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Sample records for hip dislocation congenital

  1. [Congenital anterior dislocation of the hip].

    Science.gov (United States)

    Ligier, J N; Prévot, J; Lascombes, P

    1985-01-01

    An apparently congenital antero-superior hip dislocation is identified during surgery. With reference to this case, three possible clinical courses for congenital hip dislocations are outlined: As a rule full recovery is most frequent. However, a posterior dislocation which is persistent tends to become postero-superior upon weight-bearing. Anterior dislocations as well as antero-superior subluxation appear to be rather common. Both pathology and the CAT scan attest to this fact. Extension, which is a true dislocating position for a retracted hip in adduction anc rotated externally, is probably responsible for such an evolution. Anterior dislocation and especially antero-superior subluxation are frequent findings which can be explained anatomically. The eventual complications of the antero-superior wall of the acetabulum resulting from these, will be the objective of most of the usual treatments for residual hip dysplasia. PMID:4064236

  2. Computerised tomography in non-treated congenital hip dislocation.

    Science.gov (United States)

    Ligier, J N; Prévot, J; Lascombes, P

    1988-06-01

    Computerised tomography, carried out in 5 non-treated cases of congenital dislocation of the hip, shows that the femoral head can move in a large anteroposterior cavity. When the hip is extended the common position of dislocation is lateral superior and slightly anterior to the acetabulum. When the hip is flexed (at a right angle), the femoral head is located posterior and slightly superior to the acetabulum. Dislocation reduction has always been possible. When the hip is flexed a large "click" takes place; whereas if the hip is extended, the "click" is less noticeable, or even absent. PMID:3414196

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

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    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. Occlusal asymmetries in children with congenital hip dislocation.

    Science.gov (United States)

    Harila, Virpi; Valkama, Marita; Sato, Koshi; Tolleson, Shane; Hanis, Shad; Kau, Chung H; Pirttiniemi, Pertti

    2012-06-01

    Developmental dysplasia of the hip (DDH) has been associated with other congenital postural deformities and associated with asymmetric features in the body. The aim of this study was to examine the associations between developmental DDH and malocclusions in preschool and school children. The subjects were 60 children (40 girls and 20 boys) born during 1997-2001 in Northern Ostrobothnia Hospital District and having developmental DDH and treated by Von Rosen method. The control group consisted of 71 Finnish children (46 girls and 25 boys) matched by age and gender. Children participated the cross-sectional study at the age of 5-10 years; the mean age of the DDH children was 8.0 (SD 1.4) and controls 7.9 (SD 1.4) years. Dental examinations, intra-oral photographs, and clinical examination including growth measurements were carried out. The DDH children had significantly more lateral crossbites than controls (30/9.9 per cent; P < 0.003). Overall, 77.8 per cent of cases were unilateral crossbites and found more on the right side (50 per cent) compared to the left side (22.2 per cent). Girls had more crossbite compared to boys (77.8/22.2 per cent; odds ratio 2.53). Children with congenital hip dislocation are more predisposed to the asymmetric growth of occlusion and the development of crossbite. The genetic and environmental factors including intrauterine conditions in addition to the splint therapy may be possible influencing factors. This study will give additional information of the development of occlusal asymmetries and the multifactorial nature of the aetiology of lateral malocclusions. PMID:21303807

  5. 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% ...

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

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    Mukesh Tiwari

    2013-04-01

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

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

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    I.G. Strelkova

    2012-12-01

    Full Text Available The aim of the investigation is to prove the correlation of free radical processes and the state of anti-oxidant system, and the severity of pathological process in children with congenital dislocated hip.Materials and Methods. There were examined 143 patients with congenital dislocated hip aged from 4 to 17 years, they were divided into three groups: the 1st group (n=39 — children with noncomplicated disease, the 2nd group (n=47 — children with coxarthrosis, the 3rd group (n=32 — children with Legg’s disease. The control group (n=161 included virtually healthy children. The investigations of free radical production level and the condition of anti-oxidant system were carried out in patients’ blood serum, plasma, and erythrocytes. Results. There was revealed statistically significant correlation between the intensity of lipid peroxidation and the degree of manifestation of dystrophic changes in an affected joint. There was registered the activation of anti-oxidant protection systems in children suffering from hip joint pathology due to the necessity of limitation of free radical processes intensity and their maintenance at an adequate level. Conclusion. The indices of lipid peroxidation intensity and anti-oxidant enzymes activity as diagnostic criteria enable to estimate the depth of pathological changes in children with congenital dislocated hip and degenerative and dystrophic diseases of hip joints, and timely perform effective therapeutic interventions to prevent the deformity of femoral head.

  8. Screening for congenital dislocation of the hip in the newborn: The role of clinical, ultrasonographic and radiographic examination

    International Nuclear Information System (INIS)

    The concept of examining all young infants for congenital dislocation of the hip (CDH) dates back to Le Damany in 1914, though it was Ortolani who stimulated widespread clinical screening with the publication of his method of examination in 1948. His technique was improved by Barlow and others and is now often referred to as the Ortolani/Barlow manoeuvre. Meanwhile, following the method of Hilgenreiner, Putti advocated in 1933 radiological screening of all newborn hips. In 1958 Andren and Von Rosen described their new radiological technique in which hip subluxation was provoked prior to x-ray. Although radiological examination has been criticised as a screening method, it is still apparently widely used in Europe, especially in German-speaking countries. More recently dynamic sonographic examination of the hips has been used for neonatal screening

  9. 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

  10. Right upper limb bud triplication and polythelia, left sided hemihypertrophy and congenital hip dislocation, facial dysmorphism, congenital heart disease, and scoliosis: disorganisation-like spectrum or patterning gene defect?

    OpenAIRE

    Sabry, M A; al-Saleh, Q; al-Saw'an, R; Al-Awadi, S A; Farag, T I

    1995-01-01

    A Somali female baby with right upper limb triplication, polythelia, left sided hemihypertrophy, congenital hip dislocation, facial dysmorphism, congenital heart disease, and scoliosis is described. It seems that the above described pattern of anomalies has not been reported before. The possible developmental genetic mechanism responsible for this phenotype is briefly discussed.

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

    OpenAIRE

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

    2003-01-01

    The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter). In this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months...

  12. Congenital dislocation of the knee.

    Science.gov (United States)

    Jacobsen, K; Vopalecky, F

    1985-02-01

    Congenital dislocation of the knee is a very rare condition, the incidence in Scandinavia hitherto not being known with certainty. Thirteen patients treated during the years 1960 to 1983 with 19 affected knees were reviewed and followed up. Findings of muscular imbalances in nine of these cases and of spinal abnormalities in four cases strongly indicate neuromuscular imbalance as an aetiological factor. The minimum incidence was estimated to be 0.017 per mille or approximately 1 per cent of the incidence of congenital dislocation of the hip. Recommendations for treatment are that manipulation should be carried out gently, and if not successful within 2-3 months and in all cases of Grade III, an operation is indicated. Too many newborn children in this series had manipulation fractures or slipped epiphyses. However, signs of fracture had disappeared at follow-up in most cases. PMID:3984696

  13. 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.

  14. [Treatment of congenital dislocation of the hip by Salter's innominate osteotomy. Study of the first 40 cases operated on at the Orthopedic Institute, Kassar Said, Tunisia].

    Science.gov (United States)

    Bertrand, A; Trimingham, J L; Fowles, J V; Kassab, M T

    1975-12-01

    1) Twenty-nine children aged 18 months to 7 years with 40 congenitally dislocated hips, were treated between 1964 and 1971. Six hips had a closed reduction, 34 had an open reduction and capsulorrhaphy, and all had an innominate osteotomy. 2) Complications of the treatment included 2 joint infections. Of 11 hips which were unstable post-operatively, more than half were due to errors of the operative technique, and 8 required further surgery. Avascular necrosis of the femoral head occured in 3 hips post-operatively, and another 3 showed irregular ossification of the femoral epiphysis. All 6 hips had had an open reduction, and were mainly in older children who had inadequate pre-operative traction. 18 hips were stiff post-operatively ; 17 had had an open reduction ; Seven of eleven were improved by traction and physiotherapy. 3) The average length of follow-up was 4 years. Although only 70 p. 100 of the hips were clinically satisfactory, 92 p. 100 had excellent or good anatomical results as seen on radiographs. PMID:133430

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

    Science.gov (United States)

    ... Orthopaedic Surgeons. Developmental Dislocation (Dysplasia) of the Hip (DDH) The hip is a “ball-and-socket” joint. ... children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. The ...

  16. [The role of exogenous factors in the etiology of congenital hip dislocation: a socio-epidemiologic study].

    Science.gov (United States)

    Drimal, J

    1989-10-01

    The authors present in their work the results of the analysis of the relation between congenital dislocation of vertebral joints and social factors which they have found out in 120 children singled out of 9516 live-born children in the Martin district (Slovakia) in the period 1979-1983. The investigation of social factors has been based on the analysis of socioeconomic and social conditions of the Martin district which has no regional particularities. According to their results the share of exogenous factors in the origin and development of this disease is manifested more frequently in the first-borns (having the highest representation in the examined group). On the top of the list of social indices, which they have examined in primiparae and multiparae respectively, there are unsuitable housing conditions (living in discord with mother-in-law in the same house-hold), high percentage of impregnation before marriage which can be considered a strain and longterm conflicting situation and can have together with other factors a sociopathogenetic effect. PMID:2631495

  17. Dynamic sonography of the irreducible dislocated hip

    International Nuclear Information System (INIS)

    Real-time sonography is a rapid, noninvasive modality suitable for evaluating infants with suspected hip instability. Retrospective review of over 1,000 infant hip sonograms revealed that 28 were hips believed to be completely dislocated and irreducible on clinical examination. An unexpected finding was that 14 hips thought to be frankly dislocated on the basis of the clinical examination were shown on US to be either anatomically located and stable, or dislocatable/reducible. In infants with clinically suspected complete hip dislocation, real-time US is capable of providing anatomic and dynamic information necessary for clinical management, information that traditionally has been provided by contrast arthrography

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

    Scientific Electronic Library Online (English)

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

    2003-01-01

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

  19. Developmental dysplasia of the hip

    Science.gov (United States)

    ... dislocation of the hip joint; Developmental hip dysplasia; DDH; Congenital dysplasia of the hip; Congenital dislocation of ... during pregnancy can increase a baby's risk of DDH. Other risk factors include: Being the first child ...

  20. Computed tomography arthrography in traumatic hip dislocation

    International Nuclear Information System (INIS)

    The combination of computed tomography and arthrography can be of significant diagnostic value in certain specific situations. In our case report, we describe its use in post-traumatic recurrent hip dislocation and its value, not only in depicting a posterior capsular tear, but also in the diagnosis of an internal joint derangement which may contribute to incongruous reduction of the hip joint. (orig./GDG)

  1. 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.

  2. 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 ...

  3. Paralytic dislocations of the hip in adolescence: Orthopaedic treatment

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    ?obelji? Goran

    2009-01-01

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

  4. Differentiating subluxation from developmental dislocation of the hip

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    Joao O. Tavares

    2012-01-01

    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.

  5. Imaging of traumatic dislocation of the hip in childhood

    International Nuclear Information System (INIS)

    Traumatic hip dislocation in childhood is a rare consequence of violent trauma. After reduction, outcome is usually favourable although epiphyseal necrosis can occur. Reduction must be carried out as soon as possible and is achieved easily, although if the labrum is involved, surgery may be required to achieve complete reduction. To analyze a retrospective series of traumatic hip dislocations in children, describing the therapeutic and imaging strategy. A total of 42 patients were studied. Their mean age was 10 years 3 months. All relevant radiographic, CT, MRI and radionuclide bone scan examinations were reviewed. Special attention was paid to associated lesions. In 22 patients the dislocation was caused by low-energy trauma. Road traffic accidents accounted for 17 dislocations. An acetabular fracture was present in six patients and the femoral head was fractured in three. Reduction was easily achieved in 31 patients. In 11 patients the postreduction radiograph and CT showed joint space asymmetry secondary to labral entrapment. Only two patients developed epiphyseal necrosis. It has been difficult to define and evaluate accurate principles for a medical imaging strategy in this group of patients. Analysis of plain radiographs is essential before and after reduction of the joint, and it is important to perform postreduction CT in every patient whose joint space remains widened. A radionuclide bone scan should be performed between the second and third weeks after injureen the second and third weeks after injury to assess epiphyseal vascularity. With the use of specific sequences, MRI may be an alternative modality to assess epiphyseal vitality. (orig.)

  6. Traumatic Dislocation of the Hip in a Child Caused by Trivial Force for Age

    OpenAIRE

    Furuya, Hiroyuki; Shimamura, Yoshio; Kaneko, Kazuo; Sakuramoto, Hiroshi; Hirata, Kazuhiro; Arai, Yasuhisa

    2014-01-01

    Traumatic hip dislocation in children has a relatively rare occurrence. There are some residual complications, such as avascular necrosis of the femoral head, growth disturbance caused by premature fusion, neurological injury, recurrent dislocation, and posttraumatic arthritis. There is no consensus in the literature about the period of non-weight bearing after reduction. A rare case of a 13-year-old boy of hip dislocation caused by trivial force for age is reported followed by review of the ...

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

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    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.  

  8. 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).

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

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    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.

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    1999-08-01

    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 to a congruent and stable hip joint. After rehabilitation, she returned to light sporting activities after six months. PMID:10450489

  12. 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.

  13. Relationship between developmental dislocation of the hip in infant and acetabular dysplasia at skeletal maturity.

    Science.gov (United States)

    Okano, Kunihiko; Yamaguchi, Kazumasa; Ninomiya, Yoshikazu; Matsubayashi, Shohei; Aoyagi, Kiyoshi; Osaki, Makoto; Enomoto, Hiroshi; Takahashi, Katsuro

    2015-01-01

    Previous reports demonstrated 8-60% patients treated for developmental dislocation of hip (DDH) in infancy have residual acetabular dysplasia (AD) at skeletal maturity. AD patients reportedly exhibit abnormal morphology of the pelvis, high rates of comorbid spinal congenital anomalies and high bone mineral density. These physical findings suggest that AD patients have genetic background. We examined the percentage of AD patients with hip pain at skeletal maturity having a history of DDH in infancy and the correlation between the severity of AD at skeletal maturity and history of DDH treatment to investigate the relationship between AD and DDH.A total of 245 patients were radiographically examined for any history of DDH treatment in infancy. The study included 226 women and 19 men with a mean age at examination of 40.7 years (range 17-59 years).Eighty-eight patients (36%) had a history of DDH treatment (DDH group) and the remaining 157 patients (64%) had no history of DDH treatment (non-DDH group). The average age was lower and acetabular angle was larger in the DDH group. There was a significant increasing trend of the percentage of DDH patients associated with the severity of AD classified with CE, acetabular angle, and acetabular roof angle.Our data suggest that there are several AD patients without a history of DDH in Japan, and AD in patients without a history of DDH has different characteristics from AD in patients with a history of DDH. PMID:25569642

  14. Efficacy of an Abduction Brace in Preventing Initial Dislocation in the Early Postoperative Period after Primary Total Hip Arthroplasty

    OpenAIRE

    Junko Sato; Mitsuhiro Takeda; Hideo Noguchi; Yoshinori Ishii; Yoichiro Domae

    2012-01-01

    We hypothesized that a hip brace may prevent the initial dislocation in the early postoperative period after total hip arthroplasty (THA). We performed a prospective evaluation of the efficacy of a brace in preventing dislocation in 54 primary THAs in 43 patients. All of the patients wore braces for 3 weeks postoperatively. The occurrence of dislocation was evaluated six months postoperatively. There were no cases of dislocation while wearing a brace, while two posterior dislocations occurred...

  15. Posterior dislocation of the hip following arthroscopy - a case report and discussion.

    Science.gov (United States)

    Rosenbaum, Andrew; Roberts, Timothy; Flaherty, Michael; Phillips, Nani; Patel, Nilay; Das, Patel

    2014-01-01

    A 24-year-old military policeman underwent arthroscopic femoral neck osteoplasty and labral repair of his right hip following failed conservative management of femoroacetabular impingement. His postoperative course was complicated by recurring posterior instability of his right hip initially presenting as a posterior dislocation on postoperative day 19. Iatrogenic disruption of the hip's static stabilizers in the setting of underlying coxa valga is the likely culprit. Although anterior dislocation following hip arthroscopy has been described, posterior dislocation has not. Further, we identified a successful and less-invasive approach to the treatment of this complication, in the form of a spica cast. Prior cases pertaining to post-arthroscopy hip instability have only described operative interventions, such as capsular repair and plication, as effective revision procedures. PMID:25150349

  16. 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.

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. A reduction technique of arthroplasty without subtrochanteric femoral shortening osteotomy for the treatment of developmental high dislocation of hip: a case series of 28 hips.

    Science.gov (United States)

    Yan, Fei; Chen, Guangxing; Yang, Liu; He, Rui; Gu, Lingchuan; Wang, Fuyong

    2014-12-01

    In total hip arthroplasty for the treatment of developmental dysplasia of the hip (DDH) with high hip dislocation, it can be technically challenging to locate the true acetabulum and restore limb length without subtrochantric femoral shortening osteotomy. We explored and described total hip arthroplasty without subtrochanteric femoral shortening osteotomy in 28 hips with Crowe type III and IV dislocation by intravenous injection of rocuronium at 0.9mg/kg 1minute before reduction and hip reduction combined with continuous strong traction of the affected limb with patients in a position with hip and knee flexion. All patients did not show dislocation, prosthesis loosening, and other severe complications. It is thus a safe and feasible reduction technique for arthroplasty of Crowe type III or IV dislocation of DDH. PMID:24412147

  2. Early intraprosthetic dislocation in a revision dual-mobility hip prosthesis.

    Science.gov (United States)

    Banka, Trevor R; Ast, Michael P; Parks, Michael L

    2014-04-01

    This article presents a case of early intraprosthetic dislocation of a dual-mobility hip prosthesis after revision total hip arthroplasty for instability. A 70-year-old woman was revised to a dual-mobility cup for multiple hip dislocations. She dislocated the dual-mobility construct twice, which was closed reduced. Postreduction radiographs after the second closed reduction showed that the femoral head was eccentrically positioned within the acetabular shell, raising suspicion for intraprosthetic dislocation or disassociation between the femoral head and the mobile polyethylene liner. After closed reduction, the patient reported a mobile, golf ball-size mass deep to the posterior lateral incision and new onset of crepitus. Magnetic resonance imaging verified complete intraprosthetic dissociation between the femoral head and mobile polyethylene liner, which was located between the gluteus medius and minimus. The dual-mobility cup was revised to a constrained socket with retention of the femoral stem. The patient recovered uneventfully without further instability. PMID:24762847

  3. Computed tomography in abnormalities of the hip

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-06-26

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

  4. Computed tomography in abnormalities of the hip

    International Nuclear Information System (INIS)

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

  5. 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.

  6. 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.

  7. 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.

  8. Posterior Hip Fracture -Dislocation Associated with Ipsilateral Intertrochantric Fracture; a Rare Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad H Taraz Jamshidi

    2014-03-01

    Full Text Available Hip dislocation occurs when the femur does not break and the force is transmitted towards the hip joint leading to a posterior dislocation of the femoral head with or without posterior acetabular fracture. We present the case of a 26 year old patient involved in motor vehicle accident. Clinical and imaging (radiography, CT examination revealed an intertrochanteric fracture associated with ipsilateral posterior hip dislocation and posterior acetabular wall fracture simultaneously with epsilateraal tibial and fibular fractures. Such associations is very rare and can be explained by an extremely powerful force generated the three lesions simultaneously. This case is important not only because of its extreme rarity but also because of treatment method.

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

    Directory of Open Access Journals (Sweden)

    Asif S

    2004-06-01

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

  10. 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

  11. Traumatic posterior hip dislocation and ipsilateral distal femoral fracture in a 22-month-old child: a case report.

    Science.gov (United States)

    Ciftdemir, Mert; Aydin, Deniz; Ozcan, Mert; Copuroglu, Cem

    2014-11-01

    Minor trauma may cause hip dislocation in young children because of physiologic hip joint laxity and the soft cartilaginous structure of the acetabulum. In this work, we report on a 22-month-old boy with right-sided traumatic posterior hip dislocation and ipsilateral distal femoral fracture because of an outdoor motor vehicle accident. The patient was treated with emergency closed reduction and one and a half hip spica under general anaesthesia. The femoral fracture and hip dislocation were healed smoothly without any complication. Traumatic hip dislocation is rare in children, which may occur after trivial trauma. Prognosis is better in younger patients with low-energy trauma and in cases treated early. PMID:25075766

  12. [Prevention of hip dislocation in children with spastic paralysis by using a specific therapeutic wheelchair].

    Science.gov (United States)

    Thom, H

    1991-08-01

    The hip joints of children with spastic cerebral palsy, notably in those with more severe forms of paresis as well as those with bilateral or tetraparetic involvement, are in any case exposed to extraordinarily great risks. Totally inconspicuous at birth, constant dominance of the spastically contracting hip adductor and flexor muscles leads to gradually advancing malpositioning of the femoral heads, along with flattening of the hip socket and its eventual total destruction. Complete dislocation of the hip joints results, in very severely affected cases already at age 2-3, but in the majority of children only several years later. In this equally tragic as, on the other hand, almost invariably preventable maldevelopment, the wheelchair takes on a doubly crucial role. This, for one, has to do with the many hours the child has to spend in it every day. On account of the fact that the regular wheelchair, above all when "sportively styled", is forcing both legs, i.e. the thighs and lower legs as well as the feet, to adopt a strictly parallel position, it enhances, and accelerates, the highly undesirable development of spastic hip dislocation. If, however, the wheelchair is redesigned in an appropriate manner, i.e. provided with an abduction seating orthosis, along with laterally repositioned foot rests, it will in the majority of cases be possible to prevent the development of hip dislocation. Detailed guidelines to achieve this end are included, and instructions are given for adapting commercially available wheelchairs. PMID:1947419

  13. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement

    OpenAIRE

    Sakellariou, Vasileios I.; Christodoulou, Michael; Sasalos, Gregory; Babis, George C.

    2014-01-01

    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...

  14. Potocki-Lupski syndrome with teratologic dislocation of the hip: a case report.

    Science.gov (United States)

    Kuo, Chien-Chung; Chang, Chien-Chun; Hsu, Horng-Chaung; Lu, Tung-Wu; Tsai, Nien-Ying

    2013-01-01

    Potocki-Lupski syndrome results from the duplication of chromosome 17 band p11.2. This is the first report of a case of Potocki-Lupski syndrome with teratologic dislocation of both hips. The diagnosis was made by chromosomal analysis. The association between Potocki-Lupski syndrome and musculoskeletal disorders may help elucidate the etiology and prognosis of the syndrome. PMID:22990438

  15. Recurrent dislocation following total hip arthroplasty treated a.m. Olerud.

    Science.gov (United States)

    Falkenberg-Nielsen, B; Andersen-Ranberg, F

    1989-01-01

    We present a case of recurrent dislocation after total hip arthroplasty in a patient where no malalignment of the prosthetic components was found. The patient was successfully treated with the fixation of an additional sector to the acetabular component. PMID:2801067

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

    OpenAIRE

    Yamamoto K; Ko M; Masaoka T; Shishido T; Imakiire A

    2004-01-01

    Traumatic anterior dislocation of the hip joint in children is rare, and only one case with ipsilateral femoral fracture has been reported in Japan. We report a case of such dislocation and a review of the literature. The patient was a 31-month-old girl who was injured in a car accident while asleep on a tilted front passenger seat. Radiographic examination showed dislocation of the right obturator foramen and transverse fracture of the ipsilateral femoral shaft. The dislocation of the right ...

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

    Directory of Open Access Journals (Sweden)

    Samet Karabulut

    2011-06-01

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

  18. Acetabular augmentation ring for recurrent dislocation of total hip arthroplasty: 60% stability rate after an average follow-up of 74 months

    OpenAIRE

    Bosker, B. H.; Ettema, H. B.; Verheyen, C. C. P. M.; Castelein, R. M

    2007-01-01

    Between 1988 and 2002, 47 patients (50 hips) were treated with acetabular shell augmentation arthroplasty for recurrent idiopathic dislocation of their total hip arthroplasty. Apparent causes for dislocation such as deep infection, component malposition, or polyethylene wear were excluded. Follow-up averaged 74 months (range, 12–178 months), and clinically, 30 hips (60%) did not present a subsequent dislocation at most recent follow-up. In five hips (10%), deep infection after the augmentat...

  19. 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.

  20. The Dislocating Hip Replacement – Revision with a Dual Mobility Cup in 56 Consecutive Patients

    Science.gov (United States)

    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 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. PMID:25246992

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

    Directory of Open Access Journals (Sweden)

    Vukaainovi? 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.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Diagnosis of Developmental Dislocation of the Hip by Sonospectrography

    OpenAIRE

    Kapicioglu, M. I. Safa; Feza KORKUSUZ

    2008-01-01

    Because not all infants can be screened for DDH by experts, early diagnosis of developmental dysplasia of the hip (DDH) by primary health care professionals is important. We developed a broadband electroacoustic sound transmission-detection (sonospectrography) system and explored its utility in 22 patients (average age, 5.9 years; range, 0.3–14 years) with unilateral DDH in this preliminary study. Distinct from ultrasonography, the sonospectrography system functions by sound transmission and ...

  5. Efficacy of an Abduction Brace in Preventing Initial Dislocation in the Early Postoperative Period after Primary Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Junko Sato

    2012-03-01

    Full Text Available We hypothesized that a hip brace may prevent the initial dislocation in the early postoperative period after total hip arthroplasty (THA. We performed a prospective evaluation of the efficacy of a brace in preventing dislocation in 54 primary THAs in 43 patients. All of the patients wore braces for 3 weeks postoperatively. The occurrence of dislocation was evaluated six months postoperatively. There were no cases of dislocation while wearing a brace, while two posterior dislocations occurred 8 and 12 days postoperatively while picking something up from the floor without a brace in so-called provocative positions. The results of this study suggest that a hip brace helps patients to recognize careless provocative positions and prevents the initial hip dislocation in this period instead of usual postoperative management for an average of 6 weeks after discharge, such as a high toilet seat, restricted hip flexion in the activities of daily living, use of a reacher or grabber, an abduction pillow, and a high chair.

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

    Directory of Open Access Journals (Sweden)

    Göran O. Sjödén

    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.

  7. 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.

