral neck in an infected metal on metal hip resurfacing with complex collection

    International Nuclear Information System (INIS)

    Metal on metal resurfacing hip implants are known to have complications unique to this type of implant. The case presented adds a further previously not described complication, the dislocation and spontaneous reduction of the pin of the femoral component against the femoral neck. The radiographic and CT findings are demonstrated. The dislocation was aided by bone loss due to an infection with a large periarticular collection. Periarticular collections in hip resurfacings are often due to a hypersensitivity type reaction to metal debris. However in the case presented it was due to infection. MRI was not able to discern the infection from a sterile collection. CT demonstrated bone loss and periosteal reaction suggestive of infection. In addition calcification of the pseudocapsule was seen, this is not a recognized feature of sterile collections.

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

    Directory of Open Access Journals (Sweden)

    Ezhov I.Y.

    2013-06-01

    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.

  8. MRI as a reliable and accurate method for assessment of posterior hip dislocation in children and adolescents without the risk of radiation exposure

    International Nuclear Information System (INIS)

    Posterior hip dislocation in children and adolescents may involve the non-ossified posterior acetabular wall. Plain radiographs and computed tomography (CT) have been shown to underestimate injury to the unossified acetabulum as well as associated soft-tissue structures. The purpose of this study was to describe findings on radiographs, CT and magnetic resonance imaging (MRI) after posterior hip dislocation in a series of adolescents and to report the intraoperative findings, which are considered the gold standard. Measurements of the posterior wall length using MRI and CT scans were also performed. After institutional review board approval, 40 patients who sustained a traumatic posterior dislocation of the hip between September 2007 and April 2014 were identified. Inclusion criteria were (1) age younger than 16 years old and (2) availability of MRI obtained following closed reduction of the hip. Eight male patients and one female patient with an average age of 13.2 years (range: 10.1-16.2 years) underwent hip MRI following posterior dislocation. Seven of the nine patients also underwent evaluation by CT. Plain radiographs, CT scans and MRI were evaluated in all patients by a single pediatric radiologist blinded to surgical findings for joint space asymmetry, posterior wall fracture, femoral head fracture, labrum tear, complete or partial ligamentum teres rupture and presence of intra-articular fragments. Six patients underwent surgical treatment and the intraoperative findings were compared with the imaging findings. CT identified all bone injuries but underestimated the involvement of posterior wall fractures. Assessment of the posterior wall size and fracture displacement was possible with MRI. All surgically confirmed soft-tissue injuries, including avulsion of the posterior labrum, were identified preoperatively on MRI. The measurement of posterior wall length was not statistically different using CT and MRI. Intraoperative pathological findings at the time of open surgical treatment were universally recognized on MRI but not on CT scans. MRI should be considered for evaluation of the hip following closed reduction for the treatment of a posterior dislocation in children and adolescents as it reliably allows assessment of intra-articular pathology without the risk of radiation exposure. (orig.)

  9. Advances in the early diagnosis of congenital hip dysplasia by real-time sonography

    International Nuclear Information System (INIS)

    Twenty-four infants and children aged five days to three years had their hips examined by ultrasound, and in 17 the findings were compared with the radiographic appearances. Realtime sonography, because of its flexibility, is a suitable screening method for the early diagnosis of hip dysplasia. It has the typical characteristics of a screening method: so far there have been no false negative findings. False positive results are rare, but cannot be completely excluded. The patients examined so far were mostly abnormal, and a final assessment of false positive findings will have to await larger clinical material, including normals. (orig.)

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

    OpenAIRE

    O.A. Aghdam; M.A. Mohseni; A. Rouhani; A. Sadeghpour; M. Goldust

    2012-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Gilberto Francisco Brandão

    2010-01-01

    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.

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

    Scientific Electronic Library Online (English)

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

    2007-08-01

    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. 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.

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

    Directory of Open Access Journals (Sweden)

    Ricardo Munir Nahas

    2007-08-01

    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.

  14. Small Incision Total Hip Arthroplasty

    Medline Plus

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Das Rupant

    2007-01-01

    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.

  16. Pseudoaneurysm Accompanied by Crowe Type IV Developmental Dysplasia of the Hip: A Case Report

    OpenAIRE

    Hirotake Yo; Hirotsugu Ohashi; Fumiaki Inori; Yoshiaki Okajima; Yoshio Matsui; Kosuke Shintani

    2012-01-01

    We report the case of a 72-year-old woman whose pseudoaneurysm was difficult to diagnose and treat. The patient had a history of congenital dislocated hip and was undergoing anticoagulation therapy with warfarin due to the mitral valve replacement. Her chief complaint was pain and enlargement of the left buttock, and the laboratory tests revealed severe anemia. However, her elderly depression confused her chief complaint, and she was transferred to a psychiatric hospital. Two months after the...

  17. 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)

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

    2009-09-01

    Full Text Available 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.

  18. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... looks reasonable too, okay. There you go. And Dent can just slightly dislocate that hip, sublux that ... glass head on this gentleman, okay. So your implant trial neck is a what letter? It’s an “ ...

  19. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... looks reasonable too, okay. There you go. And Dent can just slightly dislocate that hip, sublux that hip, and with just a slight bounce will feel nice and comfortable. But actually this, this reduced neck length, is appropriate for this case. Come on out, Kim. Now what would cause ...

  20. 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)

    Anderson Luiz de, Oliveira; Eduardo Gomes, Machado.

    2014-01-01

    Full Text Available 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.

  1. Imaging of hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  2. Sonography in the diagnosis and follow-up of congenital acetabular dysplasia during treatment

    International Nuclear Information System (INIS)

    Since 1987 the authors have used sonography (US) as the means to detect dysplasia and congenital dislocation of infants hips, to define severity of the disease, and to monito the results during treatment. In this paper the authors report their experience in 2000 examined babies. In 20 young patients, mainly females, 25 pathologic joints were detected and classified as 2c-4 hips. Orthopedic treatment employed Pavlick harness and, in case of partial success, Milgram abduction pillow too. This treatment has always been successful, except for a case with severe dislocation with echostructural changes in the acetabular cartilage. In this case, surgery was necessary. 'Delayed ossification' (type 2b hips) and physiological immaturity (type 2a hips) with alpha angle ?55 were not splinted in abduction: normal maturity has always been attained without dysplastic involutions. Our experience confirmed US value in the early diagnosis of congenital acetabular dysplasia, when clinics exhibited evident limitations. Nonetheless, management and economical problems are still to be solved, due to the relationship of the widespread use of US in infant population and to its successful results, also considering the low incidence of the examined pathologic condition

  3. 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)

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

    Full Text Available 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.

  4. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... on the bone. With an arthroscopic technique, the advantage of that is not to dislocate the hip, ... grow into the metal shell. This kind of technology has been around for a little bit. 00: ...

  5. Magnetic resonance imaging of hip joint cartilage and labrum

    OpenAIRE

    Ru?diger Krauspe; Bernd Bittersohl; Marcus Jager; Falk Miese; Christoph Zilkens

    2011-01-01

    Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of pre-existing cartilage damage. Biochemically sensitive MRI t...

  6. Arthroscopic management of an intraarticular osteochondroma of the hip

    OpenAIRE

    Bryan T. Kelley; Feeley, Brian T.

    2009-01-01

    The role of hip arthroscopy in the management of femoroacetabular impingement (FAI) has been advancing rapidly. In this case report, we describe the use of hip arthroscopy to successfully treat a femoral neck osteochondroma that caused a symptomatic labral tear in a 37 year old woman. Hip arthroscopy offers several advantages to surgical dislocation of the hip in the management of intra articular pathology and FAI. Hip arthroscopy is minimally invasive without the significant trauma to hip mu...

  7. Redundant anomalous vertebral artery in a case of congenital irreducible atlantoaxial dislocation: Emphasizing on the differences from the first intersegemental artery and operative steps to prevent injury while performing C1-2 joint manipulation.

    Science.gov (United States)

    Patra, Devi P; Salunke, Pravin S; Sahoo, Sushanta K; Ghuman, Mandeep S

    2015-10-01

    Anomalous vertebral artery (VA), commonly the persistent first intersegmental artery (FIA) is often seen with congenital atlantoaxial dislocations (AAD). An unusual redundant/ectatic loop of VA passing below the C1 (upside down VA) has been described below and appears to be different from FIA. The operative technique to protect it while C1-2 joint manipulation has been described. A 35 year old male presented with progressive spastic quadriparesis after trivial trauma. Radiology showed irreducible atlantoaxial dislocation with occipitalised C1 and C2-3 fusion. The left VA was anomalous passing beneath the C1 arch with a redundant loop lying posterior to the C1-2 joint. This was unlike the persistent first intersegmental artery (FIA) and was safeguarded while dissecting the C1-2 facet. The artery was dissected and safeguarded while performing C1-2 joint manipulation. A redundant/ectatic loop lying posterior to C1-2 joint is an unusual variant of anomalous VA. Evaluation of preoperative radiology helps in diagnosing such anomalous VA. Dissection of the entire redundant loop of the anomalous artery is important in opening the C1-2 joint required for reduction and placement of spacer/ bone grafts to achieve good bony fusion. Also mobilizing the loop allows safe insertion of lateral mass screw. Care needs to be taken while fastening screws to prevent compression of the loop. PMID:26527042

  8. The unstable total hip replacement.

    Science.gov (United States)

    Padgett, Douglas E; Warashina, Hideki

    2004-03-01

    Instability after total hip arthroplasty (THA) is not a rare occurrence. Numerous factors have been associated with dislocation including surgical approach, implant design, failure to restore proper hip mechanics and soft tissue restraints, and patient variables such as early postoperative compliance, soft tissue integrity, and neurologic conditions such as poor proprioception. A thorough understanding of the mechanism of dislocation, timing, and direction of dislocation is mandatory in formulating an approach toward treatment. The radiographic evaluation should evaluate hip mechanics including component orientation, adequacy of leg lengths, and restoration of offset in the frontal and sagittal planes. The treatment of the unstable total hip replacement is based on numerous variables including the timing of instability, direction, and mechanism. Instability in the early postoperative period in the hip with proper orientation and restored mechanics often is treated successfully with patient reeducation and use of adjunctive bracing. The treatment of the recurrent dislocator can be more difficult. Although reestablishing proper mechanics and orientation can be successful in many instances, some patients continue to have dislocation. Constrained acetabular liners have significantly improved the success rate of reducing the incidence of dislocation, but problems related to premature wear and dislodgement are a major concern. The use of larger articulating bearing surfaces used with the newer cross-linked polyethylene may provide the solution to instability minimizing the concerns related to constrained components. PMID:15057081

  9. Infant hip sonography: current concepts.

    Science.gov (United States)

    Harcke, H T; Grissom, L E

    1994-08-01

    Sonography of the infant hip has gained wide acceptance in the decade since its introduction. The two principle techniques of Graf and Harcke have been combined with the proposal of a Dynamic Standard Minimum Examination. Whereas sonography is used increasingly to manage developmental dislocation and/or displasia of the hip, there is no agreement on the use of sonography for universal newborn screening. This article describes in detail the Dynamic Standard Minimum Sonographic Examination of the infant hip. In addition, this article reviews the classification and management of infant hip disorders. PMID:7946476

  10. Congenital cataract

    Science.gov (United States)

    Cataract - congenital ... Unlike most cataracts, which occur with aging, congenital cataracts are present at birth. Congenital cataracts are rare. In most patients, no cause can be found. Congenital cataracts often occur as part of ...

  11. Dislocation Theory

    International Nuclear Information System (INIS)

    1. Introduction; basic definitions; the slip process in crystalline solids; the Burgers vector. 2. The elementary theory of discrete dislocations in an isotropic elastic continuum; plane and anti-plane strain. 3. Dislocation solutions in an isotropic elastic medium; stresses and strains; elastic energy of a dislocation; interactions with other dislocations. 4. Defect sources and the complete decomposition of distortion fields. 5. The general field-theoretic theory of dislocations; an elementary introduction using Green's function methods; infinitesimal loops, rational dislocation elements; incompatibility elements. 6. Discrete dislocations in anisotropic bodies; significance of anisotropy; examples. 7. Partially discrete models of dislocations; Peierls and Van-der-Merwe models; core effects. 8. Fully atomic models; harmonic lattices and general case. 9. The interaction of dislocations in crystals; dislocation nodes and sources. 10. The interaction of dislocations with point defects and the kinetics of the segregation process. 11. Work-hardening in face centred cubic metal crystals; 12. Dislocation boundaries. 13. The non-linear theory of the continuously dislocated lattice. (author)

  12. 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)

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

    2014-06-01

    Full Text Available 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.

  13. Hip sonography in the newborn

    International Nuclear Information System (INIS)

    The authors report the data relative to 1507 cases studied with clinical and US examinations, in the neonatal period, in order to exclude hip dysplasia dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips ar birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th months of life. At about one year of age all infants could normally walk, excpet for one who was being treated with herness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, thw authors belive US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period

  14. A Randomised Multi-centre Study to Compare the Long-term Performance of the Future Hip to 3 Other Implants in Primary Total Hip Replacement

    Science.gov (United States)

    2011-09-01

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

  15. Screening programmes for developmental dysplasia of the hip in newborn infants

    Scientific Electronic Library Online (English)

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

    2013-04-01

    Full Text Available 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.

  16. Ultrasound screening for hip abnormalities: preliminary findings in 1001 neonates.

    OpenAIRE

    Berman, L; Klenerman, L

    1986-01-01

    Several studies have documented the failure of neonatal clinical screening to reduce the incidence of hip dislocation later in infancy. In addition, the practice of splinting unstable hips is said to result in the treatment of many infants who would have developed normally if left unsplinted. Ultrasound provides a detailed image of the bony and cartilaginous neonatal hip. The results of conventional testing for hip instability were compared with ultrasound screening in 1001 neonates. As a res...

  17. Arthroscopic management of an intraarticular osteochondroma of the hip

    Directory of Open Access Journals (Sweden)

    Brian T. Feeley

    2009-04-01

    Full Text Available The role of hip arthroscopy in the management of femoroacetabular impingement (FAI has been advancing rapidly. In this case report, we describe the use of hip arthroscopy to successfully treat a femoral neck osteochondroma that caused a symptomatic labral tear in a 37 year old woman. Hip arthroscopy offers several advantages to surgical dislocation of the hip in the management of intra articular pathology and FAI. Hip arthroscopy is minimally invasive without the significant trauma to hip musculature, is useful in treatment of labral tears generated by FAI, and can be used to resect small lesions on the femoral head.

  18. Magnetic resonance imaging of hip joint cartilage and labrum

    Directory of Open Access Journals (Sweden)

    Christoph Zilkens

    2011-09-01

    Full Text Available Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of pre-existing cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC might help to monitor the effect of surgical or non-surgical procedures in the effort to halt or even reverse joint damage.

  19. Neglected Pipkin's fracture dislocation with bilateral femoral shaft fractures: an unusual combination

    OpenAIRE

    Panigrahi, Ranajit; Mahapatra, Amita Kumari; Palo, Nishit; Priyadarshi, Ashok

    2015-01-01

    A hip fracture dislocation with contralateral femur fracture is a rare combination. We report a case of neglected posterior dislocation of hip with Pipkins-II femoral head and medial condylar fractures associated with a contralateral femoral shaft fracture. Right hip joint was approached via the Kocher-Langenbeck, following reduction, femoral head fragments were fixed with two 4-mm cannulated cancellous screws with open reduction internal fixation plating of ipsilateral femoral condylar fract...

  20. An 8.35 Mb overlapping interstitial deletion of 8q24 in two patients with coloboma, congenital heart defect, limb abnormalities, psychomotor retardation and convulsions.

    Science.gov (United States)

    Verheij, J B G M; de Munnik, S A; Dijkhuizen, T; de Leeuw, N; Olde Weghuis, D; van den Hoek, G J; Rijlaarsdam, R S; Thomasse, Y E M; Dikkers, F G; Marcelis, C L M; van Ravenswaaij-Arts, C M A

    2009-01-01

    Chromosome analysis in two young patients with multiple congenital anomalies revealed a de novo interstitial deletion of 8q that has not been reported before. The deletions were overlapping by 8.35 Mb (8q24.21q24.23). The clinical features shared by our patients were coloboma, VSD, digital abnormalities, congenital dislocation of a hip, feeding problems, psychomotor delay and convulsions. The deletion included the region for Langer-Giedion syndrome (TRPS1 and EXT1) in the girl only. However, she is too young to present features of this syndrome, apart from dysmorphic features like a bulbous nose and notched alae nasi. Several genes are present in the commonly deleted region, including genes with unknown function, and genes for which haploinsufficiency is known to have no phenotypic effect in mice (Wnt1). A gene that might play a role in the convulsions of our patients is KCNQ3. PMID:19464398

  1. Hip, hip, hooray!

    OpenAIRE

    Pewsey, Emma

    2013-01-01

    X-rays are best known for showing where bones have fractured, but researchers can also use X-rays to investigate why bones break, which could lead to treatments that reduce the number of elderly people who suffer broken hips.

  2. [Evaluation of treatment of the hip in arthrogryposis multiplex congenita].

    Science.gov (United States)

    Guarniero, R; Montenegro, N B; Luzo, C A; Corsato, M de A; Lage, L A; Peixinho, M

    1991-01-01

    In a retrospective review of 77 patients with arthrogryposis multiplex congenita, 21 showed involvement of the hip (28%). The authors studied 18 cases with hip dislocation (11 bilateral and seven unilateral) and three with hip contracture. There were 12 female and nine male patients ranging their age from one month to 14 years. The follow-up in this series lasted from two to 23 years. The treatment was conservative or surgical. The contractures were treated by manipulation and abduction orthosis in one patient and surgically by multiple hip tenotomy in two. The dislocation was treated by abduction orthosis (two cases), closed reduction (two cases) and open reduction (one case) in the 11 cases with bilateral involvement; for the seven unilateral dislocations the treatment was: closed reduction and abduction orthosis (one case), closed reduction with abductor tenotomy and hip spica cast (four cases) and open reduction followed by hip spica and abduction orthosis (one case); one case remained without treatment of the hip involvement because of severity of deformities in knee and foot. Ten patients of this groups were not treated because they were confined to wheelchairs. The overall result was good in six patients, regular in four and poor in two in the dislocation group; for the three cases of hip contracture the result of treatment was good. In conclusion the authors recommend such treatment for the independent ambulatory patients and emphasize the necessity of treatment of patients with unilateral hip involvement. PMID:1843737

  3. Biomechanics of the Hip Capsule and Capsule Management Strategies in Hip Arthroscopy.

    Science.gov (United States)

    Nepple, Jeffrey J; Smith, Matthew V

    2015-12-01

    Recent advances in our understanding of the function of the hip capsule have clarified its importance to normal hip function and kinematics. The iliofemoral ligament is the primary stabilizing structure for controlling anterior translation and external rotation of the hip, and is violated by the arthroscopic interportal capsulotomy. Microinstability of the hip occurring after surgical trauma remains a poorly defined clinical entity. In certain at-risk populations, capsular repair should be considered as part of an arthroscopic hip procedure to achieve optimal outcomes and avoid iatrogenic instability (dislocation or microinstability). Despite a lack of conclusive evidence-based indications, we recommend capsular repair in the settings of borderline hip dysplasia (or dysplastic variants such as increased femoral anteversion), hip hypermobility, connective tissue disorders, and traumatic or atraumatic instability. With careful attention to arthroscopic capsular management, adequate exposure can be achieved and reproducibly allow for an effective capsular repair when indicated. PMID:26524549

  4. Congenital scoliosis

    OpenAIRE

    Arlet, V.; Odent, Th.; Aebi, M.

    2003-01-01

    Congenital scoliosis is the most frequent congenital deformity of the spine. Congenital curvatures are due to anomalous development of the vertebrae (failure of formation and/or segmentation). Congenital scoliosis is believed to be related to an insult to the fetus during spine embryological development, and associated malformations (heart, spinal cord, kidney...) are frequently observed. A perfect understanding of the natural history of the deformity and the treatment principles will allow b...

  5. Hip Ultrasound

    Science.gov (United States)

    ... positioned on the examination table, the radiologist or sonographer will apply a warm water-based gel to ... initial review. During hip ultrasound, the radiologist or sonographer may ask you to move the hip being ...

  6. 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 ...

  7. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Masanori [Keio Univ., Tokyo (Japan). School of Medicine

    1997-11-01

    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)

  9. Subtalar dislocations.

    Science.gov (United States)

    Ganel, A; Ahronson, Z; Heim, M; Pritch, M; Chechick, A

    1981-01-01

    Severe plantarflexion of the foot associated with adduction and supination resulted in medial subtalar dislocation in three patients. Closed manipulation in two patients and open reduction in one restored normal anatomy of the foot, with no complications in a follow-up of 1 to 2 years. PMID:7276452

  10. Computerized tomography in children with dysplasia of the hip joint

    International Nuclear Information System (INIS)

    The hip joints in 10 children were investigated with computerized tomography (CT). The method permitted the determination of the geometry of hip joints. It was used for a study of the pathogenesis of asceptic necrosis at early stages of its development in children with congenital dysplasia of the hip joint at early stages of disease. CT made it possible to establish anteversion of the cotyloid cavity, its degree, the shape and structure of the anterior and posterior wall of the cotyloid cavity, and a shift of the proximal hip end enteriorly in combination with the above changes in the shole hip joint

  11. Framing Hip Hop: New Methodologies for New Times

    Science.gov (United States)

    Dimitriadis, Greg

    2015-01-01

    This article revisits the central impulse behind early advocacy for ethnographic approaches to hip hop--that critics should try as much as possible to limit their own certainties around what hip hop can and might mean. While ethnographic approaches can engender the kinds of personal dislocations that allow for this negotiation, they do not…

  12. State-of-the-Art Hip Surgeries for Active Adults

    Medline Plus

    Full Text Available ... do anything they want after the surgery without fear of dislocation or any complications. So that’s hip ... you, Dr. Paravizi. So, one of the greatest fears patients have going into surgery, whether it’s hip ...

  13. Neonatal hip dysplasia: Differental diagnosis

    Directory of Open Access Journals (Sweden)

    Vukašinovi? Zoran

    2010-01-01

    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.

  14. Congenital Leukemia

    OpenAIRE

    Rupali Bargotra , Jyotsna Suri, Yudhvir Gupta

    2010-01-01

    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.

  15. Hip Revision

    Medline Plus

    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 ... going to be having live operative techniques of the ZMR Tapered System performed by Dr. Scott Sporer. ...

  16. Is surgery recommended in adults with neglected congenital muscular torticollis? A prospective study

    Directory of Open Access Journals (Sweden)

    Sharifi Reza

    2008-11-01

    Full Text Available Abstract Background Congenital muscular torticollis is the third most common congenital musculoskeletal anomaly after dislocation of the hip and clubfoot. When diagnosed early, it is obvious that it can be managed with good or excellent results. The aim of this prospective study was to determine the efficacy of surgery in neglected adult cases. Methods From January 2003 to June 2007, 18 adult skeletally matured patients were surgically treated for neglected congenital muscular torticollis and prospectively followed (at least one year. Bipolar release was performed in all patients. Radiography and the modified Lee's scoring system which included function and cosmesis, were used to measure the surgical results. Complications were also recorded. Results Four cases were lost during follow-up. Of the remaining 14 patients, 10 cases were males and 4 females. The age at operation ranged from 18 to 32 (average 21.9 years. The mean follow-up period was 2.5 years (range 1–5 years. Excellent results were noted in 7 patients, good in 5, and poor in 2 patients. Significant improvement (>10° of the cervico-thoracic scoliosis was noted only in 3 of 10 patients. Conclusion Patients with congenital muscular torticollis can benefit from surgical treatment even in adulthood. Surgical bipolar sectioning of the sternocleidomastoid muscle should be considered even in adults with irreversible facial and skeletal deformities. The surgery restores the range of neck motion and resolves the head tilt; therefore it can improve the quality of life. This procedure is an effective and relatively complication-free method.

  17. 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 ...

  18. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  20. Mechanics of hip dysplasia reductions in infants using the Pavlik harness: a physics-based computational model.

    Science.gov (United States)

    Ardila, Orlando J; Divo, Eduardo A; Moslehy, Faissal A; Rab, George T; Kassab, Alain J; Price, Charles T

    2013-05-31

    Biomechanical factors influencing the reduction of dislocated hips with the Pavlik harness in patients of Developmental Dysplasia of the Hip (DDH) were studied using a three-dimensional computer model simulating hip reduction dynamics in (1) subluxated and (2) fully dislocated hip joints. Five hip adductor muscles were identified as key mediators of DDH prognosis, and the non-dimensional force contribution of each in the direction necessary to achieve concentric hip reductions was determined. Results point to the adductor muscles as mediators of subluxated hip reductions, as their mechanical action is a function of the degree of hip dislocation. For subluxated hips in abduction and flexion, the Pectineus, Adductor Brevis, Adductor Longus, and proximal Adductor Magnus contribute positively to reduction, while the rest of the Adductor Magnus contributes negatively. In full dislocations all muscles contribute detrimentally to reduction, elucidating the need for traction to reduce Graf IV type dislocations. Reduction of dysplastic hips was found to occur in two distinct phases: (a) release phase and (b) reduction phase. PMID:23631856

  1. Hip ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  2. Hip Revision

    Medline Plus

    Full Text Available ... Revision Featuring the ZMR® Hip System Tapered Distal Stem Zimmer, Inc. Winfield, Illinois September 3, 2009 Welcome ... no signs of acute inflammation. And got a cell count back, which was 900. So in seeing ...

  3. 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.

  4. Hip Replacement

    Science.gov (United States)

    ... around the hip joint. Walking aids such as canes and walkers may alleviate some of the stress ... of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out ...

  5. Arthroscopic Hip Revision Surgery for Residual FAI

    Science.gov (United States)

    Larson, Christopher M.; Giveans, Russell; Bedi, Asheesh; Samuelson, Kathryn M.; Stone, Rebecca M.

    2014-01-01

    Objectives: There is a steep surgical learning curve when managing femoroacetabular impingement (FAI) and residual FAI can lead to continued pain and disability. There is very limited data reporting outcomes after revision arthroscopy for residual FAI. Methods: The records of patients that underwent arthroscopic hip revision surgery for residual FAI based on plain radiographs and 3D CT scans were reviewed. Pre and post-operative structural pathomorphology, intra-operative findings, and pre and post-operative outcomes measures using Modified Harris Hip Scoring (MHHS), SF-12 scoring, and pain on a visual analogue scale (VAS) were evaluated. Outcomes after revision arthroscopic FAI correction were compared to a cohort that underwent primary arthroscopic FAI correction. Results: 59 patients (85 hips) underwent arthroscopic revision FAI correction (mean 20.8 months follow-up). There were 98 previous arthroscopic surgeries and 4 previous surgical dislocations. There were 39 males and 46 females with a mean age of 29.5 years (range 16 - 59). 80 hips had residual cam-type FAI, and 64 hips had residual pincer-type FAI and underwent femoral and rim resections, respectively. The labrum was debrided in 27 hips, repaired in 48 hips and reconstructed with allograft in 8 hips. Adhesions were excised for 54 hips. The results of revision arthroscopic FAI correction were compared to 154 patients (169 hips) that underwent primary arthroscopic FAI correction (mean 25.2 months follow-up). The mean improvement for outcomes scores after revision FAI correction was 18.9 points (MHHS, p.05), SF-12 (p<.01), VAS (p<.01). Conclusion: With appropriate indications and expectations, arthroscopic hip revision surgery for residual FAI led to significantly improved outcome measures. Outcomes, however, were inferior to those after primary arthroscopic FAI corrective surgery.