  8. Fast-track pathway for reduction of dislocated hip arthroplasty reduces surgical delay and length of stay.

    Science.gov (United States)

    Gromov, Kirill; Willendrup, Fatin; Palm, Henrik; Troelsen, Anders; Husted, Henrik

    2015-06-01

    Background and purpose - Dislocation is one of the most common complications following hip arthroplasty. Delay until reduction leads to pain for the patient, and may increase the risk of complications. We investigated the safety aspect of a fast-track pathway for dislocated hip arthroplasties and evaluated its effect on surgical delay and length of stay (LOS). Patients and methods - 402 consecutive and unselected dislocations (253 patients) were admitted at our institution between May 10, 2010 and September 31, 2013. The fast-track pathway for early reduction was introduced on January 9, 2011. Fast-track patients with a suspected dislocation (with no radiographic verification) were moved directly to the post-anesthesia care unit and then straight to the operating room. Dislocation was confirmed under fluoroscopy with reduction under general anesthesia. Surgical delay (in hours), LOS (in hours), perioperative complications, and complications during the hospital stay were recorded. Dislocation status for fast-track patients (confirmed or unconfirmed by fluoroscopy) was also recorded. Results - Both surgical delay (2.5 h vs. 4.1 h; p < 0.001) and LOS (26 h vs. 31 h; p < 0.05) were less in patients admitted through the fast-track pathway than in patients on regular pathway. Perioperative complications (1.6% vs. 3.7%) and complications during the hospital stay (11% vs. 15%) were also less, but not statistically significantly so. Only 1 patient admitted through fast-track pathway had a fracture instead of a dislocation; all the other fast-track patients with suspected dislocation actually had dislocations. Interpretation - The fast-track pathway for reduction of dislocated hip arthroplasty results in less surgical delay and in reduced LOS, without increasing perioperative complications or complications during the patient's stay. PMID:25619606

  9. 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.

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

    OpenAIRE

    Amin Foroughi; Reza Jalli; Mehrdad Mohammadhoseini

    2009-01-01

    "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 ...

  11. 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 ...

  12. 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

  13. Iliopsoas transfer in the management of established dislocation and refractory progressive subluxation of the hip in cerebral palsy.

    Science.gov (United States)

    Sharrard, W J; Burke, J

    1982-01-01

    The authors have reviewed 25 hips in 23 patients with cerebral palsy in which iliopsoas transfer had been performed for established dislocation or refractory progressive subluxation of the hip. The iliopsoas tendon was transferred either postero-laterally or antero-laterally, depending upon the degree of fixed flexion of the hip. An adductor release was performed in all cases and an open reduction when necessary. A painfree stable joint was produced except for one hip in which the iliopsoas tendon had become detached because of sepsis. The loss of flexor power at the hip due to the transfer is thought to be a small price to pay for the relief of pain and spasm and the increase in function. PMID:7166445

  14. 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.

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

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    Karthik K

    2011-01-01

    Full Text Available Background: Intra-articular loose bodies following simple dislocations can lead to early degeneration. Nonconcentric reduction may indicate retained loose bodies and offer a method to identify patients requiring exploration so that this undesirable outcome can be avoided. Materials and Methods: One hundred and seventeen consecutive simple dislocations of the hip presenting to the hospital from January 2000 to June 2006 were assessed for congruency after reduction by fluoroscopic assessment of passive motion in the operating room as well as with good quality radiographs. Computerized tomography (CT scan with 2-mm cuts was done for confirmation of reduction and to identify the anatomy of loose bodies. Patients with nonconcentric reduction underwent open exploration to identify the etiology of the dislocation and for removal of loose bodies. Thomson and Epstein clinical and radiological criteria were used to assess the outcome. Results: Twelve of the one hundred and seventeen (10% dislocations had incongruent reduction, which was identified by the break in Shenton?s line and increase in medial joint space in seven patients, increase in the superior joint space in three patients, or increase in the joint space as a whole in two patients. CT scan identified the origin of the osteocartilaginous fragment as being from the acetabulum in six patients, the femoral head in four, and from both in one. One patient had an inverted posterior labrum. Following debridement, congruent reduction was achieved in all patients. At an average follow-up of 5 years (range: 2 years 5 months to 8 years, the outcome as evaluated by Thompson and Epstein clinical criteria was excellent in eleven cases and good in one case; the radiological outcome was excellent in eight cases and good in four cases. 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.

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

    International Nuclear Information System (INIS)

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

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

    Scientific Electronic Library Online (English)

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

    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. Abstract in english OBJECTIVE: To evaluate the results of the surgical treatment of hip dislocation through the anteromedial approach in patients with arthrogryposis multiplex congenita (AMC). METHODS: A retrospective review of the charts and radiographs of 7 children with AMC that presented dislocation of the hiprevis [...] ed, totalling 10 dislocated hips. : Pre and postoperative articular mobility, was evaluated by summing the joint range-of-motion arc of flexion and abduction. , Pre-operatively, the acetabular angle and height of the neck of femur were evaluated radiographically and postoperatively, the continuity of the arc of Shenton, acetabular angle, Sharp angle and CE angle. The presence of avascular necrosis was classified according to Ogden and Bucholz. RESULTS: The average of age of the children at the time of the surgery was 5.5 months (3 to 11 months). The average follow-up time for the patients was 9.5 years (2 to 13 years). The average of the amplitude of movement of the sum of the joint mobility arc in flexion and abduction in the pre-operative examination was 108° (70° to 155 °) and postoperatively it was 125° (75° 175°). In the last evaluation, eight hips were centered and two were subluxated. Two hips had been submitted to a Salter iliac osteotomy. Two hips (20%) had presented significant signs of Ogden type IV avascular necrosis . Eight hips had good results while two were fair. CONCLUSION: We consider the antero-medial approach a good option for the treatment of the dislocation of the hip in patients of low congenital age with arthrogryposis multiplex congenita.

  18. 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

    Directory of Open Access Journals (Sweden)

    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.

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

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    Behari S

    2000-04-01

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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Yamamoto K

    2004-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Shirin Mardookhpour

    2012-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Skand Sinha

    2013-10-01

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

  4. Early articular cartilage degeneration in a developmental dislocation of the hip model results from activation of ?-catenin

    OpenAIRE

    NING, BO; Sun, Jun; Yuan, Yi; YAO, JIE; Wang, Peng; Ruixue MA

    2014-01-01

    Developmental dislocation or dysplasia of the hip (DDH) is one of the most common deformities in children. Osteoarthritis (OA) is the most frequent long-term complication. The molecular mechanism of early articular cartilage degeneration in DDH is still unclear. It is well known that ?-catenin plays a crucial role in articular cartilage degeneration. The objective of this study was to verify the relationship between ?-catenin and DDH cartilage degeneration. We used a DDH model that was establ...

  5. 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.

  6. Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement

    Science.gov (United States)

    Sakellariou, Vasileios I.; Christodoulou, Michael; Sasalos, Gregory; Babis, George C.

    2014-01-01

    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 challenging. 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. PMID:25386570

  7. Hip dislocation following minor trauma in a patient with neurofibromatosis type 1: a case report and review of the literature.

    Science.gov (United States)

    Dearden, Paul M; Lowery, Kathryn A; Bates, Joanna; Datir, Sandeep P

    2015-04-20

    Neurofibromatosis type 1 (NF-1) is a common autosomal dominant disorder which is known to have associated skeletal manifestations. There are documented cases of hip dislocation in NF-1, although it is a rare occurrence. Previous cases have been associated with intra-articular neurofibromas, acetabular protrusio and femoral deformities such as coxa valga and in one case increased femoral offset.The authors review the literature on pelvic manifestations and report a case of hip dislocation in a 19-year-old woman with neurofibromatosis-one following minor trauma believed to be secondary to markedly increased femoral offset.This case illustrates the effect the NF-1 can have on the anatomy of the proximal femur and one of the complications that can present to the orthopaedic surgeon, without the presence on an intra-articular neurofibroma. In a review of the literature the authors found only two other cases of hip dislocation associated with NF-1 that occurred without the presence of an intra-articular neurofibroma. PMID:25768882

  8. Long-term outcome of Ludloff’s medial approach for open reduction of developmental dislocation of the hip in relation to the age at operation

    OpenAIRE

    Okano, Kunihiko; Yamada, Kenji; Takahashi, Katsuro; Enomoto, Hiroshi; OSAKI, MAKOTO; Shindo, Hiroyuki

    2009-01-01

    We reviewed long-term outcomes after open reduction by the medial approach for developmental dislocation of the hip (DDH). Forty-five hips in 43 patients with more than ten years of follow-up were assessed clinically and radiologically. The mean age at surgery was 14.0 (range 6–31) months, and the follow-up period ranged from ten to 28 years (mean 16.4 years). We compared the good (18 hips) and poor groups (27 hips) as classified by the Severin classification. The mean age at surgery was sign...

  9. 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.

  10. Surgical treatment of spastic hip dislocation--to treat or not to treat?--My personal experience.

    Science.gov (United States)

    Stotz, Sigfrid

    2011-01-01

    Patients with infantile cerebral palsy often develop a typical adduction-, internal rotation- and flexion contracture of the hip, caused by a central disturbance of muscle tone coordination. This deviation leads, when verticalisation and weight-bearing of the child is absent or insufficient, to coxa valga and spastic hip dislocation. In order to prevent or correct this faulty form, soft tissue release operations or bony joint reconstructive procedures of the proximal femur and acetabular roof or, in severely impaired patients, palliative measures can be performed. The indication must be judged critically, especially in patients with total body involvement. In this paper special procedures, performed for a number of years at the Orthopedic Poliklinik of the University of Munich and the Spastiker-Zentrum (Integrationszentrum für Cerebralparesen ICP) München ("Munich approach") are described, and the important role of surgery is discussed as part of a comprehensive rehabilitation program in patients with cerebral palsy, including sometimes also the decision, not to perform surgery. PMID:21602578

  11. 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.

  12. Applications in hip pathology.

    Science.gov (United States)

    Husson, J-L; Mallet, J-F; Huten, D; Odri, G-A; Morin, C; Parent, H-F

    2010-05-01

    Everyday clinical practice frequently leads us to suspect a close relationship between the lumbar spine and the hip-joints. Sagittal balance fundamentally expresses a postural strategy mobilizing the dynamic structure of the lumbar-pelvic-femoral complex in an authentic balance by which obligatory coupled movements transmit stresses in a single structure, the spine, to the two-part structure of the lower limbs, and vice-versa. Flexion contracture is a frequent hip pathology, but congenital dislocation and ankylosis of the hip have the greatest impact on the spine, due to excessive mechanical strain and/or spinal malalignment, which is initially supple but becomes fixed. Clinical analysis, backed up if necessary by infiltration tests and imaging, guides indications for surgical management. These considerations suggest a general attitude that considers not just the hip itself, for which the patient is consulting, but the lumbar-pelvic-femoral complex as a whole (and also the knee) before undertaking total hip replacement. Femoro-acetabular impingement is a recently described pathology associating morphological hip-joint abnormality and labral and joint cartilage lesions, leading to early osteoarthritis of the hip. Abnormal spinal or pelvic parameters have not been found associated with femoro-acetabular impingement. Congenital pelvic tilt is a benign and often overlooked pathology in children. Supra- and infra-pelvic pelvic tilt in childhood palsy raises the difficult strategic issue of how to get these children in their wheelchair with a well-balanced spine over a straight pelvis and frontally and sagittally balanced hips. PMID:20447890

  13. 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...

  14. Comparison of different treatments of hip dislocation in dog and cat

    International Nuclear Information System (INIS)

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

  15. Implementing Capsule Representation in a Total Hip Dislocation Finite Element Model

    OpenAIRE

    Stewart, Kristofer J.; Pedersen, Douglas R.; Callaghan, John J.; Brown, Thomas D.

    2004-01-01

    Previously validated hardware-only finite element models of THA dislocation have clarified how various component design and surgical placement variables contribute to resisting the propensity for implant dislocation. This body of work has now been enhanced with the incorporation of experimentally based capsule representation, and with anatomic bone structures. The current form of this finite element model provides for large deformation multi-body contact (including capsule wrap-around on bone...

  16. Congenital dislocation of the knees in a child with Down-mosaic Turner syndrome

    OpenAIRE

    Gatrad, A R

    1981-01-01

    A further case of Down-mosaic Turner syndrome is discussed. Both the cytogenetic and the dermatoglyphic data support the clinical diagnosis. The association with dislocated knees and the diagnosis of this polysyndrome at birth have not been reported before.

  17. 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.

  18. 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...

  19. Damage of oxinium femoral heads subsequent to hip arthroplasty dislocation three retrieval case studies.

    Science.gov (United States)

    Kop, Alan M; Whitewood, Colin; Johnston, Don J L

    2007-08-01

    Oxinium exhibits 4900 times less volumetric wear and 640 times less deep scratches in laboratory wear testing compared with traditional cobalt-chromium alloys. Despite the superior wear resistance because of the thin ceramic surface, the zirconium alloy substrate is relatively soft (Hv = 285) when compared with cobalt-chrome alloy femoral heads (ISO 5832-12; Hv = ~420,) and may deform in contact with acetabular shell materials (ISO5832-3; Hv = 350) in the case of dislocation. Three retrieval cases highlight the damage that may occur during dislocation and/or when performing closed reduction maneuvers. It is recommended that closed reduction be attempted with caution because significant head damage can occur. This may lead to accelerated polyethylene wear. In the case of successful reduction, close patient follow-up is recommended. Open reduction with femoral head inspection and exchange may be preferable if difficulty is encountered in closed reduction maneuvers. PMID:17689792

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

    Directory of Open Access Journals (Sweden)

    I.Y. Ezhov

    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.

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

    International Nuclear Information System (INIS)

    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.)

  2. 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.)

  3. A retrospective study of prosthetic capsule technique for the treatment of problem cases of dislocated hips

    International Nuclear Information System (INIS)

    This article describes a technique for stabilizing coxofemoral luxations in dogs that uses placement of nonabsorbable sutures from two screws in the dorsal acetabular rim to a screw in the trochanteric fossa of the femur to create a prosthetic capsule. Twenty-one hips with luxations that were either recurrent or greater than 7 days duration were treated. Owners of 17 dogs were contacted from 4 to 40 months after surgery. Eight dogs were reported as having excellent function, three had good function, three had fair function, and three had poor function. No complications directly related to the technique were reported

  4. 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...

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

    Scientific Electronic Library Online (English)

    José Ricardo Negreiros, Vicente; André Fernandes, Pires; Bruno Takasaki, Lee; Marcos Camargo, Leonhardt; Leandro, Ejnisman; Alberto Tesconi, Croci.

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

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

    Directory of Open Access Journals (Sweden)

    José Ricardo Negreiros Vicente

    2009-01-01

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

  7. 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.

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

    Scientific Electronic Library Online (English)

    Gilberto Francisco, Brandão; Luiz Renato Drumond, Américo; Cláudio Beling Gonçalves, Soares; Rodrigo Galinari Costa, Faria; Luiz Eduardo Moreira, Teixeira.

    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 pacien [...] tes 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. Abstract in english 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.

  9. 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.

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

    OpenAIRE

    Shirin Mardookhpour; Amir Sobhani Eraghi; Ramin Espandar

    2012-01-01

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

  11. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... the hip doesn't dislocate. As is the case here, we can simply with gentle external rotation ... table in a very predictable fashion. In this case, we've used a device, called the Montreal ...

  12. 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.

  13. 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.

  14. The Effect of Dislocation Type (Crowe Types I-IV) on Pelvic Development in Developmental Dysplasia of the Hip: A Radiologic Study of Anatomy.

    Science.gov (United States)

    Bilgen, Ömer Faruk; Salar, Necmettin; Bilgen, Muhammet Sad?k; Mutlu, Müren; Kara, Gökhan Kür?at; Gürsel, Enis

    2015-05-01

    Classification of hip pathology in developmental dysplasia of the hip (DDH) helps in appropriate placement of implants during total hip arthroplasty. We examined preoperative unilateral and bilateral pelvic radiographs of 57 patients (114 hips) undergoing total hip arthroplasty because of DDH. Both sides of the pelvis were visually separated into 3 areas for comparison. When area ratios of hips with Crowe types II, III, and IV DDH were compared with ratios for healthy hips, values in hips with DDH were significantly low for the iliac wings, significantly high for the acetabular regions, and significantly low for the ischial area. Using a line crossing the healthy hip's teardrop and parallel to a line joining the distal sacroiliac joints is useful for calculating limb-length discrepancy. PMID:25499171

  15. 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.

  16. 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.

  17. 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, ... in this patient, but in my opinion, the advantages that ceramic has over this plastic/metal combination ...

  18. The unstable total hip replacement

    Directory of Open Access Journals (Sweden)

    D?Angelo F

    2008-01-01

    Full Text Available Background: Dislocation is one of the most common complications of total hip arthroplasty with a reported dislocation rate of 3.2%. Despite increased experience with hip replacement, the overall rate has not yet changed. The aim of this paper is to review the most recent literature published on this topic and indexed in Medline, in order to clarify the main risk factors, and to standardize a treatment protocol of such an important complication of prosthetic surgery. Materials and Methods: Medline database was searched using key words: "hip dislocation", "hip instability" from 1980-2007. Studies were eligible for review and included if they met the following criteria: (1 publication in English, (2 clinical trials (3 review papers. Results: The risk of first-time dislocation as a function of time after the surgery is not well understood. Most, but not all, series have demonstrated that the risk of dislocation is highest during the first few months after hip arthroplasty; however, first-time late dislocation can also occur many years after the procedure. Several risk factors were described, including the surgical approach, the diameter of the head, impingement, component malposition, insufficient abductor musculature. In addition, there are also many treatment options, such as long-term bracing after closed reduction, component reorientation, capsulorraphy, trochanteric advancement, increasing offset, exchange of the modular head and the polyethylene liner, insertion of constrained liner. Conclusion: Preventing hip dislocation is obviously the best strategy. Surgeons must take into account patient and surgical risk factors. For patients at high risk for dislocation the surgeon should accurately restore leg length and femoral offset; the use of larger femoral heads, posterior transosseous repair of the capsulotendinous envelope if posterior approach is chosen or the use of a lateral approach should be considered. Proper patient education and postoperative care are very important.

  19. Kinematic assessment of hip movement when retrieving an object from the floor

    OpenAIRE

    Moorehead John D; Panchani Sunil; Shariff Raheel; Scott Simon J

    2011-01-01

    Abstract Background Activities that require extreme hip movement can dislocate hip implants in the early post operative phase. One such activity is retrieving an object from the floor. The aim of this study was to assess hip movement using four different techniques to accomplish this task. This assessment would identify the techniques least likely to cause a hip dislocation. Methods An electromagnetic tracker was used to measure the movement of 50 hips in 25 normal subjects. Sensors were atta...

  20. The hip

    International Nuclear Information System (INIS)

    These proceedings collect papers about medical disorders of the hip. Topics include computed tomography of the hip, magnetic resonance imaging of the hip, and radiographic and radionuclide hip arthography

  1. 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

  2. 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)

  3. Treatment of extension contracture of the hip in cerebral palsy.

    Science.gov (United States)

    Bowen, J R; MacEwen, G D; Mathews, P A

    1981-02-01

    Twenty patients with cerebral palsy had a total of 35 extension contractures of the hip, resulting from tightness of the gluteus maximus or hamstring muscles, with associated quadricepts muscle spasticity. Associated deformities included anteriorly dislocated hips, patella alta, lumbar lordosis, thoracic kyphosis and calcaneus feet. Active and passive exercises, surgical release of contractures and reduction of anteriorly dislocated hips improved function. Hip flexor or adductor tenotomies must be considered cautiously for patients with spastic hip extensor muscles, because severe extension constricture may develop after either procedure. PMID:7202867

  4. 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.

  5. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... stability. So we're pretty happy with this one. I'll replace this posterior retractor. We got a bone hook? Put a bone hook around the neck. Give mean little tension down. We'll dislocate our hip and we'll disassemble. So this is a 36 millimeter plus zero head. And let’s go with a glass ...

  6. Hip Revision

    Medline Plus

    Full Text Available ... guys. You know, you probably look at my dislocations. My dislocations are probably more anterior than posterior. And I ... is where you're going to see those dislocations. And so it's a matter of managing that ...

  7. 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.

  8. Evaluation of the patient with hip pain.

    Science.gov (United States)

    Wilson, John J; Furukawa, Masaru

    2014-01-01

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

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

    OpenAIRE

    Scott Yang; Quanjun Cui

    2012-01-01

    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 dic...

  10. Subtalar dislocation

    International Nuclear Information System (INIS)

    Over a period of three years we have seen nine patients with subtalar dislocation, all of whom sustained violent trauma to the region of the ankle and hind foot. All but one patient were males. Clinically a subtalar dislocation resembles a complicated fracture dislocation of the ankle but a definitive diagnosis can only be made radiographically. The mechanism of injury and radiographic features of this injury are discussed. (orig.)

  11. Magnetic resonance imaging of hip joint cartilage and labrum

    Directory of Open Access Journals (Sweden)

    Rüdiger Krauspe

    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.

  12. Congenital Hypothyroidism

    Science.gov (United States)

    Congenital Hypothyroidism Share: Fact Sheet Congenital Hypothyroidism March, 2012 Download PDFs English Espanol Editors Rosalind S. Brown, MD Stephen LaFranchi, MD Susan R. Rose, MD What is congenital hypothyroidism? Newborn ...

  13. 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 ...

  14. 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 presentation, brought to you by Zimmer. ...

  15. Quantitative measurement and analysis for detection and treatment planning of developmental dysplasia of the hip

    Science.gov (United States)

    Liu, Xin; Lu, Hongbing; Chen, Hanyong; Zhao, Li; Shi, Zhengxing; Liang, Zhengrong

    2009-02-01

    Developmental dysplasia of the hip is a congenital hip joint malformation affecting the proximal femurs and acetabulum that are subluxatable, dislocatable, and dislocated. Conventionally, physicians made diagnoses and treatments only based on findings from two-dimensional (2D) images by manually calculating clinic parameters. However, anatomical complexity of the disease and the limitation of current standard procedures make accurate diagnosis quite difficultly. In this study, we developed a system that provides quantitative measurement of 3D clinical indexes based on computed tomography (CT) images. To extract bone structure from surrounding tissues more accurately, the system firstly segments the bone using a knowledge-based fuzzy clustering method, which is formulated by modifying the objective function of the standard fuzzy c-means algorithm with additive adaptation penalty. The second part of the system calculates automatically the clinical indexes, which are extended from 2D to 3D for accurate description of spatial relationship between femurs and acetabulum. To evaluate the system performance, experimental study based on 22 patients with unilateral or bilateral affected hip was performed. The results of 3D acetabulum index (AI) automatically provided by the system were validated by comparison with 2D results measured by surgeons manually. The correlation between the two results was found to be 0.622 (p<0.01).

  16. 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)

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

    OpenAIRE

    Konstantinos Anagnostakos, Jochen Jung

    2009-01-01

    Over the past two decades antibiotic-impregnated hip spacers have become a popular procedure in the treatment of hip joint infections. Besides infection persistence and/or reinfection, major complications after hip spacer implantation include spacer fracture, -dislocation, and bone fracture. Moreover, in cases with extensive loss of femoral and/or acetabular bone alternative reconstructive techniques should be used for a stable spacer fixation and prevention of fractures or dislocations. The ...

  18. Total hip arthroplasty following failed fixation of proximal hip fractures

    Directory of Open Access Journals (Sweden)

    Srivastav Shekhar

    2008-01-01

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

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

    Scientific Electronic Library Online (English)

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

    2012-09-01

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

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

    Directory of Open Access Journals (Sweden)

    A. C da Rocha

    2012-09-01

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

  1. 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.

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

    International Nuclear Information System (INIS)

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

  3. STUDY ABOUT INCIDENCE OF CONGENITAL BONY ABNORMALITIES IN A POPULATION WITH MENTAL DEFICIENCY

    Directory of Open Access Journals (Sweden)

    Ioana Mihaela Tomulescu

    2003-01-01

    Full Text Available This study is about the incidence of congenital bony abnormalities in a population with mental deficiency. Is known that genetic disorders cause mental disorders and malformative disorders, including bony abnormalities. The most often observed congenital abnormalities are:congenital hip sprain, flat foot, club foot, equin foot and congenital vertebral column disorders. We studied 596 children interned in in Neurology and Psychiatry Clinical Hospital of Oradea between 1999 and 2001 period. In 596 children, 393 presented different types of mental deficiency. We observed that most common bony disorders in this population are congenital hip sprain, vertebral column abnormalities and club foot.

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

    Science.gov (United States)

    2014-08-13

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

  5. Osteochondritis Dissecans of the Hip

    International Nuclear Information System (INIS)

    Purpose: To investigate the clinical and radiological characteristics of osteochondritis dissecans (OD) of the hip and the outcome of this condition after treatment. Material and Methods: Twelve male and 3 female patients with OD were retrospectively studied. Six patients had a history of Legg-Calve-Perthes disease (LCPD) and among them 2 also had had a trauma to the hip. A further 5 had had trauma and 1 a developmental dislocation of the hip (DDH). The remaining 3 patients had no history of previous hip disease or trauma. All patients were examined with plain radiography, 7 with MR, 3 with CT and 2 with hip arthrography. Results: All OD lesions were detected at plain radiography, and most of them were located near the fovea. At MR the lesions had low signal intensity at T1-weighted sequences, and 6/7 had edema or fluid collection in or adjacent to the lesion on T2-weighted sequences. The early treatment in 7 patients was surgery, 2 had had conservative treatment and 6 no treatment. At follow-up 12 years after radiological diagnosis, 5 patients had hip arthrosis, 4 of whom were treated with arthroplasty. All but 3 had reduced hip rotation and all but 2 (with arthroplasty) had load pain. Three of the patients with earlier surgery had not developed arthrosis. Conclusions: OD lesions are usually well seen with plain radiography. There is a great risk of developing early arthrosis and it seems that early surgery is connected with arthrosis development. Thus only symptomatarthrosis development. Thus only symptomatic treatment is recommended

  6. 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.

  7. Hip Revision

    Medline Plus

    Full Text Available ... the line, this patient was developing increasing hip pain. And you can see here, there's been an ... reactive protein. And we -- on everybody -- send tissue back down for frozen. We just got that back ...

  8. Surface damage to an Oxinium femoral head prosthesis after dislocation.

    Science.gov (United States)

    Evangelista, G T; Fulkerson, E; Kummer, F; Di Cesare, P E

    2007-04-01

    During open reduction of an irreducible anterior dislocation of a total hip replacement with an Oxinium femoral head, it was observed that the head had been significantly damaged. Gross and scanning electron microscopic examination revealed cracking, gouging, and delamination of the surface. Because of the risk which this poses for damaging the polyethylene acetabular liner, it is strongly recommended that patients with this type of prosthetic head be carefully monitored after a dislocation. PMID:17463126

  9. Congenital epulis.

    Directory of Open Access Journals (Sweden)

    Subramaniam R

    1993-01-01

    Full Text Available A tumor was found to be arising from the right maxillary alveolar margin of a newborn baby. No other congenital abnormality was detected. Following excision and histopathological examination, diagnosis of benign congenital granular cell epulis was made. The post-operative course was uneventful.

  10. 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.

  11. STUDY ABOUT INCIDENCE OF CONGENITAL BONY ABNORMALITIES IN A POPULATION WITH MENTAL DEFICIENCY

    OpenAIRE

    Ioana Mihaela Tomulescu

    2003-01-01

    This study is about the incidence of congenital bony abnormalities in a population with mental deficiency. Is known that genetic disorders cause mental disorders and malformative disorders, including bony abnormalities. The most often observed congenital abnormalities are:congenital hip sprain, flat foot, club foot, equin foot and congenital vertebral column disorders. We studied 596 children interned in in Neurology and Psychiatry Clinical Hospital of Oradea between 1999 and 2001 period. In...

  12. The total costs of a displaced femoral neck fracture: comparison of internal fixation and total hip replacement: A randomised study of 146 hips

    OpenAIRE

    Johansson, Torsten; Bachrach-Lindström, Margareta; Aspenberg, Per; Jonsson, Dick; Wahlström, Ola

    2005-01-01

    We randomised 143 patients –age 75 years or older–with displaced femoral neck fracture to either internal fixation or total hip replacement (THR) and compared the socio-economic consequences. In the internal fixation group, 34 of 78 hips underwent secondary surgery. In the THR group, 12 of 68 hips dislocated, the majority in mentally impaired patients. We calculated the total hospital costs for two years after operation. When secondary surgery was included, there was no difference in costs be...

  13. The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years

    OpenAIRE

    Philippot, Remi; Camilleri, Jean Philippe; Boyer, Bertrand; Adam, Philippe; Farizon, Frederic

    2008-01-01

    The concept of a dual articulation acetabular cup was developed by Prof. Bousquet in 1974. This concept has been shown to provide high stability after revision and primary total hip arthroplasty. The aim of our study was to evaluate the incidence of prosthetic instability in a consecutive homogeneous series of 384 primary dual mobility cups. Incidence of instability and implant survival were evaluated. Mean follow-up was 15.3 years (range, 12–20). There was no early or late instability. On...

  14. Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty

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    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.

  15. Congenital leukemia.

    Science.gov (United States)

    Raj, Aishwarya; Talukdar, Sewali; Das, Smita; Gogoi, Pabitra Kumar; Das, Damodar; Bhattacharya, Jina

    2014-09-01

    Congenital leukemia is a rare but a well-documented disease in which leukemic process is detected at birth or very shortly thereafter (Philip McCoy and Roy Overton, Commun Clin Cytom 22:85-88, 1995). These leukemias represent approximately 0.8 % of all childhood leukemias. We present a case of congenital acute myeloid leukemia manifesting from the very first day of birth. Diagnosis of acute myeloid leukemia was suspected by the presence of blasts in the peripheral blood smear and was confirmed on bone marrow by flowcytometry. Karyotyping revealed Trisomy 21. PMID:25332567

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

    International Nuclear Information System (INIS)

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

  17. 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.

  18. 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.

  19. Outcomes of total hip arthroplasty in spastic patients.

    Science.gov (United States)

    Alosh, Hassan; Kamath, Atul F; Baldwin, Keith D; Keenan, MaryAnn; Lee, Gwo-Chin

    2014-08-01

    Patients with spasticity and hip arthritis can present challenges to treatment. This investigation evaluated the effectiveness and safety of THA in patients with upper motor neuron disease. Twenty-seven consecutive patients with history of cerebral palsy (CP) or acquired spasticity (AS) underwent 30 THAs for treatment of hip arthritis. They were followed for an average 2.5 years (range 2.1-12.1). Patients with CP were more likely to require hip adductor release and hip flexor lengthening at the time of THA. Statistically significant improvements were made in Harris Hip Scores, pain scores, range of motion, ambulatory status, and the use ambulatory-assistive devices. There were no dislocations in this group. Patients with spasticity can benefit from THA in terms of pain relief and improved mobility with relatively low complications. PMID:24736289

  20. 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

  1. Hip reduction in cerebral palsy with soft tissue operative procedures.

    Science.gov (United States)

    Bozinovski, Z; Poposka, A; Serafimoski, V

    2008-07-01

    Hip reduction in cerebral palsy patients with a soft tissue procedure was analysed during operative procedure. Eleven patients with unilateral dislocation of the hip and a quadriplegic form of cerebral palsy underwent soft tissue operation on the hips. Tenotomy of the adductor and flexor muscles of the hip was performed. The contralateral hip sustained only tenotomy of the adductor muscles. The average age of the patient study group was 8.5 and the follow-up period was 4 years. In all patients, repositionings of the hip were achieved and stabilization was maintained postoperatively at the regular outpatient follow-up. The range of extension and abduction motion were increased postoperatively compared to the preoperative range of motion. Retention of the hip was maintained within 20 degrees of abduction. Tenotomy of the adductor and flexor muscles enables hip reduction without opening the joint capsule in quadriplegic cerebral palsy patients. The hip became painless and the improvement in the hygiene was evident. PMID:18709011

  2. 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.)

  3. Congenital Anomalies in Infant with Congenital Hypothyroidism

    OpenAIRE

    Zahra Razavi; Alireza Yavarikia; Saadat Torabian

    2012-01-01

    bjective: Congenital hypothyroidism is characterized by inadequate thyroid hormone production in newborn infants. Many infants with CH have co-occurring congenital malformations. This is an investigation on the frequency and types of congenital anomalies in infants with congenital hypothyroidism born from May 2006-2010 in Hamadan, west province of Iran.Methods: The Iranian neonatal screening program for congenital hypothyroidism was initiated in May 2005. This prospective descriptive study wa...

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

    Directory of Open Access Journals (Sweden)

    Bruno de Castro Paixão Jacobino

    2012-08-01

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

  5. The gauge theory of dislocations: A nonuniformly moving screw dislocation

    International Nuclear Information System (INIS)

    We investigate the nonuniform motion of a straight screw dislocation in infinite media in the framework of the translational gauge theory of dislocations. The equations of motion are derived for an arbitrarily moving screw dislocation. The fields of the elastic velocity, elastic distortion, dislocation density and dislocation current surrounding the arbitrarily moving screw dislocation are derived explicitly in the form of integral representations. We calculate the radiation fields and the fields depending on the dislocation velocities.

  6. The gauge theory of dislocations: A nonuniformly moving screw dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Lazar, Markus, E-mail: lazar@fkp.tu-darmstadt.d [Emmy Noether Research Group, Department of Physics, Darmstadt University of Technology, Hochschulstr. 6, D-64289 Darmstadt (Germany); Department of Physics, Michigan Technological University, Houghton, MI 49931 (United States)

    2010-07-05

    We investigate the nonuniform motion of a straight screw dislocation in infinite media in the framework of the translational gauge theory of dislocations. The equations of motion are derived for an arbitrarily moving screw dislocation. The fields of the elastic velocity, elastic distortion, dislocation density and dislocation current surrounding the arbitrarily moving screw dislocation are derived explicitly in the form of integral representations. We calculate the radiation fields and the fields depending on the dislocation velocities.

  7. The gauge theory of dislocations: A nonuniformly moving screw dislocation

    Science.gov (United States)

    Lazar, Markus

    2010-07-01

    We investigate the nonuniform motion of a straight screw dislocation in infinite media in the framework of the translational gauge theory of dislocations. The equations of motion are derived for an arbitrarily moving screw dislocation. The fields of the elastic velocity, elastic distortion, dislocation density and dislocation current surrounding the arbitrarily moving screw dislocation are derived explicitly in the form of integral representations. We calculate the radiation fields and the fields depending on the dislocation velocities.

  8. Degeneration in dysplastic hips. A computer tomography study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; RØmer, Lone

    2005-01-01

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

  9. Radiographic observation of congenital diaphragmatic hernia

    International Nuclear Information System (INIS)

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

  10. 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

  11. 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.

  12. Screw Dislocations in Graphite.

    Science.gov (United States)

    Hennig, G R

    1965-02-12

    Graphite contains varying concentrations of screw dislocations whose Burgers vector parallels the c axis. Single crystals of natural graphite contain very few such dislocations; furthermore, their Burgers vector always exceeds 450 angstroms. Pyrolytic graphites annealed above 3000 degrees C contain abundant screw dislocations, ranging from 10(6) to 5 x 10(8) per square centimeter in two different samples prepared by somewhat different methods. The Burgers vectors of these screws are predominantly 3.35 angstroms. PMID:17758193

  13. Homogenization of dislocation dynamics

    CERN Document Server

    Hajj, A El; Monneau, R

    2009-01-01

    In this paper we consider the dynamics of dislocations with the same Burgers vector, contained in the same glide plane, and moving in a material with periodic obstacles. We study two cases: i) the particular case of parallel straight dislocations and ii) the general case of curved dislocations. In each case, we perform rigorously the homogenization of the dynamics and predict the corresponding effective macroscopic elasto-visco-plastic flow rule.

  14. Homogenization of dislocation dynamics

    International Nuclear Information System (INIS)

    In this paper we consider the dynamics of dislocations with the same Burgers vector, contained in the same glide plane, and moving in a material with periodic obstacles. We study two cases: i) the particular case of parallel straight dislocations and ii) the general case of curved dislocations. In each case, we perform rigorously the homogenization of the dynamics and predict the corresponding effective macroscopic elasto-visco-plastic flow rule.

  15. 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.

  16. Small Incision Total Hip Arthroplasty

    Medline Plus

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

  17. 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: ... thousands of people suffering from hip pain. A small-incision total hip arthroplasty and arthroscopic hip femoroacetabular ...

  18. Small Incision Total Hip Arthroplasty

    Medline Plus

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

  19. Congenital syphilis

    International Nuclear Information System (INIS)

    In recent years, marked increase in incidence of congenital syphilis has occurred throughout the world due to changes in social norms and development of penicillin-resistant strains. Early diagnosis plays an important role in congenital syphilis as the clinical manifestations may simulate many other conditions in the paediatric age group. The authors analyzed 52 cases of congenital syphilis admitted to the department of paediatrics, Chosun University Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 cases were admitted from OPD, during the period of 8 years from January, 1975 to December, 1982. The results obtained were as follows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Among the 52 cases, a male predominance was observed with a male to female ratio of 2 : 1. 3. The serologic test (VDRL) of the 52 studied cases showed reactive response in 49 cases (94%), and that of syphilitic mothers except 6 cases, reactive in all studied cases. 4. The major manifestations of the 52 cases were bone tenderness (12%) and swelling of the joints (7%) in skeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. The radiological skeletal changes were detected in 45 of 52 cases (87%), and the commonest findings were detected in 45 of 52 cases (87%), and the commonest findings were metaphysitis (83%) and periostitis (81%). The most characteristic type of me (81%). The most characteristic type of metaphysitis were transverse trophic line (74%) and zone of rarefaction (65%). 6. The commonest bones to be affected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order of frequency were radius (80%), uina (80%), tibia (77%), femur (69%) and humerus (40%)

  20. Congenital epulis

    Directory of Open Access Journals (Sweden)

    Adeyemi Bukola

    2010-01-01

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

  1. The gauge theory of dislocations: a nonuniformly moving screw dislocation

    OpenAIRE

    Lazar, Markus

    2010-01-01

    We investigate the nonuniform motion of a straight screw dislocation in infinite media in the framework of the translational gauge theory of dislocations. The equations of motion are derived for an arbitrary moving screw dislocation. The fields of the elastic velocity, elastic distortion, dislocation density and dislocation current surrounding the arbitrarily moving screw dislocation are derived explicitely in the form of integral representations. We calculate the radiation ...

  2. Total hip arthroplasty for arthrodesed hips.

    Directory of Open Access Journals (Sweden)

    Howard MB

    2002-06-01

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

  3. Computer aided diagnosis and treatment planning for developmental dysplasia of the hip

    Science.gov (United States)

    Li, Bin; Lu, Hongbing; Cai, Wenli; Li, Xiang; Meng, Jie; Liang, Zhengrong

    2005-04-01

    The developmental dysplasia of the hip (DDH) is a congenital malformation affecting the proximal femurs and acetabulum that are subluxatable, dislocatable, and dislocated. Early diagnosis and treatment is important because failure to diagnose and improper treatment can result in significant morbidity. In this paper, we designed and implemented a computer aided system for the diagnosis and treatment planning of this disease. With the design, the patient received CT (computed tomography) or MRI (magnetic resonance imaging) scan first. A mixture-based PV partial-volume algorithm was applied to perform bone segmentation on CT image, followed by three-dimensional (3D) reconstruction and display of the segmented image, demonstrating the special relationship between the acetabulum and femurs for visual judgment. Several standard procedures, such as Salter procedure, Pemberton procedure and Femoral Shortening osteotomy, were simulated on the screen to rehearse a virtual treatment plan. Quantitative measurement of Acetabular Index (AI) and Femoral Neck Anteversion (FNA) were performed on the 3D image for evaluation of DDH and treatment plans. PC graphics-card GPU architecture was exploited to accelerate the 3D rendering and geometric manipulation. The prototype system was implemented on PC/Windows environment and is currently under clinical trial on patient datasets.

  4. Ultrasound: Infant Hip

    Science.gov (United States)

    ... a problem called developmental dysplasia of the hip (DDH) . DDH is a hip deformity that can happen before, ... rests comfortably in its socket. In babies with DDH, the femoral head moves back and forth within ...

  5. Bursitis of the Hip

    Science.gov (United States)

    ... it can go away and come back again. Acute bursitis can become chronic if it come backs or if a hip injury occurs. ... including the following: Repeated overuse or stress of the hip Rheumatoid arthritis Gout Pseudogout Injury ...

  6. Taper Hip Prosthesis

    Medline Plus

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

  7. Taper Hip Prosthesis

    Medline Plus

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

  8. Electromechanical simulations of dislocations

    International Nuclear Information System (INIS)

    Improving the reliability of micro-electronic devices depends in part on developing a more in-depth understanding of dislocations because dislocations are barriers to charge carriers. To this end, the quasi-static simulation of discrete dislocations dynamics in materials under mechanical and electrical loads is presented. The simulations are based on the extended finite element method, where dislocations are modelled as internal discontinuities. The strong and weak forms of the boundary value problem for the coupled system are presented. The computation of the Peach–Koehler force using the J-integral is discussed. Examples to illustrate the accuracy of the simulations are presented. The motion of the network of the dislocations under different electrical and mechanical loads is simulated. It was shown that even in weak piezoelectric materials the effect of the electric field on plastic behaviour is significant. (paper)

  9. Hip arthroplasty in failed intertrochanteric fractures in elderly

    Science.gov (United States)

    Pachore, Javahir A; Shah, Vikram I; Sheth, Ashish N; Shah, Kalpesh P; Marothi, Dhiraj P; Puri, Rahul

    2013-01-01

    Background: Failed intertrochanteric fractures in elderly patients are surgical challenge with limited options. Hip arthroplasty is a good salvage procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure. Materials and Methods: 30 patients of failed intertrochanteric fractures where hip arthroplasty was done between May 2008 and December 2011 were included in study. 13 were males and 17 were females with average age of 67.3 years. There were 2 cemented bipolar arthroplasties, 19 uncemented bipolar, 4 cemented total hip arthroplasty and 5 uncemented total hip arthroplasties. 16 patients had a trochanteric nonunion, which was treated by tension band principles. Total hip was considered where there was acetabular damage due to the penetration of implant. Results: The average followup was 20 months (range 6-48 months). Patients were followed up from 6 to 48 months with average followup of 20 months. None of the patients were lost to followup. There was no dislocation. All patients were ambulatory at the final followup. Conclusion: A predictable functional outcome can be achieved by hip arthroplasty in elderly patients with failed intertrochanteric fractures. Though technically demanding, properly performed hip arthroplasty can be a good salvage option for this patient group. PMID:24379462

  10. 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.

  11. Computer-assisted total hip navigation.

    Science.gov (United States)

    Wixson, Richard L

    2008-01-01

    Accurate implant placement in total hip replacement is important in avoiding dislocation, impingement, and edge-loading throughout the patient's postoperative functional range of motion. Current implants and bearing surfaces now provide the potential for prolonged longevity of the reconstruction, which can be compromised by malposition of the components outside of designated "safe zones." Computer-assisted hip navigation offers the potential for more accurate placement of hip components and control of leg length and offset. Systems are now available that allow registration of the bony anatomy based on preoperative CT images, intraoperative fluoroscopic images, or imageless techniques based on palpation of the landmarks. In each of these approaches, cup position has been based on coordinate systems formed by identification of the anterior pelvic frontal plane. All systems have shown improved accuracy of acetabular cup placement compared with conventional manual techniques. Cup anteversion is less accurate than cup abduction with the imageless approach. Measurements made with the use of navigation systems also have shown a large variation in pelvic tilt or pelvic flexion-extension in series of cases, which can affect the appropriate cup position for each patient. The results of computer-assisted navigation in the future may be improved by incorporation of measurements of each patient's pelvic tilt, femoral stem position, and hip kinematics. PMID:18399618

  12. The irreducible floating hip: a unique presentation of a rare injury.

    Science.gov (United States)

    Tiedeken, Nathan C; Saldanha, Vilas; Handal, John; Raphael, James

    2013-01-01

    A floating hip injury occurs in the setting of poly-trauma and is a rare and difficult problem to manage. Floating hip injuries require vigilant attention not only to the osseous injuries but also the surrounding compartments and soft tissue envelope. We report the case of a 35-year-old male with a lower extremity posterior wall acetabular fracture, ipsilateral femoral shaft fracture and a postero-superior hip dislocation. Closed reduction failed, necessitating an open reduction internal fixation of his hip dislocation and acetabular fracture. The patient then developed a thigh compartment syndrome requiring a fasciotomy. Despite the obvious bony injuries, orthopedic surgeons must be vigilant of the neurovascular structures and soft tissues that have absorbed a great amount of force. A treatment plan should be formulated based on the status of the overlying soft tissue, fracture pattern and the patient's physiologic stability. PMID:24964321

  13. Use of external fixation for perilunate dislocations and fracture dislocations

    OpenAIRE

    Savvidou, Olga D; Beltsios, Michael; Sakellariou, Vasileios I.; Mavrogenis, Andreas F.; Christodoulou, Michael; Papagelopoulos, Panayiotis J.

    2014-01-01

    The purpose of this study was to review clinical and radiographic outcomes of perilunate dislocations and fracture dislocations treated with external fixation and K-wire fixation. Twenty patients (18 males and two females) with a mean age of 38 years (range 18–59) who had an acute dorsal perilunate dislocation or fracture dislocation were treated with the use of wrist external fixator and K-wires. The injuries included 12 perilunate dislocations, seven trans-scaphoid perilunate fracture dislo...

  14. The gauge theory of dislocations: a uniformly moving screw dislocation

    OpenAIRE

    Lazar, Markus

    2009-01-01

    In this paper we present the equations of motion of a moving screw dislocation in the framework of the translation gauge theory of dislocations. In the gauge field theoretical formulation, a dislocation is a massive gauge field. We calculate the gauge field theoretical solutions of a uniformly moving screw dislocation. We give the subsonic and supersonic solutions. Thus, supersonic dislocations are not forbidden from the field theoretical point of view. We show that the elas...

  15. Revision Total Hip Arthroplasty Combined with Subtrochanteric Shortening Osteotomy: Case Report

    OpenAIRE

    Sonohata, Motoki; Kitajima, Masaru; Kawano, Syunsuke; Honke, Hidefumi; Hotokebuchi, Takao; Mawatari, Masaaki

    2014-01-01

    Revision surgery is one of the most difficult reconstructive challenges facing orthopaedic surgeons; therefore, many new techniques and implants are needed to ensure that such patient can be successfully treated. We report a 66-year old female with a chronic dislocated bipolar hip prosthesis. She underwent a revision total hip arthroplasty combined with V-shaped subtrochanteric shortening osteotomy. This report demonstrates that V-shaped subtrochanteric shortening osteotomy can be us...

  16. 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...

  17. 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.

  18. 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.

  19. GPU accelerated dislocation dynamics

    Science.gov (United States)

    Ferroni, Francesco; Tarleton, Edmund; Fitzgerald, Steven

    2014-09-01

    In this paper we analyze the computational bottlenecks in discrete dislocation dynamics modeling (associated with segment-segment interactions as well as the treatment of free surfaces), discuss the parallelization and optimization strategies, and demonstrate the effectiveness of Graphical Processing Unit (GPU) computation in accelerating dislocation dynamics simulations and expanding their scope. Individual algorithmic benchmark tests as well as an example large simulation of a thin film are presented.

  20. 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

    2014-01-23

    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 AB B[Symbol: see text]AC 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. PMID:24352231

  1. Congenital platelet function defects

    Science.gov (United States)

    Platelet storage pool disorder; Glanzmann's thrombasthenia; Bernard-Soulier syndrome; Platelet function defects - congenital ... Congenital platelet function defects are bleeding disorders that cause ... function, even though there are normal platelet counts. ...

  2. 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 © ...

  3. A Replication Study for the Association of rs726252 in PAPPA2 with Developmental Dysplasia of the Hip in Chinese Han Population

    OpenAIRE

    Dongquan Shi; Wei Sun; Xingquan Xu; Zheng Hao; Jin Dai; Zhihong Xu; Dongyang Chen; Huajian Teng; Qing Jiang

    2014-01-01

    Developmental dysplasia of the hip (DDH) is a common developmental hip disorder, which ranges from mild acetabulum malformation to irreducible hip dislocation. A previous study suggested a significant association of pregnancy-associated plasma protein-A2 (PAPPA2) with DDH susceptibility in Chinese Han population. But with the consideration of the sample size, the association was still debatable. To confirm the association of the reported single nucleotide polymorphism (SNP) in PAPPA2, rs72625...

  4. 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.

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

    Science.gov (United States)

    Malek, S; Stammers, J; Ranawat, V; Skinner, JA

    2013-01-01

    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

  6. 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

  7. 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 -- ...

  8. A Simple Technique for Adjustment of the Femoral Offset at the Site of Hip Spacer Implantation

    OpenAIRE

    Anagnostakos, Konstantinos; Lorbach, Olaf; Orth, Patrick; Koch, Katrin

    2013-01-01

    The decrease of femoral offset might play a role in the emergence of hip spacer dislocations, but it has not been discussed in the literature yet. The present work describes a technique for femoral offset adjustment. Either a bended blade plate or a dynamic hip screw can be used. The depth of the insertion and the angle of the particular implant are defined by the size of the offset adjustment required in each case. The described technique is feasible to produce a customized hip spacer, allow...

  9. Congenital hyperinsulinism.

    Science.gov (United States)

    Arnoux, Jean-Baptiste; de Lonlay, Pascale; Ribeiro, Maria-Joao; Hussain, Khalid; Blankenstein, Oliver; Mohnike, Klaus; Valayannopoulos, Vassili; Robert, Jean-Jacques; Rahier, Jacques; Sempoux, Christine; Bellanné, Christine; Verkarre, Virginie; Aigrain, Yves; Jaubert, Francis; Brunelle, Francis; Nihoul-Fékété, Claire

    2010-05-01

    Congenital hyperinsulinism (CHI or HI) is a condition leading to recurrent hypoglycemia due to an inappropriate insulin secretion by the pancreatic islet beta cells. HI has two main characteristics: a high glucose requirement to correct hypoglycemia and a responsiveness of hypoglycemia to exogenous glucagon. HI is usually isolated but may be rarely part of a genetic syndrome (e.g. Beckwith-Wiedemann syndrome, Sotos syndrome etc.). The severity of HI is evaluated by the glucose administration rate required to maintain normal glycemia and the responsiveness to medical treatment. Neonatal onset HI is usually severe while late onset and syndromic HI are generally responsive to a medical treatment. Glycemia must be maintained within normal ranges to avoid brain damages, initially with glucose administration and glucagon infusion then, once the diagnosis is set, with specific HI treatment. Oral diazoxide is a first line treatment. In case of unresponsiveness to this treatment, somatostatin analogues and calcium antagonists may be added, and further investigations are required for the putative histological diagnosis: pancreatic (18)F-fluoro-L-DOPA PET-CT and molecular analysis. Indeed, focal forms consist of a focal adenomatous hyperplasia of islet cells, and will be cured after a partial pancreatectomy. Diffuse HI involves all the pancreatic beta cells of the whole pancreas. Diffuse HI resistant to medical treatment (octreotide, diazoxide, calcium antagonists and continuous feeding) may require subtotal pancreatectomy which post-operative outcome is unpredictable. The genetics of focal islet-cells hyperplasia associates a paternally inherited mutation of the ABCC8 or the KCNJ11 genes, with a loss of the maternal allele specifically in the hyperplasic islet cells. The genetics of diffuse isolated HI is heterogeneous and may be recessively inherited (ABCC8 and KCNJ11) or dominantly inherited (ABCC8, KCNJ11, GCK, GLUD1, SLC16A1, HNF4A and HADH). Syndromic HI are always diffuse form and the genetics depend on the syndrome. Except for HI due to potassium channel defect (ABCC8 and KCNJ11), most of these HI are sensitive to diazoxide. The main points sum up the management of HI: i) prevention of brain damages by normalizing glycemia and ii) screening for focal HI as they may be definitively cured after a limited pancreatectomy. PMID:20550977

  10. Hip joint replacement

    Science.gov (United States)

    ... made joint. The artificial joint is called a prosthesis . ... thromboembolic disease in patients undergoing elective hip and knee arthopolasty: Evidence-based guideline and evidence report. American ...

  11. 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, ...

  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. Left-dislocation revisited

    OpenAIRE

    Acuña Fariña, Juan Carlos

    1995-01-01

    The aim of this paper is to provide syntactic evidence that left-dislocated NPs (LDs) do not belong inside the structure of the sentences with which they are usually associated. It is argued here that the relationship between LDs and these sentences is merely a semantic one of co-reference and that, therefore, no formal, structural liaison exists between them. The analysis that contemplates the left-dislocated constituent as a sister of a lower clausal node inside the highest S node is conseq...

  14. Is Congenital Syphilis Really Congenital Syphilis?

    OpenAIRE

    Bernard Gonik; Yi Li

    2006-01-01

    Detroit has recently been distinguished as having the highest congenital syphilis rate in the United States (250.3 cases per 100 000 live births in Detroit versus 10.3 in the US). However, depending on each health department's followup and CDC reporting, these data may not accurately reflect the true congenital syphilis rate. This study examines the reported cases over a three-year time period with focus on the criteria used for diagnosis. All local health department congenital ...

  15. Variational approach in dislocation theory

    OpenAIRE

    Groma, István; Györgyi, Géza; Ispánovity, Péter Dusán

    2009-01-01

    A variational approach is presented to calculate the stress field generated by a system of dislocations. It is shown that in the simplest case, when the material containing the dislocations obeys Hooke's law the variational framework gives the same field equations as Kr\\"oner's theory. However, the variational method proposed allows to study many other problems like dislocation core regularisation, role of elastic anharmonicity and dislocation--solute atom interaction. The a...

  16. Nature of Dislocations in Silicon

    OpenAIRE

    Hansen, Lars Bruno; Stokbro, Kurt; Lundqvist, Bengt; Jacobsen, Karsten Wedel; Deaven, D. M.

    2009-01-01

    Interaction between two partial 90 degrees edge dislocations is studied with atomic-scale simulations using the effective-medium tight-binding method. A large separation between the two dislocations (up to 30 Angstrom), comparable to experimental values, is achieved with a solution of the tight-binding Hamiltonian that scales linearly with the number of atoms. The partial edge dislocation is found to be very accurately described by the Peierls-Nabarro dislocation model, with generalized stack...