  6. Hip Revision

    Medline Plus

    Full Text Available ... limp and again that impinging issue that can cause dislocations that we're all worried about. So ... osteomoty -- which effectively you take the femur and cause an intentional break and cable it. That's looking ...

  7. 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

  8. Congenital amusias.

    Science.gov (United States)

    Tillmann, B; Albouy, P; Caclin, A

    2015-01-01

    In contrast to the sophisticated music processing reported in the general population, individuals with congenital amusia show deficits in music perception and production. Congenital amusia occurs without brain damage, sensory or cognitive deficits, and has been suggested as a lifelong deficit with genetic origin. Even though recognized for a long time, this disorder has been systematically studied only relatively recently for its behavioral and neural correlates. The currently most investigated hypothesis about the underlying deficits concerns the pitch dimension, notably with impaired pitch discrimination and memory. Anatomic and functional investigations of pitch processing revealed that the amusic brain presents abnormalities in the auditory and inferior frontal cortices, associated with decreased connectivity between these structures. The deficit also impairs processing of pitch in speech material and processing of the time dimension in music for some of the amusic individuals, but does not seem to affect spatial processing. Some studies suggest at least partial dissociation in the disorder between perception and production. Recent studies revealed spared implicit pitch perception in congenital amusia, supporting the power of implicit cognition in the music domain. Current challenges consist in defining different subtypes of congenital amusia as well as developing rehabilitation programs for this "musical handicap." PMID:25726292

  9. 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 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

  10. Hip Damage Occurs at the Zone of Femoroacetabular Impingement

    OpenAIRE

    Tannast, M; Goricki, D.; Beck, M; Murphy, S. B.; Siebenrock, K. A.

    2008-01-01

    Although current concepts of anterior femoroacetabular impingement predict damage in the labrum and the cartilage, the actual joint damage has not been verified by computer simulation. We retrospectively compared the intraoperative locations of labral and cartilage damage of 40 hips during surgical dislocation for cam or pincer type femoroacetabular impingement (Group I) with the locations of femoroacetabular impingement in 15 additional hips using computer simulation (Group II). We found no ...

  11. Hip Revision

    Medline Plus

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

  12. Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Shu-Tai Shih

    2007-02-01

    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.

  13. Hip Revision

    Medline Plus

    Full Text Available ... usually. And if you don't take your time at this phase, this is where you're going to see those dislocations. And so it's a matter of managing that capsule -- that trochanter -- so you get it ...

  14. Osteonecrosis and femoro-acetabular impingement: sequelae of developmental dysplasia of the hip

    OpenAIRE

    Cheung, Jason Pui Yin; Chow, Wang; To, Michael

    2012-01-01

    A 2-year-old girl with developmental dysplasia of the right hip underwent open reduction and capsulorrhaphy via the anterior approach with hip spica casting in an internally rotated position. During her 26 years of follow-up, she was found to have osteonecrosis and subsequently cam-type femoro-acetabular impingement at 28 years of age. She was treated with surgical dislocation of the hip and osteochondroplasty to recreate the normal contour of the head and neck offset.

  15. Gene therapy and cement injection for the treatment of hip prosthesis loosening in elderly patients

    OpenAIRE

    Poorter, Jolanda de

    2010-01-01

    Approximately one million total hip replacement operations are performed worldwide annually, mostly for osteoarthritis and rheumatoid arthritis. A major complication in total hip arthroplasties is loosening of the prosthesis leading to pain and walking difficulties and a higher risk for dislocations and pathological fractures.11 Within ten years of primary hip replacement 7-13 percent of patients need revision surgery due to loosening of the implant.16 The number of revision surgeries in el...

  16. Bioball universal modular neck adapter as a salvage for failed revision total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Raju Vaishya

    2013-01-01

    Full Text Available Management of recurrent dislocation of total hip arthroplasty is often a challenging and daunting task. Re-revision of such a total hip prosthesis may not be easy as the removal of a well-fixed, fully coated stem is extremely difficult. We managed to salvage instability in three revision hip cases in which the fully coated stem had subsided by using a bioball universal neck adapter without changing the femoral stem or acetabular cup.

  17. [Congenital clubfoot].

    Science.gov (United States)

    Weimann-Stahlschmidt, K; Krauspe, R; Westhoff, B

    2010-11-01

    Congenital clubfoot is one of the most common congenital skeletal deformities with an incidence of 1-2/1000 newborns. The deformity is characterized by pathological changes of joints, bones (especially the talus), muscles, tendons and soft tissues which result in subtalar malpositions known as talipes equinus, varus adductus and cavus. Secondary clubfoot is always part of an underlying systemic or neurologic disease and can occur at birth or develop over time. The treatment of clubfoot should start early after birth and is primarily conservative, involving manipulation and serial casting. Among conservative techniques available today, the Ponseti method is the treatment of choice. Applying this treatment protocol surgical therapy can be reduced in amount and extent. Extensive surgical therapy is only necessary in exceptional cases. PMID:21052630

  18. Evaluation of surgical treatment of developmental dysplasia of hip for avascular necrosis of femoral head in children.

    Science.gov (United States)

    Sadeghpour, A; Rouhani, A; Mohseni, M A; Aghdam, O A; Goldust, M

    2012-04-15

    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). PMID:24199469

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

    Directory of Open Access Journals (Sweden)

    O.A. Aghdam

    2012-01-01

    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.

  20. Hip Implant Systems

    Science.gov (United States)

    ... and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility and ...

  1. Utility of combined hip abduction angle for hip surveillance in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Akshay Divecha

    2011-01-01

    Full Text Available Background: Spontaneous hip lateralization complicates the management of non-ambulatory children with cerebral palsy (CP. It can be diagnosed early using radiographs, but it involves standardization of positioning and exposure to radiation. Hence, the aim of this study was to assess the utility of Combined hip abduction angle (CHAA in the clinical setting to identify those children with CP who were at greater risk to develop spontaneous progressive hip lateralization. Materials and Methods: One hundred and three children (206 hips with CP formed our study population. There were 48 boys and 55 girls aged 2-11 years (mean 5.03 years. 61 children were Gross Motor Function Classification System (GMFCS level 5, while 42 were GMFCS level 4. Clinical measurements of CHAA were statistically correlated with radiographic measurements of Reimer?s migration percentage (MP for bivariate associations using c2 and t tests. Results: CHAA is evaluated against MP which is considered as a reliable measure of hip subluxation. Thus, for CHAA, sensitivity was 74.07% and specificity was 67.35%. False-positive rate was 32.65% and false-negative rate was 25.93%. Conclusions: Our study shows that correlation exists between CHAA and MP, which has been proved to be useful for hip screening in CP children at risk of hip dislocation. CHAA is an easy, rapid, cost-effective clinical test which can be performed by paraclinical health practitioners (physiotherapists and orthopedic surgeons.

  2. Characteristics of children with hip displacement in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Wagner Philippe

    2007-10-01

    Full Text Available Abstract Background Hip dislocation in children with cerebral palsy (CP is a common and severe problem. The dislocation can be avoided, by screening and preventive treatment of children with hips at risk. The aim of this study was to analyse the characteristics of children with CP who develop hip displacement, in order to optimise a hip surveillance programme. Methods In a total population of children with CP a standardised clinical and radiological follow-up of the hips was carried out as a part of a hip prevention programme. The present study is based on 212 children followed until 9–16 years of age. Results Of the 212 children, 38 (18% developed displacement with Migration Percentage (MP >40% and further 19 (9% MP between 33 and 39%. Mean age at first registration of hip displacement was 4 years, but some hips showed MP > 40% already at two years of age. The passive range of hip motion at the time of first registration of hip displacement did not differ significantly from the findings in hips without displacement. The risk of hip displacement varied according to CP-subtype, from 0% in children with pure ataxia to 79% in children with spastic tetraplegia. The risk of displacement (MP > 40% was directly related to the level of gross motor function, classified according to the gross motor function classification system, GMFCS, from 0% in children in GMFCS level I to 64% in GMFCS level V. Conclusion Hip displacement in CP often occurs already at 2–3 years of age. Range of motion is a poor indicator of hips at risk. Thus early identification and early radiographic examination of children at risk is of great importance. The risk of hip displacement varies according to both CP-subtype and GMFCS. It is sometimes not possible to determine subtype before 4 years of age, and at present several definitions and classification systems are used. GMFCS is valid and reliable from 2 years of age, and it is internationally accepted. We recommend a hip surveillance programme for children with CP with radiographic examinations based on the child's age and GMFCS level.

  3. Total hip arthroplasty.

    OpenAIRE

    Siopack, J S; Jergesen, H E

    1995-01-01

    Total hip arthroplasty, or surgical replacement of the hip joint with an artificial prosthesis, is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. In this review we briefly summarize the evolution of total hip arthroplasty, the design and development of prosthetic hip components, and the current clinical indications for this procedure. The possible complications of total hip arthroplasty...

  4. Imaging of the hip and bony pelvis. Techniques and applications

    International Nuclear Information System (INIS)

    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.)

  5. Imaging of the hip and bony pelvis. Techniques and applications

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  6. 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

  7. Congenital tuberculosis

    International Nuclear Information System (INIS)

    Congenital tuberculosis is an infection that is established in the fetus by hematogenous spread or by the aspiration or inhalation of infected amniotic fluid either before or during labor. The diagnosis can be confirmed only if both the tuberculous nature of the lesion and the antenatal origin of the infection can be proved. The authors analyzed roentgen findings of two cases of pulmonary tuberculosis, thought to be congential; 1. Diffuse distribution of nodular densities and some confluent densities were seen in the entire lungs in the initial film. The pulmonary markings were decreased in some degree. 2. Air bronchogram was noted. 3. Hepatosplenomegaly was associated.

  8. Total hip arthroplasty for arthrodesed hips.

    OpenAIRE

    Howard MB; Bruce WJ; Walsh W; Goldberg JA

    2002-01-01

    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 lea...

  9. Primary traumatic patellar dislocation

    Directory of Open Access Journals (Sweden)

    Tsai Chun-Hao

    2012-06-01

    Full Text Available Abstract Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management.

  10. Collective behavior of dislocations

    International Nuclear Information System (INIS)

    Deformation of a crystal involves the motion of dislocations. Since dislocations interact, a short range and at long range, it is basic to understanding plasticity to establish if dislocations move singly or collectively. If deformation involves the collective motion of dislocations how does it manifest itself or equivalently how can it be measured? While a variety of techniques measure the positions of single dislocations before and after a stress is applied to a crystal, giving an average dislocation velocity, these techniques do not related directly to what happens during deformation, that is the collective behavior of dislocations. The mobile dislocation density is measured as follows: Lead-10% indium crystals are deformed at 4.2K, while in a magnetic field in the range Hc1 c2 where Hc1 is the lower critical field, H the applied field and Hc2 the upper critical field. During deformation changes n the flux are observed; the changes in flux are proportional to the mobile dislocation density. These changes in flux show the following characteristics: When the deformation process changes from elastic to plastic deformation there is a pronounced increase in flux noise, well above the background noise level. In addition superposed on this noise are pronounced bursts of magnetic flux, corresponding to dislocation bursts or avalanches of dislocations. A number of checks establish that these pulses are solely related to dislocations. These include the fact that they are not reproducible in terms of time from test to test, ruling out systematic instabilities in the circuit. Also, they occur when the crystal is unloaded and then reloaded at times, after plasticity is reinitiated, which are inconsistent with any time constant of the circuit. Finally, the measuring circuit shows no instabilities or ringing in this frequency range

  11. Congenital amusia

    DEFF Research Database (Denmark)

    Williamson, Victoria J; Stewart, Lauren

    2013-01-01

    For most people, music, like language, is acquired effortlessly in early life. But a few percent of the population have lifelong difficulties in the perception and production of music. In this chapter we discuss psycho-acoustic and behavioral studies that have attempted to delineate the nature of the auditory perceptual deficits in this group and consider whether these difficulties extend outside the musical domain. Finally, we review structural imaging studies in this group which point to subtle anomalies in temporal and frontal areas. We suggest that amusia can be considered a disorder of neural development, which has relatively specific consequences at the behavioral level. Studies of congenital amusia provide a unique window on the neurocognitive architecture of music processing.

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

    DEFF Research Database (Denmark)

    Hartig-Andreasen, Charlotte; Stilling, Maiken

    2014-01-01

    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

  13. Femoroacetabular Impingement: Do Outcomes Reliably Improve with Surgical Dislocations?

    OpenAIRE

    Graves, Matt L.; Mast, Jeff W.

    2008-01-01

    Femoroacetabular impingement is a motion-based concept of conflict that occurs secondary to morphologic abnormalities of the proximal femur and/or acetabulum. Creating impingement-free motion through restoration of normal morphology serves as the goal of joint-preserving procedures. We retrospectively reviewed the short-term functional and radiographic outcomes of 46 patients (48 hips) with femoroacetabular impingement treated with a surgical dislocation and restoration of offset. The average...

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

    Directory of Open Access Journals (Sweden)

    Scott Yang

    2012-01-01

    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.

  15. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... hip pain is increasingly being recognized as a cause of hip osteoarthritis. Arthroscopy of the hip is ... the patient brings that hip into flexion can cause that labrum to start to tear. That labrum, ...

  16. Small Incision Total Hip Arthroplasty

    Science.gov (United States)

    ... small-incision total hip arthroplasty and arthroscopic hip femoroacetabular impingement resection. Hip pain is not limited to senior ... you will see footage of an arthroscopic hip femoroacetabular impingement resection. Remember, OR-Live makes it easy for ...

  17. Metal-on-Metal Hip Arthroplasty: Does Early Clinical Outcome Justify the Chance of an Adverse Local Tissue Reaction?

    OpenAIRE

    Ho, Henry; Engh, Charles A.

    2009-01-01

    Larger diameter metal-on-metal (MOM) bearing hips offer the possibility of low wear and reduced risk of dislocation. We reviewed the first 126 patients (131 hips) who had a large-head (36-mm) MOM bearing surface to report the early clinical outcome and especially to determine the occurrence of dislocation and wear-related concerns. The minimum followup was 5 years (mean, 5.6 years; range, 5–7 years). We found a 98% survivorship free of component revision. No hips had been revised for dislocat...

  18. 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

    OpenAIRE

    Bruno de Castro Paixão Jacobino; Mariana Domingues Galvão; Adriano Ferreira da Silva; Cláudio Campi de Castro

    2012-01-01

    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),...

  19. Patellar dislocation with genu valgum treated by DFO.

    Science.gov (United States)

    Kwon, Jae Ho; Kim, Jong In; Seo, Dong-Hyun; Kang, Kyung-Woon; Nam, Ji Ho; Nha, Kyung-Wook

    2013-06-01

    Congenital habitual patellar dislocation is a rare condition of the knee where the patella dislocates during flexion and relocates during extension. The congenital form is permanent, irreducible, and presents at birth. It is characterized by a short quadriceps and a major patellofemoral dysplasia and short height. This article presents a rare case of a 27-year-old woman with recurring bilateral habitual dislocation of the patella after a failed previous proximal and distal realignment procedure. Clinical examinations of both knees revealed genu valgus knees and lateral joint pain that recurred after several previous operations. Radiographs of both knees showed patellar dislocation and genu valgum associated with patellofemoral dysplasia and osteoarthritis of the lateral compartment. Long-leg standing radiographs showed an anatomic tibiofemoral angle of right 13° and left 6° valgus and a mechanical tibiofemoral angle of right 8° and left 2° valgus and weight-bearing line of 65% on the right and 48% on the left. The authors performed a distal femoral closing wedging osteotomy to correct the valgus deformity, and then percutaneous lateral release and medial reefing were performed to stabilize the patellas of both knees simultaneously. PMID:23746026

  20. Dislocation nucleation: Diffusive origins

    Science.gov (United States)

    Li, Ju

    2015-07-01

    A growing body of evidence suggests that nucleation of a first dislocation in a pristine crystal is associated with a diffusion-controlled process. Understanding this is critical for strain-engineered devices at ultrahigh stresses.

  1. 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 © ...

  2. Dislocations in bilayer graphene

    Science.gov (United States)

    Butz, Benjamin; Dolle, Christian; Niekiel, Florian; Weber, Konstantin; Waldmann, Daniel; Weber, Heiko B.; Meyer, Bernd; Spiecker, Erdmann

    2014-01-01

    Dislocations represent one of the most fascinating and fundamental concepts in materials science. Most importantly, dislocations are the main carriers of plastic deformation in crystalline materials. Furthermore, they can strongly affect the local electronic and optical properties of semiconductors and ionic crystals. In materials with small dimensions, they experience extensive image forces, which attract them to the surface to release strain energy. However, in layered crystals such as graphite, dislocation movement is mainly restricted to the basal plane. Thus, the dislocations cannot escape, enabling their confinement in crystals as thin as only two monolayers. To explore the nature of dislocations under such extreme boundary conditions, the material of choice is bilayer graphene, the thinnest possible quasi-two-dimensional crystal in which such linear defects can be confined. Homogeneous and robust graphene membranes derived from high-quality epitaxial graphene on silicon carbide provide an ideal platform for their investigation. Here we report the direct observation of basal-plane dislocations in freestanding bilayer graphene using transmission electron microscopy and their detailed investigation by diffraction contrast analysis and atomistic simulations. Our investigation reveals two striking size effects. First, the absence of stacking-fault energy, a unique property of bilayer graphene, leads to a characteristic dislocation pattern that corresponds to an alternating ABAC change of the stacking order. Second, our experiments in combination with atomistic simulations reveal a pronounced buckling of the bilayer graphene membrane that results directly from accommodation of strain. In fact, the buckling changes the strain state of the bilayer graphene and is of key importance for its electronic properties. Our findings will contribute to the understanding of dislocations and of their role in the structural, mechanical and electronic properties of bilayer and few-layer graphene.

  3. Bursitis of the Hip

    Science.gov (United States)

    ... a staph infection) Diabetes Spine problems, such as scoliosis Uneven leg lengths Bone spurs (bony growths on top of normal bone) on the hip ... How is hip bursitis treated? Treatment for bursitis ...

  4. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... doing an "OR Live" Webcast on the Kinectiv Total Hip System. At this time, let’s join Dr. ... for any reason, you need to accommodate the total anteversion of a total hip replacement, because you' ...

  5. Isolated congenital urethrocutaneous fistula.

    Science.gov (United States)

    Akman, R Yavuz; Cam, Kamil; Akyuz, Osman; Erol, Ali

    2005-04-01

    Congenital urethrocutaneous fistula of the male urethra is an extremely rare anomaly that is commonly seen in association with anorectal malformations or chordee. A case of congenital urethrocutaneous fistula not associated with other congenital anomalies is reported, discussing possible etiologies and surgical management. PMID:15948735

  6. The normal hip in the newborn infant: Sonographic standards for instability

    International Nuclear Information System (INIS)

    Despite careful clinical examinations in the nursery, some infants with significant congenital hip instability elude early diagnosis. In recent years, the use of real-time US has enabled a dynamic arthrographic type of hip examination to be performed. Preliminary experience suggests that a certain amount of instability in newborn hips is probably normal, but no standards have been established. In this study, a group of term newborn infants whose physical examinations were normal were examined by hip sonography on the first and second days of life. Each hip was imaged in the transverse plane in stressed and nonstressed positions to allow quantitation of motion. This study defines the normal range of hip instability in newborn infants

  7. Total hip arthroplasty through anterior minimal incision

    Directory of Open Access Journals (Sweden)

    Bogdan Negru-Aman

    2010-06-01

    Full Text Available Total hip arthroplasty through minimum anterior incision is a minimally invasive technique that allows access to the joint capsule without posting the skeletal muscle surrounding areas. Anterior surgical approach is advantageous because the hip joint is located closer to the front than the rear part of the limb. The surgical approach follows a internervous plane between superior and inferior gluteal nerves (in the side and femoral nerve (medially, without involving the muscle removal. This technique provides good access, through the same incision, both to the acetabul and the femur. It also allows better control of the acetabular cup, keeping the limb length, a decrease of dislocations rate and reduced post-operative precautions.

  8. Minimally-incision total hip arthoplasty: Complications

    Directory of Open Access Journals (Sweden)

    Baš?arevi? V.

    2010-01-01

    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.

  9. Treatment of developmental dysplasia of the hip with Pavlik harness: prospective study in Graf type IIc or more severe hips.

    Science.gov (United States)

    Uçar, D Hakan; I?iklar, Z U?ur; Kandemir, Utku; Tümer, Yücel

    2004-03-01

    Successful treatment of developmental dysplasia of the hip (DDH) is associated with early diagnosis and appropriate treatment. In this prospective study, the results of the treatment with Pavlik harness followed by an abduction brace in patients with severe DDH were presented. Twenty-two hips of 18 patients with a mean age of 14.8+/-5.9 weeks (range, 6-26) when diagnosed were followed for an average of 24.2+/-10.8 months (range, 10-46). The hips were staged according to the classification of Graf with ultrasonography and Pavlik harness was instituted as the first line of treatment in all hips. If there was no improvement of ultrasonographic stage at the third week follow-up the harness treatment was discontinued. After the infant became too large for Pavlik harness an abduction brace was used. In all but one hip the treatment was successful (95.4%). In two hips type I avascular necrosis was noted. Of the dislocated hips 90% were reduced. The Pavlik harness is a safe and effective method of treatment of severe DDH in infancy if potential pitfalls are avoided. PMID:15076582

  10. Bearing Change to Metal-On-Polyethylene for Ceramic Bearing Fracture in Total Hip Arthroplasty; Does It Work?

    Science.gov (United States)

    Lee, Soong Joon; Kwak, Hong Suk; Yoo, Jeong Joon; Kim, Hee Joong

    2016-01-01

    We evaluated the short-term to midterm results of reoperation with bearing change to metal-on-polyethylene (MoP) after ceramic bearing fracture in ceramic-on-ceramic total hip arthroplasty. Nine third-generation ceramic bearing fractures (6 heads and 3 liners) were treated with bearing change to MoP. Mean age at reoperation was 52.7 years. Mean follow-up was 4.3 years. During follow-up, 2 of 3 liner-fractured hips and 1 of 6 head-fractured hips showed radiologic signs of metallosis and elevated serum chromium levels. Re-reoperation with bearing rechange to a ceramic head was performed for the hips with metallosis. One liner-fractured hip had periprosthetic joint infection. Dislocation occurred in 3 hips. From our experience, bearing change to MoP is not a recommended treatment option for ceramic bearing fracture in total hip arthroplasty. PMID:26404851

  11. THERAPEUTIC STRATEGY IN THE REHABILITATION OF THE DYSPLASTIC HIP THROUGH ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Liliana SAVIN

    2012-07-01

    Full Text Available Total hip arthroplasty in degenerative pathology secondary to congenital dysplasia differentiates itself amongtotal arthroplasties by the frequent technical difficulties it poses and the site where it is performed. The existence of aform of congenital dysplasia that remained untreated or insufficiently treated in childhood leads to irreversibledeformities in adulthood. Partial or total loss of joint congruence causes, in time, degenerative changes with theimpairment of hip mobility and is associated with a number of progressive deformations (limb length discrepancy,abnormal rotation, asymmetric lesions, periarticular muscle failure, which gradually reduce the quality of the patient’slife. This study aims at investigating the incidence of prosthetic hip arthroplasty for osteoarthritis secondary todysplastic hip in the total number of arthroplasties, the age when surgery is performed, the type of deformity andprosthetic components used, and the postoperative and long-term functional results. The study was conducted on 110patients who received total hip arthroplasty due to osteoarthritis secondary to hip dysplasia, between 1994 and 2011, inthe Orthopaedics Trauma Department of the Rehabilitation Hospital of Iasi, the incidence being of 3.34% of the totalnumber of arthroplasties, with a prevalence of 65% under the age of 50 years. The functional results were assessed,according to the Harris-hip-score parameters, as good or very good in proportion of 82%. The complexity of the areawhere the total hip arthroplasty is performed requires a good management consisting of thorough preoperativeplanning, determining the operatory indication, and specialized and individualized medical recovery.

  12. Developmental dysplasia of the hip in the newborn: A systematic review

    OpenAIRE

    Saket Tibrewal; Adeel Aqil; Pooja Gulati; Muhammed Zaki Choudhury; Chika Uzoigwe; Nizar Ismail; Junaid Sayani; Kelechi Eseonu; Vivek Gulati

    2013-01-01

    Developmental dysplasia of the hip (DDH) denotes a wide spectrum of conditions ranging from subtle acetabular dysplasia to irreducible hip dislocations. Clinical diagnostic tests complement ultrasound imaging in allowing diagnosis, classification and monitoring of this condition. Classification systems relate to the alpha and beta angles in addition to the dynamic coverage index (DCI). Screening programmes for DDH show considerable geographic variation; certain risk factors have been identifi...

  13. MRI of cervical facet dislocation

    International Nuclear Information System (INIS)

    The MRI examinations of eight patients with cervical vertebral dislocation demonstrated by conventional radiography were reviewed. All patients had axial and sagittal T 1- and T 2-weighted imaging on a 1.5-T unit. This revealed unilateral partial facet dislocation (in two patients), bilateral partial facet dislocation (in two), unilateral complete dislocation (in two) and bilateral complete facet dislocation (in two). In six patients there was cord contusion, three had focal disc protrusions and four unilateral absence of normal flow void in one of the cervical vertebral arteries. In all cases, the dislocated facets were shown well on the far-lateral sagittal images. (orig.). With 5 figs., 1 tab

  14. Advanced wear of an Oxinium™ femoral head implant following polyethylene liner dislocation.

    Science.gov (United States)

    Tribe, H; Malek, S; Stammers, J; Ranawat, V; Skinner, J A

    2013-11-01

    Oxinium™ (Smith & Nephew, Memphis, TN, US) has been used in hip arthroplasty since 2003. The surface coating is hard and provides low wear rates but if this surface coating is damaged, the soft metal core is at risk of accelerated wear. Previous reports have described accelerated wear following intra and postoperative hip dislocation. We report a case of advanced wear of an in situ Oxinium™ femoral head implant following a cracked acetabular liner. The liner had disengaged from the titanium shell, allowing the Oxinium™ head to articulate directly with the shell. The disengaged liner led to dislocation of the Oxinium™ head, with associated pronounced wear of the head and the acetabular cup. The patient had a successful revision procedure. We advise close follow-up of patients with Oxinium™ implants, especially if associated with dislocation and closed reduction. PMID:24165329

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

    DEFF Research Database (Denmark)

    Jacobsen, Steffen

    2006-01-01

    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 ra...