  17. Kinematic assessment of hip movement when retrieving an object from the floor

    Directory of Open Access Journals (Sweden)

    Moorehead John D

    2011-02-01

    Full Text Available Abstract Background Activities that require extreme hip movement can dislocate hip implants in the early post operative phase. One such activity is retrieving an object from the floor. The aim of this study was to assess hip movement using four different techniques to accomplish this task. This assessment would identify the techniques least likely to cause a hip dislocation. Methods An electromagnetic tracker was used to measure the movement of 50 hips in 25 normal subjects. Sensors were attached over the iliac crest and the mid-shaft of the lateral thigh. Data was then collected for 3 repetitions of each of the following retrieval techniques:- 1. Flexing forward to pick up an object between the feet. 2. Flexing to pick up an object lateral to the foot. 3. Squatting to pick up an object between the feet. 4. Kneeling on one knee to pick up beside the knee. Results Kneeling required a mean movement of 30.4 degree(s flexion and 7.2 degree(s external rotation. This was significantly less than all the other techniques (paired t-test, P Conclusion The study showed that squatting had the most flexion and internal rotation, whereas kneeling has the least flexion. Thus, to minimise the dislocation risk when retrieving an object from the floor, kneeling should be adopted and squatting should be avoided.

  18. 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.

  19. Dislocations in anharmonic crystals

    International Nuclear Information System (INIS)

    The large correction factor by which Klemens' formula must be multiplied in order to provide a reliable description of the thermal-resistivity contribution due to dislocations is explained in the frame of the same isotropic model used by Klemens, Ziman and Carruthers and is attributed to an incorrect way of treating anharmonicity and photon averages in the theories of the mentioned authors

  20. Smectic meniscus and dislocations

    International Nuclear Information System (INIS)

    In ordinary liquids the size of a meniscus and its shape is set by a competition between surface tension and gravity. The thermodynamical process of its creation can be reversible. On the contrary, in smectic liquid crystals the formation of the meniscus is always an irreversible thermodynamic process since it involves the creation of dislocations (therefore it involves friction). Also the meniscus is usually small in experiments with smectics in comparison to the capillary length and therefore the gravity does not play any role in determining the meniscus shape. Here we discuss the relation between dislocations and meniscus in smectics. The theoretical predictions are supported by a recent experiment performed on freely suspended films of smectic liquid crystals. In this experiment the measurement of the meniscus radius of curvature gives the pressure difference, ?p, according to the Laplace law. From the measurements of the growth dynamics of a dislocation loop (governed by ?p) we find the line tension (?8 x 10-8 dyn) and the mobility of an elementary edge dislocation (?4 x 10-7 cm2 s/g). (author)

  1. Supernumerary nostril: Congenital adrenal hyperplasia with a rare congenital anomaly

    Science.gov (United States)

    Ciloglu, Sinem; Duran, Alpay; Buyukdogan, Hasan; Yigit, Ahmet K.

    2014-01-01

    Multiple or supernumerary nostril is a rare congenital anomaly with unknown etiology. The first case was reported by Lindsay as bilateral supernumerary nostrils. Supernumerary nostril cases are mostly unilateral and isolated. They are also reported with other congenital malformations like facial clefts and congenital anomalies like congenital auricular hypoplasia, congenital cataracts, eusophageal atresia and patent ductus arteriosus. Here, we report a case of supernumerary nostril with congenital adrenal hyperplasia PMID:25593872

  2. Genetics of congenital hypothyroidism

    OpenAIRE

    PARK, S.; Chatterjee, V

    2005-01-01

    Congenital hypothyroidism is the most common neonatal metabolic disorder and results in severe neurodevelopmental impairment and infertility if untreated. Congenital hypothyroidism is usually sporadic but up to 2% of thyroid dysgenesis is familial, and congenital hypothyroidism caused by organification defects is often recessively inherited. The candidate genes associated with this genetically heterogeneous disorder form two main groups: those causing thyroid gland dysgenesis and those causin...

  3. Transient osteoporosis of the hip

    International Nuclear Information System (INIS)

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

  4. 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.

  5. Genetics Home Reference: Congenital hypothyroidism

    Science.gov (United States)

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

  6. Types of Congenital Heart Defects

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Congenital Heart Defects With congenital heart defects, some part of the ... how the heart develops. Examples of Simple Congenital Heart Defects Holes in the Heart (Septal Defects) The septum ...

  7. 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.)

  8. 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.

  9. Dynamics of free, straight dislocation pairs. I. Screw dislocations

    International Nuclear Information System (INIS)

    Analytic expressions are derived for the motion of a pair of interacting, straight, parallel (or antiparallel) screw dislocations in an applied stress field. Analysis of the equations of motion of the dislocations shows that, under most circumstances, the velocity of a dislocation is proportional to the driving force (i.e., the motion is overdamped), and, in this limit, the results are exact. However, when the two dislocations are very close together, inertial terms begin to play a role, and the resultant ''finite-mass'' corrections are treated perturbatively. For the case of antiparallel screw dislocations, a capture cross section exists and is given by the product of the shear modulus and the Burgers vector over the applied stress. Based on these results, a simple statistical analysis of the motion of a large number of screw dislocations is presented

  10. 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

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

  12. 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 ...

  13. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... going to be the minimally invasive anterial lateral approach to the right hip in this gentleman. We' ... wasn’t able to get on my initial approach to begin to orient -- this is the dorsal ...

  14. Hip Conditioning Program

    Science.gov (United States)

    ... or her orthopaedic surgeon. Purpose of Program _________________________________________________________________ Hip Conditioning Program After an injury or surgery, an exercise ... Target Muscles: The muscle groups targeted in this conditioning program include: • Gluteus maximus (buttocks) • Gluteus medius (buttocks) • ...

  15. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... hip. And at this point we'll begin. All right, the incision starts from the superior anterior ... little better. Now John, you're doing this all bluntly with basically digital palpation? Exactly true and ...

  16. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... total hip replacement, because you're using the connective, you feel that you can do this directly ... rasping. These are the rasps for the new connective system. They're diamond cutting and they cut ...

  17. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... Elling on bass fiddle, I guess. And we'll get started here. The procedure today is going ... the Zimmer Kinectiv Hip System today and we'll walk you through that. If we have questions ...

  18. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... choke header and the anterior superior at the spine of the right hip. And at this point ... on their side, placing both anterior superior iliac spines against that post, which then assures me that ...

  19. 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.

  20. 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.

  1. HIP Mobile Client

    OpenAIRE

    Myry, Perttu

    2013-01-01

    HIP on lyhenne sanoista Humap Inspiration Platform. Se on Humap Software Oy:n kehittämä ja tarjoama web-pohjainen alusta, jonka avulla voidaan rakentaa varsin monimuotoisia tuotteita, palveluita ja erilaisia konsepteja. Tässä opinnäytetyössä käydään läpi prosessi kuinka tälle alustalle luotiin mobiilisovellus. HIP alustaa on kehitetty vuodesta 2008 ja sen edeltäjää Humap Tool palvelua vuodesta 2000 alkaen. Tämän vuoksi alustaan on vuosien saatossa kertynyt satoja ominaisu...

  2. Congenital Insensitivity to Pain

    Directory of Open Access Journals (Sweden)

    Praveen Kumar B,

    2011-01-01

    Full Text Available Congenital Insensitivity to Pain belongs to the family of Hereditary Sensory and Autonomic Neuropathies (HSAN. It is a rare disorder of unknown etiology associated with loss of pain sensation. Cognition and sensation is otherwise normal and there is no detectable physical abnormality. We report a case of Congenital Insensitivity to Pain in a 3 year old female child.

  3. Acetabular revision for recurrent dislocations : results in 14 cases after 3 years of follow-up

    DEFF Research Database (Denmark)

    Lind, Martin; Jensen, Niels Harry Krarup

    2002-01-01

    17 acetabular revisions (16 patients) were performed for recurrent dislocations. 14 patients were examined clinically and radiographically after mean 3 (1-8) years. We found malpositions of components in 12 of 17 cases. 8 of 17 had redislocations and 2 were rerevised. Harris hip scores improved from 57 to 70. 10 of 14 patients were satisfied with the surgical result. Recurrent dislocations have several causes. In our patients, lack of cup anteversion was the commonest indication for revision surgery. We noted a high rate of redislocations and poor clinical results, despite correction of the preoperative component malposition in the 14 cases with follow-up.

  4. Dislocations jam at any density

    Science.gov (United States)

    Tsekenis, Georgios; Goldenfeld, Nigel; Dahmen, Karin

    2011-03-01

    Crystalline materials deform in an intermittent way via dislocation-slip avalanches. Below a critical stress, the dislocations are jammed due to long-range interactions and the material exhibits plastic response, while above this critical stress the dislocations are mobile (the unjammed phase) and the material fails. We use dislocation dynamics and scaling arguments to show that the critical stress grows with the square root of the dislocation density. Consequently, dislocations jam at any density, in contrast to granular materials, which only jam below a critical density. We acknowledge funding from NSF grand DMR 03-25939 ITR and computational resources by the University of Illinois and NSF TeraGrid resources by the Texas Advanced Computing Center and the National Center for Supercomputing Applications (RG-DMR090061).

  5. Complexity in dislocation dynamics: model

    OpenAIRE

    Miguel, M. -carmen; Vespignani, Alessandro; Zapperi, Stefano; Weiss, Jerome; Grasso, Jean-robert

    2001-01-01

    We propose a numerical model to study the viscoplastic deformation of ice single crystals. We consider long-range elastic interactions among dislocations, the possibility of mutual annihilation, and a multiplication mechanism representing the activation of Frank-Read sources due to dislocation pinning. The overdamped equations of motion for a collection of dislocations are integrated numerically using different externally applied stresses. Using this approach we analyze the ...

  6. Inertial Oscillations of Pinned Dislocations

    OpenAIRE

    Bhattacharya, M.; Dutta, A.; Mukherjee, P.; Gayathri, N.; Barat, P.

    2010-01-01

    Dislocation pinning plays a vital role in the plastic behaviour of a crystalline solid. Here we report the first observation of the damped oscillations of a mobile dislocation after it gets pinned at an obstacle in the presence of a constant static shear load. These oscillations are found to be inertial, instead of forced as obtained in the studies of internal friction of solid. The rate of damping enables us to determine the effective mass of the dislocation. Nevertheless, ...

  7. Neglected locked vertical patellar dislocation

    OpenAIRE

    Gupta, Rakesh Kumar; Gupta, Vinay; Sangwan, Sukhbir Singh; Kamboj, Pradeep

    2012-01-01

    Patellar dislocations occurring about the vertical and horizontal axis are rare and irreducible. The neglected patellar dislocation is still rarer. We describe the clinical presentation and management of a case of neglected vertical patellar dislocation in a 6 year-old boy who sustained an external rotational strain with a laterally directed force to his knee. Initially the diagnosis was missed and 2 months later open reduction was done. The increased tension generated by the rotation of the ...

  8. Ullrich Congenital Muscular Dystrophy Possibly Related With COL6A1 p.Gly302Arg Variant

    OpenAIRE

    Park, Yoonhong; Park, Myung Seok; Sung, Duk Hyun; Sohn, Ji Yeon; Ki, Chang-seok; Kim, Du-hwan

    2014-01-01

    Ullrich congenital muscular dystrophy (UCMD) is characterized by congenital weakness, proximal joint contractures, and hyperlaxity of distal joints. UCMD is basically due to a defect in extra cellular matrix protein, collagen type VI. A 37-year-old woman who cannot walk independently visited our outpatient clinic. She had orthopedic deformities (scoliosis, joint contractures, and distal joint hyperlaxity), difficulty of respiration, and many skin keloids. Her hip computed tomography showed di...

  9. Hip pathology in Hutchinson-Gilford progeria syndrome: a report of two children.

    Science.gov (United States)

    Akhbari, Pouya; Jha, Shilpa; James, Kyle D; Hinves, Barry L; Buchanan, Jamie A F

    2012-11-01

    Hutchinson-Gilford progeria syndrome (HGPS) is a rare genetic disorder. The estimated incidence is one in 4 million births. Orthopaedic manifestations include abnormality of the hips occurring early in the disease process. Severe coxa valga can be apparent by the age of 2 years. We report two cases of HGPS, one in a 7-year-old girl with avascular necrosis of the left hip and the second in a 13-year-old girl with recurrent traumatic hip dislocations. We demonstrate the pathoanatomical changes in the hip with HGPS using a combination of imaging modalities including radiographic, computed tomographic and MRI scans. These include coxa magna, coxa valga and acetabular dysplasia. We also comment on how these would affect the surgical management of this high-risk group of patients. PMID:22433957

  10. Dislocation kinetics behind shear shocks

    International Nuclear Information System (INIS)

    High velocity oblique impact experiments result in both compression and shear shock waves. Behind the shear shock wave the particle velocity is transverse to the shock front. At large transverse particle velocities, dislocation kinetics can contribute a portion of the velocity. Based on a kinematic and thermodynamic model of dislocation kinetics, an analysis is made of the transverse strain and velocity behind a shear shock. Kinematics of dislocations in transverse motion behind the shock is formulated. A solution is given for an ideal case where the dislocation density function propagates as a pulse behind the shear shock. 9 refs

  11. Dislocation kinetics behind shear shocks

    Energy Technology Data Exchange (ETDEWEB)

    Stout, R.B.; Anderson, G.D.

    1985-06-01

    High velocity oblique impact experiments result in both compression and shear shock waves. Behind the shear shock wave the particle velocity is transverse to the shock front. At large transverse particle velocities, dislocation kinetics can contribute a portion of the velocity. Based on a kinematic and thermodynamic model of dislocation kinetics, an analysis is made of the transverse strain and velocity behind a shear shock. Kinematics of dislocations in transverse motion behind the shock is formulated. A solution is given for an ideal case where the dislocation density function propagates as a pulse behind the shear shock. 9 refs.

  12. Design rules for dislocation filters

    Energy Technology Data Exchange (ETDEWEB)

    Ward, T.; Sánchez, A. M.; Beanland, R., E-mail: r.beanland@warwick.ac.uk [Department of Physics, University of Warwick, Coventry CV4 7AL (United Kingdom); Tang, M.; Wu, J.; Liu, H. [Department of Electronic and Electrical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Dunstan, D. J. [School of Physics and Astronomy, Queen Mary University of London, London E1 4NS (United Kingdom)

    2014-08-14

    The efficacy of strained layer threading dislocation filter structures in single crystal epitaxial layers is evaluated using numerical modeling for (001) face-centred cubic materials, such as GaAs or Si{sub 1?x}Ge{sub x}, and (0001) hexagonal materials such as GaN. We find that threading dislocation densities decay exponentially as a function of the strain relieved, irrespective of the fraction of threading dislocations that are mobile. Reactions between threading dislocations tend to produce a population that is a balanced mixture of mobile and sessile in (001) cubic materials. In contrast, mobile threading dislocations tend to be lost very rapidly in (0001) GaN, often with little or no reduction in the immobile dislocation density. The capture radius for threading dislocation interactions is estimated to be approximately 40?nm using cross section transmission electron microscopy of dislocation filtering structures in GaAs monolithically grown on Si. We find that the minimum threading dislocation density that can be obtained in any given structure is likely to be limited by kinetic effects to approximately 10{sup 4}–10{sup 5?}cm{sup ?2}.

  13. Design rules for dislocation filters

    International Nuclear Information System (INIS)

    The efficacy of strained layer threading dislocation filter structures in single crystal epitaxial layers is evaluated using numerical modeling for (001) face-centred cubic materials, such as GaAs or Si1?xGex, and (0001) hexagonal materials such as GaN. We find that threading dislocation densities decay exponentially as a function of the strain relieved, irrespective of the fraction of threading dislocations that are mobile. Reactions between threading dislocations tend to produce a population that is a balanced mixture of mobile and sessile in (001) cubic materials. In contrast, mobile threading dislocations tend to be lost very rapidly in (0001) GaN, often with little or no reduction in the immobile dislocation density. The capture radius for threading dislocation interactions is estimated to be approximately 40?nm using cross section transmission electron microscopy of dislocation filtering structures in GaAs monolithically grown on Si. We find that the minimum threading dislocation density that can be obtained in any given structure is likely to be limited by kinetic effects to approximately 104–105?cm?2

  14. Nature of Dislocations in Silicon

    DEFF Research Database (Denmark)

    Hansen, Lars Bruno; Stokbro, Kurt

    1995-01-01

    Interaction between two partial 90 degrees edge dislocations is studied with atomic-scale simulations using the effective-medium tight-binding method. A large separation between the two dislocations (up to 30 Angstrom), comparable to experimental values, is achieved with a solution of the tight-binding Hamiltonian that scales linearly with the number of atoms. The partial edge dislocation is found to be very accurately described by the Peierls-Nabarro dislocation model, with generalized stacking-fault restoring forces, as reflected both in the interaction energy and in the displacement field. An asymmetric core reconstruction provides fourfold coordination, making Si behave elastically down to atomic distances.

  15. Congenital anomalies associated with hypothyroidism.

    OpenAIRE

    Bamforth, J S; Hughes, I; Lazarus, J.; John, R.

    1986-01-01

    Seven of the 34 infants identified through the Welsh Hypothyroid Screening Programme have additional congenital abnormalities. Two infants have a previously undescribed syndrome, two have chromosomal abnormalities, two have congenital heart disease, and one has a myelomeningocoele. Congenital hypothyroidism often seems to be associated with other congenital abnormalities.

  16. Dynamic behavior of tripolar hip endoprostheses under physiological conditions and their effect on stability.

    Science.gov (United States)

    Fabry, Christian; Kaehler, Michael; Herrmann, Sven; Woernle, Christoph; Bader, Rainer

    2014-01-01

    Tripolar systems have been implanted to reduce the risk of recurrent dislocation. However, there is little known about the dynamic behavior of tripolar hip endoprostheses under daily life conditions and achieved joint stability. Hence, the objective of this biomechanical study was to examine the in vivo dynamics and dislocation behavior of two types of tripolar systems compared to a standard total hip replacement (THR) with the same outer head diameter. Several load cases of daily life activities were applied to an eccentric and a concentric tripolar system by an industrial robot. During testing, the motion of the intermediate component was measured using a stereo camera system. Additionally, their behavior under different dislocation scenarios was investigated in comparison to a standard THR. For the eccentric tripolar system, the intermediate component demonstrated the shifting into moderate valgus-positions, regardless of the type of movement. This implant showed the highest resisting torque against dislocation in combination with a large range of motion. In contrast, the concentric tripolar system tended to remain in varus-positions and was primarily moved after stem contact. According to the results, eccentric tripolar systems can work well under in vivo conditions and increase hip joint stability in comparison to standard THRs. PMID:24209390

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

    Scientific Electronic Library Online (English)

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

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Julio Nazer H

    2001-01-01

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

  19. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... because of recent advances in surgical instrumentation and techniques. In addition to the live hip replacement, you ... to that hip in a more minimally invasive technique with this procedure he's using here today. The ...

  20. 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 ...

  1. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... a destroyed hip and needing a hip replacement. Suture. 00:05:28 PIETER J. HOMMEN, MD: There's ... PIETER J. HOMMEN, MD: And that's an absorbable suture, meaning that suture will -- 00:49:17 CARLOS ...

  2. Hip Fractures among Older Adults

    Science.gov (United States)

    ... Social Media Publications Injury Center Hip Fractures Among Older Adults On this Page How big is the problem? ... Hip fractures can be prevented by preventing falls. Older adults can stay independent and reduce their chances of ...

  3. Small Incision Total Hip Arthroplasty

    Medline Plus

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

  4. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... on that view, we could maybe see the approach to that hip a little bit. What Dr. ... go through muscle and tendon and get that approach to that hip in a more minimally invasive ...

  5. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... a hip replacement through the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. Good ... to watch Dr. Keith Berend perform an anterior approach total hip replacement with the patient on a ...

  6. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... the next hour, you will see two important orthopedic procedures used to help thousands of people suffering from hip pain. A small-incision total hip arthroplasty and arthroscopic ...

  7. Dislocations in anharmonic crystals

    International Nuclear Information System (INIS)

    In view of the second part of the work, concerning the problem of photon scattering by dislocations, the anharmonic properties of an isotropic solid are simply described in terms of a single dimensionless parameter, which can be related both to the Gruneisen constant and to the pressure derivative of the bulk modulus in the low-temperature limit. The model is strictly justifiable only for atoms interacting through a volume-independent pair potential, but represent also a good starting point for an approximate description of anharmonicity in metals

  8. Fractures and dislocations

    International Nuclear Information System (INIS)

    As detailed as necessary: Complete survey of fractures and dislocations, - high-quality, full-detail schematic drawings and pictures, - all clinically relevant classifications (AO, OTA, Neer, etc.), - criteria for reports of high informative value, - usual therapies, complications, clinical and radiological follow-ups. As concise as possible: Brief clinical description of any fracture type, - rapid characterization via AO/OTA classifications shown in sidenotes, - condensed information on recommended use of optimal imaging methods, - summarizing representations of typical X-ray signs. (orig./CB)

  9. Proximal tibiofibular dislocation

    OpenAIRE

    Horan, J.; Quin, G

    2006-01-01

    Proximal tibiofibular joint dislocation is an uncommon injury, which may be easily missed on plain radiography. If recognised, it can be treated in the emergency department, avoiding surgery and long term problems. The case is presented of a 22 year old male rugby player who was tackled from the left hand side while turning to the left. He heard a “pop” from his knee as he fell to the ground. Clinical examination revealed a prominence in the area of the fibular head. There was no evidence...

  10. Annealing of dislocation loops in dislocation dynamics simulations

    International Nuclear Information System (INIS)

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

  11. Hip biomechanics during gait.

    Science.gov (United States)

    Krebs, D E; Robbins, C E; Lavine, L; Mann, R W

    1998-07-01

    The literature is devoid of complete descriptions of hip biomechanics during gait. We present for the first time simultaneously acquired in vivo acetabular contact pressures, ground reaction forces, kinematics, hip torques, and electromyographic (EMG) activity during gait with and without a cane from an 85-year-old male with a left instrumented femoral head prosthesis. Highest acetabular contact pressures occurred in all gait trials at the posterosuperior acetabulum, just prior to peak EMG, adductor torque, and ground reaction force during late stance phase. Contralateral cane use reduced both peak acetabular contact pressure and gluteus medius EMG but not adductor torque or ground reaction force. These data identify a small area of high acetabular and femoral head stress that could occur during each of a human's millions of gait cycles annually and indicate that muscle activity, rather than solely body weight, drives hip loading, Clinicians who desire to limit hip loads should reduce both hip muscle contraction and weight bearing in late stance. PMID:9653690

  12. Hip resurfacing: a technology reborn

    OpenAIRE

    Cutts, Steven; Carter, Paul B.

    2006-01-01

    In recent years there has been a resurgence of interest in the concept of hip resurfacing. Much of this interest has stemmed from the work of McMinn in the West Midlands. Hip resurfacing is now emerging as a viable alternative to conventional hip replacement. In this article, we discuss the conceptual advantages offered by hip resurfacing and review the early clinical results and the ongoing clinical concerns regarding this technology.

  13. Extra-articular hip endoscopy

    Science.gov (United States)

    Verhelst, L.; Guevara, V.; De Schepper, J.; Van Melkebeek, J.; Pattyn, C.; Audenaert, E. A.

    2012-01-01

    The aim of this review is to evaluate the current available literature evidencing on peri-articular hip endoscopy (the third compartment). A comprehensive approach has been set on reports dealing with endoscopic surgery for recalcitrant trochanteric bursitis, snapping hip (or coxa-saltans; external and internal), gluteus medius and minimus tears and endoscopy (or arthroscopy) after total hip arthroplasty. This information can be used to trigger further research, innovation and education in extra-articular hip endoscopy. PMID:23610664

  14. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... to not be worried as much as about dislocation as -- Exactly. The soft tissues here are intact. ... from a Dr. Carter here that wondered if, dislocations aside, what about just choice of bearing based ...

  15. 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.

  16. Congenital Hypomyelinating Neuropathy (CHN)

    Science.gov (United States)

    ... About Muscle Diseases Help Through Services Hope Through Research Ways to Help MDA Partners in Progress Search form Search Charcot-Marie-Tooth Disease (CMT) Congenital Hypomyelinating Neuropathy (CHN) What is ...

  17. 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.

  18. Congenital hypomyelinating neuropathy.

    OpenAIRE

    Harati, Y; Butler, I J

    1985-01-01

    Two patients with congenital hypomyelinating neuropathy are reported with details of sural nerve pathology. The resemblance of this condition to the hypomyelinating neuropathy of Trembler mice is discussed and the pertinent medical literature reviewed.

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

  20. Screening for congenital hypothyroidism.

    OpenAIRE

    Gerard Henry; Sobki, Samia H.; Johara M. Othman

    1980-01-01

    OBJECTIVES To review the screening program for congenital hypothyroidism in the Riyadh Al-Kharj Hospital Programme, Riyadh, Kingdom of Saudi Arabia, and to investigate the clinical and biochemical characteristics of affected infants. METHODS The study was carried out from 1985 to 2000 in the Clinical Chemistry Division, Department of Pathology, Riyadh Armed Forces Hospital, Kingdom of Saudi Arabia. Laboratory data and case notes of infants diagnosed with congenital hypothyroidism wer...

  1. Isolated congenital bifid tongue

    OpenAIRE

    Surej, Kumar L. K.; Kurien, Nikhil M.; Sivan, Madhu P.

    2010-01-01

    Human growth and development is a meticulously planned and precisely executed process. Even a mild disturbance can have clinically significant manifestations later on. Even today, ancient beliefs and practices override/delay patient's aspiration for seeking treatment as seen in the case report presented here. Congenital bifid tongue in association with various other orofacial abnormalities has been reported, many of which have been linked to various syndromes. But congenital bifid tongue occu...

  2. Congenital scoliosis – Quo vadis?

    OpenAIRE

    Debnath Ujjwal; Goel Vivek; Harshavardhana Nanjanduppa; Webb John

    2010-01-01

    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 de...

  3. Ullrich Congenital Muscular Dystrophy

    OpenAIRE

    Goknur Haliloglu; Haluk Topaloglu

    2011-01-01

    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...

  4. 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

  5. Pathologic morphology of the dislocated proximal femur in children with cerebral palsy.

    Science.gov (United States)

    Lundy, D W; Ganey, T M; Ogden, J A; Guidera, K J

    1998-01-01

    We describe the gross and microscopic anatomic changes in the hip that result from the deforming forces in children with neuromuscular imbalance. Twelve dislocated proximal femora that had been resected from children with spastic diplegia or tetraplegia were evaluated with respect to their gross, microscopic, and radiographic structure. The epiphyses were wedge shaped with deformation of the femoral head apparent in all cases. In addition to a severe loss of articular cartilage, a furrowed erosion of epiphyseal bone suggested a sustained, blunt, band-like force across the surface of the hip where it opposed the acetabular labrum. The underlying physis of the capital femur was irregular with aberrant histologic structure, whereas that of the lesser trochanter was hypertrophic and angulated in a superior and anterior direction. A significant degree of valgus was not noticeable in most specimens. In summary, the spastic adductor and iliopsoas, responsible for the changes in the lesser trochanter, work in conjunction with the hip flexor and internal rotator muscles to subluxate the proximal femur. In the process, the superior rim of the acetabulum and capsule causes focal deformation of the superolateral femoral head, creating a fulcrum upon which the hip then progressively subluxates. The indentation locks the femoral head at the lateral acetabular margin, preventing complete dislocation, but leading to bone pain consequent to cartilage erosion. PMID:9661867

  6. Small diameter acetabulum and femoral head in total hip arthroplasty for developmental dysplasia of the hip, with no femoral osteotomy.

    Science.gov (United States)

    Verettas, Dionysios-Alexandros; Chloropoulou, Pelagia; Xarchas, Konstantinos; Drosos, Georgios; Ververidis, Athanasios; Kazakos, Konstantinos

    2015-05-26

    We present the results of 66 total hip arthroplasties in 62 patients of mean age 46 years (24-74 years), with developmental dysplasia of the hip. In all cases the centre of rotation of the new hip was positioned at the site of the true acetabulum. In all patients cementless press fit acetabular components of small diameter (42-44 mm) were used, articulating exclusively with a 22.25 mm modular metal femoral head, without the use of bone grafts or shortening osteotomies of the femur. Despite the use of small diameter femoral heads the rate of dislocation was 3%. After an average follow-up period of 9 years (4-18 years), no revisions were required for infection, loosening or wear or implant migration. Osteolytic lesions were seen in the periacetabular region in 3 patients who were symptom free. A total of 2 revisions were required for instability and 2 patients had the wires of their trochanteric osteotomy removed because of bursitis. Leg length inequality was improved in 55% of the patients and one postoperative transient sciatic nerve lesion settled within 4 months. We believe that in patients with painful dysplastic hips, the use of small diameter implants with the centre of rotation at the true acetabulum, can give very satisfactory results, without any supplementary procedures. PMID:25907394

  7. 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 on 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.)

  8. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  9. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

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

  10. Taper Hip Prosthesis

    Medline Plus

    Full Text Available Zimmer M/L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome to this "OR Live" Webcast presentation brought to ... approximately one centimeter to the shoulder of my prosthesis. And then I will simply use the prosthesis ...

  11. Taper Hip Prosthesis

    Medline Plus

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

  12. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... the fact that the stems that we're using can allow for addition of some additional anteversion but certainly not the degree ... reason, you need to accommodate the total anteversion of a total hip replacement, because you're using the connective, you feel that you can do ...

  13. 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.

  14. 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

  15. 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

  16. Association analysis between HOXD9 genes and the development of developmental dysplasia of the hip in Chinese female Han population

    OpenAIRE

    Tian Wei; Zhao Lixi; Wang Jing; Suo Peisu; Wang Jianmin; Cheng Longfei; Cheng Zhi; Jia Jian; Kan Shilian; Wang Binbin; Ma Xu

    2012-01-01

    Abstract Background Developmental dysplasia of the hip (DDH) is a congenital or acquired deformation or misalignment of the hip joint which affects mainly females. We hypothesized that HOXD9 gene could be regulated in acetabular size or shape and related in DDH developing. Methods Two hundred and nine Chinese Han female DDH patients and 173 ethnic, age matched healthy female controls were genotyped for HOXD9 two tag SNPs using sequenom method. Results One of the two tag SNPs, rs711822, was no...

  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. Congenital Heart Defects (For Parents)

    Science.gov (United States)

    ... and any related health problems. How a Healthy Heart Works To understand more about congenital heart defects, ... affect its ability to function properly. Continue Common Heart Defects Common types of congenital heart defects, which ...

  19. Congenital Heart Defects and CCHD

    Science.gov (United States)

    ... page It's been added to your dashboard . Congenital heart defects and CCHD Congenital means present at birth. ... babies and children with heart problems. How can heart defects affect your baby? Heart defects can affect ...

  20. Impact of Congenital Heart Defects

    Science.gov (United States)

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

  1. Environmental aspects of congenital scoliosis.

    Science.gov (United States)

    Li, Zheng; Yu, Xin; Shen, Jianxiong

    2015-04-01

    Growing evidence has proved that many aspects of our lifestyle and the environment contribute to the development of congenital disease. Congenital spinal deformities are due to anomalous development of the vertebrae including failure of formation and segmentation during embryogenesis. The causes of congenital scoliosis have not been fully identified. A variety of factors are implicated in the development of vertebral abnormalities. Previous studies have demonstrated that both genetics and environmental factors are implicated in the development of vertebral abnormalities. However, no specific cause for congenital scoliosis has been identified. In our review, we focus on the environmental factors for the development of congenital scoliosis. Various maternal exposures during pregnancy including hypoxia, alcohol use, vitamin deficiency, valproic acid, boric acid, and hyperthermia have been observed to be associated with the occurrence of congenital scoliosis. This review describes the major environmental contributors of congenital scoliosis with an emphasis on treatment aspects associated with environmental disposition in congenital scoliosis. PMID:25628116

  2. Continuum theory of evolving dislocation fields

    OpenAIRE

    Sedlacek, Radan; Schwarz, Cornelia; Kratochvil, Jan; Werner, Ewald

    2007-01-01

    Abstract Continuum theory of moving dislocations is used to set up a non-local constitutive law for crystal plasticity in the form of partial differential equations for evolving dislocation fields. The concept of single-valued dislocation fields that enables to keep track of the curvature of the continuously distributed gliding dislocations with line tension is utilized. The theory is formulated in the Eulerian as well as in so-called dislocation-Lagrangian for...

  3. Aberrometry changes and IOL dislocation

    Directory of Open Access Journals (Sweden)

    A.B. Kachanov

    2013-02-01

    Full Text Available ABSTRACT Purpose. To study the aberrometric changes in eyes with posterior IOL decentration. Material and methods. All ophthalmic examinations were performed including Hartmann-Shack WASCA and CRS-Master aberrometry system (Carl Zeiss Meditec. Ocular wavefront aberrations were measured in 14 eye with IOL dislocation (main group and 52 eyes with a normal central intracapsular position of IOL and 22 emmetropic (control groups. Results. We revealed total aberrations and HOAs (especially trefoil, spherical-like and mild positive vertical coma increasing in eyes with IOL dislocation. However, the accuracy of IOL decentration aberrometry depends on the capsular bag opacities, secondary cataract and a pronounced level of IOL dislocation. Conclusions. All aberrations and especially high order aberrations (HOAs increased in the eyes with IOL dislocation.

  4. Complexity in dislocation dynamics model

    CERN Document Server

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

    2001-01-01

    We propose a numerical model to study the viscoplastic deformation of ice single crystals. We consider long-range elastic interactions among dislocations, the possibility of mutual annihilation, and a multiplication mechanism representing the activation of Frank-Read sources due to dislocation pinning. The overdamped equations of motion for a collection of dislocations are integrated numerically using different externally applied stresses. Using this approach we analyze the avalanche-like rearrangements of dislocations during the dynamic evolution. We observe a power law distribution of avalanche sizes which we compare with acoustic emission experiments in ice single crystals under creep deformation. We emphasize the connections of our model with non-equilibrium phase transitions and critical phenomena.

  5. 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.

  6. Contiguous bifacet cervical fracture dislocations

    Scientific Electronic Library Online (English)

    JWM, Kigera; M, Nyati.

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

  7. Congenital syphilis in the newborn.

    OpenAIRE

    Chawla, V.; Pandit, P. B.; Nkrumah, F. K.

    1988-01-01

    We studied 53 newborn babies with congenital syphilis. The common clinical features seen were low birth weight, hepatosplenomegaly, anaemia, jaundice, and symmetrical superficial desquamation of the skin affecting palms and soles. The presence of these clinical signs is highly suggestive of early congenital syphilis. Hydrops fetalis without rhesus or ABO isoimmunisation should always arouse the suspicion of congenital syphilis.

  8. 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

  9. Femoroacetabular impingement due to synovial chondromatosis of the hip joint.

    Science.gov (United States)

    Padhy, Debabrata; Park, Sang-Won; Jeong, Woong-Kyo; Lee, Dae-Hee; Park, Jong Hoon; Han, Seung-Beom

    2009-12-01

    This article describes a rare case of primary synovial chondromatosis of the hip associated with classical femoroacetabular impingement. A 38-year-old man presented with left hip pain of 3 years' duration and range of motion (ROM) limitations. Flexion abduction external rotation and impingement tests were positive and preoperative Harris Hip Score was 68. Radiographs showed multiple loose bodies, a calcified labrum, and a bump at the head-neck junction. Computed tomography (CT) confirmed the findings. Acetabular overcoverage and the crossing over sign were present. The lateral center edge angle was 48 degrees, acetabular roof angle was +2 degrees, alpha angle was 80 degrees, triangular index was 2 mm more than the radius of the femoral head, and anterior offset was 4.5 mm. Magnetic resonance imaging (MRI) revealed an acetabular labral tear, impaction on the femoral head-neck junction, and mild synovial hypertrophy with no acetabular cartilage damage. Loose body removal along with a total synovectomy, excision of the calcified labrum, and osteochondroplasty of the head-neck junction were performed after safe surgical dislocation. At 6-month follow-up, the patient was doing well with a Harris Hip Score of 96, improved ROM, and negative flexion abduction external rotation and impingement tests. Early diagnosis of synovial chondromatosis and impingement can be made by MRI and CT. Clinically, flexion abduction external rotation and impingement tests are positive in 99% and 97% of cases, respectively. Although arthroscopy management has been described for both the entities separately, it has drawbacks. With an open procedure, debridement of the hip joint and excision of femoral and acetabular impingement deformities are possible at the same time. PMID:19968228

  10. Congenital hearing impairment

    International Nuclear Information System (INIS)

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

  11. 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.)

  12. Congenital hearing impairment

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-04-15

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

  13. Isolated Congenital Heart Block

    OpenAIRE

    Tunaoglu, F. Sedef; Yildirim, Ayse; Vurali, Dogus

    2010-01-01

    Isolated congenital heart block, frequently seen in mothers who have connective-tissue disease, can be transmitted to the fetus through transplacental passage of anti-Ro/SSA and anti-La/SSB autoantibodies. Even if the antibodies appear transiently in the fetal circulation, the block is permanent and can require pacemaker implantation. Complete congenital heart block is seen in 1% to 5% of neonates born to mothers who carry these autoantibodies. Herein, we report the case of a baby—born to a...

  14. 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.

  15. 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)

  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. Congenitally corrected transposition

    Directory of Open Access Journals (Sweden)

    Debich-Spicer Diane

    2011-05-01

    Full Text Available Abstract Congenitally corrected transposition is a rare cardiac malformation characterized by the combination of discordant atrioventricular and ventriculo-arterial connections, usually accompanied by other cardiovascular malformations. Incidence has been reported to be around 1/33,000 live births, accounting for approximately 0.05% of congenital heart malformations. Associated malformations may include interventricular communications, obstructions of the outlet from the morphologically left ventricle, and anomalies of the tricuspid valve. The clinical picture and age of onset depend on the associated malformations, with bradycardia, a single loud second heart sound and a heart murmur being the most common manifestations. In the rare cases where there are no associated malformations, congenitally corrected transposition can lead to progressive atrioventricular valvar regurgitation and failure of the systemic ventricle. The diagnosis can also be made late in life when the patient presents with complete heart block or cardiac failure. The etiology of congenitally corrected transposition is currently unknown, and with an increase in incidence among families with previous cases of congenitally corrected transposition reported. Diagnosis can be made by fetal echocardiography, but is more commonly made postnatally with a combination of clinical signs and echocardiography. The anatomical delineation can be further assessed by magnetic resonance imaging and catheterization. The differential diagnosis is centred on the assessing if the patient is presenting with isolated malformations, or as part of a spectrum. Surgical management consists of repair of the associated malformations, or redirection of the systemic and pulmonary venous return associated with an arterial switch procedure, the so-called double switch approach. Prognosis is defined by the associated malformations, and on the timing and approach to palliative surgical care.

  18. [Radiocarpal dislocation after a trivial injury].

    Science.gov (United States)

    Jiménez-Jiménez, I J; Caballero-Martel, J R; Ojeda-Castellano, J

    2015-01-01

    Radiocarpal dislocation is an extremely uncommon injury in Traumatology, and is usually produced by high energy trauma. There are two types of dislocation, type I: pure radiocarpal dislocation and type II: fracture-dislocation. The gold standard treatment according to the literature is surgical treatment fixing the fractures and repairing the injured ligaments. We report a clinical case of radiocarpal dislocation type I in a healthy 19 year-old male after a minor trauma. The dislocation was reduced by traction, and the wrist immobilized in a plaster cast. The functional outcome 12 months after the injury was excellent. PMID:24813623

  19. Non-singular dislocation fields

    International Nuclear Information System (INIS)

    Non-singular solutions for dislocation and disclination fields have recently been obtained by the author and his co-workers by using a robust model of gradient elasticity theory. These solutions, whose form is simple and easy to implement, are obtained by reducing the gradient elasticity problem to a corresponding linear elasticity boundary value problem through the solutions of an inhomogeneous Helmholtz equation where the source term is the classical singular solution. The Laplacian in the Helmholtz equation, involving the extra gradient coefficient, produces a new term in the gradient solution which asymptotically approaches the negative of the classical elasticity solution on the dislocation line. Thus, the singularity is eliminated and an arbitrary estimate of the dislocation core size introduced in classical theory, is not required. These predictions are tested against atomistic calculations and their implications to various dislocation related configurations are discussed. Due to the simple and elegant form of these solutions, it is hoped that they will be useful in discrete dislocation dynamics simulations.

  20. Non-singular dislocation fields

    Energy Technology Data Exchange (ETDEWEB)

    Aifantis, Elias C, E-mail: mom@mom.gen.auth.gr [Laboratory of Mechanics and Materials, Faculty of Engineering, Aristotle University of Thessaloniki, GR-54124, Thessaloniki (Greece); Center for Mechanics of Materials, Michigan Technological University, Houghton MI 49931 (United States)

    2009-07-15

    Non-singular solutions for dislocation and disclination fields have recently been obtained by the author and his co-workers by using a robust model of gradient elasticity theory. These solutions, whose form is simple and easy to implement, are obtained by reducing the gradient elasticity problem to a corresponding linear elasticity boundary value problem through the solutions of an inhomogeneous Helmholtz equation where the source term is the classical singular solution. The Laplacian in the Helmholtz equation, involving the extra gradient coefficient, produces a new term in the gradient solution which asymptotically approaches the negative of the classical elasticity solution on the dislocation line. Thus, the singularity is eliminated and an arbitrary estimate of the dislocation core size introduced in classical theory, is not required. These predictions are tested against atomistic calculations and their implications to various dislocation related configurations are discussed. Due to the simple and elegant form of these solutions, it is hoped that they will be useful in discrete dislocation dynamics simulations.

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

    Science.gov (United States)

    Fisher, Kimberly A; Fisher, David A

    2014-04-01

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

  2. Dislocations in strained-layer semiconductor heterostructures

    International Nuclear Information System (INIS)

    The reliability of semiconductor devices depends upon the stability of the constituent materials. Strained-layer semiconductor structures contain a layer whose lattice constant differs from the surrounding layers, resulting in a misfit strain. As dislocations are the main failure mechanism in semiconductor lasers, it is essential to establish whether the stability of these structures is affected by the lattice mismatch and the possibility of relaxation by the formation of misfit dislocations. In this thesis, dislocations in strained-layer semiconductor structures are investigated. Relaxation of strained-layer GaAs/InxGa1-xAs/GaAs heterostructures through the formation of misfit dislocations is found to occur in stages. Firstly, generation and elongation of misfit dislocations on threading dislocations during molecular beam epitaxy (MBE) growth have been demonstrated with increasing strained-layer thickness. The onset of this stage has been shown to occur at strained-layer thicknesses below those predicted by the Matthews-Blakeslee (M-B) model. The second stage of relaxation is marked by the formation of a network of 60 deg. misfit dislocations. A third stage of relaxation has been discovered, in which pure edge (i.e. 90 deg.) misfit dislocations are formed in addition to the existing network of 60 deg. misfit dislocations. Different mechanisms are found to be responsible for the three stages of relaxation. The M-B model describes the transformati. The M-B model describes the transformation of threading dislocations to generate 60 deg. misfit dislocations. As this affects individual dislocations, it results in only local relaxation. A separate mechanism, which remains unclear but is not dependent on the interactions of dislocations, dominates the formation of a 60 deg. misfit dislocation network. The edge dislocations responsible for further relaxation of the structures are produced by vacancy-producing jogs. These protrude from pre-existing 60 deg. dislocations and trail edge dislocation pairs as they climb. (author)

  3. 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 rey both points of view have merit and in reality both mechanisms contribute to the phenomena

  4. Transfer of molecular dynamics data to dislocation dynamics to assess dislocation–dislocation loop interaction in iron

    International Nuclear Information System (INIS)

    We propose a computationally fast and physically justifiable method to treat dislocation loops as stochastic thermally activated finite-size obstacles in discrete dislocation dynamics simulations. The method was parameterized using molecular dynamics data for the interaction of dislocations with a0/2?1 1 1? dislocation loops. As demonstration, the method is applied to rationalize experimental hardening of neutron-irradiated iron. The obtained results show good agreement with experimental data

  5. Biomechanics of the hip joint

    International Nuclear Information System (INIS)

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

  6. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... bone, please. I'm fixing that to the patient's priorly implanted stem, and it's actually a soldering type effect ... a matter of days. The other 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 ...

  7. 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 ...

  8. Intermittent dislocation flow in viscoplastic deformation

    CERN Document Server

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

    2001-01-01

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

  9. Elbow dislocation with ipsilateral distal radius fracture

    OpenAIRE

    Meena, Sanjay; Trikha, Vivek; Kumar, Rakesh; Saini, Pramod; Sambharia, Abhishek Kumar

    2013-01-01

    Elbow dislocation associated with ipsilateral distal radius fracture is a rare pattern of injury, although it is common for elbow dislocation and forearm fractures to occur separately. We report a rare case of a 20-year-old male who had a posterior elbow dislocation and ipsilateral distal radius fracture. Elbow dislocation was first reduced in extension and distal radius fracture was then reduced in flexion. Both the injuries were conservatively managed. At 6 months follow-up, the patient had...

  10. Intermittent dislocation flow in viscoplastic deformation

    OpenAIRE

    Miguel, M. -Carmen; Vespignani, Alessandro, 1965-; Zapperi, Stefano; Weiss, Jerome; Grasso, Jean-Robert

    2001-01-01

    The viscoplastic deformation (creep) of crystalline materials under constant stress involves the motion of a large number of interacting dislocations. Analytical methods and sophisticated `dislocation-dynamics' simulations have proved very effective in the study of dislocation patterning, and have led to macroscopic constitutive laws of plastic deformation. Yet, a statistical analysis of the dynamics of an assembly of interacting dislocations has not hitherto been performed....

  11. 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

  12. Update on congenital glaucoma

    Directory of Open Access Journals (Sweden)

    Mandal Anil

    2011-12-01

    Full Text Available Congenital glaucoma is a global problem and poses a diagnostic and therapeutic challenge to the ophthalmologist. A detailed evaluation under general anesthesia is advisable to establish the diagnosis and plan for management. Medical therapy has a limited role and surgery remains the primary therapeutic modality. While goniotomy or trabeculotomy ab externo is valuable in the management of congenital glaucoma, primary combined trabeculotomy-trabeculectomy offers the best hope of success in advanced cases. Trabeculectomy with antifibrotic agent and glaucoma drainage devices has a role in the management of refractory cases, and cyclodestructive procedures should be reserved for patients where these procedures have failed. Early diagnosis, prompt therapeutic intervention and proper refractive correction are keys to success. Management of residual vision and visual rehabilitation should be an integral part of the management of children with low vision and lifelong follow-up is a must.

  13. Congenital intestinal lymphangiectasia

    Directory of Open Access Journals (Sweden)

    Popovi? Dušan ?.

    2011-01-01

    Full Text Available Background. Congenital intestinal lymphangiectasia is a disease which leads to protein losing enteropathy. Tortous, dilated lymphatic vessels in the intestinal wall and mesenterium are typical features of the disease. Clinical manifestations include malabsorption, diarrhea, steatorrhea, edema and effusions. Specific diet and medication are required for disease control. Case report. A 19-year old male patient was hospitalized due to diarrhea, abdominal swelling, weariness and fatigue. Physical examination revealed growth impairment, ascites, and lymphedema of the right hand and forearm. Laboratory assessment indicated iron deficiency anaemia, lymphopenia, malabsorption, inflammatory syndrome, and urinary infection. Enteroscopy and video capsule endoscopy demonstrated dilated lymphatic vessels in the small intestine. The diagnosis was confirmed by intestinal biopsy. The patient was put on high-protein diet containing medium-chain fatty acids, somatotropin and suportive therapy. Conclusion. Congenital intestinal lymphangiectasia is a rare disease, usually diagnosed in childhood. Early recognition of the disease and adequate treatment can prevent development of various complications.

  14. Autosomal recessive congenital ichthyosis.

    Science.gov (United States)

    Rodríguez-Pazos, L; Ginarte, M; Vega, A; Toribio, J

    2013-05-01

    The term autosomal recessive congenital ichthyosis (ARCI) refers to a group of rare disorders of keratinization classified as nonsyndromic forms of ichthyosis. This group was traditionally divided into lamellar ichthyosis (LI) and congenital ichthyosiform erythroderma (CIE) but today it also includes harlequin ichthyosis, self-healing collodion baby, acral self-healing collodion baby, and bathing suit ichthyosis. The combined prevalence of LI and CIE has been estimated at 1 case per 138 000 to 300 000 population. In some countries or regions, such as Norway and the coast of Galicia, the prevalence may be higher due to founder effects. ARCI is genetically highly heterogeneous and has been associated with 6 genes to date: TGM1, ALOXE3, ALOX12B, NIPAL4, CYP4F22, and ABCA12. In this article, we review the current knowledge on ARCI, with a focus on clinical, histological, ultrastructural, genetic, molecular, and treatment-related aspects. PMID:23562412

  15. 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.

  16. 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.

  17. Nonclassic Congenital Adrenal Hyperplasia

    OpenAIRE

    Selma Feldman Witchel; Ricardo Azziz

    2010-01-01

    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 ...

  18. Congenital diaphragmatic hernia

    OpenAIRE

    Tovar Juan A

    2009-01-01

    Abstract Congenital Diaphragmatic Hernia (CDH) is defined by the presence of an orifice in the diaphragm, more often left and posterolateral that permits the herniation of abdominal contents into the thorax. The lungs are hypoplastic and have abnormal vessels that cause respiratory insufficiency and persistent pulmonary hypertension with high mortality. About one third of cases have cardiovascular malformations and lesser proportions have skeletal, neural, genitourinary, gastrointestinal or o...

  19. Congenital Short QT Syndrome

    OpenAIRE

    Charles Antzelevitch; Johnson Francis

    2010-01-01

    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 (

  20. 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.

  1. Radiology of congenital heart disease

    International Nuclear Information System (INIS)

    This is a text on the radiologic diagnosis of congenital heart disease and its clinical manifestations. The main thrust of the book is the logical approach which allows an understanding of the complex theory of congenital heart disease. The atlas gives a concise overview of the entire field of congenital heart disease. Emphasis is placed on the understanding of the pathophysiology and its clinical and radiological consequences. Surgical treatment is included since it provides a different viewpoint of the anatomy

  2. Alberta Congenital Anomalies Surveillance System

    OpenAIRE

    Lowry, R. B.; Thunem, N. Y.; Anderson-redick, S.

    1990-01-01

    The Alberta Congenital Anomalies Surveillance System was started in 1966 in response to the thalidomide tragedy earlier in the decade. It was one of four provincial surveillance systems on which the federal government relied for baseline statistics of congenital anomalies. The government now collects data from six provinces and one territory. The Alberta Congenital Anomaly Surveillance System originally depended on three types of notification to the Division of Vital Statistics, Department of...

  3. Current trends in congenital syphilis

    OpenAIRE

    Phiske, Meghana Madhukar

    2014-01-01

    In many parts of the world particularly sub-Saharan Africa, congenital syphilis is a significant public health problem. Though it is rare in most affluent countries there has been a slight resurgence recently in several European countries. The diagnosis of suspected cases and management of congenital syphilis may be confusing and the potential for severe disability is high when cases are missed. The cornerstone of congenital syphilis control is antenatal screening and treatment of mothers wit...

  4. 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

  5. Care and Treatment for Congenital Heart Defects

    Science.gov (United States)

    ... Resources Stroke More Care and Treatment for Congenital Heart Defects Updated:Jan 8,2015 Not all people with ... you in your pursuit of heart health. Congenital Heart Defects • Home • About Congenital Heart Defects • The Impact of ...

  6. Genetics Home Reference: Congenital diaphragmatic hernia

    Science.gov (United States)

    ... literature OMIM Genetic disorder catalog Conditions > Congenital diaphragmatic hernia On this page: Description Genetic changes Inheritance Diagnosis ... definitions Reviewed September 2013 What is congenital diaphragmatic hernia? Congenital diaphragmatic hernia is a defect in the ...

  7. 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

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

    Directory of Open Access Journals (Sweden)

    Ali Ghoz

    2014-01-01

    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.

  9. Contemporary Ceramic Total Hip Arthroplasty in Patients with Cerebral Palsy: Does It Work?

    Science.gov (United States)

    Yoon, Byung-Ho; Ha, Yong-Chan; Koo, Kyung-Hoi

    2015-01-01

    Background Adult patients with cerebral palsy (CP), who have advanced degenerative arthritis of the hip, have been treated with resection arthroplasty and arthrodesis. Although total hip arthroplasty (THA) has also been used as one of the alternative options, there are few studies on contemporary bearings used in THA. Therefore, we evaluated the results of the contemporary ceramic-on-ceramic THA in adult patients with CP. Methods From January 2005 to December 2007, five adult CP patients (5 hips) underwent THA using contemporary ceramic-on-ceramic bearings. All patients were able to stand or ambulate with intermittent use of assistive devices at home. We retrospectively reviewed the series to determine the results of THA in terms of pain relief, improved function, and durability of prosthesis. Results There were 3 men and 2 women with a mean age of 35.9 years. All patients had pain relief without decline in mobility postoperatively. One hip was dislocated, which was treated successfully with closed reduction and an abduction brace for 2 months. There was no ceramic fracture, loosening, or osteolysis during the mean follow-up of 6.8 years (range, 5.8 to 8.3 years). Conclusions Cementless THA using contemporary ceramic-on-ceramic bearings is a useful option for the treatment of advanced degenerative arthritis of the hip in ambulatory adults with CP. PMID:25729517

  10. 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.