  16. Synovial Chondromatosis of the Hip: Management with Arthroscope-Assisted Synovectomy and Removal of Loose Bodies: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Chun-Yang Chen

    2003-03-01

    Full Text Available Primary synovial chondromatosis is an uncommon disorder, and involvement of the hipjoint is rare. The clinical symptoms are usually non-specific, and a clinical diagnosis of synovialchondromatosis of the hip may be difficult and delayed, especially before the ossifyingnodules become evident. Loose bodies in the joint can cause secondary degenerativeosteoarthritis of the hip. Currently, the recommended management is surgical removal of theloose bodies and a synovectomy without dislocation of the hip joint. Herein we report on 2cases of synovial chondromatosis of the hip, which were managed with an arthroscopeassistedsynovectomy and removal of the loose bodies. We believe this is an easy and safemethod for management of this disorder.

  17. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... people suffering from hip pain. A small-incision total hip arthroplasty and arthroscopic hip femoroacetabular impingement resection. Hip pain ... ORLive.com for a live webcast of a total hip arthroplasty surgery. This is a very special program. Not ...

  18. Congenital contractural arachnodactyly with neurogenic muscular atrophy: case report

    OpenAIRE

    Scola Rosana Herminia; Werneck Lineu Cesar; Iwamoto Fabio Massaiti; Ribas Letícia Cristine; Raskin Salmo; Correa Neto Ylmar

    2001-01-01

    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 s...

  19. Readmissions after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl

    2010-01-01

    With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced. However, it has been speculated that a decrease in LOS may be associated with an increase in readmissions in general, including risk of dislocation after total hip arthroplasty (THA) or manipulation after total knee arthroplasty (TKA).

  20. Can pelvic tilting be ignored in total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Won Yong Shon

    2014-01-01

    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.

  1. Neglected irreducible posterolateral knee dislocation

    Directory of Open Access Journals (Sweden)

    Saini Raghav

    2010-01-01

    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.

  2. Neglected irreducible posterolateral knee dislocation

    OpenAIRE

    Saini Raghav; Mootha Aditya; Goni Vijay; Dhillon Mandeep

    2010-01-01

    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.

  3. Behavior of dislocations in silicon

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-08-01

    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.

  4. Hip resurfacing: history, current status, and future.

    Science.gov (United States)

    Amstutz, Harlan C; Le Duff, Michel J

    2015-09-01

    Hip resurfacing arthroplasty (HRA) presents several advantages over conventional total hip arthroplasty (THA), including conservation and preservation of bone, reduced risk of dislocation, easy replication of hip biomechanics and easy revision if needed. It is a particularly appealing procedure for young patients. HRA has been performed for over 40 years following the same technological advances as THA. The bearing material used by most designs is metal-on-metal (MoM), which has the best compromise between strength and wear properties. However, MoM HRA has a specific set of possible complications. Aseptic femoral failures were initially the most prevalent cause for revision but progress in patient selection and surgical technique seem to have resolved this problem. Wear-related failures (high metal ion levels and adverse local tissue reactions) are now the main concern, and are essentially associated with poor acetabular component design and orientation, to which MoM is more sensitive than other bearing materials. The concept of functional coverage is key to understanding how MoM bearings are affected by edge wear. Only a 3-D assessment of cup position (e.g. the contact patch to rim distance) provides the necessary information to determine the role of cup positioning in relationship with abnormal bearing wear.The concept of hip resurfacing is more valid today than ever as the age of the patients in need of hip arthroplasty keeps getting lower. The recent publication of several excellent long-term survivorship results suggests that selection of a well-designed resurfacing system and accuracy in the placement of the cup can achieve long-term durability. PMID:26109156

  5. Perinatal risk factors for developmental dysplasia of the hip

    OpenAIRE

    Chan, A.; McCaul, K.; Cundy, P.; Haan, E; Byron-Scott, R.

    1997-01-01

    AIMS—To identify perinatal risk factors for developmental dysplasia of the hip (DDH) and define the risk for each factor.?METHODS—In this case control study, using logistic regression analysis, all 1127 cases of isolated DDH live born in South Australia in 1986-93 and notified to the South Australian Birth Defects Register were included; controls comprised 150 130 live births in South Australia during the same period without any notified congenital abnormalities.?RESULTS—Breech presentation, ...

  6. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft; Olsen, Jørn

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980–1996. Results: Of 38,151 pregnant women who had newborn infants without any congenital abnormalities (population control group), 774 (3.4%); of 22,865 case pregnant women who had newbo...

  7. Hip resurfacing: not your average hip replacement

    OpenAIRE

    Siverling, Scott; Felix, Ioonna; Chow, S. Betty; Niedbala, Elizabeth; Su, Edwin P.

    2012-01-01

    Hip resurfacing (HR) has become a widely used surgical intervention for younger patients requiring hip joint arthroplasty. While case reports have been published describing rehabilitation programs following HR, there has yet to be established rehabilitation guidelines. Through experience and clinical reasoning, the following guidelines have been developed based on the patients at the Hospital for Special Surgery. The demographics of the typical HR patient, along with the surgical process are ...

  8. 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 -- ...

  9. Genetics Home Reference: Congenital afibrinogenemia

    Science.gov (United States)

    ... What is congenital afibrinogenemia? Congenital afibrinogenemia is a bleeding disorder caused by impairment of the blood clotting process. ... with congenital afibrinogenemia can have abnormally heavy menstrual ... women with this disorder may have difficulty carrying a pregnancy to term, ...

  10. Screening the newborn for developmental dysplasia of the hip: now what do we do?

    Science.gov (United States)

    Schwend, Richard M; Schoenecker, Perry; Richards, B Stephens; Flynn, John M; Vitale, Michael

    2007-09-01

    The Pediatric Orthopaedic Society of North America recommends that all health care providers who are involved in the care of infants continue to follow the clinical practice guideline for early detection of developmental hip dysplasia (DDH) outlined by the American Academy of Pediatrics. Although evaluation of children with risk factors for DDH is important, most DDH occurs in infants who have no risk factors. For all infants, a competent newborn physical examination using the Ortolani maneuver is the most useful procedure to detect hip instability. Early treatment of an unstable hip with a Pavlik harness or similarly effective orthosis is effective, safe, and strongly advised. Despite having had normal newborn and infant hip examinations, there remains the possibility of a late-onset hip dislocation needing treatment in approximately 1 in 5000 infants. PMID:17717457

  11. 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 - ...

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

    Directory of Open Access Journals (Sweden)

    Paji? Miloš

    2007-01-01

    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. .

  13. Congenital Fibrous Maxillomandibular Fusion

    OpenAIRE

    Bali, Rishi; Parveen SHARMA; Jain, Samit; Thapar, Deepti

    2010-01-01

    Congenital fibrous fusion of the jaws (synechiae) without any concomitant oral anomalies is a very rare malformation. Less than 40 cases have been documented in the literature. Early division of fibrous bands not only allows effective feeding but also prevents development of facial deformity. Here we present a case of congenital maxillomandibular fusion in a neonate.

  14. Most frequent errors in ultrasound screening examination of infant's hip joints

    International Nuclear Information System (INIS)

    Authors at the base of their own experience and knowledge obtained by performing lessons in ultrasound diagnostics of contenital dislocation of the hip call attention to most frequent errors and unclear spots in examination and evaluation of sonographic images of infants and evaluation of sonographic images of infants and emphasise its prevention. (authors). 9 figs., 5 refs

  15. [Patella dislocation in athletes].

    Science.gov (United States)

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

    2014-10-01

    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

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

    CERN Document Server

    Trzesowski, Andrzej

    2007-01-01

    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.

  17. TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

    Full Text Available In this thesis, our purpose is to show that using physiotherapy on patients with hip dysplasia from the very beginning, in the first months of life, helps treating them faster. Common literature proposes to use physiotherapy on patients with hip dysplasia either after their recovery or in the terminal phase of recovery, claiming that any earlier intervention will prolong the hip recovery. The effects of hip dysplasia reflect over the whole musculoskeletal system, while it hinders the knees (genu valgum, the ankles (ankle valgus, calcaneal valgus and the spine (scoliosis especially at the lumbar level. The most spectacular are at the hip level, that is why we made an analytical evaluation only for this joint. To show the importance of physiotherapy for children with hip dysplasia we started from the hypothesis: untimely treatment for children with hip dysplasia has improved results in functional recovery and in obtaining a better stability, without the necessity of orthopedics or surgical interventions. The research methods used in this study are: the observation method, the bibliographic study method, the experimental method, the graphics method and the statistical mathematical method to process the data and to represent the results graphically. In the end, the results obtained are significantly different from the initial evaluations and we came to the conclusion that starting an untimely analytical kinetic treatment and globally personalizing it to every patient improves stability and biomechanical parameters for the hip.

  18. Hip Problems in Infants

    Science.gov (United States)

    ... in bone problems in children. Sometimes a baby's hips may be checked by ultrasound. Ultrasound uses sound waves to take a picture ... babies, tell your doctor. Even if your baby's hips seem normal, the doctor may want your baby to have an ultrasound or an X-ray to be sure. Questions ...

  19. Total Hip Replacement

    Science.gov (United States)

    ... 1960, improvements in joint replacement surgical techniques and technology have greatly increased the effectiveness of total hip ... spend most of your time. Things like the phone, television remote control, reading ... hazard until your hip is strong and mobile. You should use a cane, crutches, a walker, ...

  20. Misdiagnosis induced intraocular lens dislocation in anterior megalophthalmos.

    Science.gov (United States)

    Wang, Qi-Wei; Xu, Wen; Zhu, Ya-Nan; Li, Jin-Yu; Zhang, Li; Yao, Ke

    2012-09-01

    Anterior megalophthalmos (AM) is an uncommon developmental anomaly of the anterior segment of the eye with a constellation of findings that includes enlarged cornea, deep anterior chamber, posterior positioning of the iris and lens, iris stroma atrophy, hypoplasia of iris dilator, pupil displacement, large capsular bag, lens subluxation, prematurely cataract and the tendency to retinal detachment. AM, especially when symptoms are mild, is not an easy disease to diagnose. We present 3 AM cases that were misdiagnosed as congenital cataract with weak zonule and megalocornea. Intraocular lenses (IOLs) dislocated after standard cataract surgeries and subsequent surgery (replacing the dislocated IOLs with iris-claw intraocular lenses) achieved satisfactory outcome. Although rare, AM should be included in the differential diagnosis of enlarged cornea and we recommend implanting Artisan lens in AM patients. PMID:22932204

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

    Scientific Electronic Library Online (English)

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

    2008-09-01

    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 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.

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

    Directory of Open Access Journals (Sweden)

    Luciane Zanusso Pagnossim

    2008-09-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Mantu Jain

    2013-10-01

    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.

  4. Dislocation core field. II. Screw dislocation in iron

    OpenAIRE

    Clouet, Emmanuel; Ventelon, Lisa; Willaime, F.

    2011-01-01

    The dislocation core field, which comes in addition to the Volterra elastic field, is studied for the screw dislocation in alpha-iron. This core field, evidenced and characterized using ab initio calculations, corresponds to a biaxial dilatation, which we modeled within the anisotropic linear elasticity. We show that this core field needs to be considered when extracting quantitative information from atomistic simulations, such as dislocation core energies. Finally, we look...

  5. Formed HIP Can Processing

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Kester Diederik [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-07-27

    The intent of this report is to document a procedure used at LANL for HIP bonding aluminum cladding to U-10Mo fuel foils using a formed HIP can for the Domestic Reactor Conversion program in the NNSA Office of Material, Management and Minimization, and provide some details that may not have been published elsewhere. The HIP process is based on the procedures that have been used to develop the formed HIP can process, including the baseline process developed at Idaho National Laboratory (INL). The HIP bonding cladding process development is summarized in the listed references. Further iterations with Babcock & Wilcox (B&W) to refine the process to meet production and facility requirements is expected.

  6. Hip resurfacing: not your average hip replacement.

    Science.gov (United States)

    Siverling, Scott; Felix, Ioonna; Chow, S Betty; Niedbala, Elizabeth; Su, Edwin P

    2012-03-01

    Hip resurfacing (HR) has become a widely used surgical intervention for younger patients requiring hip joint arthroplasty. While case reports have been published describing rehabilitation programs following HR, there has yet to be established rehabilitation guidelines. Through experience and clinical reasoning, the following guidelines have been developed based on the patients at the Hospital for Special Surgery. The demographics of the typical HR patient, along with the surgical process are described. Current published literature reporting rehabilitation for patients with arthritic hip pathologies has been incorporated into the guidelines and is presented. The guidelines are divided into three phases, with goals for each phase explained. A progression through phases by way of reaching certain milestones and goals is advocated. PMID:22231958

  7. The other hip in unilateral hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; RØmer, Lone

    2006-01-01

    We reviewed transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. A center-edge angle of 20 degrees or less was considered the upper normal value. Four groups were identified: 69 patients with apparently unilateral right developmental dysplasia (left hip center-edge angles greater than 20 degrees), 26 patients with apparently unilateral left developmental dysplasia (right hip center-edge angles greater than 20 degrees), 68 patients with bilateral developmental dysplasia, and 34 patients with bilateral borderline developmental dysplasia (bilateral center-edge angles less than or equal to 25 degrees). The pelvic computed tomography scans were compared with computed tomography scans of 41 control subjects with healthy hips. The joint anatomy of patients with developmental dysplasia differed from that of control subjects in almost all aspects. Acetabular anteversion was larger in control subjects compared with patients with developmental dysplasia. We found inverse relationships between femoral anteversion and the anterior acetabular sector angle and coronal and sagittal center-edge angles in dysplastic hips, and also between femoral neck-shaft angles and the anterior acetabular sector angle. There was an inverse relationship between reduced anterior support developmental dysplasia in which plain radiographs suggested unilateral dysplastic abnormality only, computed tomography scans revealed both hips to be abnormal. The data suggest that patients referred with seemingly unilateral developmental dysplasia also are at risk of having contralateral dysplastic malformation. Level of Evidence: Diagnostic study, Level II (development of diagnostic criteria on consecutive patients [with universally applied reference "gold" standard]). See the Guidelines for Authors for a complete description of levels of evidence.

  8. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... small-incision total hip arthroplasty and arthroscopic hip femoroacetabular impingement resection. Hip pain is not limited to senior ... you will see footage of an arthroscopic hip femoroacetabular impingement resection. Remember, OR-Live makes it easy for ...

  9. 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. ...

  10. Understanding the dual mobility concept for total hip arthroplasty. Investigations on a multiscale analysis-highlighting the role of arthrofibrosis

    OpenAIRE

    Geringer, Jean; Boyer, Bertrand; Farizon, Frédéric

    2011-01-01

    In hip implants, UHMWPE (ultra high molecular weight polyethylene) liner wear is believed to be a key issue affecting the lifetime of the artificial joint. Dual mobility, a THA (total hip arthroplasty) concept where the liner moves inside the metallic shell, has become popular due to its low dislocation rate. To understand the tribological behavior of this particular implant, especially the role of the second mobility, 12 representative explants were selected from a bank of 250 explants. The ...

  11. Synovial Chondromatosis of the Hip: Management with Arthroscope-Assisted Synovectomy and Removal of Loose Bodies: Report of Two Cases

    OpenAIRE

    Chun-Yang Chen; Alvin Chao-Yu Chen; Yu-Han Chang; Tsai-Sheng Fu; Lee, Mel S.

    2003-01-01

    Primary synovial chondromatosis is an uncommon disorder, and involvement of the hipjoint is rare. The clinical symptoms are usually non-specific, and a clinical diagnosis of synovialchondromatosis of the hip may be difficult and delayed, especially before the ossifyingnodules become evident. Loose bodies in the joint can cause secondary degenerativeosteoarthritis of the hip. Currently, the recommended management is surgical removal of theloose bodies and a synovectomy without dislocation of t...

  12. Conductivity and Photoconductivity at Dislocations

    OpenAIRE

    Labusch, R.

    1997-01-01

    The general features of one-dimensional states at dislocations, including those that are bound in the electrostatic field of trapped charges, are discussed. An overview of the available evidence for the existence or nonexistence of one-dimensional conduction in these states is given. Photoconductivity measurements along dislocations and from the dislocation core to the bulk are presented and discussed in some detail. The analysis of the results leads to a revision of some old concepts in disl...

  13. Mobility of dislocations in semiconductors

    CERN Document Server

    Stokbro, K; Lundqvist, B I

    1996-01-01

    Atomic-scale calculations for the dynamics of the 90$^0$ partial glide dislocation in silicon are made using the effective-medium tight-binding theory. Kink formation and migration energies for the reconstructed partial dislocation are compared with experimental results for the mobility of this dislocation. The results confirm the theory that the partial moves in the dissociated state via the formation of stable kinks. The correlation between glide activation energy and band gap in semiconducting systems is discussed.

  14. Multiligamentous injuries and knee dislocations.

    Science.gov (United States)

    Gimber, Lana H; Scalcione, Luke R; Rowan, Andrew; Hardy, Jolene C; Melville, David M; Taljanovic, Mihra S

    2015-11-01

    Complex capsular ligamentous structures contribute to stability of the knee joint. Simultaneous injury of two or more knee ligaments, aside from concurrent tears involving the anterior cruciate and medial collateral ligaments, is considered to be associated with femorotibial knee dislocations. Proximal tibiofibular joint dislocations are not always easily recognized and may be overlooked or missed. Patellofemoral dislocations can be transient with MR imaging sometimes required to reach the diagnosis. In this article, the authors describe the mechanism of injury, ligamentous disruptions, imaging, and treatment options of various types of knee dislocations including injuries of the femorotibial, proximal tibiofibular, and patellofemoral joints. PMID:26002747

  15. Magnetic resonance imaging of labral cysts of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Schnarkowski, P. [Department of Radiology, University of California, San Francisco, CA (United States)]|[Department of Radiology, Ludwig-Maximilians-University, Munich (Germany); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Tirman, P.F.J. [Department of Radiology, University of California, San Francisco, CA (United States)]|[San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Peterfy, C.G. [Department of Radiology, University of California, San Francisco, CA (United States); Genant, H.K. [Department of Radiology, University of California, San Francisco, CA (United States)

    1996-11-01

    Objective. To present the magnetic resonance (MR) imaging findings in patients with labral cysts adjacent to the acetabulum and to examine their association with hip pathology. Design. MR images and conventional radiographs of seven patients with paralabral cysts were retrospectively reviewed by three musculoskeletal radiologists. Patients. The patients included three men and four women with hip pain, ranging in age from 29 to 82 years. Two patients had developmental dysplasia of the hip and six had a history of remote trauma/dislocation. Clinical history and follow-up were obtained in all patients. Surgery was performed on one patient. Results and conclusions. Paralabral cysts were located in the posterosuperior aspect of the hip joint in five patients and in the anterior aspect in two patients. A tear of the adjacent acetabular labrum was confirmed surgically in one patient, and in all patients the MR features suggested the presence of an abnormal labrum. Osteoarthritis was observed in three patients and there was associated subchondral cyst formation in the acetabulum adjacent to the cyst in three patients. The paralabral cyst of the hip is well visualized on MR imaging and is seen in patients with a predisposition to labral pathology. (orig.). With 3 figs., 1 tab.

  16. Metal-on-metal hip resurfacings. A radiological perspective

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  17. 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.)

  18. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavkovi? Nemanja

    2012-01-01

    Full Text Available Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability. Surgical technique, biomaterials, design of the prosthesis and fixation techniques have evolved with time adjusting to each other. After total hip arthroplasty patients’ quality of life should be improved. There are many various postoperative complications. Some of them are fatal, and some are minor, which may become manifested years after surgery. Each next surgical procedure following previous hip surgery is associated with considerably lower chances to be successful. Therefore, in primary total hip arthroplasty, preoperative evaluation and preparation of patients are essential. Every orthopaedic surgeon needs to improve already adopted surgical skills applying them with precision and without compromise, with the main goal to achieve long-term durability of the selected implant. The number of total hip arthroplasties will also increase in future, and newer and higher quality materials will be used.

  19. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Hip joint femoral (hemi-hip...SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES... § 888.3400 Hip joint femoral (hemi-hip...portion of the hip joint. This generic type of device includes...

  20. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Hip joint (hemi-hip) acetabular...SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES... § 888.3370 Hip joint (hemi-hip) acetabular...portion of the hip joint. This generic type of device includes...

  1. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Hip joint femoral (hemi-hip...SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES... § 888.3360 Hip joint femoral (hemi-hip...portion of the hip joint. This generic type of device includes...

  2. Congenital orbital teratoma

    Directory of Open Access Journals (Sweden)

    Shereen Aiyub

    2013-01-01

    Full Text Available 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.

  3. Congenital parvovirus infection.

    OpenAIRE

    Wright, I.M.; Williams, M.L.; Cohen, B J

    1991-01-01

    A case of congenital parvovirus (B19) viraemia with associated thrombocytopenic purpura and platelet antigen incompatibility in an infant is reported. Results of laboratory investigations indicated that the baby was infected in utero.

  4. Surgical management of the problematic hip in adolescent and young adult patients.

    Science.gov (United States)

    Schoenecker, Perry L; Clohisy, John C; Millis, Michael B; Wenger, Dennis R

    2011-05-01

    Surgical management of the problematic hip in adolescent and young adult patients can be challenging. In many of these patients, hip arthrosis and pain occur secondary to hip dysplasia associated with chronic instability, whether the result of prior treatment or chronic unmanaged acetabular dysplasia. Surgical techniques such as the Bernese periacetabular osteotomy are performed to correct acetabular deficiency, restore hip joint stability, and eliminate pain. Patients with previous Legg-Calvé-Perthes disease or slipped capital femoral epiphysis frequently note onset of symptomatic hip arthrosis and pain in adolescence or young adulthood. Pain occurs secondary to pathologic impingement of the deformed proximal femur against the anterolateral acetabulum (ie, femoroacetabular impingement). The recent successful innovation of the transtrochanteric surgical hip dislocation approach provides complete access to the hip and offers the potential for comprehensive correction of both the often severe proximal femoral deformity and associated labral chondral disease secondary to Legg-Calvé-Perthes disease and slipped capital femoral epiphysis. Restoration of more normal proximal femoral morphology results in marked improvement in functional outcome. Effective orthopaedic management requires an understanding of the mechanisms of hip disease as well as surgical expertise. PMID:21536627

  5. Congenital Cystic Lung Diseases

    OpenAIRE

    Jain, Aditi; ANAND, K; Singla, Saurabh; Kumar, Ashok

    2013-01-01

    Congenital cystic diseases of the lung are a rare but significant cause of morbidity in children and young adults presenting with respiratory distress and repeated chest infections. They consist of cystic adenomatoid malformation, bronchogenic cyst, pulmonary sequestration, and congenital lobar emphysema. Surgical treatment is a safe and an effective method of treatment. Chest X-ray and computed tomography are the key imaging modalities used for diagnosis.

  6. Congenital Cystic Lung Diseases

    Directory of Open Access Journals (Sweden)

    Aditi Jain

    2013-01-01

    Full Text Available Congenital cystic diseases of the lung are a rare but significant cause of morbidity in children and young adults presenting with respiratory distress and repeated chest infections. They consist of cystic adenomatoid malformation, bronchogenic cyst, pulmonary sequestration, and congenital lobar emphysema. Surgical treatment is a safe and an effective method of treatment. Chest X-ray and computed tomography are the key imaging modalities used for diagnosis.

  7. 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)

    van Raaij Jos JAM

    2008-10-01

    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

  8. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... hip area, and images are recorded on a computer. The black-and-white images show the internal ...

  9. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... is going to be the minimally invasive anterial lateral approach to the right hip in this gentleman. ... or you as we proceed. Patient’s in the lateral position. We've already marked out the boundary ...

  10. 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 ... start rasping. These are the rasps for the new connective system. They're diamond cutting and they ...

  11. 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 ... hopefully you will see the benefits and the advantages of the new Zimmer Kinectiv System. Thank you. ...

  12. Taper Hip Prosthesis

    Medline Plus

    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 ...

  13. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... position. And I'll check that our locking mechanism is closed and moves freely and any hitting ... tremendously stable. Always remember through these relative anterior approaches that we need to check our hip at ...

  14. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... on the Kinectiv Total Hip System. At this time, let’s join Dr. Maltry in the operating room. ... you show us that leg position one more time? Can we show his front view of how ...

  15. Congenital hyperthyroidism: autopsy report Hipertireoidismo Congenital

    OpenAIRE

    Marcus Aurelho Lima; Lília Beatriz Oliveira; Neiva Paim; Maria de Fátima Borges

    1999-01-01

    We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and h...

  16. MR imaging in congenital lower limb deformities

    International Nuclear Information System (INIS)

    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.)

  17. Treatment of displaced neck fractures of the femur with total hip arthroplasty.

    Science.gov (United States)

    Rudelli, Sergio; Viriato, Sergio P; Meireles, Tadeu L O; Frederico, Tiago N

    2012-02-01

    We report our experience in unstable fractures of the femoral neck in a consecutive series of patients who underwent total hip arthroplasty. Over a period of 12 years, 88 patients were treated with a cemented total hip arthroplasty; 3 patients were lost to follow-up, leaving 86 fractures (85 patients) for retrospective analysis. Seven patients had dislocations, all but 1 of which were treated successfully without reoperation. Four patients required reoperation in the same hip undergoing arthroplasty. There was a graded increase in mortality rates across the continuum of risk groups at the time of surgery. The low incidence (4.6%) of a second procedure on the hip repaired initially, as well as low mortality rates, makes this treatment strategy quite satisfactory. PMID:22138454

  18. Follow-up study of the cup supporter (F-S type in total hip replacement.

    Directory of Open Access Journals (Sweden)

    Takahashi,Tsuneo

    1985-10-01

    Full Text Available Twenty-five patients (30 hips have had a total hip replacement using the cup supporter developed in our department. This report describes the follow-up findings on these patients. The mean period after hip replacement was 2 years and 8 months (range from 6 months to 6 years. The cup supporter was used in patients with rheumatoid arthritis with acetabular protrusions, central migration of the prosthesis after hemi-arthroplasty, revision operation for a defecting acetabular floor, primary acetabular protrusions (including osteoarthritis with acetabular protrusions and traumatic fracture-dislocation of the hip. In five cases, autograft of bone was used in addition to the cup supporter for reinforcement of a thin acetabular floor. This combination appeared to provide good clinical results. The cup supporter was of value in revision operations due to loosening of the acetabular cup with severe acetabular protrusions.