  11. Early failure of the Ultima metal-on-metal total hip replacement in the presence of normal plain radiographs.

    Science.gov (United States)

    Donell, S T; Darrah, C; Nolan, J F; Wimhurst, J; Toms, A; Barker, T H W; Case, C P; Tucker, J K

    2010-11-01

    Metal-on-metal total hip replacement has been targeted at younger patients with anticipated long-term survival, but the effect of the production of metal ions is a concern because of their possible toxicity to cells. We have reviewed the results of the use of the Ultima hybrid metal-on-metal total hip replacement, with a cemented polished tapered femoral component with a 28 mm diameter and a cobalt-chrome (CoCr) modular head, articulating with a 28 mm CoCr acetabular bearing surface secured in a titanium alloy uncemented shell. Between 1997 and 2004, 545 patients with 652 affected hips underwent replacement using this system. Up to 31 January 2008, 90 (13.8%) hips in 82 patients had been revised. Pain was the sole reason for revision in 44 hips (48.9%) of which 35 had normal plain radiographs. Peri-prosthetic fractures occurred in 17 hips (18.9%) with early dislocation in three (3.3%) and late dislocation in 16 (17.8%). Infection was found in nine hips (10.0%). At operation, a range of changes was noted including cavities containing cloudy fluid under pressure, necrotic soft tissues with avulsed tendons and denuded osteonecrotic upper femora. Corrosion was frequently observed on the retrieved cemented part of the femoral component. Typically, the peri-operative findings confirmed those found on pre-operative metal artefact reduction sequence MRI and histological examination showed severe necrosis. Metal artefact reduction sequence MRI proved to be useful when investigating these patients with pain in the absence of adverse plain radiological features. PMID:21037343

  12. Pipe diffusion at dislocations in UO2

    International Nuclear Information System (INIS)

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

  13. 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.

  14. Intraprosthetic dislocation of a contemporary dual-mobility design used during conversion THA.

    Science.gov (United States)

    Odland, Andrew N; Sierra, Rafael J

    2014-12-01

    Although dual-mobility sockets have been in clinical use for decades in other parts of the world, they recently gained popularity in the United States as an option for primary and revision total hip arthroplasty (THA). Improvements in dual-mobility socket technology include articulation with a metal insert impacted into a metal shell and a femoral head made of highly cross-linked polyethylene. The results and complications associated with the use of dual-mobility sockets employing these technologic advancements are not known. Specifically, intraprosthetic dislocation is a well-known complication of these implants and has been reported extensively in the literature. To the authors' knowledge, its occurrence in a modern dual-mobility socket has not been reported. The authors report a case of early intraprosthetic dislocation of a contemporary dual-mobility design used to convert a patient to THA after failed fixation of intertrochanteric hip fracture. At retrieval, there was evidence that the outer bearing may have ceased moving, causing localized focal impingement of the implant neck on the retentive ring. The authors theorized that external hip impingement (pelvic against trochanter) and previous surgery that led to the formation of scar tissue could have caused the outer bearing surface to cease its motion. This ultimately led to impingement of the femoral component neck on the retentive ring, which led to the intraprosthetic dislocation. Dual-mobility cups provide an attractive option to decrease wear and improve stability. Further research is needed to establish the ideal construct design and materials. PMID:25437088

  15. Genetics Home Reference: Giant congenital melanocytic nevus

    Science.gov (United States)

    ... and Families Resources for Health Professionals What glossary definitions help with understanding giant congenital melanocytic nevus? anxiety ; cancer ; cell ; cM ; congenital ; embryonic ; gene ; hypertrichosis ; inherited ; ...

  16. Primary total hip replacement versus hip resurfacing - hospital considerations.

    Science.gov (United States)

    Ward, William G; Carter, Christina J; Barone, Marisa; Jinnah, Riyaz

    2011-01-01

    Multiple factors regarding surgical procedures and patient selection affect hospital staffing needs as well as hospital revenues. In order to better understand the potential impact on hospitals that hip arthroplasty device selection (standard total hip arthroplasty vs. resurfacing) creates, a review of all primary hip arthroplasties performed at one institution was designed to identify factors that impacted hospital staffing needs and revenue generation. All primary hip arthroplasties undertaken over three fiscal years (2008 to 2010) were reviewed, utilizing only hospital business office data and medical records data that had been previously extracted prior for billing purposes. Analysis confirmed differing demographics for two hip arthroplasty populations, with the resurfacing patients (compared to the conventional total hip arthroplasty population) consisting of younger patients (mean age, 50 vs. 61 years), who were more often male (75% vs. 45%), were more likely to have osteoarthritis as their primary diagnosis (83 vs. 67%) and were more often covered by managed care or commercial insurance (83 vs. 34%). They also had shorter hospital stays (mean length of stay, 2.3 vs. 4.1 days) and consequently provided a more favorable financial revenue stream to the hospital on a per patient basis. Several trends appeared during the study periods. There was a steady increase in all procedures in all groups except for the resurfacings, which decreased 26% in males and 53% in females between 2009 and 2010. Differences were observed in the demographics of patients presenting for resurfacing, compared to those presenting for conventional total hip arthroplasty. In addition to the revenue stream considerations, institutions undertaking a resurfacing program must commit the resources and planning in order to rehabilitate these patients more expeditiously than is usually required with conventional hip arthroplasty patients. PMID:22035493

  17. Discrete dislocation dynamics simulations in a cylinder

    Science.gov (United States)

    Li, Maosheng; Gao, Chan; Xu, Jianing

    2015-02-01

    Mechanical properties of material are closely related to the motion of dislocations, and predicting the interactions and resulting collective motion of dislocations is a major task in understanding and modelling plastically deforming materials. A discrete dislocation dynamics model is used to describe the orientation substructure within the microstructure. Discrete dislocation dynamics simulations in three dimensions have been used to examine the role of dislocation multiplication and mobility on the plasticity in small samples under uniaxial compression. In this paper we describe the application of the dislocation dynamics simulations in a cylindrical geometry. The boundary conditions for the simulation were estimated from the distribution of the geometrically necessary dislocation density which was obtained from the orientation map. Numerical studies benchmark could validate the accuracy of the algorithms and the importance of handling the singularity correctly. The results of the simulation explain the formation of the experimentally observed substructure.

  18. Morphological study of the hip joint of coxarthrosis by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hijikata, Hiromi; Tagawa, Hiroshi; Kashiyama, Masahiro; Yokohata, Yumiko; Kohno, Atsushi; Iida, Keiko (Tokyo Women' s Medical Coll. (Japan))

    1983-02-01

    The hip joint in coxarthrosis with severe deformities was studied by CT scan. In this disease, the supero-inferior diameter increased according to the degree of incomplete dislocation, while the antero-posterior diameter remained small. The acetabulum was shallow showing a small distance from the femur axis to the outer plate of the floor, but the floor of the acetabulum was thick with a considerable distance from the axis to the inner plate of the floor. The tangenital angle of the acetabulum was around 20/sup 0/, without remarkable changes depending on the degree of incomplete dislocation. The angle of covering the acetabulum at the center of the capitum was normally around 180/sup 0/, and became smaller in incomplete dislocation, showing poor adaptability. The anterior torsion angle in incomplete dislocation tended to be larger depending upon severity of dislocation. In the cavum medullare of proximal diaphysis of the femur, the antero-posterior diameter was larger than the right-left diameter; and this relation was reversed in the use of artificial joint. Atrophy of the gluteal muscle developed with severeness of coxarthrosis.

  19. A morphological study of the hip joint of coxarthrosis by computed tomography

    International Nuclear Information System (INIS)

    The hip joint in coxarthrosis with severe deformities was studied by CT scan. In this disease, the supero-inferior diameter increased according to the degree of incomplete dislocation, while the antero-posterior diameter remained small. The acetabulum was shallow showing a small distance from the femur axis to the outer plate of the floor, but the floor of the acetabulum was thick with a considerable distance from the axis to the inner plate of the floor. The tangenital angle of the acetabulum was around 200, without remarkable changes depending on the degree of incomplete dislocation. The angle of covering the acetabulum at the center of the capitum was normally around 1800, and became smaller in incomplete dislocation, showing poor adaptability. The anterior torsion angle in incomplete dislocation tended to be larger depending upon severity of dislocation. In the cavum medullare of proximal diaphysis of the femur, the antero-posterior diameter was larger than the right-left diameter; and this relation was reversed in the use of artificial joint. Atrophy of the gluteal muscle developed with severeness of coxarthrosis. (Ueda, J.)

  20. Fracture dislocation of sacroiliac joint associated with triradiate cartilage injury in a child: a case report.

    Science.gov (United States)

    Sener, Muhittin; Karapinar, Hasan; Kazimoglu, Cemal; Yagdi, Serhan; Akgun, Ulas

    2008-03-01

    We report a very rare injury of a 8-year-old girl with sacroiliac fracture dislocation and triradiate cartilage separation. After the restoration of the sacroiliac joint by open means, reduction of the separated cartilage was seen. At 20 months follow-up, an osseous bridging at the triradiate cartilage and mild coxa valga deformity developed. We think that every child with serious sacroiliac joint injury should be evaluated for associated triradiate cartilage injury and followed to skeletal maturity for late complications such as acetabular dysplasia, hip subluxation and pelvic asymmetry. PMID:18510160

  1. 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

  2. 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.

  3. 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 ...

  4. Small Incision Total Hip Arthroplasty

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    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. ...

  5. Small Incision Total Hip Arthroplasty

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    Full Text Available ... a hip replacement, which is a very, very long incision between approximately 12 to 14 inches, right ... picture, that's a ball-and-socket. The big long bone is called the femur bone, or thigh ...

  6. Small Incision Total Hip Arthroplasty

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    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 ...

  7. Anterior Approach Total Hip Replacement

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    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 ...

  8. Small Incision Total Hip Arthroplasty

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    Full Text Available ... move that hip in space, okay? I'm moving the leg around with my finger inside the ... these surgeries. So we encourage these patients to walk and to be as active as possible after ...

  9. Small Incision Total Hip Arthroplasty

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    Full Text Available ... called cartilage, and this cartilage has extremely unique mechanical behavior. The coefficient of friction on a healthy ... a very active guy, and came in with mechanical clicking and symptoms in the hip, not an ...

  10. Small Incision Total Hip Arthroplasty

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    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 ...

  11. Small Incision Total Hip Arthroplasty

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    Full Text Available ... outcomes, primarily because of recent advances in surgical instrumentation and techniques. In addition to the live hip ... the surgery, but with this newer, you know, instrumentation, the availability of centers and surgeons has really ...

  12. Anterior Approach Total Hip Replacement

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    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. Small Incision Total Hip Arthroplasty

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    Full Text Available ... So that's a total hip replacement surgery. Actually, I think right here we can pan in, this is ... operating room based on what I feel, and I think we're going to stop at the next ...

  14. Anterior Approach Total Hip Replacement

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    Full Text Available ... you’re very comfortable around the hip in general. How’s that look there, Roger? Are we getting ... this works good too. But just fractures in general with this type of stem, obviously it can ...

  15. Small Incision Total Hip Arthroplasty

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    Full Text Available ... mechanical behavior. The coefficient of friction on a healthy joint between the parts is lower than that ... the lungs. It's a little different than a healthy 60-year-old that has just a hip ...

  16. Small Incision Total Hip Arthroplasty

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    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 ...

  17. Small Incision Total Hip Arthroplasty

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    Full Text Available ... I'm measuring using a very primitive little string how this hip is now compared to what ... the measurement that I did was with those strings. Well, with the computer-assisted technology, I am ...

  18. Small Incision Total Hip Arthroplasty

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    Full Text Available ... click on the "request information" button on your webcast screen and open the door to informed medical ... joining us on ORLive.com for a live webcast of a total hip arthroplasty surgery. This is ...

  19. Anterior Approach Total Hip Replacement

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    Full Text Available ... the fact that you have such a dry field. We have a question here from Dr. Hurley ... be. Yeah. There’s no bleeding you can’t control in this part of the hip. But occasionally ...

  20. Small Incision Total Hip Arthroplasty

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    Full Text Available ... into the hip here. This is a titanium aluminum alloy type stem that is going to go down ... is a -- a metallic stem, okay, a titanium aluminum alloy type stem as well. All right, and it's ...

  1. Total Hip Replacement Learning Module

    Science.gov (United States)

    ... After Surgery Risks and Complications Conclusion Exit This Module Informed Patient - Total Hip Replacement Help Introduction Welcome ... Orthopaedic Surgeons' Informed Patient Program. These online learning modules have been developed by orthopaedic surgeons to help ...

  2. Small Incision Total Hip Arthroplasty

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    Full Text Available ... have over 40 years of experience with this material in the hip and the knee joints. Now ... of the most important advances in terms of materials in the last 25 years. The plastic that ...

  3. Small Incision Total Hip Arthroplasty

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    Full Text Available ... pretty much completely numbed. The reason I'm putting this local anesthetic in the area of where ... hip device that I utilize, and I'm putting a rod inside the femur to find that ...

  4. 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 ...

  5. 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. ...

  6. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... about it that arthroscopy will be helpful on rare occasions in total hip replacement. 00:44:46 ... biological fixation that I used, but that's very rare. For the most part, most osteoporotic patients do ...

  7. Developmental Dysplasia of the Hip

    Science.gov (United States)

    ... a limp or waddling gait, back and hip pain, and overall decreased agility. Reviewed by: Alfred Atanda Jr., MD Date reviewed: ... and Joints Common Childhood Orthopedic Conditions In-toeing & Out-toeing in Toddlers Should ...

  8. Small Incision Total Hip Arthroplasty

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    Full Text Available ... that may lead in a later stage in life to having a destroyed hip and needing a ... you the faster rehabilitation and getting back to life a lot sooner. This is the plastic that ...

  9. Small Incision Total Hip Arthroplasty

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    Full Text Available ... the -- into the hip here. This is a titanium aluminum alloy type stem that is going to ... we call this, this is a fiber-metal titanium shell. If you would show that -- here, this ...

  10. Small Incision Total Hip Arthroplasty

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    Full Text Available ... little bit of a manual type procedure. The recovery after a hip arthroscopy is a little bit ... weight-bear-- partial weight-bearing and, you know, recovery really depends on letting that labrum heal. If ...

  11. Small Incision Total Hip Arthroplasty

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    Full Text Available ... to the United States, so we speak many languages down here. As you can see in the ... hip injuries, are fairly common depending on the type of sports that patients are involved in, anywhere ...

  12. Small Incision Total Hip Arthroplasty

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    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 ...

  13. Small Incision Total Hip Arthroplasty

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    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 ...

  14. Anterior Approach Total Hip Replacement

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    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 ...

  15. Small Incision Total Hip Arthroplasty

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    Full Text Available ... the incisions an arthroscopic surgery would require. I'll show you that in one second. Actually, here ... little smaller -- that lubricates the hip. And you'll see some of that liquid coming into the ...

  16. Anterior Approach Total Hip Replacement

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    Full Text Available ... Biomet Orthopedics. In just a few moments, you’ll be able to join Doctors Keith Berend and ... Albany Surgical Hospital in New Albany, Ohio. We’ll be doing a right hip tonight. This is ...

  17. Hip joint reaction force - review

    Directory of Open Access Journals (Sweden)

    Matej Daniel

    2007-02-01

    Full Text Available This paper provides a review of various methods used to determine reaction force in the human hip: from simple statical models through dynamical inverse dynamics model to experimental measurements. Special attention is taken to inverse dynamics modeling.

  18. 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 Dr. ... 28 PIETER J. HOMMEN, MD: There's a -- the sports injuries, hip injuries, are fairly common depending on the ...

  19. 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.

  20. 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.

  1. 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.

  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. 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

  4. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... as much as about dislocation as -- Exactly. The soft tissues here are intact. It’s simply, like I said, I don’t think these patients need any postoperative restrictions for the average person. ...

  5. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... if, dislocations aside, what about just choice of bearing based on a patient activity? Are you comfortable ... Do you concerns about you post-op weight bearing restrictions with a collarless stem?” No. Okay. I ...

  6. Dislocations in AIIIBVI single crystals

    International Nuclear Information System (INIS)

    High densities of planar defects are evidenced in various AIIIBVI layer compounds by systematic electron microscopy observations with the dark-field weak-beam image technique. Several samples are analyzed, as obtained from different crystal ingots of InSe grown by the Bridgman-Stockbarger method, and some GaS and GaSe single crystals grown both, from the melt and from the vapour. The observed defects are identified mainly as screw and edge dislocations, the orientation of which is obtained in some cases by the analysis of the Moire fringes. Dislocation densities ranging between 108 and 1010 cm-2 are measured, not uniformly distributed in the various regions of each sample. Finally, the observed defects are attributed to the particular structure of the crystals and mainly to extrinsic origins, such as mechanical and chemical treatments for thinning the samples for transmission electron microscopy observations and thermal interaction between the electron beam and the sample during the observations. (author)

  7. Dislocation detection algorithm for atomistic simulations

    International Nuclear Information System (INIS)

    We present a novel computational method that makes it possible to directly extract dislocation lines and their associated Burgers vectors from three-dimensional atomistic simulations. The on-the-fly dislocation detection algorithm is based on a fully automated Burgers circuit analysis, which locates dislocation cores and determines their Burgers vector. Through a subsequent vectorization step, the transition from the atomistic system to a discrete dislocation representation is achieved. Using a parallelized implementation of the algorithm, the dislocation analysis can be efficiently performed on the fly within a molecular dynamics simulation. This enables the visualization and investigation of dislocation processes occurring on sub-picosecond time scales, whose observation is otherwise impeded by the presence of other crystal defects or simply by the huge amount of data produced by large-scale atomistic simulations. The presented method is able to identify individual segments as well as networks of perfect, partial and twinning dislocations. The dislocation density can be directly determined and even more sophisticated information is made accessible by our dislocation analysis, including dislocation reactions and junctions, as well as stacking fault and twin boundary densities

  8. 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.)

  9. Revision total hip arthroplasty with modular femoral stems.

    Science.gov (United States)

    Stimac, Jeffrey D; Boles, John; Parkes, Natalie; Gonzalez Della Valle, Alejandro; Boettner, Friedrich; Westrich, Geoffrey H

    2014-11-01

    As the rate of revision total hip arthroplasty (THA) rises, attention must be paid to potential complications relating to bone loss, soft tissue deficiencies, and loss of tissue planes. Using modular femoral stems in revision surgery allows for varying amounts of bone loss in the proximal and distal femur while letting the surgeon adjust rotation, leg length, and offset. We retrospectively reviewed 125 patients that underwent revision THA with a modular femoral component system and had minimum 2 year follow-up. Ten patients required reoperations for infection, recurrent dislocation, or fracture treatment. There was no evidence of radiographic loosening or mechanical failure in the remaining patients. Modular femoral components provide excellent intraoperative flexibility and significant radiographic and clinical benefits as seen in this patient cohort. PMID:25086449

  10. Reaction HIP process for titanium-aluminide alloys

    International Nuclear Information System (INIS)

    Titanium-aluminide can be produced by reactive hot isostatic pressing (RHIP) of cold extruded titanium-aluminium elemental powder mixtures. The Kirkendall porosity to be closed by HIP is considerably less than the porosity of simply reacted powder compacts. Additional cold working of the extruded rod is possible such that sheets and foils can easily be produced. Various RHIP temperatures as well as additional heat treatments can be applied in order to produce different microstructures. Tensile tests show that RHIP material is more brittle than cast and forged material. Although the oxygen content of the material is considerably high, some ductility can be obtained by optimizing the microstructure. The fracture mode is mainly brittle at all temperatures. Increased measured elongation at high temperature is attributed to manily microcracking of TiAl as well as increased dislocation density and twinning. (orig.) With 9 figs., 1 tab

  11. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

    Full Text Available DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Scott M. Sporer, MD. and the contributors have aimed providing the reader practical and clinically relevant information, evidence-based advices, their preferences and opinions containing current concepts for difficult and controversial clinical situations in total hip replacement surgery which are often not addressed clearly in traditional references. FEATURES The book is composed of 9 sections and 49 articles each written by a different expert designed in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected. Second section is about preoperative acetabulum questions. Third section is about preoperative femur questions. Fourth section is about intraoperative questions. Intraoperative acetabulum question is subjected in the fifth section and the intraoperative femur questions in the sixth section. The seventh section is about postoperative questions. Eighth and ninth sections are about general questions about failure and failure of acetabulum in turn. AUDIENCE Mainly practicing orthopedic surgeons, fellows and residents who are interested in hip arthroplasty have been targeted but several carefully designed scenarios of controversial and difficult situations surrounding total hip replacement surgery and the current information will also be welcomed by experienced clinicians practicing in hip arthroplasty. ASSESSMENT Scott M. Sporer, MD. and his collaborators designing the "Curbside Consultation in Hip Arthroplasty" try to widen the reader insight for a better outcome in hip arthroplasty by the expert opinions and current concepts for various treatment options in difficult or controversial cases. The carefully chosen scenarios forming the sections and brief answers containing clinically relevant information and practical solutions to frequently encountered problems are making the book almost a comprehensive and current reference of difficult clinical situations in total hip replacement surgery. The questions and the answers format and casual style of articles resembling the advices in a dialog of colleagues on a curbside consult provides a quicker access to a subject and makes the text easier to read and understand. Various image and diagrams enhances the knowledge in the text

  12. 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 thventional 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

  13. Worker Dislocation. Case Studies of Causes and Cures.

    Science.gov (United States)

    Cook, Robert F., Ed.

    Case studies were made of the following dislocated worker programs: Cummins Engine Company Dislocated Worker Project; GM-UAW Metropolitan Pontiac Retraining and Employment Program; Minnesota Iron Range Dislocated Worker Project; Missouri Dislocated Worker Program Job Search Assistance, Inc.; Hillsborough, North Carolina, Dislocated Worker Project;…

  14. Dislocation interactions mediated by grain boundaries

    International Nuclear Information System (INIS)

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

  15. Effects of dislocations on electron channeling

    Energy Technology Data Exchange (ETDEWEB)

    George, Juby; Pathak, A P [School of Physics, University of Hyderabad, Hyderabad 500046 (India)], E-mail: appsp@uohyd.ernet.in

    2009-02-18

    The phenomenon of electron channeling in a crystal affected by dislocations is considered. Earlier we had considered the quantum aspects of the positron channeling in a crystal bent by dislocations where the effects of longitudinal motion of the particle were also considered along with the transverse motion. In this paper, the effective potential for the electron case is found for the two regions of dislocation-affected channel. There is considerable shift in the potential minima due to dislocations. The frequency and the corresponding spectrum of the channeling radiation due to electrons channeling through the perfect channel and the two regions of dislocation-affected channels are calculated. The spectral distribution of radiation intensity changes with the parameters of dislocation. The continuity of wavefunctions and their derivatives is used at the three boundaries and the reflection and transmission coefficients are found using these boundary conditions in the same way as in the positron case.

  16. Effects of dislocations on electron channeling.

    Science.gov (United States)

    George, Juby; Pathak, A P

    2009-02-18

    The phenomenon of electron channeling in a crystal affected by dislocations is considered. Earlier we had considered the quantum aspects of the positron channeling in a crystal bent by dislocations where the effects of longitudinal motion of the particle were also considered along with the transverse motion. In this paper, the effective potential for the electron case is found for the two regions of dislocation-affected channel. There is considerable shift in the potential minima due to dislocations. The frequency and the corresponding spectrum of the channeling radiation due to electrons channeling through the perfect channel and the two regions of dislocation-affected channels are calculated. The spectral distribution of radiation intensity changes with the parameters of dislocation. The continuity of wavefunctions and their derivatives is used at the three boundaries and the reflection and transmission coefficients are found using these boundary conditions in the same way as in the positron case. PMID:21817325

  17. Effects of dislocations on electron channeling

    International Nuclear Information System (INIS)

    The phenomenon of electron channeling in a crystal affected by dislocations is considered. Earlier we had considered the quantum aspects of the positron channeling in a crystal bent by dislocations where the effects of longitudinal motion of the particle were also considered along with the transverse motion. In this paper, the effective potential for the electron case is found for the two regions of dislocation-affected channel. There is considerable shift in the potential minima due to dislocations. The frequency and the corresponding spectrum of the channeling radiation due to electrons channeling through the perfect channel and the two regions of dislocation-affected channels are calculated. The spectral distribution of radiation intensity changes with the parameters of dislocation. The continuity of wavefunctions and their derivatives is used at the three boundaries and the reflection and transmission coefficients are found using these boundary conditions in the same way as in the positron case.

  18. Direct observation of dissociated dislocations in garnet.

    Science.gov (United States)

    Allen, F M; Smith, B K; Buseck, P R

    1987-12-18

    Dislocation core structures in garnet [grossularite (Ca(2.9)Fe(II)(0.1))(Al(1.9)Fe(III)(0.1)Si(3.0)O(12)] have been examined with near atomic resolution transmission electron microscopy. Dissociated dislocations have been observed as parallel a/4 partial dislocations that are separated by stacking faults. The partial dislocations have narrow cores ( approximately 3 burgers vectors), and the stacking fault zone between the narrow partial dislocations is apparently a low-energy configuration that results from the occupancy of previously unfilled dodecahedral and tetrahedral sites. Previous studies of garnet dislocations suggested that dissociation involves departures from garnet stoichiometry (that is, trace amounts of impurities), but evidence of detectable amounts of impurities has not been found even in the highest resolution images. These results have implications for mantle mineral rheology and transformations as well as for ceramics of material science interest. PMID:17737669

  19. 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).

  20. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ...hemi-hip) metallic cemented or uncemented prosthesis. 888.3360 Section 888.3360...hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip...hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  1. 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.

  2. 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.

  3. Kinetics of a Fast Moving Partial Dislocation

    Science.gov (United States)

    Daphalapurkar, Nitin; Ramesh, K. T.

    2013-03-01

    Plastic deformation in materials under extreme stresses requires a kinetic description of moving dislocations. The velocities with which the partial dislocations can propagate under an applied stress has implications for plasticity at high strain rates, specifically, the rate of plastic deformation and the rate-sensitivity. In this work, we focus our attention on motion of a twinning partial dislocation in a face-centered cubic (FCC) material, Ni. We use molecular dynamics simulations to simulate the velocity of a propagating twinning partial dislocation and investigate the effect of applied shear stress. Results suggest a limiting value for the speeds of a propagating partial dislocation. The material speeds based on the nonlinear part (under high stresses) of the stress-strain curve are shown to have an influence on the velocity with which a partial dislocation can propagate. Predicted velocities from simulations will be related to observations from high rate impact experiments. Plastic deformation in materials under extreme stresses requires a kinetic description of moving dislocations. The velocities with which the partial dislocations can propagate under an applied stress has implications for plasticity at high strain rates, specifically, the rate of plastic deformation and the rate-sensitivity. In this work, we focus our attention on motion of a twinning partial dislocation in a face-centered cubic (FCC) material, Ni. We use molecular dynamics simulations to simulate the velocity of a propagating twinning partial dislocation and investigate the effect of applied shear stress. Results suggest a limiting value for the speeds of a propagating partial dislocation. The material speeds based on the nonlinear part (under high stresses) of the stress-strain curve are shown to have an influence on the velocity with which a partial dislocation can propagate. Predicted velocities from simulations will be related to observations from high rate impact experiments. Supported by Hopkins Extreme Materials Institute

  4. Complex dislocation dynamics in ice: experiments

    OpenAIRE

    Weiss, Jerome; Grasso, Jean-Robert; Miguel, M. -Carmen; Vespignani, Alessandro, 1965-; Zapperi, Stefano

    2001-01-01

    We present a statistical analysis of the acoustic emissions induced by dislocation motion during the creep of ice single crystals. The recorded acoustic waves provide an indirect measure of the inelastic energy dissipated during dislocation motion. Compression and torsion creep experiments indicate that viscoplastic deformation, even in the steady-state (secondary creep), is a complex and inhomogeneous process characterized by avalanches in the motion of dislocations. The di...