  19. The success of management with the Pavlik harness for developmental dysplasia of the hip using a United Kingdom screening programme and ultrasound-guided supervision.

    Science.gov (United States)

    Walton, M J; Isaacson, Z; McMillan, D; Hawkes, R; Atherton, W G

    2010-07-01

    We present the results of treatment of developmental dysplasia of the hip in infancy with the Pavlik harness using a United Kingdom screening programme with ultrasound-guided supervision. Initially, 128 consecutive hips in 77 patients were reviewed over a 40-month period; 123 of these were finally included in the study. The mean age of the patients at the start of treatment was five weeks (1 to 12). All hips were examined clinically and monitored with ultrasound scanning. Failure of treatment was defined as an inability to maintain reduction with the harness. All hips diagnosed with dysplasia or subluxation but not dislocation were managed successfully in the harness. There were 43 dislocated hips, of which 39 were reducible, but six failed treatment in the harness. There were four dislocated but irreducible hips which all failed treatment in the harness. One hip appeared to be successfully treated in the harness but showed persistent radiological dysplasia at 12 and 24 months. Grade 1 avascular necrosis was identified radiologically in three patients at 12 months. PMID:20595124

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

    Energy Technology Data Exchange (ETDEWEB)

    Mulhall, K.J. E-mail: kjm@indigo.ie; Khan, Y.; Masterson, E.; Burke, T.E

    2003-05-01

    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.

  1. 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

  2. Hips at risk osteoporosis and prevention of hip fractures

    OpenAIRE

    Ekman, Anna

    2001-01-01

    Hip fractures are the most serious consequence of osteoporosis, and are one important cause of morbidity and mortality among the elderly. Prophylactic treatment for hip fractures are now available. Early detection of individuals with increased risk for hip fractures is therefor of great interest. A subset of non-institutionalised patients with a first hip fracture (cases;n=l18) and controls (n=263), aged 65-85 years, underwent dual X-ray absorptiometry (DXA) of the femoral neck, quantitative ...

  3. Facts about Congenital Heart Defects

    Science.gov (United States)

    ... to Other Websites Information For... Media Policy Makers Facts about Congenital Heart Defects Language: English Español (Spanish) ... are living longer and healthier lives. Learn more facts about CHDs below. What are Congenital Heart Defects ( ...

  4. Quenched Dislocation Enhanced Supersolid Ordering

    OpenAIRE

    Toner, John

    2007-01-01

    I show using Landau theory that quenched dislocations can facilitate the supersolid (SS) to normal solid (NS) transition, making it possible for the transition to occur even if it does not in a dislocation-free crystal. I make detailed predictions for the dependence of the SS to NS transition temperature T_c(L), superfluid density %\\rho_S(T, L), and specific heat C(T,L) on temperature T and dislocation spacing L, all of which can be tested against experiments. The results sh...

  5. Phase Field Methods and Dislocations

    CERN Document Server

    Rodney, D

    2001-01-01

    We present a general formalism for incorporating dislocations in Phase Field methods. This formalism is based on the elastic equivalence between a dislocation loop and a platelet inclusion of specific stress-free strain related to the loop Burgers vector and normal. Dislocations are thus treated as platelet inclusions and may be coupled dynamically to any other field such as a concentration field. The method is illustrated through the simulation of a Frank-Read source and of the shrinkage of a loop in presence of a concentration field.

  6. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... Hip pain is not limited to senior citizens. It can begin to affect people in their 40s. ... hip femoroacetabular impingement resection. Remember, OR-Live makes it easy for you to learn more. Just click ...

  7. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... hip joint has a liquid inside called synovial fluid that -- once, a little smaller -- that lubricates the ... going to do right now is try the mechanics of the hip, okay? So we're going ...

  8. Small Incision Total Hip Arthroplasty

    Medline Plus

    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 ...

  9. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... taper hip. I designed this hip with a group of surgeons and engineers, and it's made out ... webcast screen and open the door to informed medical care. 01:03:35 [ end of webcast

  10. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... occasion will carry pretty close to six times body weight, and in a regular person, during walking, the ... actually have anywhere between two to four times body weight on the hip. The hip can get quite ...

  11. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... which is essentially a destruction of the hip joint. Because the patient cannot tolerate the non-operative ... activities of daily living without pain. The hip joint is a ball-and-socket joint that on ...

  12. Fracture After Total Hip Replacement

    Science.gov (United States)

    .org Fracture A er Total Hip Replacement Page ( 1 ) A periprosthetic fracture is a broken bone that occurs around the ... that most o en requires surgery. Although a fracture may occur during a hip replacement procedure, the ...

  13. Genetics Home Reference: Congenital hyperinsulinism

    Science.gov (United States)

    ... congenital hyperinsulinism? hyperinsulinemia hypoglycemia of infancy infancy hyperinsulinemia hypoglycemia neonatal hyperinsulinism persistent hyperinsulinemia hypoglycemia of infancy persistent hyperinsulinemic ...

  14. Identification of congenital deafblindness

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2012-01-01

    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.

  15. A patient-specific model of the biomechanics of hip reduction for neonatal Developmental Dysplasia of the Hip: Investigation of strategies for low to severe grades of Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Huayamave, Victor; Rose, Christopher; Serra, Sheila; Jones, Brendan; Divo, Eduardo; Moslehy, Faissal; Kassab, Alain J; Price, Charles T

    2015-07-16

    A physics-based computational model of neonatal Developmental Dysplasia of the Hip (DDH) following treatment with the Pavlik Harness (PV) was developed to obtain muscle force contribution in order to elucidate biomechanical factors influencing the reduction of dislocated hips. Clinical observation suggests that reduction occurs in deep sleep involving passive muscle action. Consequently, a set of five (5) adductor muscles were identified as mediators of reduction using the PV. A Fung/Hill-type model was used to characterize muscle response. Four grades (1-4) of dislocation were considered, with one (1) being a low subluxation and four (4) a severe dislocation. A three-dimensional model of the pelvis-femur lower limb of a representative 10 week-old female was generated based on CT-scans with the aid of anthropomorphic scaling of anatomical landmarks. The model was calibrated to achieve equilibrium at 90° flexion and 80° abduction. The hip was computationally dislocated according to the grade under investigation, the femur was restrained to move in an envelope consistent with PV restraints, and the dynamic response under passive muscle action and the effect of gravity was resolved. Model results with an anteversion angle of 50° show successful reduction Grades 1-3, while Grade 4 failed to reduce with the PV. These results are consistent with a previous study based on a simplified anatomically-consistent synthetic model and clinical reports of very low success of the PV for Grade 4. However our model indicated that it is possible to achieve reduction of Grade 4 dislocation by hyperflexion and the resultant external rotation. PMID:25957995

  16. Hip Arthroscopy in The Athlete

    OpenAIRE

    Byrd, J. W. Thomas

    2007-01-01

    Sports related injuries to the hip have received relatively little attention, in the part because the clinical assessment, imaging studies, and surgical techniques are less sophisticated. The evolution of hip arthroscopy has offered a less invasive technique that allows for recognition and treatment of hip pathologies that previously went unrecognized. The success of hip arthoscopy is dependent on proper patient selection based on the patient's history and diagnosis. The purpose of this clini...

  17. Congenital contractural arachnodactyly with neurogenic muscular atrophy: case report

    Directory of Open Access Journals (Sweden)

    Scola Rosana Herminia

    2001-01-01

    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.

  18. Ullrich Congenital Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Goknur Haliloglu

    2011-06-01

    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.

  19. Ullrich Congenital Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Goknur Haliloglu

    2011-09-01

    Full Text Available ObjectiveUllrich congenital muscular dystrophy is a rather severe type of congenitalmuscular dystrophy with early onset features related to motor development.In general it is inherited in autosomal recessive principles, however in theWestern world mostly seen with de novo dominant mutations in the collagenVI genes. Milder form of the condition is the Bethlem myopathy. There may beoverlap forms in the clinic resembling the Ehler-Danlos syndrome. There hasbeen some radical efforts for cure especially through the apoptosis cascades.Key words: Ullrich congenital muscular dystrophy, collgen VI genes, Bethlemmyopathy, autophagy.

  20. Congenital spinal malformations

    International Nuclear Information System (INIS)

    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered. (orig.)

  1. Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip.

    Science.gov (United States)

    van der Sluijs, J A; De Gier, L; Verbeke, J I; Witbreuk, M M E H; Pruys, J E H; van Royen, B J

    2009-08-01

    We prospectively studied the benefits and risks of prolonged treatment with the Pavlik harness in infants with idiopathic developmental dysplasia of the hip. Bracing was continued as long as abduction improved. It was started at a mean age of four months (1 to 6.9). Outcome measures were the number of successful reductions, the time to reduction, the acetabular index and evidence of avascular necrosis at follow-up at one year. In 50 infants with 62 subluxated and dislocated hips (42 Graf type III and 20 type IV), 37 were reduced successfully with a mean time to reduction of 13.4 weeks (sd 6.8). Bracing was successful in 31 type-III (73.8%) and in only six type-IV hips (20%, p = 0.002). Avascular necrosis was seen in ten hips. Prolonged treatment with the Pavlik harness for developmental dysplasia of the hip over the age of one month can be beneficial in type-III hips, but it is unclear as to whether this is the optimal treatment, since it may postpone the need for closed or open reduction to a more unfavourable age. The use of the Pavlik harness in type-IV hips in this age group is questionable, but if used, prolonged bracing is not advised. PMID:19651841

  2. Management of femoral bone loss in revision total hip arthroplasty.

    Science.gov (United States)

    Sculco, Peter K; Abdel, Matthew P; Lewallen, David G

    2015-09-01

    Femoral bone loss is frequently encountered during revision total hip arthroplasty. The quality and quantity of remaining bone helps determine the best method for reconstruction. Extensively porous-coated cylindrical stems or titanium fluted tapered devices that achieve fixation in the diaphysis have both demonstrated excellent long-term survivorship. Titanium fluted tapered stems with a modular proximal body allow for more accurate leg length, offset, and version adjustments independent of the distal stem which may optimise hip biomechanics. Intraoperative fractures are more common with cylindrical stems and subsidence with tapered stems, particularly monoblock designs and in both dislocation continues to be one of the most common postoperative complications. In salvage situations in which an ectatic femoral canal is unable to support an uncemented device, impaction bone grafting, allograft-prosthetic composite, or a segmental proximal femoral replacement may be required. PMID:26351121

  3. Dislocation dynamics simulations in 2-dimensions

    International Nuclear Information System (INIS)

    In this paper two methods for simulating dislocation dynamics in 2-dimensions are described. The first method uses molecular dynamic to study the motion of individual dislocations in their slip planes. This method is atomistic in nature so the phonon emission from driven dislocation may be observed. Results on straight edge and screw dislocations, dislocation loops and Frank-Read sources will be presented. The second method extends this approach by solving the equations of motion for many dislocations. In order to handle the densities of dislocations typically found in metals (or order 1012/m2), this method must abandon the atomistic approach. Using this method we observe the formation of dislocation substructure and examine the influence of stress and dislocation density on the spatially correlated dislocation patterns

  4. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... a -- about to start a total hip arthroplasty live. So that's a total hip replacement surgery. Actually, I think right here we can pan in, this is the ... is the ability of an artificial material to live inside the body without being ... What I'm showing you right here is the actual hip -- it's called the ...

  5. 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 hip that we talked about. And there's a bump on top of the neck here, and that bump, as ...

  6. Clinical features and treatment of the hip in multiple epiphyseal dysplasia in childhood.

    Science.gov (United States)

    Li, Lian Yong; Zhao, Qun; Ji, Shi Jun; Zhang, Li Jun; Li, Qi Wei

    2011-05-01

    Multiple epiphyseal dysplasia is a rare congenital osteochondrodysplasia disorder characterized by a delay in the appearance of the epiphyses; irregular, symmetric epiphyseal formation; mild short stature; and early-onset osteoarthritis. Peripheral weight-bearing and nonweight-bearing joints can be affected. Treatment of the hip deformity in multiple epiphyseal dysplasia is a challenge for orthopedic surgeons.We reviewed the clinical features and treatment options of hip joints affected by multiple epiphyseal dysplasia in 6 young patients (4 boys and 2 girls). Average patient age was 8.8 years (range, 5-14 years). The spectrum of hip joint deformity ranged from mild to severe. Surgical procedures included intertrochanteric extension osteotomy of the femur in 2 patients (4 hips), Staheli acetabular augmentation in 1 patient (2 hips), and trochanter arthroplasty associated with Dega osteotomy in 2 patients (4 hips). One patient did not undergo surgical treatment. All patients were followed up for an average 7.2 years. Joint function improved in the patients treated surgically. The coxa vara deformity was corrected satisfactorily, and the femoral head was covered completely by the acetabulum.Good mid-term outcomes were obtained for the treatment of severe hip deformity by using intertrochanteric extension osteotomy and trochanter arthroplasty. However, because of the inherent nature of this disorder, long-term follow-up of the patients is required. PMID:21598888

  7. Progressive hip joint subluxation in Saul-Wilson syndrome.

    Science.gov (United States)

    Chinen, Yasutsugu; Kaneshi, Takuya; Kamiya, Takeshi; Hata, Kenichiro; Nishimura, Gen; Kaname, Tadashi

    2015-11-01

    Saul-Wilson syndrome (SWS) is a rare congenital skeletal syndrome characterized by postnatal onset of short stature, relative microcephaly, frontal bossing, prominent eyes with shallow orbits, midface hypoplasia, cataract, and generalized skeletal changes, including spondylar dysplasia, overtubulation of the long bones with metaphyseal flaring and megaepiphyses, coxa valga, elbow deformity, and brachydactyly. We describe a boy with the overall clinical and radiological features fitting the characteristics of SWS, although cataract, elbow deformity, and overt brachydactyly were not seen. He presented with painful hip joint due to hip subluxation in late childhood, which exacerbated with age and ultimately, required surgical intervention. Awareness of this orthopedic complication in SWS is essential in the management of patients with SWS. © 2015 Wiley Periodicals, Inc. PMID:26239279

  8. Outcomes of Mixed Femoral Fixation Technique Using Both Cement and Ingrowth in Revision Total Hip Arthroplasty: Minimum 2-Year Follow-up.

    Science.gov (United States)

    Yin, Tsung-Cheng; Yen, Shih-Hsiang; Kuo, Feng-Chih; Wang, Jun-Wen

    2015-10-01

    The use of a modular femoral stem in revision total hip arthroplasty (THA) has been increasing recently. However, complications such as subsidence, dislocation and stem fracture are still noted, especially in hips with high grade femoral deficiency. We retrospectively studied a consecutive 41 hips (40 patients) that underwent revision THA with allograft reconstruction of the proximal femur in conjunction with hybrid fixation (proximally cemented and distally press-fit) of a modular femoral component. At a mean follow-up of 5.2years (2 to 8years), no hips sustained dislocation, subsidence or fracture of the stem in the follow-up period. We provided evidence that this technique may be a good alternative in the management of proximal femoral bone loss during revision THA. PMID:26044999

  9. Proximal carpal row dislocation: a case report

    OpenAIRE

    Capo, John T; Armbruster, Edward J.; Hashem, Jenifer

    2010-01-01

    Carpal dislocations commonly occur as the result of high-energy axial loading of the forearm with the wrist extended. There exists several variants of carpal dislocations with the most commonly observed being those about the lunate. Perilunate dislocations and fracture dislocations were first characterized by Mayfield in 1980 and represent a spectrum of traumatic carpal dislocation beginning radial and progressing to the ulnar side of the wrist (Mayfield et al. J Hand Surg [Am] 5:226–241, 198...

  10. Congenital skeletal abnormalities in a tawny owl chick (Strix aluco).

    Science.gov (United States)

    Barreiro, Andrés; de Trocóniz, Patricia Fdez; Vila, Mónica; López-Beceiro, Ana M; Pereira, José L

    2003-01-01

    In this case report, we describe a tawny owl chick (Strix aluco) coming from a Wild Fauna Recovery Center with multiple congenital malformations in the limbs. The animal was unable to fly and showed marked malnutrition and poor general appearance. Physical, radiologic, and anatomic examinations showed osseous malformations including dislocation of radius and carpometacarpus with abnormal nonfunctional fixation of ligamentum propatagialis, absence of most parts of the bones of the manus in both wings, and twisted nonfused left tarsometatarsus with marked griphosis of digits. Routine toxicologic and pathologic examinations did not reveal a specific etiology. PMID:14562912

  11. IDIOPATHIC CHONDROLYSIS OF HIP

    Directory of Open Access Journals (Sweden)

    ShanmugaRaju P

    2014-06-01

    Full Text Available A 13 Year old girl with history of pain in the left hip, stiffness, walking difficulty for one month. There was no history of trauma, fever and weight loss. Physical examination revealed left side antalgic gait and pelvic obliquity. There was restriction of abduction, flexion and external rotation on the affected side. Laboratory investigations for C - reactive protein, Rheumatoid factor and serum complement were normal. The complete blood profile was normal. Conventional Radiography of the left hip showed decrease in the joint space, decrease femoral head height, sclerosis and irregularities in articular margins. Her pelvis was tilted towards femoral side, femoral head was small and flattened with irregular margins. The young girl was treated initially with bed rest, traction, physiotherapy treatment including positioning, passive mobilization exercise, active range of motion exercise, static quadriceps contraction and Gait retraining. This case of idiopathic chondrolysis of hip is a rare clinical entity.

  12. 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

  13. Similar range of motion and function after resurfacing large-head or standard total hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole

    2013-01-01

    Large-size hip articulations may improve range of motion (ROM) and function compared to a 28-mm THA, and the low risk of dislocation allows the patients more activity postoperatively. On the other hand, the greater extent of surgery for resurfacing hip arthroplasty (RHA) could impair rehabilitation. We investigated the effect of head size and surgical procedure on postoperative rehabilitation in a randomized clinical trial (RCT). Methods We followed randomized groups of RHAs, large-head THAs and standard THAs at 2 months, 6 months, 1 and 2 years postoperatively, recording clinical rehabilitation parameters.

  14. Developmental dysplasia of the hip: diagnosis and management to 18 months.

    Science.gov (United States)

    Clarke, Nicholas M P

    2014-01-01

    Developmental dysplasia of the hip represents a spectrum of disease ranging from transient neonatal instability to established dislocation. It is accepted that female sex, breech presentation, and family history are risk factors for the disease. Early diagnosis by clinical examination or ultrasound imaging is emphasized, with splint treatment ideally commencing by 6 weeks of age. Treatment using the Pavlik harness is successful in up to 90% of patients. Ultrasound imaging is the gold standard for monitoring a patient during harness wear. Failed splintage or late presentation usually necessitates surgical intervention depending on the patient's age and the severity of the hip dysplasia and displacement. PMID:24720316

  15. Congenital aggressive lipomatosis

    International Nuclear Information System (INIS)

    Three cases of congenital lipomatosis involving the thoracic region posteriorly are presented delineating the natural history of the disease and depicting underlying bone and soft tissue changes. The rib widening and pleural thickening appear to be related to increased intercostal vascularity feeding the overlying tumor, as delineated by angiography. This entity is not described in the radiologic literature. (orig.)

  16. Congenital Absence of Tibia

    Directory of Open Access Journals (Sweden)

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

    2002-10-01

    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

  17. Congenital complete atrioventricular block.

    OpenAIRE

    Kertesz, N J; Fenrich, A L; Friedman, R A

    1997-01-01

    Congenital complete atrioventricular block is found in 1 of 22,000 live births. Over time, it has become apparent that these patients represent not a single distinct disease process, but several processes with the common manifestation of atrioventricular block. The evaluation of these patients to determine their risk of sudden death and need for pacing is not well defined.

  18. Multiple congenital cranial hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Koulouris, George [Alfred Hospital, Department of Radiology, Prahran, Victoria (Australia); Rao, Padma [Royal Children' s Hospital, Department of Radiology, Parkville, Victoria (Australia)

    2005-08-01

    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.)

  19. 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.)

  20. The painful hip: new concepts

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  1. Dislocations in Monolayers and Semiconductors.

    Science.gov (United States)

    Ren, Qiang

    1995-01-01

    Four different aspects of the properties of dislocations in monolayer and semiconductors have been investigated: (i) Using atomic relaxation techniques, dislocation dipoles of various sizes and orientations have been studied for monolayers with the Lennard-Jones potential (LJP) and the nearest-neighbour piecewise linear force (PLF) interactions. In the WP system the lower energy vacancy dipoles have over a wide range of angles an energy which is mainly a function of the vacancy content of the dipole. There is a competition between the elastic forces and the topological constraints which favour a five-fold coordinate vacancy (FCV) at the centre of each core. For the short range PLF system the lattice usually compresses upon the introduction of a dislocation, a consequence of the soft core of the interaction potential, and interstitial dipoles are lower in energy. For the long range LJP system the dislocations are mobile whereas for the PLF system they are pinned. The relevance of these results to existing theories of melting are discussed. (ii) Using generalized stacking-fault (GSF) energies obtained from first-principles density-functional calculations, a zero-temperature model for dislocations in silicon is constructed within the framework of a Peierls-Nabarro (PN) model. Core widths, core energies, PN pinning energies, and stresses are calculated for various possible perfect and imperfect dislocations. Both shuffle and glide sets are considered. 90^circ partials are shown to have a lower Peierls stress (PS) than 30 ^circ partials in accord with experiment. (iii) We have also studied by atomic relaxation techniques the properties of dislocations in silicon, modelled by the empirical potential of Stillinger and Weber. In order to compare with the preceding calculation no reconstruction is allowed. We find no evidence of dissociation in the shuffle dislocations. Within this model shuffle dislocations glide along their slipping planes. On the other hand, glide sets are shown to glide only in dissociated form. The dislocation displacement fields are essentially planar. The PS is found to be isotropic within the (111) plane. In other words the minimum stress at 0K required to move the dislocation in any direction with in that plane has the same projection unto the Burgers vector, the PS of the dislocation. Our PS are in good agreement with those from (ii). (iv) Using a simple two dimensional UP model, relaxation mechanisms of the epitaxial strain layers (ESL) have been simulated for various misfits and layer thickness. In this model, the relationship of two competing relaxation mechanisms is found. At small misfit, strain is released by nucleating misfit dislocations from the edges of system. This process is more favourable for the thicker layer. At large misfit, stress is relaxed through surface instability, allowing easy generation of misfit dislocations from the surface. Those results are qualitatively in agreement with experiments.

  2. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... Kinectiv Total Hip System. At this time, let’s join Dr. Maltry in the operating room. Hello, everybody. ... d like to thank you for letting us join you in the operating room. And that’s really ...

  3. Sonography of hip dysplasia.

    Science.gov (United States)

    Smergel, Eleanor; Losik, Steve B; Rosenberg, Henrietta Kotlus

    2004-12-01

    Early diagnosis of developmental dysplasia of the hip (DDH) is important to institute appropriate treatment and reduce the incidence of long-term complications. Risk factors for DDH include genetic, developmental, mechanical, and physiologic factors. Physical examination using Ortolani and Barlow maneuvers is standard for early detection. Plain film radiography is limited for the diagnosis of DDH even when applying several classic landmarks, lines, and measurements, due to the lack of visualization of the cartilaginous components of the infant's hip. Ultrasound arose as a tool for evaluation of the cartilaginous structures of the hip in the early 1980s. Graf's method of examination by ultrasound stresses morphology, whereas dynamic examination uses physical maneuvers to elicit laxity of the hip. The Pavlik harness is the mainstay of treatment of DDH in the young infant, and ultrasound examination in the harness is useful to monitor progress. Closed or open surgical reduction is reserved for unresponsive or advanced cases. Universal ultrasound screening of newborns is not deemed cost effective by most North American authors, although in Europe non-selective screening has been more widely used. PMID:15602221

  4. INL HIP Plate Fabrication

    Energy Technology Data Exchange (ETDEWEB)

    B. H. Park; C. R. Clark; J. F. Jue

    2010-02-01

    This document outlines the process used to bond monolithic fuel plates by Hot Isostatic Pressing (HIP). This method was developed at Idaho National Laboratory (INL) for the Reduced Enrichment for Research and Test Reactors (RERTR) program. These foils have been used in a number of irradiation experiments in support of the United States Global Threat Reduction Initiative (GTRI) program.

  5. Neonatal clinical screening of the hip in the diagnosis of developmental dysplasia of the hip: a 15-year prospective longitudinal observational study.

    Science.gov (United States)

    Mace, J; Paton, R W

    2015-02-01

    Over a 15-year prospective period, 201 infants with a clinically unstable hip at neonatal screening were subsequently reviewed in a 'one stop' clinic where they were assessed clinically and sonographically. Their mean age was 1.62 weeks (95% confidence interval (CI) 1.35 to 1.89). Clinical neonatal hip screening revealed a sensitivity of 62% (mean, 62.6 95%CI 50.9 to 74.3), specificity of 99.8% (mean, 99.8, 95% CI 99.7 to 99.8) and positive predictive value (PPV) of 24% (mean, 26.2, 95% CI 19.3 to 33.0). Static and dynamic sonography for Graf type IV dysplastic hips had a 15-year sensitivity of 77% (mean, 75.8 95% CI 66.9 to 84.6), specificity of 99.8% (mean, 99.8, 95% CI 99.8 to 99.8) and a PPV of 49% (mean, 55.1, 95% CI 41.6 to 68.5). There were 36 infants with an irreducible dislocation of the hip (0.57 per 1000 live births), including six that failed to resolve with neonatal splintage. Most clinically unstable hips referred to a specialist clinic are female and stabilise spontaneously. Most irreducible dislocations are not identified from this neonatal instability group. There may be a small subgroup of females with instability of the hip which may be at risk of progression to irreducibility despite early treatment in a Pavlik harness. A controlled study is required to assess the value of neonatal clinical screening programmes. PMID:25628293

  6. 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

  7. Orthostatic intolerance during early mobilization after fast-track hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, O; Bundgaard-Nielsen, M; Solgaard, S; Johansson, P I; Kehlet, H

    2012-01-01

    BACKGROUND: /st>Early postoperative mobilization is a cornerstone in fast-track total hip arthroplasty (THA), but postoperative orthostatic intolerance (OI) may delay early recovery or lead to fainting, falls, and prosthesis dislocation or fracture. However, the prevalence and pathophysiology of OI has not been established after THA. This study evaluated the cardiovascular response and tissue oxygenation to mobilization before and after surgery in relation to OI in fast-track THA patients. METHO...

  8. Outcome for congenital hypothyroidism.

    Science.gov (United States)

    Hulse, J A

    1984-01-01

    In a study designed to provide retrospective control data for a neonatal thyroid screening programme, the problems of 141 hypothyroid children were examined. The mean IQ (Weschler intelligence scale) was 79.5 for children with congenital hypothyroidism but was normal in 6 children diagnosed before age 6 weeks. Diagnostic delay was associated with a steady decline in mean IQ but there was an improvement in some late diagnosed cases. A strong association was found between IQ and parental social class. Twenty five percent of the children were mentally retarded and 29% were at special schools; 54% of children at normal schools and 43% at special schools showed deviant behaviour. Other problems included clumsiness (26.2%) and squints (26.2%), and these were more common in children with a lower IQ. Congenital hypothyroidism is associated with persistent morbidity in many aspects of cerebral function. The adverse effects of prenatal hypothyroidism are largely reversible if treated before age 6 weeks. PMID:6198974

  9. Congenital nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Claudia Fanni

    2014-06-01

    Full Text Available CNS (Congenital nephrotic syndrome is a disorder characterized by the presence of a nephrotic syndrome in the first three months of life. Different pathologies can cause this syndrome. In general, we can distinguish primary forms (sporadic and hereditary and secondary forms (acquired and associated with other syndromes. The most common form is the Finnish CNS (CNF, congenital nephrotic syndrome of the Finnish type, a hereditary form whose name derives from the fact that the highest incidence is described in that country (1.2:10,000. The pathogenesis, the clinical picture, the diagnostic criteria, the therapy and the outcome are described in details.  Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  10. Congenital lipodystrophies and dyslipidemias.

    Science.gov (United States)

    Prieur, Xavier; Le May, Cedric; Magré, Jocelyne; Cariou, Bertrand

    2014-09-01

    Lipodystrophies are rare acquired and genetic disorders characterized by the selective loss of adipose tissue. One key metabolic feature of patients with congenital inherited lipodystrophy is hypertriglyceridemia. The precise mechanisms by which the lack of adipose tissue causes dyslipidemia remain largely unknown. In recent years, new insights have arisen from data obtained in vitro in adipocytes, yeast, drosophila, and very recently in several genetically modified mouse models of generalized lipodystrophy. A common metabolic pathway involving accelerated lipolysis and defective energy storage seems to contribute to the dyslipidemia associated with congenital generalized lipodystrophy syndromes, although the pathophysiological changes may vary with the nature of the mutation involved. Therapeutic management of dyslipidemia in patients with lipodystrophy is primarily based on specific approaches using recombinant leptin therapy. Preclinical studies suggest a potential efficacy of thiazolidinediones that remains to be assessed in dedicated clinical trials. PMID:25047893

  11. Congenital diaphramatic hernia

    Energy Technology Data Exchange (ETDEWEB)

    Kline-Fath, Beth M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Fetal Care Center of Cincinnati, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States)

    2012-01-15

    Congenital diaphragmatic hernia, despite advances in therapy, remains a complex condition with significant morbidity and mortality. The etiology of the disorder is still incompletely understood, though the pulmonary hypoplasia and pulmonary hypertension that develop secondarily must be overcome to improve survival. Prenatal US and fetal MRI have helped in the development of a greater understanding of this disease. Also with these modalities, measurement techniques have been developed in an attempt to provide prognosticators for the development of pulmonary hypoplasia and pulmonary hypertension. There is a broad range of approaches for performing these measurements, and variability among imaging centers is noted. Despite inconsistent approaches, these techniques have become the foundation for counseling and prenatal and postnatal therapy. It is hoped that with further research with prenatal US and fetal MRI and the development of innovative medical and surgical therapies that the morbidity and mortality of children with congenital diaphragmatic hernias can be significantly reduced. (orig.)

  12. Congenital absence of dermatoglyphs.

    Science.gov (United States)

    Límová, M; Blacker, K L; LeBoit, P E

    1993-08-01

    Congenital absence or unusual patterns of human dermatoglyphs (fingerprints) occur in several syndromes that are rare and poorly understood. The abnormalities of dermatoglyphs fall into four categories: complete absence, ridge hypoplasia, ridge dissociation, and ridges-off-the-end. Complete congenital absence of ridges is an exceedingly rare syndrome that consists of neonatal blisters and milia, adult traumatic blistering and fissuring, absence of sweating, contracture of digits, and absence of dermatoglyphs on the hands and feet. The syndrome is inherited in an autosomal dominant pattern, and only two kindreds have been described in the literature. We describe a newly identified patient and kindred with findings similar to the previously reported cases and review the clinical and histopathologic findings of this syndrome. PMID:8340514

  13. Congenital club foot

    Directory of Open Access Journals (Sweden)

    Baš?arevi? V.D.

    2010-01-01

    Full Text Available Congenital club foot is the most frequent foot deformity. It occurs in 1% of newborns, two times more frequently in boys, with family inheritance. Patoanatomicaly, entity consists of bone deformities, articular malpositions and soft tissues retraction. All these produce adduction of the forefoot and varus and equinovarus of the hindfoot. Lateral side of the foot is convex and medial side is concave. Forefoot is in adduction and plantar flexion in relation to the hindfoot. The heel is rotated medially which induces varus and eqinus of the foot. The aim of the treatment is to establish anatomically normal foot, painless, with moderate movements, which is suitable for normal shoes. At the beginning treatment is nonsurgical. If nonsurgical treatment fails further step should be surgical treatment. The success of treatment of congenital clubfoot depends on the time of diagnosis and treatment beginning.

  14. Relaxation strain measurements in cellular dislocation structures

    International Nuclear Information System (INIS)

    The conventional picture of what happens during a stress relaxation usually involves imagining the response of a single dislocation to a steadily decreasing stress. The velocity of this dislocation decreases with decreasing stress in such a way that we can measure the stress dependence of the dislocation velocity. Analysis of the data from a different viewpoint enables us to calculate the apparent activation volume for the motion of the dislocation under the assumption of thermally activated glie. Conventional thinking about stress relaxation, however, does not consider the eventual fate of this dislocation. If the stress relaxes to a low enough level, it is clear that the dislocation must stop. This is consistent with the idea that we can determine the stress dependence of the dislocation velocity from relaxation data only for those cases where the dislocation's velocity is allowed to approach zero asymptotically, in short, for those cases where the dislocation never stops. This conflict poses a dilemma for the experimentalist. In real crystals, however, obstacles impede the dislocation's progress so that those dislocations which are stopped at a given stress will probably never resume motion under the influence of the steadily declining stress present during relaxation. Thus one could envision stress relaxation as a process of exhaustion of mobile dislocations, rather than a process of decreasing dislocation velocity. Clearly both points of view have merit and in reality both mechanisms contribute to the phenomena

  15. Congenital hyperthyroidism: autopsy report

    OpenAIRE

    Lima Marcus Aurelho; Oliveira Lília Beatriz; Paim Neiva; Borges Maria de Fátima

    1999-01-01

    We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and h...

  16. Outcome for congenital hypothyroidism.

    OpenAIRE

    Hulse, J. A.

    1984-01-01

    In a study designed to provide retrospective control data for a neonatal thyroid screening programme, the problems of 141 hypothyroid children were examined. The mean IQ (Weschler intelligence scale) was 79.5 for children with congenital hypothyroidism but was normal in 6 children diagnosed before age 6 weeks. Diagnostic delay was associated with a steady decline in mean IQ but there was an improvement in some late diagnosed cases. A strong association was found between IQ and parental social...

  17. Congenital mercury poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, R.D.

    1971-05-06

    The case of congenital mercury poisoning reported here occurred in a family with several cases of acquired mercury poisoning secondary to the misuse of mercury-treated seed grain. An infant whose mother had ingested mercury-contaminated meat during pregnancy was born with symptoms of mercury poisoning. At birth, he had elevated urinary mercury levels, and neurologic signs attributed to mercury poisoning subsequently developed. This clinical state is attributed to transplacental poisoning with organic mercury. 12 references, 1 figure, 1 table.

  18. [Congenital lobar emphysema].

    Science.gov (United States)

    Kienzle, H F; Vorbach, M

    1981-04-01

    Congenital lobar emphysema is mainly seen in new-born and young babies. In the first hours or days, symptoms appear such as dyspnea, cyanosis, tachypnea, wheezing, thoracic and epigastric retractions. Later symptoms are faintness, psychomotoric retardation and malformation of the thorax. Etiology and pathogenesis of this emphysema of individual parts of the lung are unclear. The course is paroxysmatic, persistent or chronic. Preferred therapy of choice is the resection of the parts concerned. After operation the prognosis is good. PMID:7227006

  19. Congenital long QT syndrome

    OpenAIRE

    Celano Giuseppe; Crotti Lia; Dagradi Federica; Schwartz Peter J

    2008-01-01

    Abstract Congenital long QT syndrome (LQTS) is a hereditary cardiac disease characterized by a prolongation of the QT interval at basal ECG and by a high risk of life-threatening arrhythmias. Disease prevalence is estimated at close to 1 in 2,500 live births. The two cardinal manifestations of LQTS are syncopal episodes, that may lead to cardiac arrest and sudden cardiac death, and electrocardiographic abnormalities, including prolongation of the QT interval and T wave abnormalities. The gene...

  20. Congenital indifference to pain

    OpenAIRE

    Kapasi A; Trasi S; Khopkar U; Wadhwa S

    1992-01-01

    A 9-month old female infant developed a non-healing deep necrotic ulcer on the tongue in apposition with the central incisors. There was no response to painful stimuli. Investigations revealed normal blood biochemistry, sweat, histamine and capsaicin tests. Nerve conduction studies and light microscopy of sural nerve and skin were normal. The child was diagnosed as a case of congenital indifference to pain and was treated with teeth extraction and plastic repair of the tongue. In next 2 year...

  1. Surgery for Congenital Cataract

    OpenAIRE

    David Yorston FRCS FRCOphth

    2004-01-01

    The management of congenital cataract is very different to the treatment of a routine age-related cataract. In adults, surgery may be delayed for years without affecting the visual outcome. In infants, if the cataract is not removed during the first year of life, the vision will never be fully regained after surgery. In adults, if the aphakia is not corrected immediately, it can be corrected later. In young children, if the aphakia is not corrected, the vision will never develop normally.

  2. Characterizing congenital amusia

    DEFF Research Database (Denmark)

    Stewart, Lauren

    2011-01-01

    The ability to make sense of the music in our environment involves sophisticated cognitive mechanisms that, for most people, are acquired effortlessly and in early life. A special population of individuals, with a disorder termed congenital amusia, report lifelong difficulties in this regard. Exploring the nature of this developmental disorder provides a window onto the cognitive architecture of typical musical processing, as well as allowing a study of the relationship between processing of mus...

  3. Characterizing Congenital Amusia

    OpenAIRE

    Stewart, Lauren

    2011-01-01

    The ability to make sense of the music in our environment involves sophisticated cognitive mechanisms that, for most people, are acquired effortlessly and in early life. A special population of individuals, with a disorder termed congenital amusia, report lifelong difficulties in this regard. Exploring the nature of this developmental disorder provides a window onto the cognitive architecture of typical musical processing, as well as allowing a study of the relationship between processing of ...

  4. Congenital esophageal stenosis.

    OpenAIRE

    Mahmoud A. Machmouchi; Mohamed Al Harbi; Khalid A. Bakhsh; Zain H. Al Shareef

    2004-01-01

    ABSTRACT Congenital esophageal stenosis CES is an uncommon anomaly that rarely goes undiagnosed until adulthood. We report 2 cases of CES. The first was a one-month-old baby boy who was referred for work up of swallowing disorder and recurrent pneumonias. The diagnosis was confirmed by a continuous fluoroscopic esophagogram, and endoscopic exploration. Simple dilatation resolved his symptoms completely. The second was an 18-month-old boy, who was referred with a feeding gastrostomy due to ...

  5. Congenital scoliosis - Quo vadis?

    Directory of Open Access Journals (Sweden)

    Debnath Ujjwal

    2010-01-01

    Full Text Available Congenital spinal vertebral anomalies can present as scoliosis or kyphosis or both. The worldwide prevalence of the vertebral anomalies is 0.5-1 per 1000 live births. Vertebral anomalies can range from hemi vertebrae (HV which may be single or multiple, vertebral bar with or without HV, block vertebrae, wedge shaped or butterfly vertebrae. Seventy per cent of congenital vertebral anomalies result in progressive deformities. The risk factors for progression include: type of defect, site of defect (junctional regions and patient?s age at the time of diagnosis. The key to success in managing these spinal deformities is early diagnosis and anticipation of progression. One must intervene surgically to halt the progression of deformity and prevent further complications associated with progressive deformity. Planning for surgery includes a preoperative MRI scan to rule out spinal anomalies such as diastematomyelia. The goals of surgical treatment for congenital spinal deformity are to achieve a straight growing spine, a normal standing sagittal profile, and a short fusion segment. The options of surgery include in situ fusion, convex hemi epiphysiodesis and hemi vertebra excision. These basic surgical procedures can be combined with curve correction, instrumentation and short segment fusion. Most surgeons prefer posterior (only surgery for uncomplicated HV excision and short segment fusion. These surgical procedures can be performed through posterior, anterior or combined approaches. The advocates of combined approaches suggest greater deformity correction possibilities with reduced incidence of pseudoarthrosis and minimize crankshaft phenomenon. We recommend posterior surgery for curves involving only an element of kyphosis or modest deformity, whereas combined anterior and posterior approach is indicated for large or lordotic deformities. In the last decade, the use of growing rods and vertebral expandable prosthetic titanium rib has improved the armamentarium of the spinal surgeon in dealing with certain difficult congenital spinal deformities. The goal of growing rod treatment is to provide simultaneous deformity correction and allow for continued spinal growth. Once maximal spinal growth has been achieved, definitive fusion and instrumentation is performed.

  6. The Etiology of Osteoarthritis of the Hip: An Integrated Mechanical Concept

    OpenAIRE

    Ganz, Reinhold; Leunig, Michael; Leunig-Ganz, Katharina; William H. Harris

    2008-01-01

    The etiology of osteoarthritis of the hip has long been considered secondary (eg, to congenital or developmental deformities) or primary (presuming some underlying abnormality of articular cartilage). Recent information supports a hypothesis that so-called primary osteoarthritis is also secondary to subtle developmental abnormalities and the mechanism in these cases is femoroacetabular impingement rather than excessive contact stress. The most frequent location for femoroacetabular impingemen...

  7. The heart: Congenital disease

    International Nuclear Information System (INIS)

    The most important diagnostic requirement in congenital heart disease (CHD) is definition of cardiovascular pathoanatomy. The considerable success in operative correction of even the most complex anomalies in recent years compels ever increasing precision in preoperative demonstration of these anomalies. Early experience with magnetic resonance imaging (MRI) at several institutions indicated that this modality is an effective noninvasive technique for evaluation of CHD. Indeed, MRI seems to have some advantage over other techniques, including angiography, for definitive diagnosis of congenital anomalies of the heart and great arteries and veins. The absence of ionizing radiation and contrast medium in MRI is an additional advantage; the former is particularly important for children, who, up to this time, have frequently been subjected to enormous radiation burdens from multiple cineangiograms during initial diagnosis and follow-up. This chapter describes the MRI appearance of cardiovascular anatomy im the segmental fashion proposed for analysis of complex CHD. Likewise, MRI demonstration of congenital cardiovascular lesions is organized into abnormalities situated at the four segmental cardiovascular levels: great vessels, atria, ventricles, and visceroatrial relationship. The role of MRI in evaluation of complex ventricular anomalies such as single ventricle and thoracic aortic abnormalities is specifically described

  8. CONGENITAL DUODENAL OBSTRUCTIONS

    Directory of Open Access Journals (Sweden)

    S.G. Aprodu

    2005-07-01

    Full Text Available The purpose of this study is to analyze a cohort of 46 cases of congenital duodenal obstruction, operated on between 1996 and 2002, 23 of them being diagnosed in neonatal period. In one case, the diagnosis was made antenatally, by ultrasonography. There were 15 males and 8 females, 17 with duodenal atresia and 6 with duodenal diaphragmatic stenosis. Surgery was performed in all cases, consisting in lateral duodeno-duodenal anastomosis in 5 cases and "diamond-shape" duodeno-duodenal anastomosis in 18 cases. The survival rate in this study was 69.5%. 12 cases (52,1% had other congenital pathologies: trisomy 21 (6 cases, multiple ileal atresia (2 cases, dextrocardy (2 cases, omphalocel (1 case, situs inversus (1 case. The complications of surgery were: anastomotic leaking with peritonitis, biliary fistula, intestional adhesions with occlusion. Congenital duodenal obstruction (midgut volvulus, atresia, stenosis remains a challenging issue for pediatric surgeons, especially in our country, due to limited possibilities of quick diagnosis and treatment of associated anomalies.

  9. 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.

  10. Transplantation of congenitally opaque corneas

    OpenAIRE

    Frueh, B; Brown, S

    1997-01-01

    AIMS—To assess retrospectively the prognosis and complications of corneal grafting for congenital opacities.?METHODS—Fifty eight eyes of infants and young children with congenital corneal opacities were studied retrospectively. Preoperative diagnoses included sclerocornea (27 eyes), Peters' anomaly (17 eyes), partial sclerocornea (12 eyes), and congenital glaucoma (two eyes). Penetrating keratoplasty was performed between 5 days and 65 months of age with a mean follow up of 40 (SD 29) months....

  11. Congenital syphilis, still a reality

    Directory of Open Access Journals (Sweden)

    Rajat Gupta

    2013-01-01

    Full Text Available Congenital syphilis is a potentially serious pathology affecting newborns of infected mothers. Even one case of congenital syphilis is a sentinel public health event, since timely diagnosis and treatment of syphilis infected pregnant woman should prevent transmission almost entirely. Here, we are reporting a case of early symptomatic congenital syphilis presented with severe desquamating papulosquamous lesions over multiple body parts along with erosive lesions around oral cavity and nostrils.

  12. Genetics Home Reference: Hypomyelination and congenital cataract

    Science.gov (United States)

    ... OMIM Genetic disorder catalog Conditions > Hypomyelination and congenital cataract On this page: Description Genetic changes Inheritance Diagnosis ... Reviewed July 2009 What is hypomyelination and congenital cataract? Hypomyelination and congenital cataract is an inherited condition ...

  13. Genetics Home Reference: Congenital hepatic fibrosis

    Science.gov (United States)

    ... Research studies PubMed Recent literature Conditions > Congenital hepatic fibrosis On this page: Description Genetic changes Inheritance Diagnosis ... definitions Reviewed January 2012 What is congenital hepatic fibrosis? Congenital hepatic fibrosis is a disease of the ...

  14. Genetics Home Reference: Congenital mirror movement disorder

    Science.gov (United States)

    ... throughout life, without other associated signs and symptoms. Intelligence and lifespan are not affected. People with congenital ... mildly affected individuals may never be diagnosed. What genes are related to congenital mirror movement disorder? Congenital ...

  15. Genetics Home Reference: Severe congenital neutropenia

    Science.gov (United States)

    ... literature OMIM Genetic disorder catalog Conditions > Severe congenital neutropenia On this page: Description Genetic changes Inheritance Diagnosis ... definitions Reviewed April 2010 What is severe congenital neutropenia? Severe congenital neutropenia is a condition that causes ...

  16. Genetics Home Reference: Leber congenital amaurosis

    Science.gov (United States)

    ... PubMed Recent literature OMIM Genetic disorder catalog Conditions > Leber congenital amaurosis On this page: Description Genetic changes ... names Glossary definitions Reviewed August 2010 What is Leber congenital amaurosis? Leber congenital amaurosis is an eye ...

  17. Early detection of congenital syphilis

    Directory of Open Access Journals (Sweden)

    Nagalakshmi Chowdhary

    2014-01-01

    Full Text Available Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson?s teeth.

  18. Transient osteoporosis of the hip

    OpenAIRE

    Rengin Güzel; Sibel Ba?aran

    2009-01-01

    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...

  19. Chondrosarcoma of the Hip.

    Science.gov (United States)

    Sperier, Aubrey D; Hammel, Nathan C; Rosenthal, Michael D

    2015-10-01

    The patient was a 27-year-old woman who was being evaluated by a physical therapist 1 month following a right Achilles tendon repair. She reported the presence of a painful firm mass in her left hip that she first noticed approximately 6 months prior. As an initial assessment of the mass, the physical therapist ordered radiographs of the left hip, which revealed a mass projecting off the left lateral iliac bone. The radiologist recommended contrast-enhanced magnetic resonance imaging for further characterization, which revealed a large lobulated mass that was consistent with an osteochondroma. J Orthop Sports Phys Ther 2015;45(10):814. doi:10.2519/jospt.2015.0410. PMID:26424575

  20. Dislocation core structure in ordered intermetallic alloys

    OpenAIRE

    Pasianot, R.; Farkas, D.; Savino, E.

    1991-01-01

    The basic features of dislocation core structures in ordered intermetallic alloys are discussed, as revealed by atomistic computer simulation. The simulated dislocation core structures are for the most commonly observed slip systems in both L12 and B2 alloys. The simulations were carried out with embedded atom interatomic potentials. Screw and edge dislocations were studied, particularly investigating the planarity of the dislocations cores. The general trend of the results agrees with the re...

  1. Drift of dislocation tripoles under ultrasound influence.

    Science.gov (United States)

    Murzaev, R T; Bachurin, D V; Nazarov, A A

    2016-01-01

    Numerical simulations of dynamics of different stable dislocation tripoles under influence of monochromatic standing sound wave were performed. The basic conditions necessary for the drift and mutual rearrangements between dislocation structures were investigated. The dependence of the drift velocity of the dislocation tripoles as a function of the frequency and amplitude of the external influence was obtained. The results of the work can be useful in analysis of motion and self-organization of dislocation structure under ultrasound influence. PMID:26278625

  2. IDIOPATHIC CHONDROLYSIS OF HIP

    OpenAIRE

    ShanmugaRaju P; Raghuram C; Naveen Kumar S

    2014-01-01

    A 13 Year old girl with history of pain in the left hip, stiffness, walking difficulty for one month. There was no history of trauma, fever and weight loss. Physical examination revealed left side antalgic gait and pelvic obliquity. There was restriction of abduction, flexion and external rotation on the affected side. Laboratory investigations for C - reactive protein, Rheumatoid factor and serum complement were normal. The complete blood profile was normal. Conventional Radio...

  3. Uncemented total hip replacement.

    OpenAIRE

    Ring, P A

    1981-01-01

    During the last 20 years almost 3000 uncemented total hip replacements have been used in the treatment of osteoarthritis and rheumatoid arthritis. The development of an axially located prosthesis is outlined, and the causes of failure indicated. Uncemented prostheses have the advantage of a relatively low mortality and morbidity and the rate of infection in particular is low. Interface pain, with or without frank prosthetic loosening, is the commonest cause of failure, but revisional surgery ...

  4. Relation between the ultrasound and x-ray imaging of the infant hip joint

    International Nuclear Information System (INIS)

    The function of the imaging in DDH is very important. Ultrasound of the infant hip has gained acceptance since its introducing by Graf in 1980. It id an easily accessible real-time technique, is available at reasonable cost and does not expose the patient to ionizing radiation or require sedation; and addition, the equipment is portable. Conversely, ultrasound of the hip must be performed by an experienced sonographer and images must be obtained in two orthogonal planes (axial and coronal). Furthermore, measurements of acetabular angles can be time consuming. Recognizing these advantages and challenges, we originated a project sonographic technology to determine the strengths and limitation of this new imaging tool. Of the infants brought to out patient department of the clinic, radiographs were made when hip dislocation was clinically and sonographically suspected. (author)

  5. DISLOCATION KINETICS OF SHOCK WAVE METAL DEFORMATION

    OpenAIRE

    Merzhievsky, L.; Tyagel'Sky, A.

    1991-01-01

    A construction is made for the dislocation metal deformation kinetics in a shock wave, that takes into account, besides the traditional dislocation multiplication mechanisms, the mechanism of heterogeneous dislocation nucleation on point defects. The applicability of kinetics for modelling the shock wave processes in metals is shown.

  6. 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

  7. Medial subtalar dislocation: Case report

    Directory of Open Access Journals (Sweden)

    Manojlovi? Radovan

    2010-01-01

    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.

  8. Complications of revision hip arthroplasty using fresh bone allografts

    Directory of Open Access Journals (Sweden)

    Miljkovi? Nataša

    2007-01-01

    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. .

  9. Leucemia congénita / Congenital leukemia

    Scientific Electronic Library Online (English)

    Wilfredo, Roque-García; Niurka, Morán-Obregón; Maday, Rodríguez-Acosta; Adys, Gutiérrez-Díaz.

    2013-12-01

    Full Text Available La leucemia congénita constituye una entidad rara que se diagnostica entre el momento del nacimiento y los primeros 30 días de vida. Menos del 1 % de las leucemias de la infancia se diagnostican en el neonato. Se caracteriza por la presencia en un recién nacido, de hepatomegalia, esplenomegalia y le [...] siones hemorrágicas o infiltrativas en piel. El hemograma completo, el examen de la lámina de la sangre periférica, el aspirado de médula ósea, junto con el inmunofenotipaje y los estudios de biología molecular confirmarán el diagnóstico. El trastorno mieloproliferativo transitorio y las infecciones congénitas constituyen los principales diagnósticos diferenciales. El pronóstico de la enfermedad es sombrío. El tratamiento está basado en regímenes de poliquimioterapia intensiva y el trasplante de progenitores hematopoyéticos constituye una opción terapéutica en un grupo de pacientes. Abstract in english Congenital leukemia is a rare but well documented disease which can be diagnosed on the first 30 days of life. The diagnosis requires a high index of clinical suspicion in a newborn with hepatosplenomegaly and hemorragic or infiltratives cutaneous lesions (red, brown or purple papules or nodules) al [...] ong with further investigations such as complete blood count, peripheral blood smear, bone marrow aspirate and immunopfenotypic profile. A true congenital leukemia has to be distinguished from other conditions such as a transient mieloproliferative disorder described in Down´s syndrome and congenital infections. The prognosis of neonatal leukemia is dismal. Treatment includes intensive multi-agent chemotherapy and supportive care, being the hematopoietic stem cell transplantation an additional treatment option in a group of patients.

  10. Prevalence of Congenital Malformations

    Directory of Open Access Journals (Sweden)

    Akhavan Karbasi Sedighah

    2009-05-01

    Full Text Available Congenital malformation (CM will begin to emerge as one of the major childhood health problems .Treatment and rehabilitation of children with congenital malformations are costly and complete recovery is usually impossible. The aim of this study was to determine frequency of CM in Yazd central city of the Islamic Republic of Iran to find out if there has been any difference in the rate and types of CM in this area. This descriptive-observational study carried on 4800 births delivered at all maternity hospitals in Yazd from October 2003 to June 2004. Prevalence of CM was 2.83% (2.86 % in male and 2.68 % in female out of the 136 cases 69(51.88% were males and 64 (48.12% were females and 3 with ambiguous genitalia. Positive family history of CM in sibling was in only 6 cases (4.41%.Overall, musculoskeletal (0.83%, central nerv-ous system (0.47% and genital system (0.37% were accounted as the most common. Frequency of CM was more seen in still birth (12.5% as in comparison to live birth (2.71%. There was not statistical difference be-tween prevalence of CM and neonatal's gender, gestational age, birth order and mother's age, drug ingestion, illness and parental consanguinity. In this study the overall prevalence of congenital malformation among the newborn was higher than those previous reported in Iran and determining the causes of this difference needs more extensive studies.