  5. Dislocation induced anomalous softening of solid helium

    OpenAIRE

    Zhou, Caizhi; Su, Jung-jung; Graf, Matthias J.; Reichhardt, Charles; Balatsky, Alexander V.; Beyerlein, Irene J.

    2011-01-01

    The classical motion of gliding dislocation lines in slip planes of crystalline solid helium leads to plastic deformation even at temperatures far below the Debye temperature and can affect elastic properties. In this work we argue that the gliding of dislocations and plasticity may be the origin of many observed elastic anomalies in solid He-4, which have been argued to be connected to supersolidity. We present a dislocation motion model that describes the stress-strain $\\t...

  6. Modelling of Dislocation Bias in FCC Materials

    OpenAIRE

    Chang, Zhongwen

    2013-01-01

    Irradiation induced void swelling is problematic for the application of austenitic steels under high dose irradiation. In this thesis, the swelling is characterized by dislocation bias. The dislocation bias is obtained using the finite element method, accounting for fcc copper and nickel under electron irradiation. The methodology is implemented with the interaction energies between an edge dislocation and point defects. Analytically derived interaction energies, which are based on elasticity...

  7. A screw dislocation in a functionally graded material using the translation gauge theory of dislocations

    OpenAIRE

    Lazar, Markus

    2011-01-01

    The aim of this paper is to provide new results and insights for a screw dislocation in functionally graded media within the gauge theory of dislocations. We present the equations of motion for dislocations in inhomogeneous media. We specify the equations of motion for a screw dislocation in a functionally graded material. The material properties are assumed to vary exponentially along the x and y-directions. In the present work we give the analytical gauge field theoretic s...

  8. Molecular Mechanisms of HipA Mediated Multidrug Tolerance and its Neutralization by HipB

    OpenAIRE

    Schumacher, Maria A.; Piro, Kevin M.; Xu, Weijun; Hansen, Sonja; Lewis, Kim; Brennan, Richard G.

    2009-01-01

    Bacterial multidrug tolerance is largely responsible for the inability of antibiotics to eradicate infections and is caused by a small population of dormant bacteria called persisters. HipA is a critical Escherichia coli persistence factor that is normally neutralized by HipB, a transcription repressor, which also regulates hipBA expression. Here we report multiple structures of HipA and a HipA-HipB-DNA complex. HipA has a eukaryotic Ser/Thr kinase-like fold and can phosphorylate the translat...

  9. Anderson localization of light with topological dislocations

    CERN Document Server

    Lobanov, Valery E; Vysloukh, Victor A; Torner, Lluis

    2013-01-01

    We predict Anderson localization of light with nested screw topological dislocations propagating in disordered two-dimensional arrays of hollow waveguides illuminated by vortex beams. The phenomenon manifests itself in the statistical presence of topological dislocations in ensemble-averaged output distributions accompanying standard disorder-induced localization of light spots. Remarkably, screw dislocations are captured by the light spots despite the fast and irregular transverse displacements and topological charge flipping undertaken by the dislocations due to the disorder. The statistical averaged modulus of the output local topological charge depends on the initial vorticity carried by the beam.

  10. 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.

  11. Massive congenital orbital teratoma.

    Science.gov (United States)

    Gnanaraj, Lawrence; Skibell, Bentley C; Coret-Simon, Judith; Halliday, William; Forrest, Christopher; DeAngelis, Dan D

    2005-11-01

    Orbital teratomas are rare embryonic tumors composed of a wide diversity of tissues derived from the three germinal layers. The presenting features include, a healthy newborn with extreme unilateral proptosis; marked stretching of the eyelids over a tense, fluctuating mass, with elongation of the palpebral fissure; enlargement of the bony orbit (two to three times normal size) with subsequent nasal and malar deformities; and transillumination of all or part of the orbital mass. Commonly the eye is normally developed but often vision is not preserved either due to exposure or secondary optic atrophy. The objective in the management of orbital teratoma is to save the eye to encourage orbitofacial development, maintain cosmesis and retain some vision. We report a case of massive congenital orbital teratoma successfully removed by an eyelid-sparing exenteration technique. PMID:16304523

  12. Congenital sensorineural hearing loss

    International Nuclear Information System (INIS)

    The ears of 47 selected patients with congenital sensorineural hearing loss were examined with complex-motion tomography. The patients were divided into 3 general categories: those with a recognized syndrome, those with sensorineural hearing loss unrelated to any known syndrome, and those with microtia. A great variety of inner ear anomalies was detected, but rarely were these characteristic of a particular clinical entity. The most common finding was the Mondini malformation or one of its variants. Isolated dysplasia of the internal auditory canal or the vestibular aqueduct may be responsible for sensorineural hearing loss in some patients. Patients with microtia may also have severe inner ear abnormalities despite the fact that the outer and inner ears develop embryologically from completely separate systems

  13. [Olfaction in congenital hypothyroidism].

    Science.gov (United States)

    Walczak, Marta; Pruszewicz, Antoni; ?acka, Katarzyna; Karlik, Micha?

    2002-01-01

    The aim of the study is to present results of the olfactory testing in congenital hypothyroidism in the group of 20 subjects. The etiology of hypothyroidism included: Pendred's syndrome in 2 cases, hypoplasia in 2 cases, athyreosis in 5 cases and ectopy of thyroid gland in 11 cases. Olfactory testing involved olfactometry by Elsberg-Levy modified by Pruszewicz for 4 odorants: coffee, lemon, mint and anise; smell fatigability test by Pruszewicz et al. for lemon. Level of plasma TSH was determined in each subject. Age of the subjects, at which hormonal replacement therapy was started and regularity of the treatment were taken into consideration. Obtained results: impaired odorant identification and shortened smell fatigability period prove a significant impact of thyroid status on central nervous system development most probably already prior to birth and on cognition processes. PMID:12523167

  14. Congenital pyriform aperture stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Osovsky, Micky [Schneider Pediatric Hospital, Department of Neonatology, Petach Tikvah (Israel); Rabin Medical Center, Department of Neonatology, Schneider Children' s Medical Center of Israel, Beilinson Campus, Petah Tikvah (Israel); Aizer-Danon, Anat; Horev, Gadi [Schneider Pediatric Hospital, Department of Pediatric Radiology, Petach Tikvah (Israel); Sirota, Lea [Schneider Pediatric Hospital, Department of Neonatology, Petach Tikvah (Israel)

    2007-01-15

    Nasal airway obstruction is a potentially life-threatening condition in the newborn. Neonates are obligatory nasal breathers. The pyriform aperture is the narrowest, most anterior bony portion of the nasal airway, and a decrease in its cross-sectional area will significantly increase nasal airway resistance. Congenital nasal pyriform aperture stenosis (CNPAS) is a rare, unusual form of nasal obstruction. It should be considered in the differential diagnosis of any neonate or infant with signs and symptoms of upper airway compromise. It is important to differentiate this level of obstruction from the more common posterior choanal stenosis or atresia. CNPAS presents with symptoms of nasal airway obstruction, which are often characterized by episodic apnea and cyclical cyanosis. (orig.)

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

    International Nuclear Information System (INIS)

    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.

  16. 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.

  17. Neutropenias congénitas Congenital neutropenias

    Directory of Open Access Journals (Sweden)

    Aramís Núñez Quintana

    2004-04-01

    Full Text Available Los neutrófilos desempeñan un papel vital en la protección del organismo frente a infecciones bacterianas y micóticas. La neutropenia crónica severa, se define como un número absoluto de neutrófilos menor de 500xmm3 que persiste meses o años. Las causas de esta condición son múltiples; pueden ser congénitas y existir desde el nacimiento, o adquiridas y aparecer en cualquier momento de la vida. Las neutropenias congénitas severas se pueden presentar de forma aislada o estar asociadas con síndromes genéticos complejos. Dentro de las primeras, la neutropenia cíclica y el síndrome de Kostmann han cobrado gran interés por el descubrimiento reciente de una mutación común a ambas que afecta al gen de la elastasa del neutrófilo (ELA2. El uso del factor estimulante de colonias granulocíticas ha mejorado el pronóstico de estas entidadesNeutrophils play a vital role in the protection of the organism against bacterial and mycotic infections. Chronic severe neutropenia is defined as an absolute number of neutrophils under 500xmm3 that persist months or years. The causes of this condition are multiple. They may be congenital and exist since birth, or acquired and appear at any moment of life. The severe congenital neutropenias may appear isolatedly or they may be associated with complex genetic syndromes. Among the first, clinical neutropenia and Kostmann’s syndrome are of great interest due to the recent discovery of a mutation common to both affecting the neutrophil elastase gene (ELA2. The use of the granulocytic colony stimulating factor has improved the prognosis of these entities

  18. Elbow Dislocations: A Review Ranging from Soft Tissue Injuries to Complex Elbow Fracture Dislocations

    OpenAIRE

    Carsten Englert; Johannes Zellner; Michael Koller; Michael Nerlich; Andreas Lenich

    2013-01-01

    This review on elbow dislocations describes ligament and bone injuries as well as the typical injury mechanisms and the main classifications of elbow dislocations. Current treatment concepts of simple, that is, stable, or complex unstable elbow dislocations are outlined by means of case reports. Special emphasis is put on injuries to the medial ulnar collateral ligament (MUCL) and on posttraumatic elbow stiffness.

  19. Developmental dysplasia of the hip

    Directory of Open Access Journals (Sweden)

    Haq Nawaz

    2010-09-01

    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.

  20. Falls, fractures, and hip pads.

    Science.gov (United States)

    Sinaki, Mehrsheed

    2004-12-01

    Improvement of balance along with bone-enhancing pharmacotherapy can improve the level of an individual's physical activity and mobility. Balance can be improved with enhancement of postural proprioception and muscular strength. Postural deformities have been shown to impair quality of life of osteoporotic individuals. Kyphotic posture has been demonstrated to contribute to propensity to fall in osteoporotic individuals. Kyphotic posturing and gait disorders can be managed through proprioceptive training, use of a weighted kypho-orthosis, muscle re-education, and safe resistance exercises. Proprioceptive balance training can reduce falls and fracture. Sarcopenia and osteoporotic fractures create musculoskeletal challenges that cannot be met with pharmacotherapy alone. Bone loss, imbalance, and gait disorder along with cognitive concerns can increase with aging. Even in healthy persons, predisposition to falls increases with age-related neuromuscular changes. Muscle strength decreases approximately 50% from age 30 to 80. Furthermore, the amount of body sway increases with reduction of proprioception. Therefore, measures that can decrease imbalance can reduce the risk for falls and fracture. In normal balance, ankle strategies are recruited rather than hip strategies. Strengthening of the lower extremity muscles reduces the risk for falls. Gait aids can also decrease the risk for falls. During a fall, the risk for hip fracture increases 30-fold if there is direct impact to the hip. The use of hip protectors can decrease the risk for hip fracture during a sideways fall. Training in effective safe-landing strategies should be included in fall prevention programs. PMID:16036094

  1. Transient Osteoporosis of the Hip

    Directory of Open Access Journals (Sweden)

    Farideh Shahandeh

    2009-01-01

    Full Text Available   "nTransient osteoporosis of the hip as originally described in women, almost exclusively involved the left hip with the third trimester of pregnancy. It is now recognized as actually being more common in middle-aged men and affecting either hip. "nSymptoms include severe hip pain and decreased range of motion that resolves spontaneously in 6 to 12 months. The etiology is poorly understood, and the disease has been associated with a type of reflex sympathetic dystrophy syndrome. It may be migratory, with subsequent involvement of the opposite hip on an adjacent joint. Radiological changes may simulate indolent infection, osteonecrosis or infiltrative neoplasm. The underlying pathologic condition appears to be bone marrow reaction or edema. Current terminology may refer to this entity as transient bone marrow edema syndrome. Radiographs usually show osteopenia, and bone scan reveals intense activity locally within the femoral head – unlike A.V.N which often displays central photopenia. MRI demonstrates diffuse marrow abnormalities that usually extend from the subchondral femoral head to the inter trochanteric and sub trochanteric regions. There is low signal intensity on T1 weighted MR images and high signal intensity on T2 weighted sequences. The MRI changes reflect the nonspecific marrow reaction or edema that is present. Focal osteoporotic bone marrow defects in the subchondral region or subtle femoral head flattening should be searched for diligently on MR images. Unlike the case with A.V.N. , these defects are usually absent in transient osteoporosis.   

  2. Interface Micromotion of Cementless Hip Stems in Simulated Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohammed R.A. Kadir

    2009-01-01

    Full Text Available Problem statement: The design of hip prostheses has evolved over time due to various complications found after hip replacement surgery. The currently commercially available cementless femoral stems can be categorized into one of three major types, straight cylindrical, tapered rectangular and anatomical. Each type proposes a unique concept to achieve primary stability-a major requirement for bone healing process. Virtual analyses have been made on individual implants, but comparison between the three major types is required to determine the strength and weaknesses of the design concepts. Approach: Three types of implants were modeled in three dimensions-the straight cylindrical, rectangular taper and anatomical. The size of the three implants was carefully designed to fit and fill the canal of a femur reconstructed from a computed tomography image dataset. Hip arthroplasty was simulated virtually by inserting the hip stem into the femoral canal. Finite element method was used in conjunction with a specialized sub-routine to measure micromotion at the bone-implant interface under loads simulating physiological walking and stair-climbing. Another sub-routine was used to assign bone properties based on the grayscale values of the CT image. Results: All the three types of cementless hip stems were found to be stable under both walking and stair climbing activities. Large micromotion values concentrated around the proximal and distal part of the stems. Conclusion/Recommendations: The three major types of hip stems were compared in this study and all of them were found to be stable after simulated physiological activities.

  3. Ultrasonography of the hip and lower extremity.

    Science.gov (United States)

    Malanga, Gerard A; Dentico, Richard; Halperin, Jonathan S

    2010-08-01

    Musculoskeletal ultrasonographic evaluation of the proximal lower limb includes the evaluation of the soft tissue structures, including tendons, ligaments, or muscles, and the bony structures of this region, include the hip, pubic symphysis, and sacroiliac joints. The evaluation of the hip or proximal lower limb region can be performed in an efficient and systematic manner. Ultrasonography of the lateral hip, intra-articular hip, medial thigh, and posterior thigh are discussed in the article. PMID:20797548

  4. Mechanical Evaluation of Polymer Composite Hip Protectors

    OpenAIRE

    Jose Daniel Diniz Melo; Gon Amp Alves Barbosa, Ayrles S.; Ricardo Oliveira Guerra

    2010-01-01

    Hip fractures often result in serious health implications, particularly in the geriatric population, and have been related to long-term morbidity and death. In most cases, these fractures are caused by impact loads in the area of the greater trochanter, which are produced in a fall. This work is aimed at developing hip protectors using composite materials and evaluating their effectiveness in preventing hip fractures under high impact energy (120?J). The hip protectors were developed ...

  5. Spontaneous modular femoral head dissociation complicating total hip arthroplasty.

    Science.gov (United States)

    Talmo, Carl T; Sharp, Kinzie G; Malinowska, Magdalena; Bono, James V; Ward, Daniel M; LaReau, Justin

    2014-06-01

    Modular femoral heads have been used successfully for many years in total hip arthroplasty. Few complications have been reported for the modular Morse taper connection between the femoral head and trunnion of the stem in metal-on-polyethylene bearings. Although there has always been some concern over the potential for fretting, corrosion, and generation of particulate debris at the modular junction, this was not considered a significant clinical problem. More recently, concern has increased because fretting and corrosive debris have resulted in rare cases of pain, adverse local tissue reaction, pseudotumor, and osteolysis. Larger femoral heads, which have gained popularity in total hip arthroplasty, are suspected to increase the potential for local and systemic complications of fretting, corrosion, and generation of metal ions because of greater torque at the modular junction. A less common complication is dissociation of the modular femoral heads. Morse taper dissociation has been reported in the literature, mainly in association with a traumatic event, such as closed reduction of a dislocation or fatigue fracture of the femoral neck of a prosthesis. This report describes 3 cases of spontaneous dissociation of the modular prosthetic femoral head from the trunnion of the same tapered titanium stem because of fretting and wear of the Morse taper in a metal-on-polyethylene bearing. Continued clinical and scientific research on Morse taper junctions is warranted to identify and prioritize implant and surgical factors that lead to this and other types of trunnion failure to minimize complications associated with Morse taper junctions as hip implants and surgical techniques continue to evolve. PMID:24972443

  6. The lateral approach for hip arthrography

    International Nuclear Information System (INIS)

    Despite advances in imaging techniques, hip arthrography is still a useful diagnostic tool. We have found that the lateral approach to the hip joint, with the needle inserted superior to the greater trochanter and parallel to th table top under fluoroscopic control, allows easy advancement of the needle into the lateral hip joint space. (orig.)

  7. Dermatoglyphs in congenital heart disease.

    Science.gov (United States)

    David, T J

    1981-10-01

    The palmar dermatoglyphs of 800 patients with anatomically proven congenital heart disease were compared with prints from 1000 controls. A review of the previous studies revealed major technical deficiencies, and the present study failed to confirm most of the previously reported positive findings. An overall increase in the incidence of hypothenar patterns was found, probably explaining the previous suggestion of increased atd angle in congenital heart disease. A large number of statistical comparisons inevitably produced a few 'significant' results, most of which were inconsistent in various ways. Two percent of cases were found to have rare epidermal ridge malformation, ridge dissociation. The nature of the relationship between this and congenital heart disease is obscure. Claims that there are diagnostically useful dermatoglyphic changes in congenital heart disease can be disregarded. PMID:7328614

  8. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  9. Case report 548: Nail-patella syndrome (hereditary onycho-osteodysplasia) with congenital absence of the fibulae

    International Nuclear Information System (INIS)

    Nail-patella syndrome is a rare disease inherited in an autosomal dominant fashion with multiple skeletal anomalies, including absent or hypoplastic patellae, absent or hypoplastic nails, dislocation of the radial heads and the pathognomonic sign of posterior iliac horns. The most clinically significant anomaly associated with this syndrome is a disorder of the renal basement membrane causing proteinuria and sometimes chronic renal failure. Congenital absence of the fibulae is believed to be a spontaneous mutation. (orig./GDG)

  10. 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.

  11. Major reconstruction for periacetabular metastasis: early complications and outcome following surgical treatment in 40 hips.

    Science.gov (United States)

    Kunisada, T; Choong, P F

    2000-12-01

    We performed 40 total hip arthroplasties with pelvic reconstruction in 37 patients with metastatic periacetabular tumor. 3 patients underwent bilateral periacetabular reconstructive surgery and 2 of these had bilateral procedures at the single operation. There were 8 Harrington class I, 7 class II, and 25 class III lesions. A modified Harrington procedure was employed. All patients showed improvements in hip pain, analgesic use, ambulation and mobility postoperatively. 1 prosthetic dislocation occurred after a fall at home 2 months following surgery. 2 patients had pulmonary emboli during the femoral procedure, 1 of whom died during surgery. There were no prosthetic loosenings. Preoperative CT and/or MRI are important for the study of metastatic involvement of acetabular bone. Durability of reconstruction requires appropriate use of acetabular mesh, Steinmann pins, acetabular reinforcement rings and long-stem femoral prostheses. Careful patient selection may improve quality of life. A sequential bilateral procedure should be considered for some patients. PMID:11145385

  12. [A T-shaped plate for osteosynthesis of the hip bone].

    Science.gov (United States)

    Diatlov, M M

    2007-01-01

    A T-shaped metallic plate can stabilize the hip bone fragments at the bottom of the cotyloid cavity (on its medial side). The shape of the plate follows the shape of the bone in the region between the cavity and the tuber of the sciatic bone. The plate is applied to the pubic, iliac, and ischial bones in the region of the small pelvis, which is especially difficult for surgical intervention. The three ends of the plate are attached to the hip bone fragments with screws. The plate is used in patients with horizontal peracetabular fractures with considerable dislocation. The implant described in this work increases the flexibility of surgical treatment of isolated and combined injuries of pelvis. It is especially useful in case of injuries of intrapelvic organs. PMID:17598481

  13. Developmental hip dysplasia in adolescence

    Directory of Open Access Journals (Sweden)

    Vukašinovi? Zoran

    2009-01-01

    Full Text Available The authors define adolescence and developmental dysplasia of the hip (DDH. Special attention is paid to pathological findings characteristic of DDH in adolescence (unrecognized and untreated DDH; treated DDH, but non-terminated treatment; DDH diagnosed with delay, inadequately treated, with complications. The authors emphasise that DDH treatment has to be successfully terminated well before the adolescence; possibilities are explained on management modes at the time of adolescence, and possible persons guilty for the persistence of later hip problems are indicated. Based on the authors' experience and having in mind all surgical possibilities for the treatment (pelvic osteotomies, femoral osteotomies, trochanteroplasties, leg length equalization procedures the authors propose treatment protocols. The intention is to provide better treatment results and to prevent secondary hip arthrosis. Furthermore, how to improve the struggle against DDH is suggested.

  14. Radiology of the resurfaced hip

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, Luthfur [The London Hip Unit, London (United Kingdom); Hall-Craggs, Margaret [University College London Hospital, London (United Kingdom); Muirhead-Allwood, Sarah K. [The London Hip Unit, London (United Kingdom); The Royal National Orthopaedic Hospital, Middlesex (United Kingdom)

    2011-07-15

    Hip resurfacing arthroplasty is an increasingly common procedure for osteoarthritis. Conventional radiographs are used routinely for follow-up assessment, however they only provide limited information on the radiological outcome. Various complications have been reported in the scientific literature although not all are fully understood. In an effort to investigate problematic or failing hip resurfacings, various radiological methods have been utilized. These methods can be used to help make a diagnosis and guide management. This paper aims to review and illustrate the radiographic findings in the form of radiography, computerized tomography (CT), magnetic resonance imaging (MRI), and ultrasound of both normal and abnormal findings in hip resurfacing arthroplasty. However, imaging around a metal prosthesis with CT and MRI is particularly challenging and therefore the potential techniques used to overcome this are discussed. (orig.)

  15. [Differential congenital myasthenia syndrome diagnosis].

    Science.gov (United States)

    Spuler, S; Lehmann, T-N; Engel, A G

    2004-02-01

    Among myopathies and disorders of neuromuscular transmission, the congenital myasthenic syndromes (CMS) are particularly rare. However, because of the available therapeutic options, it is still clinically important to achieve a correct diagnosis in these patients. We report an adult patient with ophthalmoplegia and nonfluctuating limb-girdle syndrome. For almost 20 years, a congenital myopathy or mitochondriopathy had been suspected before CMS was diagnosed caused by an epsilon subunit mutation of the acetylcholine receptor (epsilon1276delG). PMID:14770284

  16. Dermatoglyphs in congenital heart disease.

    OpenAIRE

    David, T. J.

    1981-01-01

    The palmar dermatoglyphs of 800 patients with anatomically proven congenital heart disease were compared with prints from 1000 controls. A review of the previous studies revealed major technical deficiencies, and the present study failed to confirm most of the previously reported positive findings. An overall increase in the incidence of hypothenar patterns was found, probably explaining the previous suggestion of increased atd angle in congenital heart disease. A large number of statistical ...

  17. Cementless Metasul metal-on-metal total hip arthroplasties at 13 years.

    Science.gov (United States)

    Randelli, Filippo; Banci, Lorenzo; D'Anna, Alessandro; Visentin, Ornella; Randelli, Gianni

    2012-02-01

    Second-generation metal-on-metal bearings have been used since the late 1980s as alternative bearings to eliminate aseptic loosening due to polyethylene wear. The aim of the present study was to evaluate the long-term results of a series of Metasul (Zimmer GmbH, Winterthur, Switzerland) metal-on-metal total hip arthroplasty (THA). One hundred forty-nine cementless THAs with a 28-mm Metasul articulation were performed in 111 consecutive patients. The results were retrospectively reviewed at 13 years postoperatively. Clinical and radiographic evaluations and implant survivorship were performed. Seven hips (4.7%) were revised. The overall survivorship with revision for any reason as the end point was 0.94. The average Harris hip score was 91.4. Expansive osteolysis was found adjacent to the stem in 4 hips. Metal wear-related aseptic loosening was not the major reason for failure in our Metasul metal-on-metal THAs. Recurrent dislocation was the main reason for revision in our series. PMID:21621954

  18. Screw dislocations in the field theory of elastoplasticity

    OpenAIRE

    Lazar, Markus

    2002-01-01

    A (microscopic) static elastoplastic field theory of dislocations with moment and force stresses is considered. The relationship between the moment stress and the Nye tensor is used for the dislocation Lagrangian. We discuss the stress field of an infinitely long screw dislocation in a cylinder, a dipole of screw dislocations and a coaxial screw dislocation in a finite cylinder. The stress fields have no singularities in the dislocation core and they are modified in the core...

  19. 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.

  20. 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.

  1. On the role of stacking faults on dislocation generation and dislocation cluster formation in multicrystalline silicon

    Science.gov (United States)

    Kivambe, Maulid M.; Ervik, Torunn; Ryningen, Birgit; Stokkan, Gaute

    2012-11-01

    The microstructure of highly dislocated stacking fault regions (dislocation density >106 cm-2) in industrial cast multicrystalline silicon has been investigated by light microscopy, scanning electron microscopy, and transmission electron microscopy. Our observations indicate that stacking faults form strong barriers to lattice dislocation movement and to the formation of sub grain boundaries. Stepped and curved stacking fault edges appear to generate dislocations. The observations suggest that stacking faults play an important role in the plasticity as well as in the formation of the microstructure of dislocations in multicrystalline silicon.

  2. 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. The relative risk being highest within the first years following the fracture. Nursing home residents have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about 24% of these impacts lead to hip fracture. The force acting on the hip may reach 3.7 kN in falls on the hip from standing height, which means that only susceptible subjects will sustain a hip fracture in such falls. The effective load acting on the hip is 35% of the body weight in unprotected falls on the hip. Women with hip fractures have a lower body weight compared with controls, and they may also have less soft tissue covering the hip even when adjusted for body mass index, indicating a more android body habitus. Experimental studies show that the passive energy absorption in soft tissue covering the hip may influence the risk of hip fracture, and being an important determinant for the development of hip fracture, maybe more important than bone strength. External hip protectors were developed and tested in an open randomised nursing home study. The rate of hip fractures was reduced by 50%, corresponding to 9 out of 247 residents saved from sustaining a hip fracture. The review points to the essentials of the development of hip fracture, which constitutes; risk of fall, type of fall, type of impact, energy absorption, and lastly bone strength, which is the ultimate and last permissive factor in the cascade leading to hip fracture. Risk estimation and prevention of hip fractures may prove realistic when these issues are taken into consideration.