  11. Management of developmental dysplasia of the hip in less than 24 months old children

    Directory of Open Access Journals (Sweden)

    Mehmet Bulut

    2013-01-01

    Full Text Available Background: There is no consensus on the treatment of developmental dysplasia of the hip in children less than 24 months of age. The aim of this study was to present the results of open reduction and concomitant primary soft-tissue intervention in patients with developmental dysplasia of the hip in children less than 24 months of age. Materials and Methods: Sixty hips of 50 patients (4 male, 46 female with mean age of 14.62 ± 5.88 (range 5-24 months months with a mean followup of 40.00 ± 6.22 (range 24-58 months months were included. Twenty five right and 35 left hips (10 bilaterally involved were operated. Open reduction was performed using the medial approach in patients aged < 20 months (with Tönnis type II-III and IV hip dysplasias and for those aged 20-24 months with Tönnis type II and III hip dysplasias ( n = 47. However for 13 patients aged 20-24 months with Tönnis type IV hip dysplasias, anterior bikini incision was used. Results: Mean acetabular index was 41.03 ± 3.78° (range 34°-50° in the preoperative period and 22.98 ± 3.01° (range 15°-32° at the final visits. Mean center-edge angle at the final visits was 22.85 ± 3.35° (18°-32°. Based on Severin radiological classification, 29 (48.3% were type I (very good, 25 (41.7% were type II (good and 6 (10% were type III (fair hips. According to the McKay clinical classification, postoperatively the hips were evaluated as excellent ( n = 42; 70%, good ( n = 14; 23.3% and fair ( n = 4; 6.7%. Reduction of all hip dislocations was achieved. Additional pelvic osteotomies were performed in 14 (23.3% hips for continued acetabular dysplasia and recurrent subluxation. (Salter [ n = 12]/Pemberton [ n = 2] osteotomy was performed. Avascular necrosis (AVN developed in 7 (11.7% hips. Conclusion: In DDH only soft-tissue procedures are not enough, because of the high rate of the secondary surgery and AVN for all cases aged less than 24 months. Bone procedures may be necessary in the walking age group with high acetabular index.

  12. Congenital Cataracts – Facial Dysmorphism – Neuropathy

    OpenAIRE

    Kalaydjieva Luba

    2006-01-01

    Abstract Congenital Cataracts Facial Dysmorphism Neuropathy (CCFDN) syndrome is a complex developmental disorder of autosomal recessive inheritance. To date, CCFDN has been found to occur exclusively in patients of Roma (Gypsy) ethnicity; over 100 patients have been diagnosed. Developmental abnormalities include congenital cataracts and microcorneae, primary hypomyelination of the peripheral nervous system, impaired physical growth, delayed early motor and intellectual development, mild facia...

  13. Molecular basis of congenital neutropenia

    OpenAIRE

    Klein, Christoph

    2009-01-01

    In 1950 Rolf Kostmann discovered autosomal recessive severe congenital neutropenia and for more than 50 years its molecular etiology has remained enigmatic. In the last years, however, there have been impressive advances in this field. In this perspective article, Dr. Klein summarizes our current knowledge of the molecular basis of congenital neutropenia. See related paper on page 1449.

  14. Congenital giant melanocytic nevi

    Directory of Open Access Journals (Sweden)

    Shahla Khan

    2009-07-01

    Full Text Available Nevi are common skin tumors caused by abnormal overgrowth of cells from the epidermal and dermal layers of the skin. Most nevi are benign, but some pre-cancerous nevi must be monitored or removed. The giant congenital nevus is greater than 10 cm in size, pigmented and often hairy. Between 4% and 6% of these lesions will develop into a malignant melanoma. Since approximately 50% of the melanoma develop by the age of two, and 80% by the age of seven, early removal is recommended. The objective of this paper is to present a unique case of giant nevi and their surgical management.

  15. Nonclassic Congenital Adrenal Hyperplasia

    Directory of Open Access Journals (Sweden)

    Selma Feldman Witchel

    2010-01-01

    Full Text Available Nonclassic congenital adrenal hyperplasia (NCAH due to P450c21 (21-hydroxylase deficiency is a common autosomal recessive disorder. This disorder is due to mutations in the CYP21A2 gene which is located at chromosome 6p21. The clinical features predominantly reflect androgen excess rather than adrenal insufficiency leading to an ascertainment bias favoring diagnosis in females. Treatment goals include normal linear growth velocity and “on-time” puberty in affected children. For adolescent and adult women, treatment goals include regularization of menses, prevention of progression of hirsutism, and fertility. This paper will review key aspects regarding pathophysiology, diagnosis, and treatment of NCAH.

  16. Congenital indifference to pain

    Directory of Open Access Journals (Sweden)

    Kapasi A

    1992-01-01

    Full Text Available A 9-month old female infant developed a non-healing deep necrotic ulcer on the tongue in apposition with the central incisors. There was no response to painful stimuli. Investigations revealed normal blood biochemistry, sweat, histamine and capsaicin tests. Nerve conduction studies and light microscopy of sural nerve and skin were normal. The child was diagnosed as a case of congenital indifference to pain and was treated with teeth extraction and plastic repair of the tongue. In next 2 years the child had recurrent ulcers of the tongue leading to fibrosis and shortening of tongue hampering the speech.

  17. Surgery for Congenital Cataract

    Directory of Open Access Journals (Sweden)

    David Yorston FRCS FRCOphth

    2004-01-01

    Full Text Available The management of congenital cataract is very different to the treatment of a routine age-related cataract. In adults, surgery may be delayed for years without affecting the visual outcome. In infants, if the cataract is not removed during the first year of life, the vision will never be fully regained after surgery. In adults, if the aphakia is not corrected immediately, it can be corrected later. In young children, if the aphakia is not corrected, the vision will never develop normally.

  18. Congenital acute megakaryocytic leukemia

    Directory of Open Access Journals (Sweden)

    N B Mathur

    2011-01-01

    Full Text Available Congenital leukemia (CL is an extremely rare disorder in the newborn, significant proportion of which is of myeloid origin, primarily of M4 or M5 morphology. As compared to pediatric leukemia, CL is a more aggressive disease. Acute myeloid leukemia (AML-M7 or acute megakaryocytic leukemia is a rare type of AML with an incidence of 0.5 per million per year. Median age of presentation is 6 years, and children may present with a broad variety of symptoms including low-grade fever, diarrhea, easy bruising, failure to gain weight and life-threatening conditions.

  19. Congenital acute megakaryocytic leukemia

    OpenAIRE

    Mathur, N. B.; Joshi, Neha; Singh, T.; Singh, Meeta

    2011-01-01

    Congenital leukemia (CL) is an extremely rare disorder in the newborn, significant proportion of which is of myeloid origin, primarily of M4 or M5 morphology. As compared to pediatric leukemia, CL is a more aggressive disease. Acute myeloid leukemia (AML-M7) or acute megakaryocytic leukemia is a rare type of AML with an incidence of 0.5 per million per year. Median age of presentation is 6 years, and children may present with a broad variety of symptoms including low-grade fever, diarrhea, ea...

  20. Congenital Rhabdomyosarcoma of Shoulder

    OpenAIRE

    Khaleghnejad-tabari, Ahmad; Mirshemirani, AliReza; Rouzrokh, Mohsen; Nariman, Shahin; Hassas-Yeganeh, Shaghayegh; Gharib, Atoosa; Khaleghnejad-Tabari, Nasibeh

    2012-01-01

    A 16-day-old female was referred with congenital swelling on her right shoulder. On examination, there was a hard, round, ecchymotic, nontender, slightly movable, warm and shiny 10x15 cm mass on the right axillary pits which was extended to the right side of neck and chest wall. The mass separated the shoulder from the chest wall causing paralysis of right hand. Chest X-ray, ultrasound and MRI with contrast demonstrated a soft tissue mass suspected to be a hemangioma. The mass rapidly increas...

  1. Congenital Leukemia in Down's syndrome

    International Nuclear Information System (INIS)

    Congenital Leukemia is a condition and often associated with fatal outcome/sup 1/. Most of the neonatal cases reported have acute non-lymphoblastic leukemia, in contrast to the predominance of acute lymphoblastic leukemia found in later childhood. congenital leukemia is occasionally associated with number of congenital anomalies and with chromosomal disorders such as Down's syndrome. Subtle cytogenetic abnormalities may occur more commonly in the affected infants and their parents, when studied with newer cytogenetic techniques/sup 2/. Inherent unstable hematopoieses resulting from chromosomal aberration in children with Downs's syndrome can present with transient myeloproliferative disorder, mimicking leukemia which undergoes spontaneous recovery/sup 3/. Only few cases of congenital leukemia with Downs syndrome, presented as congenital leukemia. (author)

  2. Congenital nystagmus and negative electroretinography

    Directory of Open Access Journals (Sweden)

    Roussi M

    2011-04-01

    Full Text Available Mirella Roussi, Hélène Dalens, Jean Jacques Marcellier, Franck BacinDepartment of Ophthalmology, Clermont-Ferrand University, Clermont-Ferrand, FranceAbstract: Congenital nystagmus is a pathologic oculomotor state appearing at about three to four months of age. The precise diagnosis requires detailed clinical examination and electrophysiological findings. This case report presents two male patients with congenital nystagmus examined longitudinally from the age of six months until 17-18 years of age. Clinical and electrophysiological protocols were detailed. The first results showed electronegative electroretinography in the two cases and examination combined with electroretinographic findings helped us to make the diagnosis of Congenital Night Stationary Blindness (CSNB. This diagnosis was confirmed by genetic studies. CSNB is interesting to study because through electrophysiological findings, it enables a better understanding of the physiology of neural transmission in the outer part of the retina.Keywords: Congenital nystagmus, negative electroretinography, congenital night stationary blindness

  3. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... six times body weight, and in a regular person, during walking, the patient will actually have anywhere between two to four times body weight on the hip. The hip can get quite sick from a number of diseases, including sports injuries. And I'm going to now have ...

  4. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... length of the leg, we're going to check the stability of the leg because these hips, they can pop out. For the first six weeks, the patient has ... a hip replacement? How many of those patients out of 100 would you say may ... before surgery and you check, okay, the hemoglobin has to be greater than ...

  5. Hip-Hop Education Resources

    Science.gov (United States)

    Hall, Marcella Runell

    2009-01-01

    Hip-hop music and culture are often cited as being public pedagogy, meaning the music itself has intrinsic educational value. Non-profit organizations and individual educators have graciously taken the lead in utilizing hip-hop to educate. As the academy continues to debate its effectiveness, teachers and community organizers are moving forward.…

  6. Chronic infections in hip arthroplasties

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Thomsen, Reimar W; Søballe, Kjeld

    2012-01-01

    Two-stage revision is regarded by many as the best treatment of chronic infection in hip arthroplasties. Some international reports, however, have advocated one-stage revision. No systematic review or meta-analysis has ever compared the risk of reinfection following one-stage and two-stage revisions for chronic infection in hip arthroplasties.

  7. X-Ray Exam: Hip

    Science.gov (United States)

    What It Is A hip X-ray is a safe and painless test that uses a small amount of radiation to make images of the hip joints (where ... attach to the pelvis). During the examination, an X-ray machine sends a beam of radiation through the ...

  8. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... correct. But in actual fact, for the actual person that’s simply not a problem. That’s correct. And then you’re soft tissues are intact, and not just your capsule. Your rotators are intact. Your gluteus maximus is ... hip in. These people are just totally different than your hip that ...

  9. 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 ...

  10. 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 ... hip resection looks like here? Show a little video snippet of that and ... completely cosmetic type procedure, and do patients tend to have incision ...

  11. Dislocation motion in tungsten: Atomistic input to discrete dislocation simulations.

    Czech Academy of Sciences Publication Activity Database

    Srivastava, K.; Gröger, Roman; Weygand, D.; Gumbsch, P.

    2013-01-01

    Ro?. 47, AUG (2013), s. 126-142. ISSN 0749-6419 R&D Projects: GA ?R GAP204/10/0255; GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081723 Keywords : body-centered cubic * non-Schmid effects * anomalous slip * discrete dislocation dynamics Subject RIV: BM - Solid Matter Physics ; Magnetism; BM - Solid Matter Physics ; Magnetism (UFM-A) Impact factor: 5.971, year: 2013

  12. Transient Osteoporosis of the Hip

    Directory of Open Access Journals (Sweden)

    Rengin Güzel

    2009-04-01

    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.

  13. Congenital extrahepatic portosystemic shunts

    Energy Technology Data Exchange (ETDEWEB)

    Murray, Conor P.; Yoo, Shi-Joon; Babyn, Paul S. [Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, Ontario (Canada)

    2003-09-01

    A congenital extrahepatic portosystemic shunt (CEPS) is uncommon. A type 1 CEPS exists where there is absence of intrahepatic portal venous supply and a type 2 CEPS where this supply is preserved. The diagnosis of congenital portosystemic shunt is important because it may cause hepatic encephalopathy. To describe the clinical and imaging features of three children with CEPS and to review the cases in the published literature. The diagnostic imaging and medical records for three children with CEPS were retrieved and evaluated. An extensive literature search was performed. Including our cases, there are 61 reported cases of CEPS, 39 type 1 and 22 type 2. Type 1 occurs predominantly in females, while type 2 shows no significant sexual preponderance. The age at diagnosis ranges from 31 weeks of intrauterine life to 76 years. Both types of CEPS have a number of associations, the most common being nodular lesions of the liver (n=25), cardiac anomalies (n=19), portosystemic encephalopathy (n=10), polysplenia (n=9), biliary atresia (n=7), skeletal anomalies (n=5), and renal tract anomalies (n=4). MRI is recommended as an important means of diagnosing and classifying cases of CEPS and examining the associated cardiovascular and hepatic abnormalities. Screening for CEPS in patients born with polysplenia is suggested. (orig.)

  14. Congenital extrahepatic portosystemic shunts

    International Nuclear Information System (INIS)

    A congenital extrahepatic portosystemic shunt (CEPS) is uncommon. A type 1 CEPS exists where there is absence of intrahepatic portal venous supply and a type 2 CEPS where this supply is preserved. The diagnosis of congenital portosystemic shunt is important because it may cause hepatic encephalopathy. To describe the clinical and imaging features of three children with CEPS and to review the cases in the published literature. The diagnostic imaging and medical records for three children with CEPS were retrieved and evaluated. An extensive literature search was performed. Including our cases, there are 61 reported cases of CEPS, 39 type 1 and 22 type 2. Type 1 occurs predominantly in females, while type 2 shows no significant sexual preponderance. The age at diagnosis ranges from 31 weeks of intrauterine life to 76 years. Both types of CEPS have a number of associations, the most common being nodular lesions of the liver (n=25), cardiac anomalies (n=19), portosystemic encephalopathy (n=10), polysplenia (n=9), biliary atresia (n=7), skeletal anomalies (n=5), and renal tract anomalies (n=4). MRI is recommended as an important means of diagnosing and classifying cases of CEPS and examining the associated cardiovascular and hepatic abnormalities. Screening for CEPS in patients born with polysplenia is suggested. (orig.)

  15. Congenital hyperthyroidism: autopsy report / Hipertireoidismo Congenital

    Scientific Electronic Library Online (English)

    Marcus Aurelho de, Lima; Lília Beatriz, Oliveira; Neiva, Paim; Maria de Fátima, Borges.

    1999-06-01

    Full Text Available Relata-se necropsia de natimorto com hipertireoidismo congênito, filho de mãe portadora de doença de Graves não tratada, que teve como causa de óbito insuficiência cardíaca congestiva. Os achados fundamentais foram vistos no crânio, tireóide coração e placenta. As suturas cranianas encontravam-se fe [...] chadas, com acavalgamento dos ossos cranianos. A tireóide apresentava aumento de volume e congestão sangüinea intensa e, histologicamente, os folículos mostravam hiperatividade. O coração estava aumentado de volume, amolecido, com cavidades dilatadas e sufusões hemorrágicas no epicárdio. A placenta apresentava infartos que acometiam menos de 20% da superfície placentária e os vasos do cordão umbilical encontravam-se completamente expostos por diminuição da geléia de Warton. O hipertireoidismo ficou comprovado pelos dados clínicos maternos, os achados fetais de exoftalmia, craniosinostose prematura e bócio com sinais de hiperatividade folicular. A craniosinostose é causada pela ação anabólica dos hormônios tireoidianos na formação óssea, nos estágios iniciais do desenvolvimento. O início tardio do tratamento no presente caso contribuiu para severidade do hipertireoidismo fetal e óbito. Abstract in english We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull [...] bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton 's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

  16. A computational analysis of squeaking hip prostheses

    OpenAIRE

    Askari, Ehsan; Flores, Paulo; Dabirrahmani, Danè; Appleyard, Richard

    2015-01-01

    A ceramic-on-ceramic (CoC) hip prosthesis with clearance is modeled as a multibody dynamics system for the purpose of studying hip squeaking. A continuous contact force model provides the intrajoint forces developed at the hip joint. Friction effects due to the relative motion are also considered. A FFT analysis of the audible sounds from CoC hip acceleration is carried out to analyze hip squeaking. The effects of friction, hip implant size, and the head initial position on hip squeaking a...

  17. 10-year experience with short stem total hip arthroplasty.

    Science.gov (United States)

    von Lewinski, Gabriela; Floerkemeier, Thilo

    2015-03-01

    Since 1998, short stem total hip arthroplasty (THA) has been performed at the authors' institution. Currently, 30% of THAs are performed with short stems. This article reports on complications that required revision of a short stem THA. Between September 2005 and February 2012, a total of 1953 Metha short stem THAs were performed; of these, 38 required revision due to mechanical complications. In 12 cases, the modular titanium neck adapter failed. In 19 cases, aseptic implant loosening occurred; of these, 11 cases were due to major stem subsidence. In 2 cases, via falsa (cortical penetration) implantation occurred. In 5 cases, periprosthetic fractures led to revision. This corresponds to an aseptic total revision rate of 1.3% for 26 short stems and 1.9% including the cases of all 38 documented revision cases. Thirty-four cases were revised with cementless standard hip stems, 2 cases were revised with short stems, and 2 cases were revised with long revision stems. Undersizing was analyzed in 58% of aseptic revisions. Fifty-four percent of revisions were performed in male patients - 23% with osteonecrosis of the femoral head, and 7% with short hip stems positioned in varus in coxa vara deformities. Seventy-two percent of revisions after marked early stem subsidence and position change into valgus were performed in female patients. Dysplastic hips with coxa valga did not show elevated revision rates. No revisions were performed for dislocation or femoral thigh pain. Short stem THA with the Metha implant is a bone-preserving option for various indications in select patient groups. PMID:25826634

  18. Atlantoaxial dislocation and Down's syndrome.

    OpenAIRE

    Whaley, W J; Gray, W. D.

    1980-01-01

    The phenotypic features of Down's syndrome are easily recognized and include characteristic facial features, hypotonia, ligament laxity, transverse palmar creases and mental subnormality. Associated manifestations and complications are also familiar and involve almost every organ system. Congenital heart defects, bowel malformations and a tendency to leukemia are common attendant problems. Less common, however, are defects of the skeletal system; in fact, the most recent edition of a standard...

  19. Congenital hypothyroidism: current perspectives

    Directory of Open Access Journals (Sweden)

    Dayal D

    2015-07-01

    Full Text Available Devi Dayal, Rajendra Prasad Department of Pediatrics, Pediatric Endocrinology and Diabetes Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India Abstract: Congenital hypothyroidism (CH, the most common pediatric endocrine disorder with an estimated prevalence of 1:2,000 to 1:4,000, is an under-recognized problem in countries without routine newborn screening (NBS programs. Thyroid dysgenesis (TD is the most common cause of primary CH accounting for approximately 85% of all cases; most of the remaining patients have dyshormonogenesis. Transient CH and CH with eutopic gland, are increasingly being identified after introduction of routine NBS. The clinical features of CH are often subtle resulting in delayed diagnosis and eventually poor intellectual outcome. In developed countries, detection by NBS and early initiation of treatment has largely eliminated the intellectual disability caused by this disorder. The lower screening thyroid stimulating hormone (TSH cutoff and changes in birth demographics in some countries have been associated with an increase in the reported incidence of CH. However, the additional cases detected by the lower TSH cutoff tend to have either milder or transient hypothyroidism. Diagnosis of CH is made on the basis of serum concentrations of TSH and thyroxine (T4. Thyroid ultrasound, radionuclide scintigraphy, serum thyroglobulin (TG levels and specific genetic tests help ascertaining the exact etiological diagnosis. Non-availability of later tests should not deter the pediatrician from initiation of treatment. Age at initiation of treatment and starting dose of levothyroxine are critical factors that determine the long-term outcome. Higher doses of levothyroxine at 10–15 µg/kg/day are required in infants, with titration based on T4 and TSH levels, which are repeated frequently. Coexistence of other congenital anomalies in children with CH adds to the morbidity. Approximately 70% of babies worldwide are not born in an area with an established NBS program and hence are not detected and treated early. Consequently, the economic burden of mental retardation due to CH remains a significant public health challenge in countries without NBS. The health burden owing to CH continues to be high even in countries with well-developed NBS. Keywords: congenital hypothyroidism, newborn screening, thyroid stimulating hormone, Down syndrome, IQ, mutations

  20. Profiles in congenital heart disease

    International Nuclear Information System (INIS)

    Pediatric cardiology has made great strides in the diagnosis, management, and correction of complex congenital malformations in the past two decades. The foundation of these advances is a more precise understanding of the physiology and anatomy of complex lesions that has been obtained from cardiac catheterization and angiography. The techniques for catheterization of infants and children have been discussed in another paper. This chapter focuses on brief profiles of some of the more important congenital abnormalities. The incidence cited in the discussion of each abnormality pertains to a population comprises of children and adults referred to The Children's Hospital Medical Center and Peter Bent Brigham Hospital, respectively, for evaluation of congenital heart disease

  1. Outcomes of dual modular cementless femoral stems in revision hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Ali Ghoz

    2014-03-01

    Full Text Available With an increasing number of primary hip replacements being performed every year, the burden of revision hip arthroplasty, for septic and aseptic loosening, recurrent dislocation or periprosthetic fracture, is also increasing. In recent years, different approaches to revising the femoral prosthesis have emerged; including both cemented and cementless techniques. With a stable cement mantle and good bone quality, or through the use of impaction bone grafting when bone stock is lacking, it is possible to re-cement a femoral prosthesis. Alternatively, a cementless modular femoral prosthesis may be used, providing the surgeon with further options for restoring leg length, hip offset, anteversion and stability. Studies evaluating the use of modular cementless prostheses have so far been limited to mid-term studies, with results comparable to primary hip arthroplasty. There are some concerns, however, regarding tribological complications such as stem fracture, corrosion, and failure, and long-term studies are required to further evaluate these concerns. This review outlines the current evidence for the use of both cemented and cementless modular femoral prostheses in the setting of revision hip arthroplasty. Results of prospective and retrospective studies will be outlined, along with results obtained from national joint registries.

  2. Treatment for developmental dysplasia of the hip using the Pavlik harness: long-term results.

    Science.gov (United States)

    Nakamura, J; Kamegaya, M; Saisu, T; Someya, M; Koizumi, W; Moriya, H

    2007-02-01

    We reviewed the medical records of 115 patients with 130 hips with developmental dysplasia with complete dislocation in the absence of a neuromuscular disorder, spontaneous reduction with a Pavlik harness, and a minimum of 14 years' follow-up. The mean age at the time of harness application was 4.8 months (1 to 12) and the mean time spent in the harness was 6.1 months (3 to 12). A total of 108 hips (83.1%) were treated with the harness alone and supplementary surgery for residual acetabular dysplasia, as defined by an acetabular index > 30 degrees , was performed in 22 hips (16.9%). An overall satisfactory outcome (Severin grade I or II) was achieved in 119 hips (91.5%) at a mean follow-up of 16 years (14 to 32) with a follow-up rate of 75%. Avascular necrosis of the femoral head was noted in 16 hips (12.3%), seven of which (44%) underwent supplementary surgery and nine (56%) of which were classified as satisfactory. The acetabular index was the most reliable predictor of residual acetabular dysplasia. PMID:17322441

  3. Revision Total Hip Replacement: A Case Report

    OpenAIRE

    Md Hafizur Rahman; Md Mohoshin Sarker; Md. Abdul Matin

    2013-01-01

    Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging oc...

  4. Congenital parameatal urethral cyst

    Directory of Open Access Journals (Sweden)

    U?ur Öztürk

    2012-03-01

    Full Text Available A parameatal urethral cyst, which is a very rare congenital anomaly, was first reported in two male cases in 1956 by Thompson and Lantin. We report the case of a 20-year-old male having a spherical, cystic swelling, 7 mm in size at the external urethral meatus. The diagnosis was made by physical examination and ultrasonography. The cyst was completely excised under general anesthesia. Histologically, the cyst wall was lined by a columnar pseudo-stratified and squamous epithelium. Good cosmetic results without recurrence were achieved during the 6-month postoperative period. A parameatal cyst should be treated with complete surgical excision. Puncture of the cyst with a needle or surgical incision may result in recurrence.

  5. Characterizing congenital amusia

    DEFF Research Database (Denmark)

    Stewart, Lauren

    2011-01-01

    The ability to make sense of the music in our environment involves sophisticated cognitive mechanisms that, for most people, are acquired effortlessly and in early life. A special population of individuals, with a disorder termed congenital amusia, report lifelong difficulties in this regard. Exploring the nature of this developmental disorder provides a window onto the cognitive architecture of typical musical processing, as well as allowing a study of the relationship between processing of music and other domains, such as language. The present article considers findings concerning pitch discrimination, pitch memory, contour processing, experiential aspects of music listening in amusia, and emerging evidence concerning the neurobiology of the disorder. A simplified model of melodic processing is outlined, and possible loci of the cognitive deficit are discussed.

  6. Congenital pseudoarthrosis of clavicula.

    Science.gov (United States)

    Korkmaz, Ahmet; Aydo?du, Ay?e Yavuz

    2014-09-01

    Right clavicula fracture was found in a male patient who was brought to our outpatient clinic at the age of 7 days with a complaint of swelling on the right clavicula. The patient had no history of difficult delivery or resuscitation. He was born at term by spontaneous vaginal delivery with a birth weight of 3 340 g from the first pregnancy of his mother and there was no consanguinity between the parents. Orthopaedic examination repeated at the age of 2 months revealed pathological movement in the middle of the clavicula and a swelling with a diameter of 1 cm. There was no tenderness. Asymmetry was noted between the shoulders, but range of motion was normal in both shoulders. On radiographic examination, it was observed that the proximal and distal fragment in the middle region of the clavicula were displaced by 1 cm and there was no callus. It was noted that the medial end of the distal fragment was blunt and sclerotic. There was no other pathology related with the musculosketal system. Examination of the other systems was found to be normal. Thus, a diagnosis of congenital clavicula pseudoarthrosis was made. This condition is rare and there are less than 200 cases in the literature. Congenital clavicula pseudoarthrosis almost always develops on the right side. Pseudoarthrosis was also on the right side in our patient. It is rarely bilateral (10%). It rarely occurs on the left clavicula and is usually associated with dextrocardia. Familial association is present in very few of the reported cases, but there is no genetic background. It is rarely diagnosed in the neonatal period. The diagnosis was made in the neonatal period in our patient. Shoulder functions are not affected, but painful deformity, cosmetic problems or thoracic outlet syndrome may be observed in the adolescence and afterwards. PMID:26078674

  7. Traumatic injuries of the hip.

    LENUS (Irish Health Repository)

    Marshall, Nina

    2009-11-01

    Traumatic lesions of the hip in athletes may be clinically challenging because of the overlap in clinical presentation due to differing pathologies and the presence of multiple injuries. Imaging of the hip in the athlete has undergone a recent resurgence of interest and understanding related to the increasing accessibility and use of hip arthroscopy, which expands the treatment options available for intra-articular pathology. MR imaging and MR arthrography have a unique role in diagnosis of these pathologies, guiding the surgeon, arthroscopist, and referring clinician in their management of bony and soft tissue injury.

  8. Downturn in hip fracture incidence.

    OpenAIRE

    MELTON, L. J.; Atkinson, E.J.; Madhok, R.

    1996-01-01

    Although there was evidence of a decline in hip fracture incidence in the northern United States between 1984 and 1987, most historical data in the United States and Northern Europe indicate that the age-adjusted incidence is rising. Analysis of data from Rochester, MN, from 1928 to 1992 demonstrates that age-adjusted hip fracture incidence rates rose in women from 1928 to 1950, and in men from 1928 to 1980, with falling rates thereafter. These trends were accounted for by initial hip fractur...

  9. Observation of giant diffusivity along dislocation cores.

    Science.gov (United States)

    Legros, Marc; Dehm, Gerhard; Arzt, Eduard; Balk, T John

    2008-03-21

    Diffusion of atoms in a crystalline lattice is a thermally activated process that can be strongly accelerated by defects such as grain boundaries or dislocations. When carried by dislocations, this elemental mechanism is known as "pipe diffusion." Pipe diffusion has been used to explain abnormal diffusion, Cottrell atmospheres, and dislocation-precipitate interactions during creep, although this rests more on conjecture than on direct demonstration. The motion of dislocations between silicon nanoprecipitates in an aluminum thin film was recently observed and controlled via in situ transmission electron microscopy. We observed the pipe diffusion phenomenon and measured the diffusivity along a single dislocation line. It is found that dislocations accelerate the diffusion of impurities by almost three orders of magnitude as compared with bulk diffusion. PMID:18356520

  10. MOBILITY OF DISLOCATIONS IN GRAIN BOUNDARIES

    OpenAIRE

    Grabski, M.

    1988-01-01

    The mobility of grain boundary (GB) dislocations is discussed in terms of the dissociation of lattice dislocations into extrinsic GB dislocations and subsequent spreading of the dissociation products along the boundary plane. The kinetics of spreading is analysed and compared with the experimental evidence. It is shown that the motion of EGBDs is controlled by the GB diffusion and is a definite, characteristic property of an individual interface. The new experimental results related to the de...

  11. Diffusion-controlled phase growth on dislocations

    OpenAIRE

    Massih, Ali R

    2009-01-01

    Abstract We treat the problem of diffusion of solute atoms around screw dislocations. In particular, we express and solve the diffusion equation in 2-dimensions with radial symmetry in an elastic field of a screw dislocation subject to conservation of flux at the interface of a new phase. We consider an incoherent second-phase precipitate growing under the action of the stress field of a screw dislocation. The second-phase growth rate as a function of the supersaturation and a...

  12. Atomistic simulations of dislocation processes in copper

    DEFF Research Database (Denmark)

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

    We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example, the stability of screw dislocation dipoles is discussed. We show that the presence of jogs will strongly influence cross slip barriers and dipole stability. We furthermore present some new results on jogged edg...

  13. Dislocation mechanism of interface point defect migration

    OpenAIRE

    Kolluri, Kedarnath; Demkowicz, Michael J.

    2010-01-01

    Vacancies and interstitials absorbed at Cu-Nb interfaces are shown to migrate by a multistage process involving the thermally-activated formation, motion, and annihilation of kinks and jogs on interface misfit dislocations. This mechanism, including the energy along the entire migration path, can be described quantitatively within dislocation theory, suggesting that analysis of misfit dislocation networks may enable prediction of point defect behaviors at semicoherent heterointerfaces.

  14. Análise da expressão do colágeno VI na distrofia muscular congênita / Analysis of the expression of collagen VI in congenital muscular dystrophy

    Scientific Electronic Library Online (English)

    Regina Toni Loureiro de, Freitas; Edmar, Zanoteli; Maria da Penha Ananias, Morita; Acary Souza Bulle, Oliveira.

    2005-06-01

    Full Text Available A distrofia muscular congênita (DMC) compõe um grupo de miopatias caracterizadas por hipotonia e fraqueza muscular notadas já no primeiro ano de vida. A forma de Ullrich é caracterizada por retrações musculares proximais e hiperextensibilidade distal. Cerca de 40% destes pacientes apresentam mutaçõe [...] s em um dos genes que codificam as três sub-unidades do colágeno VI (COL6), acarretando deficiência total ou parcial na marcação da proteína. Analisamos, através de imunofluorescência, a marcação do COL6 em fragmentos musculares de 50 pacientes com DMC, 20 deles com ausência da marcação para merosina. Identificamos 4 casos com deficiência total da marcação do COL6 (8% do total), representando 13% dos casos com marcação normal para merosina. As alterações histológicas musculares dos pacientes com COL6 deficiente eram indistinguíveis das outras formas de DMC, porém mais brandas que as observadas na DMC com deficiência de merosina. Em três dos pacientes com COL6 deficiente observou-se hipotonia e fraqueza muscular, notadas já no período neonatal, atraso do desenvolvimento motor, retrações musculares em joelhos e cotovelos, hiperextensibilidade distal e luxação congênita do quadril (dois pacientes). Um paciente perdeu a capacidade para a marcha, e outro faleceu por problemas respiratórios. A análise da marcação do COL6, assim como da merosina, no tecido muscular de pacientes com DMC pode auxiliar na identificação e caracterização fenotípica dos diversos subtipos de DMC. Abstract in english Congenital muscular dystrophy (CMD) composes a group of disorders characterized by hypotonia and muscular weakness noticed in the first year of life. The Ullrich's form is characterized by proximal joint contractures and distal hiperextensibility. About 40% of these patients present mutations in one [...] of the genes that codify the sub-units of the collagen VI protein (COL6), producing total or partial deficiency of the protein expression. We analyzed, through immunohistochemistry, the expression of COL6 in muscle fragments of 50 patients with CMD; 20 of them presented merosin expression deficiency. We identified 4 cases with total COL6 deficiency (8% of the total), representing 13% of the cases with normal merosin expression. The histological findings of patients with deficiency of COL6 were indistinguishable from other forms of CMD, but milder than that abnormalities observed in merosin deficient patients. In three COL6 deficient patients were observed hypotonia and weakness in the neonatal period, delayed of motor milestones, muscular retractions of knees and elbows, distal joint hiperextensibility and congenital hip dislocation (two patients). One patient lost the ability to walk; and one died due to respiratory problems. The analysis of COL6 expression, as well as merosin expression, in the muscle tissue from CMD patients, can be important for identification and phenotypic characterization of different CMD subtypes.

  15. Análise da expressão do colágeno VI na distrofia muscular congênita Analysis of the expression of collagen VI in congenital muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Regina Toni Loureiro de Freitas

    2005-06-01

    Full Text Available A distrofia muscular congênita (DMC compõe um grupo de miopatias caracterizadas por hipotonia e fraqueza muscular notadas já no primeiro ano de vida. A forma de Ullrich é caracterizada por retrações musculares proximais e hiperextensibilidade distal. Cerca de 40% destes pacientes apresentam mutações em um dos genes que codificam as três sub-unidades do colágeno VI (COL6, acarretando deficiência total ou parcial na marcação da proteína. Analisamos, através de imunofluorescência, a marcação do COL6 em fragmentos musculares de 50 pacientes com DMC, 20 deles com ausência da marcação para merosina. Identificamos 4 casos com deficiência total da marcação do COL6 (8% do total, representando 13% dos casos com marcação normal para merosina. As alterações histológicas musculares dos pacientes com COL6 deficiente eram indistinguíveis das outras formas de DMC, porém mais brandas que as observadas na DMC com deficiência de merosina. Em três dos pacientes com COL6 deficiente observou-se hipotonia e fraqueza muscular, notadas já no período neonatal, atraso do desenvolvimento motor, retrações musculares em joelhos e cotovelos, hiperextensibilidade distal e luxação congênita do quadril (dois pacientes. Um paciente perdeu a capacidade para a marcha, e outro faleceu por problemas respiratórios. A análise da marcação do COL6, assim como da merosina, no tecido muscular de pacientes com DMC pode auxiliar na identificação e caracterização fenotípica dos diversos subtipos de DMC.Congenital muscular dystrophy (CMD composes a group of disorders characterized by hypotonia and muscular weakness noticed in the first year of life. The Ullrich's form is characterized by proximal joint contractures and distal hiperextensibility. About 40% of these patients present mutations in one of the genes that codify the sub-units of the collagen VI protein (COL6, producing total or partial deficiency of the protein expression. We analyzed, through immunohistochemistry, the expression of COL6 in muscle fragments of 50 patients with CMD; 20 of them presented merosin expression deficiency. We identified 4 cases with total COL6 deficiency (8% of the total, representing 13% of the cases with normal merosin expression. The histological findings of patients with deficiency of COL6 were indistinguishable from other forms of CMD, but milder than that abnormalities observed in merosin deficient patients. In three COL6 deficient patients were observed hypotonia and weakness in the neonatal period, delayed of motor milestones, muscular retractions of knees and elbows, distal joint hiperextensibility and congenital hip dislocation (two patients. One patient lost the ability to walk; and one died due to respiratory problems. The analysis of COL6 expression, as well as merosin expression, in the muscle tissue from CMD patients, can be important for identification and phenotypic characterization of different CMD subtypes.

  16. Congenital contractural arachnodactyly with neurogenic muscular atrophy: case report Aracnodactilia contratural congênita com atrofia muscular espinhal: relato de caso

    OpenAIRE

    Rosana Herminia Scola; Lineu Cesar Werneck; Fabio Massaiti Iwamoto; Letícia Cristine Ribas; Salmo Raskin; Ylmar Correa Neto

    2001-01-01

    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 s...

  17. Congenital Self-Healing Reticulohistiocytosis

    OpenAIRE

    Lee, Young H; Talekar, Mala K.; Chung, Catherine G.; Bell, Moshe D.; Zaenglein, Andrea L

    2014-01-01

    Congenital self-healing reticulohistiocytosis, also known as congenital self-healing Langerhans cell histiocytosis or Hashimoto-Pritzker disease, is a Langerhans cell histiocytosis. It is characterized by skin lesions in the newborn period in an otherwise healthy infant that show a Langerhans cell infiltrate in the skin on histological analysis. These findings subsequently spontaneously involute. This report describes two newborns who presented at birth with differing presentations of congeni...

  18. Enabling Strain Hardening Simulations with Dislocation Dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Arsenlis, A; Cai, W

    2006-12-20

    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.

  19. Elasticity and dislocation anelasticity of crystals

    Science.gov (United States)

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

    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.

  20. Combined radiotherapy and indomethacin for the prevention of heterotopic ossification after total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Pakos, Emilios E.; Stafilas, Kosmas S.; Politis, Aggelos N.; Mitsionis, Gregory; Xenakis, Theodore A. [Dept. of Orthopedic Surgery, Univ. Hospital of Ioannina (Greece); Tsekeris, Pericles G. [Dept. of Radiation Therapy, Univ. Hospital of Ioannina (Greece)

    2009-08-15

    Background and Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. The aim of this study was to evaluate the efficacy of combined radiotherapy and indomethacin as compared to indomethacin alone for the prevention of HO after hip arthroplasty. Patients and Methods: 96 patients were prospectively enrolled to receive either a single dose of postoperative radiotherapy of 7.0 Gy and indomethacin for the first 15 postoperative days or indomethacin alone for the same period. A historical group of 50 patients that received indomethacin alone served as control. Primary endpoint was the radiographic evidence of HO at 6 months. Secondary endpoints were the evaluation of factors related to HO development, side effects from each treatment, and group differences in the clinical assessment with the Merle d'Aubigne Score. Results: Four patients in the combined-therapy group developed HO compared to 13 patients in the indomethacin group (p < 0.05) and 13 patients in the historical group (p < 0.05). One patient each in the combined group and the historical group developed Brooker III HO (nonsignificant difference). Duration of surgery and congenital hip disease were associated with HO development in the indomethacin groups, while age and congenital hip disease showed such an association in the combined-therapy group. The side effects and mean Merle d'Aubigne Score did not differ significantly between the three groups. Conclusion: Combined radiotherapy and indomethacin was more efficacious in preventing HO after total hip arthroplasty compared to indomethacin alone and should be considered for future investigation. (orig.)

  1. Combined radiotherapy and indomethacin for the prevention of heterotopic ossification after total hip arthroplasty

    International Nuclear Information System (INIS)

    Background and Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. The aim of this study was to evaluate the efficacy of combined radiotherapy and indomethacin as compared to indomethacin alone for the prevention of HO after hip arthroplasty. Patients and Methods: 96 patients were prospectively enrolled to receive either a single dose of postoperative radiotherapy of 7.0 Gy and indomethacin for the first 15 postoperative days or indomethacin alone for the same period. A historical group of 50 patients that received indomethacin alone served as control. Primary endpoint was the radiographic evidence of HO at 6 months. Secondary endpoints were the evaluation of factors related to HO development, side effects from each treatment, and group differences in the clinical assessment with the Merle d'Aubigne Score. Results: Four patients in the combined-therapy group developed HO compared to 13 patients in the indomethacin group (p < 0.05) and 13 patients in the historical group (p < 0.05). One patient each in the combined group and the historical group developed Brooker III HO (nonsignificant difference). Duration of surgery and congenital hip disease were associated with HO development in the indomethacin groups, while age and congenital hip disease showed such an association in the combined-therapy group. The side effects and mean Merle d'Aubigne Score did not differ significantly between the three groups. Conclusion: Combined radiotherapy and indomethacin was more efficacious in preventing HO after total hip arthroplasty compared to indomethacin alone and should be considered for future investigation. (orig.)

  2. Congenital and perinatal cytomegalovirus infection

    Directory of Open Access Journals (Sweden)

    Chun Soo Kim

    2010-01-01

    Full Text Available Cytomegalovirus (CMV is currently the most common agent of congenital infection and the leading infectious cause of brain damage and hearing loss in children. Symptomatic congenital CMV infections usually result from maternal primary infection during early pregnancy. One half of symptomatic infants have cytomegalic inclusion disease (CID, which is characterized by involvement of multiple organs, in particular, the reticuloendothelial and central nervous system (CNS. Moreover, such involvement may or may not include ocular and auditory damage. Approximately 90% of infants with congenital infection are asymptomatic at birth. Preterm infants with perinatal CMV infection can have symptomatic diseases such as pneumonia, hepatitis, and thrombocytopenia. Microcephaly and abnormal neuroradiologic imaging are associated with a poor prognosis. Hearing loss may occur in both symptomatic and asymptomatic infants with congenital infection and may progress through childhood. Congenital infection is defined by the isolation of CMV from infants within the first 3 weeks of life. Ganciclovir therapy can be considered for infants with symptomatic congenital CMV infection involving the CNS. Pregnant women of seronegative state should be counseled on the importance of good hand washing and other control measures to prevent CMV infection. Heat treatment of infected breast milk at 72?#608;for 5 seconds can eliminate CMV completely.

  3. Hip complications following chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, P.J.; Sebag Montefiore, D.J.; Arnott, S.J. [Saint Bartholomew`s Hospital, London (United Kingdom)

    1995-12-01

    Chemoradiotherapy protocols are a recent development in the management of tumours where preservation of organ function is important. It is now recognized that such combined treatment may produce adverse effects below the accepted dose thresholds for either modality. This enhancement of toxicity is generally thought to reflect depletion of stem cells within the tissue concerned. We report four patients who have developed avascular necrosis or fractures of the hip following chemoradiotherapy for carcinoma of the vulva or anus. These complications developed after a radiation dose of 4500 cGy in 20 fractions. The possible role of cytotoxic agents in sensitizing bone to radiation damage is discussed, and a novel mechanism is proposed to account for this phenomenon. (author).

  4. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... CARLOS J. LAVERNIA, MD, FAAOS: Biocompatibility is the ability of an artificial material to live inside the ... doing research on computer-assisted orthopedic surgery in general, not just in hips and knees but we' ...

  5. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... this particular patient is pretty destroyed. There's no space between the ball and the socket, and as ... now you watch me move that hip in space, okay? I'm moving the leg around with ...

  6. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... to the United States, so we speak many languages down here. As you can see in the ... needs a hip replacement because he has a disease called osteoarthritis, which is essentially a destruction of ...

  7. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... Because most likely you have seen on the internet or heard advertised ceramic hips. Well, in my ... those that are watching have seen in the internet. It's a whole issue of surface replacement and ...

  8. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... total hip arthroplasty surgery. This is a very special program. Not only are we broadcasting this in ... that you seek an orthopedic surgeon that has special expertise in implant surgery. Most orthopedic surgeons are ...

  9. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... and he's going to wake up with a brand-new hip. Go up. 00:38:44 PIETER ... this local stuff, and then the preemptive pain management that makes this truly small incision faster type ...

  10. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... HOMMEN, MD: Another question. How long is the rehabilitation after a hip replacement surgery? 00:25:10 ... spectrum. With the newer pain-management modalities, the rehabilitation is much faster. This is a real implant ...

  11. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... the patient on a regular OR table supine. My name is Dr. Roger Emerson from Plano, Texas, ... 2005, and currently use it for most of my primary and even some revision hip procedures. I ...

  12. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... outcomes, primarily because of recent advances in surgical instrumentation and techniques. In addition to the live hip ... taking right now, and because we have better instruments and we have much more experience doing these ...

  13. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... MD, FAAOS: It's a lot less than a knee replacement procedure, but overall, I tell the patients ... with this material in the hip and the knee joints. Now I'm going to impact it ...

  14. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... arthroscopic technique. That includes the knee or the shoulder. But we're getting there. I think smaller ... years, who knows, we may be putting in shoulder, hip, and knee replacements through a tiny poke- ...

  15. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... the benefits of the Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement ... to your questions that you send in by e-mail. The email button is at the bottom ...

  16. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... of the bone, and Dr. Hommen has a sample of the hip device that I utilize, and ... actually this component right here. I have a sample in my hands. This is a -- the acetabular ...

  17. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... or ball. And normally, it has a very nice, smooth surface on top that's called cartilage, and ... hip arthritis, the femoral head has a very nice shine to it. It's very nice and round, ...

  18. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... that labrum to get torn can be from something called hip impingement. If there's a bump or ... mild as just an occasional groin feeling that something's not quite right all the way up to ...

  19. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... guidance if desired. And it’s easy to assess leg lengths and check the offset of the hip. ... dysplastic joint; otherwise having excellent and relatively normal anatomy. Any question or comments, Roger? Yeah. I like ...

  20. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... a disease called osteoarthritis, which is essentially a destruction of the hip joint. Because the patient cannot ... grow into the metal shell. This kind of technology has been around for a little bit. 00: ...

  1. Abstract: Lightweight Authentication for HIP

    Science.gov (United States)

    Heer, Tobias

    In recent years numerous solutions for overcoming the architectural constraints of the Internet have emerged. One of the most promising among them is the Host Identity Protocol (HIP) [2], which was recently approved as an experimental standard by the IETF. HIP adds an additional protocol layer between TCP and IP to implement the Identifier/Locator split. Apart from mobility and multihoming, HIP supports host authentication, payload encryption, and a cryptographic namespace without requiring changes to the network infrastructure or network applications. However, especially mobile devices with tightly limited CPU resources are slowed down by HIP. Its poor performance on these mobile devices is a result of the extensive use of public-key (PK) cryptography for securing the main protocol functions.

  2. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... of the hip and we’ll use the bipolar tissue sealing device. I know, Roger, you have ... Hurley that wants to know who makes the bipolar device. Okay. So we’re getting pretty close ...

  3. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... and currently use it for most of my primary and even some revision hip procedures. I would ... I think it’s important that you have some type of a mentorship program. Oh, absolutely. This is ...

  4. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the anterior supine ... renewed interest at this time due to several advantages that it brings. The approach that is performed ...

  5. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... surgery. This is a very special program. Not only are we broadcasting this in English tonight, but ... started, he was using pretty much all cement, only cement on both sides of the hip, on ...

  6. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... And now we already planned the surgery utilizing computers. We'll show you that in a second. ... your experience with hip replacement surgery using a computer or a robot or something of that sort. ...

  7. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... into the hip here. This is a titanium aluminum alloy type stem that is going to go ... shell is made out of an alloy, titanium aluminum vanadium. It's one of the super-alloys, and ...

  8. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... of the hip, you can actually cause a fracture. And that's a disaster when you break the ... we don't know. The chances of a fracture, okay, with surface replacement are around 5-6%. ...

  9. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... is a hip that is not going to benefit from any kind of an arthroscopic technique or ... bed the day of surgery already feeling the benefit, so in a nutshell, it's variable, but I ...

  10. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... may become destroyed as the femur and pelvis bones pinch together. Otherwise known as hip impingement, this ... that's a ball-and-socket. The big long bone is called the femur bone, or thigh bone. ...

  11. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... of ice on ice. Through either an injury mechanism, an infection, or disease process, the lubrication characteristics ... on that view, we could maybe see the approach to that hip a little bit. What Dr. ...

  12. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... an anterior approach total hip replacement with the patient on a regular OR table supine. My name ... less invasive without being small incision surgery. Obese patients can be easier due to less distribution of ...

  13. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... hook and go proximal to the sling and sleep it around. It’s outside of the lateralus, around the hip, proximal to the gluteus, perfectly safe zone to go around. Okay. Yeah. And you ...

  14. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... the hip, proximal to the gluteus, perfectly safe zone to go around. Okay. Yeah. And you walked ... with extra stockinettes because it’s below the play zone now. And then when we come back up ...

  15. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... ve done studies in animals and in some humans in which they've implanted these porous, coated ... Yeah, no, the patient's awake. And now you watch me move that hip in space, okay? I' ...

  16. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... quite sick from a number of diseases, including sports injuries. And I'm going to now have ... 28 PIETER J. HOMMEN, MD: There's a -- the sports injuries, hip injuries, are fairly common depending on ...

  17. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... be. Yeah. There’s no bleeding you can’t control in this part of the hip. But occasionally ... on. My experience, these patients have full leg control in about 24 hours. Yeah. They can get ...

  18. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... don’t have a lot of subcutaneous adipose tissue in this layer in the front of their ... the hip and we’ll use the bipolar tissue sealing device. I know, Roger, you have used ...

  19. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... have better instruments and we have much more experience doing these smaller incision operations, we have to ... get rejected. We have over 40 years of experience with this material in the hip and the ...

  20. 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 ... can get quite sick from a number of diseases, including sports injuries. And I'm going to ...

  1. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... needle. This patient, we avoid general anesthetic in these procedures, and what you see me holding in ... we saw just a minute ago and arthroscopic. These are two portals being placed into the hip. ...

  2. Developmental dysplasia of the hip

    OpenAIRE

    Haq Nawaz; Kamran Hafeez; Masood Umer; Shahryar Noordin

    2010-01-01

    Developmental dysplasia of the hip (DDH) is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the ...

  3. Ultrasound-Assisted Hip Arthroscopy

    OpenAIRE

    Weinrauch, Patrick; Kermeci, Sharon

    2014-01-01

    We describe the use of intraoperative ultrasound for the safe development of arthroscopic portals during hip arthroscopy without the requirement for fluoroscopy. We find this technique consistently accurate, allowing the safe introduction of arthroscopic instruments into the hip with a very low rate of iatrogenic injury. We have further developed the technique for application to both central- and peripheral-compartment procedures. We now have a total experience of more than 700 procedures to ...

  4. Hip: Anatomy and US technique

    OpenAIRE

    Molini, L.; Precerutti, M.; Gervasio, A.; Draghi, F.; Bianchi, S., de

    2011-01-01

    Ultrasound (US) has always had a relatively limited role in the evaluation of the hip due to the deep location of this joint. However, many hip diseases are well detectable at US, but before approaching such a study it is necessary to be thoroughly familiar with the normal anatomy and related US images. The study technique is particularly important as optimization of various parameters is required, such as probe frequency, focalization, positioning of the probe, etc. Also the patient’s positi...

  5. Excess mortality following hip fracture

    DEFF Research Database (Denmark)

    Abrahamsen, B; van Staa, T; Ariely, R; Olson, M; Cooper, C

    2009-01-01

    Summary This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter, highlighting the need for interventions to reduce this risk.Patients experiencing hip fracture after low-impact trauma are at considerable risk for subsequent osteoporotic fractures and premature death. We cond...

  6. Complications after total hip replacement. Komplikationen nach Hueftgelenksendoprothesen

    Energy Technology Data Exchange (ETDEWEB)

    Engelbrecht, E.; Siegel, A. (Endo-Klinik, Hamburg (Germany, F.R.))

    1989-10-01

    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.).

  7. Total hip replacement for proximal femoral tumours: our midterm results.

    Science.gov (United States)

    Sokolovski, V A; Voloshin, V P; Aliev, M D; Zubikov, V S; Saravanan, S A; Martynenko, D V; Nisichenko, D V; Strelnikov, K N

    2006-10-01

    Data from 44 patients (23 males, 21 females) with a median age of 39 (range 13-80) years who underwent total hip arthroplasty for proximal femoral tumours (1994-2004) were analysed. The histological diagnoses included 14 metastases, six osteosarcomas, six chondrosarcomas, four Ewing's sarcomas, four giant cell tumours, three malignant fibrous histiocytomas, two parosteal and two periosteal osteosarcomas, and one each primary neuroectodermal tumour, myeloid disease, and aneurysmal bone cyst. Twenty-one patients (48%) had pathological fractures. The cause of the pathological fracture was metastasis in 12 patients (57%). Twenty-eight patients (64%) had soft tissue invasion. Complications observed in 17 patients (37%) were local recurrence in two, postoperative haematoma in two, dislocation of prosthesis in five, deep infection in six, and one patient died of myocardial infarction in the early postoperative period. During our midterm survival analysis, functional results were excellent in 25% of patients, good in 57%, fair in 12%, and poor in 6%. PMID:16821012

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  9. [Congenital myasthenic syndromes].

    Science.gov (United States)

    Ohno, Kinji

    2012-01-01

    Congenital myasthenic syndromes (CMS) are caused by germline mutations of molecules expressed at the neuromuscular junction (NMJ). Mutations in 11 molecules encoded by 15 genes have been reported in association with CMS. CMS can be classified into four clinical categories. First, missense mutations in the acetylcholine receptor (AChR) subunits lead to slow- and fast-channel syndromes. Second, mutations in the AChR subunits, rapsyn, agrin, MuSK, Dok-7, plectirn, and GFPT1 lead to endplate AChR deficiency. Third, collagen Q (ColQ) anchors acetylcholinesterase (AChE) to the synaptic basal lamina and mutations in COLQ lead to endplate AChE deficiency. By exploiting the synaptic basal lamina-targeting signal of ColQ, we recently reported that the exogenously administered AChE/ColQ complex can be specifically localized to the NMJ. The protein-anchoring therapy can be potentially applicable to a wide spectrum of defective extracellular matrix molecules. Fourth, CMS associated with episodic apnea is caused by mutations in choline acetyltransferase (ChAT) and skeletal muscle voltage-gated sodium channel (Na(V)1.4). In the past two years, we diagnosed 15 cases with CMS in Japan, and identified mutations in 12 patients. All the mutations except for one are unique to Japanese patients. We assume that more CMS cases still remain undiagnosed in Japan. PMID:23196549

  10. Primary congenital glaucoma.

    Science.gov (United States)

    Ko, Fang; Papadopoulos, Maria; Khaw, Peng T

    2015-01-01

    Primary congenital glaucoma (PCG) is the most common nonsyndromic glaucoma in infancy, which can lead to blindness, or a lifetime of vision when diagnosed and treated properly. PCG is more common in populations with a higher prevalence of consanguinity and is associated with CYP1B1 gene mutations which show variable expressivity and phenotypes. The immature angle appearance of PCG likely results from arrested development of tissues of neural crest origin in the third trimester, with the severity of abnormality varying according to the stage at which arrested development occurred. Classic symptoms at presentation include tearing, photophobia, blepharospasm, eye rubbing, and irritability. Examination may reveal elevated intraocular pressure, corneal edema, increased corneal diameter, Haab striae, or enlarged axial length. Angle surgery remains the first line treatment for PCG with a recent advance being circumferential trabeculotomy with the potential to incise the whole angle during one operation as oppose to an incremental approach and the associated multiple anesthetics. Once angle surgery fails, either trabeculectomy or glaucoma drainage device surgery may be appropriate. PMID:26518078

  11. Congenital hypothyroidism in neonates

    Directory of Open Access Journals (Sweden)

    Aneela Anjum

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011. Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8% newborns had elevated TSH level. CH had statistically significant association with mother?s hypothyroidism (P value 0.000 and mother?s drug intake during the pregnancy period (P value 0.013. Conclusion: CH is 0.8% in neonates. It has statistically significant association with mother?s hypothyroidism and mother?s drug intake during pregnancy.

  12. Congenital Short QT Syndrome

    Directory of Open Access Journals (Sweden)

    Charles Antzelevitch

    2004-04-01

    Full Text Available Long QT intervals in the ECG have long been associated with sudden cardiac death. The congenital long QT syndrome was first described in individuals with structurally normal hearts in 1957.1 Little was known about the significance of a short QT interval. In 1993, after analyzing 6693 consecutive Holter recordings Algra et al concluded that an increased risk of sudden death was present not only in patients with long QT interval, but also in patients with short QT interval (<400 ms.2 Because this was a retrospective analysis, further evaluation of the data was not possible. It was not until 2000 that a short-QT syndrome (SQTS was proposed as a new inherited clinical syndrome by Gussak et al.3 The initial report was of two siblings and their mother all of whom displayed persistently short QT interval. The youngest was a 17 year old female presenting with several episodes of paroxysmal atrial fibrillation requiring electrical cardioversion.3 Her QT interval measured 280 msec at a heart rate of 69. Her 21 year old brother displayed a QT interval of 272 msec at a heart rate of 58, whereas the 51 year old mother showed a QT of 260 msec at a heart rate of 74. The authors also noted similar ECG findings in another unrelated 37 year old patient associated with sudden cardiac death.

  13. Congenital pulmonary lymphangiectasia

    Directory of Open Access Journals (Sweden)

    Campisi Corradino

    2006-10-01

    Full Text Available Abstract Congenital pulmonary lymphangiectasia (PL is a rare developmental disorder involving the lung, and characterized by pulmonary subpleural, interlobar, perivascular and peribronchial lymphatic dilatation. The prevalence is unknown. PL presents at birth with severe respiratory distress, tachypnea and cyanosis, with a very high mortality rate at or within a few hours of birth. Most reported cases are sporadic and the etiology is not completely understood. It has been suggested that PL lymphatic channels of the fetal lung do not undergo the normal regression process at 20 weeks of gestation. Secondary PL may be caused by a cardiac lesion. The diagnostic approach includes complete family and obstetric history, conventional radiologic studies, ultrasound and magnetic resonance studies, lymphoscintigraphy, lung functionality tests, lung biopsy, bronchoscopy, and pleural effusion examination. During the prenatal period, all causes leading to hydrops fetalis should be considered in the diagnosis of PL. Fetal ultrasound evaluation plays a key role in the antenatal diagnosis of PL. At birth, mechanical ventilation and pleural drainage are nearly always necessary to obtain a favorable outcome of respiratory distress. Home supplemental oxygen therapy and symptomatic treatment of recurrent cough and wheeze are often necessary during childhood, sometimes associated with prolonged pleural drainage. Recent advances in intensive neonatal care have changed the previously nearly fatal outcome of PL at birth. Patients affected by PL who survive infancy, present medical problems which are characteristic of chronic lung disease.

  14. Congenital hyperthyroidism: autopsy report

    Directory of Open Access Journals (Sweden)

    Lima Marcus Aurelho de

    1999-01-01

    Full Text Available We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton 's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

  15. Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures

    DEFF Research Database (Denmark)

    Bensen, Anne S; Jakobsen, Thomas

    2014-01-01

    PURPOSE: Total hip arthroplasty (THA) as primary treatment for displaced femoral neck fractures is controversial as THA is associated with higher rates of dislocation but lower rates of re-operation compared to hemiarthroplasty (HA). A dual mobility cup (DMC) design is associated with lower dislocation and re-operation rates in elective surgery. Is this also the case when used to treat displaced femoral neck fractures? The aim of this study is to compare rates of dislocation and re-operation of any kind following treatment for displaced femoral neck fractures with either bipolar HA or THA with DMC. METHODS: Two consecutive groups of patients treated for displaced femoral neck fractures at the Regional Hospital in Viborg in Denmark were included. In 2007-2008 171 patients (mean age 84.1 years) were treated with bipolar HA. In 2009-2010 175 patients (mean age 75.2 years) were treated with THA with DMC. Data regarding rates of dislocation and re-operation were obtained by retrospective review of medical records. RESULTS: We found a statistically significant difference regarding rates of dislocation and re-operation of any kind in favour of THA with DMC. Dislocation occurred in 25/171 patients [95 % confidence interval (CI) 9.3-19.9 %] treated with bipolar HA and 8/175 patients (95 % CI 1.5-7.7 %) treated with THA with DMC (p?=?0.002). Re-operations were required in 32/171 patients (95 % CI 12.9-24.6 %) treated with bipolar HA and 16/175 patients (95 % CI 4.8-13.4 %) treated with THA with DMC (p?=?0.01). CONCLUSIONS: Our findings indicate that THA with DMC is superior to bipolar HA following treatment for displaced femoral neck fractures in regard to rates of dislocation and re-operation.

  16. Analysis of some networks of interfacial dislocations

    International Nuclear Information System (INIS)

    Certain particular aspects of intergranular dislocations are investigated. It is shown that the recombination and dissociation of these dislocations are necessary to explain the intergranular structures. First, electron microscopy observations are discussed, then it is demonstrated that the boundary geometrical model leads to intergranular structures similar to those obtained from energetic models

  17. Dislocation morphology in deformed and irradiated niobium

    International Nuclear Information System (INIS)

    Niobium foils of moderate purity were examined for the morphology of dislocations or defect clusters in the deformed or neutron-irradiated state by transmission electron microscopy. New evidence has been found for the dissociation of screw dislocations into partials on the (211) slip plane according to the Crussard mechanism: (a/2) [111] ? (a/3) [111] + (a/6) [111

  18. Atomistic simulations of dislocation processes in copper

    DEFF Research Database (Denmark)

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

    We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example, the stability of screw dislocation dipoles is discussed. We show that the presence of jogs will strongly influence cross slip barriers and dipole stability. We furthermore present some new results on jogged edge dislocations and edge dislocation dipoles. The jogs are found to be extended, and simulations of vacancy controlled climb show the jogs to climb easily in their extended form. The stability of small vacancy dipoles is discussed and it is seen that the introduction of jogs may lead to the formation of Z-type faulted vacancy dipoles.

  19. Modeling of Dislocation Structures in Materials

    CERN Document Server

    Rickman, J M; Vinals, Jorge

    1996-01-01

    A phenomenological model of the evolution of an ensemble of interacting dislocations in an isotropic elastic medium is formulated. The line-defect microstructure is described in terms of a spatially coarse-grained order parameter, the dislocation density tensor. The tensor field satisfies a conservation law that derives from the conservation of Burgers vector. Dislocation motion is entirely dissipative and is assumed to be locally driven by the minimization of plastic free energy. We first outline the method and resulting equations of motion to linear order in the dislocation density tensor, obtain various stationary solutions, and give their geometric interpretation. The coupling of the dislocation density to an externally imposed stress field is also addressed, as well as the impact of the field on the stationary solutions.

  20. Influence of the Orientation of a Reacting Slipping Dislocation on the Strength of Dislocation Junctions in FCC Crystals

    Science.gov (United States)

    Kurinnaya, R. I.; Zgolich, M. V.; Starenchenko, V. A.

    2015-08-01

    A change in the dislocation configuration formed as a result of dislocation reaction under the action of stress in the slip plane is considered. The influence of the geometry of intersection of reacting dislocations, change in the orientation of reacting segments of an expanding dislocation loop, and change in the spectrum of forest dislocations on the destruction stress of dislocation junction is investigated. Theoretical values of the contact interdislocation interaction parameter are obtained and their correlation with the experimental values is estimated.

  1. Imaging of the hip

    International Nuclear Information System (INIS)

    Full text: Standard radiographs represent the basic tool of hip joint imaging. For detailed analysis of abnormalities related to bone marrow, articular cartilage, labrum and periarticular soft tissues, MRI has become the method of choice. MR arthrography is superior to standard MRI with regard to depicting the intra-articular abnormalities. CT is supporting plain radiographs for accurate depiction of subtle bone details. Ultrasound is commonly used in postoperative hematoma, bursitis, initial diagnosis of cysts and solid soft tissue tumors as well as for image guided injections and biopsies. Bone scintigraphy is suitable for the mapping of multifocal disease, such as osseous metastatic deposits. PET and PET/CT may be able to differentiate malignant neoplasm and infection from other abnormalities. A common disorder often requested for evaluation, is osteoarthritis. MRI is able to depict early degenerative changes which are occult on plain radiographs. CT- or MR arthrography provide a better evaluation of these changes but should only be performed in cases in which conservative surgery is considered to offer a significant clinical improvement for the patient. These cases include cam type femoroacetabular impingement and traumatic chondrolysis. MRI is an imaging technique that allows direct visualization of the bone marrow. Marrow disorders of the hip may induce a variety of imaging findings and frequently are not detected by conventional radiographic techniques until they have reached an advanced clinical stage. The excellent spatial and contrast resolution provided by MRI facilitates early detection and evaluation of various disorders allowing thus prompt treatment. Imaging findings may alter or guide the correct treatment. In addition, the association of marrow changes and pain such as in osteonecrosis and osteoarthritis is clinically relevant. For imaging the bone marrow, we use a combination of pulse sequences, including T1-w spin echo, PD/T2-w turbo spin echo with fat suppression and turboshort T1 inversion recovery. In selected cases, contrast enhanced T1-w spin echo with fat suppression is applied. Radiological interpretation of the marrow space requires an understanding of normal maturation and recognition that red and yellow marrow coexist with variable amounts depending upon the age and location. With MRI, this variability yields normal patterns ranging from very uniform and homogeneous signal intensity to patchy and heterogeneous signal intensity. Signal changes also depend on the pulse sequence applied. The marrow reflects the health of the patient and may herald developing anemia with marrow reconversion from inactive to active. Clinical correlation will contribute to narrow the differential diagnosis. Bone tumors may require additional imaging with CT in order to explore the pattern of matrix calcification and/or guide a diagnostic biopsy

  2. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3370 Section 888.3370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip...

  3. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  4. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3400 Section 888.3400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be implanted to replace a portion of the hip...

  5. Low revision rate after total hip arthroplasty in patients with pediatric hip diseases

    DEFF Research Database (Denmark)

    Engesæter, Lars B; Engesæter, Ingvild Ø

    2012-01-01

    The results of primary total hip arthroplasties (THAs) after pediatric hip diseases such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Perthes' disease have been reported to be inferior to the results after primary osteoarthritis of the hip (OA).

  6. Optimising the management of congenital talipes.

    Science.gov (United States)

    Huntley, James S

    2013-10-01

    Congenital talipes equinovarus (CTEV) is a condition of the lower limb in which there is fixed structural cavus, forefoot adductus, hindfoot varus and ankle equinus. In Caucasian populations the incidence is around 1.2 per 1,000 live births, with a male to female ratio of 2.25:1. The left and right feet are equally commonly affected, and 50% of cases are bilateral. It is important to differentiate CTEV from a non-structural or positional talipes which is fully correctable. This positional variant occurs about five times as commonly as CTEV. The latter condition does not require casting or surgical treatment. The majority of CTEV cases are picked up at the early baby check or on prenatal ultrasound, and referred to the paediatric orthopaedic service. However, some cases are mistaken early on as the positional variant, and may therefore present to the GP e.g. at the six week check. Urgent referral is warranted as the Ponseti treatment should be started early. The feet must be examined directly to see if the components of the deformity are fixed, defining CTEV. The hips (stability, length equivalence, range and symmetry of abduction) and spine (in particular looking for peripheral stigmata of spina bifida) must also be examined. Most cases of CTEV occur in isolation i.e. without other anomalies. However, a proportion are syndromic. In a recent study of patients with fixed CTEV, 27.7% had a syndromal cause. Over the past 25 years there has been a dramatic shift away from extensive surgical releases to manipulative methods/serial casting such as the Ponseti technique. The technique involves a series of manipulations and casts, usually on a weekly basis, in which the foot is brought round to a corrected position. The boots and bar splintage is a vital part of the Ponseti technique and relapse is strongly correlated with non-compliance. PMID:24367876

  7. Congenital Anomalies in Diamond Blackfan Anemia (DBA)

    Science.gov (United States)

    ... that the two eyes do not align normally. CONGENITAL CATARACTS Clouding of the lens of the eye. About one in five people with DBA have congenital abnormalities in the kidneys, urinary tract, and genital ...

  8. Genetics Home Reference: Congenital leptin deficiency

    Science.gov (United States)

    ... deficiency? Congenital leptin deficiency is a condition that causes severe obesity beginning in the first few months of life. ... are unknown. Congenital leptin deficiency is a rare cause of obesity. Researchers are studying the factors involved in more ...

  9. Sífilis congénita Congenital syphilis

    Directory of Open Access Journals (Sweden)

    Fernando Montoya

    1992-01-01

    Full Text Available

     

    Se discuten diversos aspectos de la sífilis congénita con énfasis en los siguientes: el hecho de que 60% de las madres que engendran niños sifil??ticos no presentan evidencia clínica de la enfermedad; la necesidad de ordenar un mínimo de dos serologías, al comienzo y al final del embarazo, ya que 15% de las embarazadas reactivas lo son sólo al final de la gestación; la disponibilidad de la cordocentesis a partir de la decimaséptima semana del embarazo, con el fin de obtener muestras de sangre para diagnóstico prenatal; la aceptación de 9.600.000 U. de penicilina benzatínica para el tratamiento de la sífilis durante el embarazo; esta dosis evita los casos de niños Infectados que se han observado con el esquema de 7.200.000 U.

     

    Several aspects of congenital syphilis are discussed with emphasis on the fact that 60% of women who give birth to syphilitic children do not have clinical evidence of the disease; the need to order at least two serological tests at the beginning and at the end of pregnancy, because 15% of pregnant women become reactive only at the end of pregnancy; the possibility of obtaining prenatal fetal blood specimens for diagnostic purposes, by cordocenthesis from the seventeenth week of pregnancy on; the acceptance of a dose of 9.600.000 units of benzathine penicillin for the treatment of syphilis during pregnancy to avoid the cases of Infected Infants observed with doses of 7.200.000 units.

  10. Cyanotic congenital heart disease

    International Nuclear Information System (INIS)

    Authors analyzed 265 cases of cyanotic congenital heart disease in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between April 1973 and August 1979. The results are as follows; 1. Among 265 cases, 178 patients were male and 87 patients were female. 240 patients were below the age of 20 and none was over 35 year. 2. The incidence of individual lesions are as follows: tetralogy of Fallot-176; double outlet right ventricle-20; pentalogy-12; trilogy-11; corrected transposition of great arteries-10; complete transposition of great arteries-8; pulmonary atresia-7; single ventricle-6; Ebstein's anomaly-5; total anomalous pulmonary venous return-4; tricuspid atresia-3; double outlet left ventricle-1; truncus arteriosus-1; hypoplastic left ventricle-1. 3. Fallot's teralogy, pentalogy and trilogy were characteristic in their simple chest and angiocardiographic manifestations, but in a few cases of tetralogy and pentalogy it was difficult to differentiate them from double outlet right ventricle or pulmonary atresia. 4. In double outlet right ventricle and transposition of great arteries which are the pathologic spectrum resulting from abnormal conal growth, differential points were ventricular and great arterial loop patterns and their connections but it was very difficult to differentiate them from each other by single injection into one ventricle alone. 5. Ebstein's anomaly and total anomalous pulmonary venous return were so characteristic in angiocardiography was done ventriculography alone. 6. In 7 cases with double outlet right ventricle and transposition of great arteries, selective biventriculography was done and more accurate diagnosis could be made, which was quite difficult with one ventriculography alone. In 31 cases, cineangiocardiography was done and it gave more accurate information about the type and degree of pulmonary stenosis and overriding of aorta, the origin of great arteries from the ventricles and the location of the interventricular septum.

  11. Review on squeaking hips

    Science.gov (United States)

    Levy, Yadin David; Munir, Selin; Donohoo, Shane; Walter, William Lindsay

    2015-01-01

    Squeaking is a well-recognized complication for hard-on-hard bearings. The nature of squeaking is not yet completely understood however it is considered a multifactorial phenomenon. Patient, implant, and surgical factors play a role in squeaking. It is believed that mechanisms damaging the fluid film lubrication in which these bearings function optimally have a critical role. Such mechanisms include edge loading, stripe wear, impingement, third body particles and ceramic fracture. The resonance of metallic parts can produce noise in the human audible range hence the implant metallurgic composition and design may play a role. Implant positioning can facilitate impingement and edge loading enhancing the occurrence of squeaking. The recent introduction of large heads (> 36 mm) 4th generation ceramic-on-ceramic bearing may accentuate the conditions facilitating noise formation; however the current literature is insufficient. Clinically, squeaking may manifest in extreme hip positions or during normal gait cycle however it is rarely associated with pain. Evaluations of patients with squeaking include clinical and radiographic assessments. Computer tomography is recommended as it can better reveal ceramic breakage and implant malposition. The treatments for most squeaking patients include reassurance and activity modification. However for some, noise can be a problem, requiring further surgical intervention. In the occurrence of ceramic fracture, implant failure, extreme components malposition, instability and impingement, surgery should be advised. This review will aim to discuss the current literature regarding squeaking. PMID:26601063

  12. Emerging topics on the hip: Ligamentum teres and hip microinstability

    Energy Technology Data Exchange (ETDEWEB)

    Cerezal, Luis, E-mail: lcerezal@gmail.com [Diagnóstico Médico Cantabria, C/Castilla 6, 39002 Santander (Spain); Arnaiz, Javier; Canga, Ana; Piedra, Tatiana [Valdecilla University Hospital, 39011 Santander (Spain); Altónaga, José R. [Leon University, 24071 Leon (Spain); Munafo, Ricardo [CETEA, Buenos Aires (Argentina); Pérez-Carro, Luis [Valdecilla University Hospital, 39011 Santander (Spain)

    2012-12-15

    Microinstability and ligament teres lesions are emergent topics on the hip pathology. These entities are an increasingly recognized cause of persistent hip pain and should be considered in the differential diagnosis of the patient with hip pain. Conventional (non-arthrographic) CT and MR have a very limited role in the evaluation of these entities. CTa and MRa have emerged as the modalities of choice for pre-operative imaging of ligamentum teres injuries and microinstability. To date, pre-operative imaging detection of these pathologies is not widespread but with appropriate imaging and a high index of suspicion, preoperative detection should improve. This article discusses current concepts regarding anatomy, biomechanics, clinical findings, diagnosis and treatment of ligament teres lesions and microinstability.

  13. Physiopathology and biomechanics of hip osteoarthritis

    OpenAIRE

    Cutolo, M; Testa, M(INFN Laboratori Nazionali di Frascati, Frascati, Italy); Sulli, A.; G. Frosi

    2011-01-01

    Several factors seem to play a relevant role in the pathogenesis of hip osteoarthritis. Among these, an altered biomechanic and neuromuscular integrity of the hip joint should be considered. This is a review of the recent international literature concerning the role of loads and strengths acting on the hip joint, in order to better understand the pathogenesis and the physiopathology of the hip osteoarthritis. The study of these factors might be important to prevent the development of the oste...

  14. Developmental dysplasia of the hip

    Directory of Open Access Journals (Sweden)

    Shahryar Noordin

    2010-10-01

    Full Text Available Developmental dysplasia of the hip (DDH is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign, asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

  15. Hip fractures. Epidemiology, risk factors, falls, energy absorption, hip protectors, and prevention

    DEFF Research Database (Denmark)

    Lauritzen, J B

    1997-01-01

    The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially with aging, but the time-trend in increasing age-specific incidence may not be a universal phenomenon. Postmenopausal women suffering earlier non-hip fractures have an increased risk of later hip fracture....

  16. Hip Hop Versus Rap: An Ethnography of the Cultural Politics of New Hip Hop Practices

    OpenAIRE

    Turner, Patrick

    2010-01-01

    Using field observations, interview narratives, and lyrical analysis, this thesis argues that the increasing presence of hip hop arts in social spheres not popularly associated with hip hop such as community activism, school-based education and theatre is traceable to an intra cultural political struggle I term ‘hip hop versus rap’. Hip hop versus rap opposes the notion of a temporally prior, authentic hip hop culture to its degeneration into commercial and ‘anti-social’ rap music. As a redem...

  17. Outcome after surgery of congenital cataract

    OpenAIRE

    Lundvall, Anna

    2002-01-01

    The visual outcome in infants undergoing surgery for bilateral congenital cataract has improved considerably because of improved surgical methods and the realisation that early detection, allowing early cataract extraction and immediate optical correction, can prevent otherwise irreversible deprivation amblyopia. The management of unilateral congenital cataract is still of the most difficult problems in paediatric ophtalmology. In unilateral congenital cataract, interven...

  18. Evolution, Interaction, and Intrinsic Properties of Dislocations in Intermetallics: Anisotropic 3D Dislocation Dynamics Approach

    Energy Technology Data Exchange (ETDEWEB)

    Qian Chen

    2008-08-18

    The generation, motion, and interaction of dislocations play key roles during the plastic deformation process of crystalline solids. 3D Dislocation Dynamics has been employed as a mesoscale simulation algorithm to investigate the collective and cooperative behavior of dislocations. Most current research on 3D Dislocation Dynamics is based on the solutions available in the framework of classical isotropic elasticity. However, due to some degree of elastic anisotropy in almost all crystalline solids, it is very necessary to extend 3D Dislocation Dynamics into anisotropic elasticity. In this study, first, the details of efficient and accurate incorporation of the fully anisotropic elasticity into 3D discrete Dislocation Dynamics by numerically evaluating the derivatives of Green's functions are described. Then the intrinsic properties of perfect dislocations, including their stability, their core properties and disassociation characteristics, in newly discovered rare earth-based intermetallics and in conventional intermetallics are investigated, within the framework of fully anisotropic elasticity supplemented with the atomistic information obtained from the ab initio calculations. Moreover, the evolution and interaction of dislocations in these intermetallics as well as the role of solute segregation are presented by utilizing fully anisotropic 3D dislocation dynamics. The results from this work clearly indicate the role and the importance of elastic anisotropy on the evolution of dislocation microstructures, the overall ductility and the hardening behavior in these systems.

  19. Hip-Hop and the Academic Canon

    Science.gov (United States)

    Abe, Daudi

    2009-01-01

    Over the last 30 years, the hip-hop movement has risen from the margins to become the preeminent force in US popular culture. In more recent times academics have begun to harness the power of hip-hop culture and use it as a means of infusing transformative knowledge into the mainstream academic discourse. On many college campuses, hip-hop's…

  20. MRI of congenital urethroperineal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Ghadimi-Mahani, Maryam; Dillman, Jonathan R.; Pai, Deepa; DiPietro, Michael [C. S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, University of Michigan Health System, Ann Arbor, MI (United States); Park, John [C. S. Mott Children' s Hospital, Department of Pediatric Urology, University of Michigan Health System, Ann Arbor, MI (United States)

    2010-12-15

    We present the MRI features of a congenital urethroperineal fistula diagnosed in a 12-year-old boy being evaluated after a single urinary tract infection. This diagnosis was initially suggested by voiding cystourethrogram and confirmed by MRI. Imaging revealed an abnormal fluid-filled tract arising from the posterior urethra and tracking to the perineal skin surface that increased in size during micturition. Surgical resection and histopathological evaluation of the abnormal tract confirmed the diagnosis of congenital urethroperineal fistula. MRI played important roles in confirming the diagnosis and assisting surgical planning. (orig.)