  3. Synovial chondromatosis of the hip

    International Nuclear Information System (INIS)

    Synovial chondromatosis of the hip joint is not always easily detected on conventional radiography, especially when the intracapsular cartilaginous bodies are not calcified. Although a benign disorder, the delay in diagnosis and treatment may disable the patient. Magnetic resonance imaging proved to be an adequate and agreeable method of investigation in three patients with symptoms of the hip. Better delineation of the joint capsule was achieved, as compared to those with CT and more irregularities were found in the joint fluid using MRI. Small calcifications, however, were seen on CT and not with MRI. MRI proved to be very helpful in the assessment of the correct diagnosis. (Author). 8 refs.; 4 figs

  4. Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images

    OpenAIRE

    Honda,Mitsugi; Arita,Seizaburo; Mitani,Shigeru; Takeda, Yoshihiro; Ozaki, Toshifumi; Inamura,Keiji; Kanazawa, Susumu

    2010-01-01

    Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH). The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on t...

  5. Cumulative Hip Contact Stress Predicts Osteoarthritis in DDH

    OpenAIRE

    Mav?i?, Blaž; Igli?, Aleš; Kralj-Igli?, Veronika; Brand, Richard A; Vengust, Rok

    2008-01-01

    Hip stresses are generally believed to influence whether a hip develops osteoarthritis (OA); similarly, various osteotomies have been proposed to reduce contact stresses and the risk of OA. We asked whether elevated hip contact stress predicted osteoarthritis in initially asymptomatic human hips. We identified 58 nonoperatively treated nonsubluxated hips with developmental dysplasia (DDH) without symptoms at skeletal maturity; the control group included 48 adult hips without hip disease. The ...

  6. Statistics of dislocation pinning at localized obstacles

    Energy Technology Data Exchange (ETDEWEB)

    Dutta, A. [S. N. Bose National Centre for Basic Sciences, Salt Lake, Kolkata 700098 (India); Bhattacharya, M., E-mail: mishreyee@vecc.gov.in; Barat, P. [Variable Energy Cyclotron Centre, 1/AF Bidhannagar, Kolkata 700064 (India)

    2014-10-14

    Pinning of dislocations at nanosized obstacles like precipitates, voids, and bubbles is a crucial mechanism in the context of phenomena like hardening and creep. The interaction between such an obstacle and a dislocation is often studied at fundamental level by means of analytical tools, atomistic simulations, and finite element methods. Nevertheless, the information extracted from such studies cannot be utilized to its maximum extent on account of insufficient information about the underlying statistics of this process comprising a large number of dislocations and obstacles in a system. Here, we propose a new statistical approach, where the statistics of pinning of dislocations by idealized spherical obstacles is explored by taking into account the generalized size-distribution of the obstacles along with the dislocation density within a three-dimensional framework. Starting with a minimal set of material parameters, the framework employs the method of geometrical statistics with a few simple assumptions compatible with the real physical scenario. The application of this approach, in combination with the knowledge of fundamental dislocation-obstacle interactions, has successfully been demonstrated for dislocation pinning at nanovoids in neutron irradiated type 316-stainless steel in regard to the non-conservative motion of dislocations. An interesting phenomenon of transition from rare pinning to multiple pinning regimes with increasing irradiation temperature is revealed.

  7. Statistics of dislocation pinning at localized obstacles

    International Nuclear Information System (INIS)

    Pinning of dislocations at nanosized obstacles like precipitates, voids, and bubbles is a crucial mechanism in the context of phenomena like hardening and creep. The interaction between such an obstacle and a dislocation is often studied at fundamental level by means of analytical tools, atomistic simulations, and finite element methods. Nevertheless, the information extracted from such studies cannot be utilized to its maximum extent on account of insufficient information about the underlying statistics of this process comprising a large number of dislocations and obstacles in a system. Here, we propose a new statistical approach, where the statistics of pinning of dislocations by idealized spherical obstacles is explored by taking into account the generalized size-distribution of the obstacles along with the dislocation density within a three-dimensional framework. Starting with a minimal set of material parameters, the framework employs the method of geometrical statistics with a few simple assumptions compatible with the real physical scenario. The application of this approach, in combination with the knowledge of fundamental dislocation-obstacle interactions, has successfully been demonstrated for dislocation pinning at nanovoids in neutron irradiated type 316-stainless steel in regard to the non-conservative motion of dislocations. An interesting phenomenon of transition from rare pinning to multiple pinning regimes with increasing irradiation temperature is revealed.

  8. Statistics of dislocation pinning at localized obstacles

    Science.gov (United States)

    Dutta, A.; Bhattacharya, M.; Barat, P.

    2014-10-01

    Pinning of dislocations at nanosized obstacles like precipitates, voids, and bubbles is a crucial mechanism in the context of phenomena like hardening and creep. The interaction between such an obstacle and a dislocation is often studied at fundamental level by means of analytical tools, atomistic simulations, and finite element methods. Nevertheless, the information extracted from such studies cannot be utilized to its maximum extent on account of insufficient information about the underlying statistics of this process comprising a large number of dislocations and obstacles in a system. Here, we propose a new statistical approach, where the statistics of pinning of dislocations by idealized spherical obstacles is explored by taking into account the generalized size-distribution of the obstacles along with the dislocation density within a three-dimensional framework. Starting with a minimal set of material parameters, the framework employs the method of geometrical statistics with a few simple assumptions compatible with the real physical scenario. The application of this approach, in combination with the knowledge of fundamental dislocation-obstacle interactions, has successfully been demonstrated for dislocation pinning at nanovoids in neutron irradiated type 316-stainless steel in regard to the non-conservative motion of dislocations. An interesting phenomenon of transition from rare pinning to multiple pinning regimes with increasing irradiation temperature is revealed.

  9. Intermittent dislocation flow in viscoplastic deformation.

    Science.gov (United States)

    Miguel, M C; Vespignani, A; Zapperi, S; Weiss, J; Grasso, J R

    2001-04-01

    The viscoplastic deformation (creep) of crystalline materials under constant stress involves the motion of a large number of interacting dislocations. Analytical methods and sophisticated 'dislocation dynamics' simulations have proved very effective in the study of dislocation patterning, and have led to macroscopic constitutive laws of plastic deformation. Yet, a statistical analysis of the dynamics of an assembly of interacting dislocations has not hitherto been performed. Here we report acoustic emission measurements on stressed ice single crystals, the results of which indicate that dislocations move in a scale-free intermittent fashion. This result is confirmed by numerical simulations of a model of interacting dislocations that successfully reproduces the main features of the experiment. We find that dislocations generate a slowly evolving configuration landscape which coexists with rapid collective rearrangements. These rearrangements involve a comparatively small fraction of the dislocations and lead to an intermittent behaviour of the net plastic response. This basic dynamical picture appears to be a generic feature in the deformation of many other materials. Moreover, it should provide a framework for discussing fundamental aspects of plasticity that goes beyond standard mean-field approaches that see plastic deformation as a smooth laminar flow. PMID:11287948

  10. The kink picture of dislocation mobility and dislocation-point-defect interaction

    International Nuclear Information System (INIS)

    The paper gives a coherent account of the theory of dislocation mobility in terms of kink-pair formation and kink migration. Three levels of description arise in a natural way, namely those of the motion of straight dislocations, of kink-pair formation on dislocations, and of kink migration. The interrelationships between these levels (''hierarchies'') are discussed. The interaction with phonons and foreign atoms (''impurities'') is treated on the third level, that of the kink mobility. Experimental information on the properties of kinks may be obtained from measurements of dislocation velocities, of flow stress, and of internal friction and modulus effect. The comparison between theory and experiment is illustrated by examples from valence crystals (dislocation velocity in Ge) and from body-centred cubic transition metals (? relaxation = kink-pair formation on screw dislocations; dislocation-enhanced Snoek effect; Snoek-Koester relaxation in Nb and Ta)

  11. Poor fixation of the Mittelmeier hip prosthesis

    International Nuclear Information System (INIS)

    We have evaluated 30 Mittelmeier hips on an average 3.3 years after the operation. Seven hips had been revised because of severe pain and mechanical loosening and one because of fracture of the threaded ceramic cup. Only five of the remaining 22 hips were asymptomatic. There was radiographic migration of the acetabular and femoral components in more than one third of the hips and increased scintimetric values around the femoral component in all but two hips. Unfavorable design of the Mittelmeier prosthesis may be an important etiologic factor contributing to poor component fixation and inferior clinical results. (author)

  12. Dislocations

    Science.gov (United States)

    ... by falls and hard impacts, such as in sports injuries, and are more common in teens than young children. These injuries require emergency medical care to avoid further damage. Signs and Symptoms A joint is where two ...

  13. 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.

  14. Tracer diffusion in a dislocated lamellar system

    CERN Document Server

    Gurarie, V; Gurarie, Victor; Lobkovsky, Alexander E.

    2002-01-01

    Many lamellar systems exhibit strongly anisotropic diffusion. When the diffusion across the lamellae is slow, an alternative mechanism for transverse transport becomes important. A tracer particle can propagate in the direction normal to the lamellae, never leaving a particular layer, by going around a screw dislocation. Given the density of positive and negative screw dislocations, we calculate the statistical properties of the transverse transport. When either positive or negative dislocations are in excess, the tracer moves ballistically normally to the layers with the mean square of the displacement growing like the square of time T^2. When the average dislocation charge is zero, the mean square of the normal displacement grows like T log T for large times. To obtain this result, the trajectory of the tracer must be smoothed over distances of order of the dislocation core size.

  15. Distribution of dislocations in nanostructured bainite

    Energy Technology Data Exchange (ETDEWEB)

    Cornide, J [CENIM-CSIC, Madrid, Spain; Miyamoto, G [Institute for Materials Research, Tohoku University, Sendai, Japan; Caballero, Francesca G. [CENIM-CSIC, Madrid, Spain; Furuhara, T [Institute for Materials Research, Tohoku University, Sendai, Japan; Miller, Michael K [ORNL; Garcia-Mateo, C. [CENIM-CSIC, Madrid, Spain

    2011-01-01

    The dislocation density in ferrite and austenite of a bainitic microstructure obtained by transformation at very low temperature (300 C) has been determined using transmission electron microscopy. Observations revealed that bainitic ferrite plates consist of two distinctive regions with different substructures. A central region in the ferrite plate is observed with dislocations that may result from lattice-invariant deformation at the earlier stage of bainite growth. As plastic deformation occurs in the surrounding austenite to accommodate the transformation strain as growth progresses, the Ferrite/Austenite interface has also a very distinctive dislocation profile. In addition, atom-probe tomography suggested that dislocation tangles observed in the vicinity of the ferrite/austenite interface might trap higher amount of carbon than single dislocations inside the bainitic ferrite plate.

  16. Ullrich Congenital Muscular Dystrophy Possibly Related With COL6A1 p.Gly302Arg Variant.

    Science.gov (United States)

    Park, Yoonhong; Park, Myung Seok; Sung, Duk Hyun; Sohn, Ji Yeon; Ki, Chang-Seok; Kim, Du-Hwan

    2014-04-01

    Ullrich congenital muscular dystrophy (UCMD) is characterized by congenital weakness, proximal joint contractures, and hyperlaxity of distal joints. UCMD is basically due to a defect in extra cellular matrix protein, collagen type VI. A 37-year-old woman who cannot walk independently visited our outpatient clinic. She had orthopedic deformities (scoliosis, joint contractures, and distal joint hyperlaxity), difficulty of respiration, and many skin keloids. Her hip computed tomography showed diffuse fatty infiltration and the 'central shadow' sign in thigh muscles. From the clinical information suggesting collagen type VI related muscle disorder, UCMD was highly considered. COL6A1 gene sequencing confirmed this patient as UCMD with novel c.904G>A (p.Gly302Arg) variant. If musculoskeletal and dermatologic manifestations and radiologic findings imply abnormalities in collagen type VI network, COL6A related congenital muscular dystrophy was to be suspected. PMID:24855628

  17. 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.

  18. [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

  19. 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.

  20. Small Incision Total Hip Arthroplasty

    Science.gov (United States)

    ... shell here, okay, and that head and the stem here go inside this plastic dish. This plastic dish here is a -- a cross-linked plastic or polyethylene. This would go inside here; this is how the hip would move, okay? It's a very low coefficient of friction and this fits inside the cup or the ...

  1. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... shell here, okay, and that head and the stem here go inside this plastic dish. This plastic dish here is a -- a cross-linked plastic or polyethylene. This would go inside here; this is how the hip would move, okay? It's a very low coefficient of friction and this fits inside the cup or the ...

  2. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... re going to check the length of the leg, we're going to check the stability of the leg because these hips, they can pop out. For ... Now, is that a problem, to lengthen a leg a little bit? 00:32:29 CARLOS J. ...

  3. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... going to -- I checked. We're going to check the length of the leg, we're going to check the stability of the leg because these hips, ... weeks, four weeks, five weeks, and then they check the amount of bone that has grown into ...

  4. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... the -- into the hip here. This is a titanium aluminum alloy type stem that is going to go down ... it is a -- a metallic stem, okay, a titanium aluminum alloy type stem as well. All right, and it's ...

  5. Small Incision Total Hip Arthroplasty

    Medline Plus

    Full Text Available ... down here. As you can see in the field right now, I have drawn out -- if we can have the field, please -- the old way of doing a hip ... see some of that liquid coming into the field right now. 00:09:02 PIETER J. HOMMEN, ...

  6. Medium-term results of cementless hydroxyapatite-coated primary total hip arthroplasty: a clinical and radiological review.

    Directory of Open Access Journals (Sweden)

    Theis JC

    2003-12-01

    Full Text Available PURPOSE: To evaluate the clinical and radiological outcomes following cementless primary hydroxyapatite-coated total hip arthroplasty. METHODS: A retrospective study of 69 patients (82 hips who underwent uncemented hydroxyapatite-coated Anatomic Benoist Girard total hip replacement between October 1991 and October 1995 at our institution was conducted. Patient records were reviewed. All patients were evaluated clinically using the Merle D'Aubigne hip score, and osteointegration was assessed radiographically by analysing the bone implant interface in the 7 zones of Gruen on followup review. RESULTS: The mean follow-up period was 7.3 years. Clinical results were excellent with an improvement seen in clinical score from 9.9 preoperatively to 16.5 at last review. A total of 15% of patients recorded some thigh discomfort, which was intermittent and not functionally limiting, except in 2 cases. There were 3 cases of severe acetabular osteolysis and loosening requiring revision surgery, and 4 cases of localised proximal femoral osteolysis around well-ingrown implants. There were few perioperative complications, with the exception of 5 dislocations of which 3 were recurrent and required a revision procedure. CONCLUSION: Clinical and radiological outcomes following cementless hydroxyapatite-coated total hip arthroplasty were seen to be favourable in this medium-term retrospective study.

  7. Ultrasound-Guided Hip Arthrocentesis in a Child with Hip Pain and Fever

    Directory of Open Access Journals (Sweden)

    James H. Moak

    2012-09-01

    Full Text Available Children presenting to the emergency department with hip pain and fever are at risk for significant morbidity due to septic arthritis. Distinguishing between septic arthritis and other causes of hip pain may be challenging. Sonographic visualization of the hip with real-time ultrasound-guided arthrocentesis may allow faster differentiation between etiologies, hastening definitive therapy and improving analgesia. This report describes the use of hip sonography in a case of Lyme arthritis. The authors review the medical literature in support of bedside hip sonography and discuss how to perform ultrasound-guided hip arthrocentesis. Clinical findings in septic and Lyme arthritis are also described.

  8. Dislocation Creep of Dry Quartz

    Science.gov (United States)

    Kilian, R.; Heilbronner, R.; Stunitz, H.

    2011-12-01

    Small scale shear zones formed during heterogeneous, amphibolite facies condition in the Truzzo granite in the Penninic Tambo nappe. Magmatic quartz grains recrystallized dynamically by subgrain rotation and grain boundary migration. The presence of a monoclinic shape fabric and a crystallographic preferred orientation are typical for deformation by dislocation creep. Dynamically recrystallized mean grain sizes vary between 200 and 750 ?m which indicate deformation at relatively low differential stresses (5 - 30 MPa). Fourier-Transform-Infrared (FTIR) spectroscopy reveals water contents mostly below 200 H/10^6 Si in the interior of recrystallized grains (in the form of discrete OH peaks and very little broad band absorption). This water content is in the range of values reported for dry Brazil quartz. Primary magmatic quartz grains contain fluid-inclusion-rich areas with a broad absorption band and higher water concentrations. Recrystallized grains are dry, except for postkinematic inclusion trails. These measurements present the first data on strictly intragranular water contents of dynamically recrystallized quartz in nature. Dry quartz is extremely strong and does not deform by dislocation creep in deformation experiments at the low differential stress levels that would correspond to natural deformation. In contrast, deformation experiments on wet polycrystalline quartz have produced flow laws that can be extrapolated to natural conditions, which yield satisfying results. This is in contrast with our data of the dry quartz deforming by dislocation creep at relatively low differential stresses at natural strain rates. Contrary to the conventional concept of recovery, our data and observations imply that quartz would be hardening as a consequence of grain boundary migration because fluid inclusions are expelled. The drainage of fluid inclusions and microstructures in the feldspar-mica matrix indicate that water during deformation was at least present in the grain boundary region. FTIR measurements of natural deformed quartz reported in literature include grain boundaries and usually yield concentration of up to several 1000s H/10^6 Si. Therefore it is concluded that either introduction of water into the deforming grains must have been transient or that the intragranular water concentrations which are rheologically effective in the naturally deformed Truzzo granite are much lower than those previously reported in the literature.

  9. Biotribology of artificial hip joints

    Science.gov (United States)

    Di Puccio, Francesca; Mattei, Lorenza

    2015-01-01

    Hip arthroplasty can be considered one of the major successes of orthopedic surgery, with more than 350000 replacements performed every year in the United States with a constantly increasing rate. The main limitations to the lifespan of these devices are due to tribological aspects, in particular the wear of mating surfaces, which implies a loss of matter and modification of surface geometry. However, wear is a complex phenomenon, also involving lubrication and friction. The present paper deals with the tribological performance of hip implants and is organized in to three main sections. Firstly, the basic elements of tribology are presented, from contact mechanics of ball-in-socket joints to ultra high molecular weight polyethylene wear laws. Some fundamental equations are also reported, with the aim of providing the reader with some simple tools for tribological investigations. In the second section, the focus moves to artificial hip joints, defining materials and geometrical properties and discussing their friction, lubrication and wear characteristics. In particular, the features of different couplings, from metal-on-plastic to metal-on-metal and ceramic-on-ceramic, are discussed as well as the role of the head radius and clearance. How friction, lubrication and wear are interconnected and most of all how they are specific for each loading and kinematic condition is highlighted. Thus, the significant differences in patients and their lifestyles account for the high dispersion of clinical data. Furthermore, such consideration has raised a new discussion on the most suitable in vitro tests for hip implants as simplified gait cycles can be too far from effective implant working conditions. In the third section, the trends of hip implants in the years from 2003 to 2012 provided by the National Joint Registry of England, Wales and Northern Ireland are summarized and commented on in a discussion. PMID:25621213

  10. Biotribology of artificial hip joints.

    Science.gov (United States)

    Di Puccio, Francesca; Mattei, Lorenza

    2015-01-18

    Hip arthroplasty can be considered one of the major successes of orthopedic surgery, with more than 350000 replacements performed every year in the United States with a constantly increasing rate. The main limitations to the lifespan of these devices are due to tribological aspects, in particular the wear of mating surfaces, which implies a loss of matter and modification of surface geometry. However, wear is a complex phenomenon, also involving lubrication and friction. The present paper deals with the tribological performance of hip implants and is organized in to three main sections. Firstly, the basic elements of tribology are presented, from contact mechanics of ball-in-socket joints to ultra high molecular weight polyethylene wear laws. Some fundamental equations are also reported, with the aim of providing the reader with some simple tools for tribological investigations. In the second section, the focus moves to artificial hip joints, defining materials and geometrical properties and discussing their friction, lubrication and wear characteristics. In particular, the features of different couplings, from metal-on-plastic to metal-on-metal and ceramic-on-ceramic, are discussed as well as the role of the head radius and clearance. How friction, lubrication and wear are interconnected and most of all how they are specific for each loading and kinematic condition is highlighted. Thus, the significant differences in patients and their lifestyles account for the high dispersion of clinical data. Furthermore, such consideration has raised a new discussion on the most suitable in vitro tests for hip implants as simplified gait cycles can be too far from effective implant working conditions. In the third section, the trends of hip implants in the years from 2003 to 2012 provided by the National Joint Registry of England, Wales and Northern Ireland are summarized and commented on in a discussion. PMID:25621213

  11. Neutron Diffraction Measurement of Residual Stresses, Dislocation Density and Texture in Zr-bonded U-10Mo “Mini” Fuel Foils and Plates

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Donald W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Okuniewski, M. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Sisneros, Thomas A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Clausen, Bjorn [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Moore, G. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Balogh, L [Queen' s Univ., Kingston, ON (Canada)

    2014-08-07

    Aluminum clad monolithic uranium 10 weight percent molybdenum (U-10Mo) fuel plates are being considered for conversion of several research and test nuclear reactors from high-enriched to low-enriched uranium fuel due to the inherently high density of fissile material. Comprehensive neutron diffraction measurements of the evolution of the textures, residual phase stresses, and dislocation densities in the individual phases of the mini-foils throughout several processing steps and following hot-isostatic pressing to the Al cladding, have been completed. Recovery and recrystallization of the bare U-10Mo fuel foil, as indicated by the dislocation density and texture, are observed depending on the state of the material prior to annealing and the duration and temperature of the annealing process. In general, the HIP procedure significantly reduces the dislocation density, but the final state of the clad plate, both texture and dislocation density, depends strongly on the final processing step of the fuel foil. In contrast, the residual stresses in the clad fuel plate do not depend strongly on the final processing step of the bare foil prior to HIP boding. Rather, the residual stresses are dominated by the thermal expansion mismatch of the constituent materials of the fuel plate.

  12. 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.

  13. Lisfranc fracture dislocation. Clinical case

    Directory of Open Access Journals (Sweden)

    Lora-Fernández Alberto Carlos

    2010-12-01

    Full Text Available The Lisfranc fracture dislocation is a serious lesion occur in tarsometatarsian joint and produce importants consequence, for anatomic complexiti of this foot area. The injury mechanisms ocasionality is asociated to automovilistic accidents. Our report of a clinical case into a patient endure fall since 8 meter altitud. Quirurgical manegement was make, open reduction and osteosíntesis with Kirschner nails. Favorable evolution and adecuate reponse to rehabilitation.RESUMENLa luxofractura de Lisfranc es una lesión grave que compromete la articulacióntarsometatarsiana, generando secuelas importantes, dada la complejidad anatómica de esta zona del pie. Los mecanismos de lesión en general han sido asociados a accidentes en automotores. Se reporta un caso clínico, en el cual el paciente sufre caída de una altura de ocho metros. Realizado el manejo quirúrgico con reducción abierta más osteosíntesis con clavos de Kirschner. Evolución favorable y adecuada respuesta a la rehabilitación.

  14. Acute dislocations of the knee

    Scientific Electronic Library Online (English)

    HR, Hobbs; J, Walters.

    Full Text Available Acute dislocation of the knee is an uncommon but devastating injury. A high level of suspicion is needed in diagnosing it. Repeated neurovascular examinations are extremely important and even though it is wiser in our setting to do a routine angiogram, this is not a substitute for and does not exemp [...] t the patient from receiving a full neurovascular assessment. Outcome is better when the knees are treated surgically - immediately if there is vascular compromise, with the remainder being treated before two weeks as soon as the soft tissues allow. Anatomical restitution of the injured structures is the surgical goal. Avoidance of chronic persistent posterior subluxation and a controlled rehabilitation programme will yield best results.

  15. Genetics Home Reference: Congenital dyserythropoietic anemia

    Science.gov (United States)

    ... literature OMIM Genetic disorder catalog Conditions > Congenital dyserythropoietic anemia (often shortened to CDA ) On this page: Description ... Reviewed July 2009 What is CDA? Congenital dyserythropoietic anemia (CDA) is an inherited blood disorder that affects ...

  16. Five Facts about Congenital Heart Defects

    Science.gov (United States)

    ... Past Emails CDC Features Five Facts about Congenital Heart Defects Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Congenital heart defects are the most common types of birth defects. ...

  17. Signs and Symptoms of Congenital Heart Defects

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Congenital Heart Defects? Many congenital heart defects cause few or no signs and symptoms. A doctor may not even detect signs of a heart defect during a physical exam. Some heart defects do ...

  18. The Boundary Value Problem of Dislocation Dynamics

    Energy Technology Data Exchange (ETDEWEB)

    El-Azab, Anter Aa (BATTELLE (PACIFIC NW LAB))

    1999-12-01

    The present work is concerned with the mathematical formulation of the boundary value problem of dislocation dynamics. The boundary conditions for the elastic and dislocation fields are derived for two cases which are currently treated by dislocation dynamics simulation models. In the first case, the crystal space under consideration is a representative subvolume of a much larger crystal undergoing statistically homogeneous plastic distortion. The second is the case of a crystal which is bounded by a free surface. For the former case, the condition of statistical homogeneity of the elastic stress and the plastic distortion fields is used to derive local traction and dislocation flux boundary conditions on the surface of the deforming crystal space. When the crystal is bounded, the formation of slip traces is connected with the dislocation flux and dislocation emission at the free surface. Three theorems are derived, two on conservation of the total Burgers vector and the dislocation flux in a deforming crystal, and the third on image interactions. Some important mathematical ideas related to the geometry of deforming crystals are also discussed.

  19. Dislocation structure in neutron irradiated zircaloy

    International Nuclear Information System (INIS)

    Transmission electron microscopy of neutron irradiated Zircaloy-2 and 4 shows for the first time that network dislocations introduced by cold work prior to irradiation are retained to relatively high neutron doses (4.3 x 1025 n msup(-2),E > 1 MeV or approx. equal to 10 dpa). The dislocations, which have c-component Burgers vectors, are observed by imaging with the 0002 reflection to eliminate contrast due to irradiation damage which otherwise obscures contrast of the network dislocation structure. No such network dislocations are observed in material annealed prior to irradiation and no dislocation loops with c-component Burgers vectors are produced by irradiation in either annealed or cold-worked material. The orientation distribution of the dislocations appears to change during irradiation from predominantly edge to predominantly screw character. These observations provide essential support for models of irradiation growth requiring the presence of network dislocations to act as point defect sinks or paths for short circuit diffusion of point defects to grain boundaries in order to explain high growth rates in cold-worked material. (orig.)

  20. Random organization in periodically driven gliding dislocations

    International Nuclear Information System (INIS)

    We numerically examine dynamical irreversible to reversible transitions and random organization for periodically driven gliding dislocation assemblies using the stroboscopic protocol developed to identify random organization in periodically driven dilute colloidal suspensions. We find that the gliding dislocations exhibit features associated with random organization and evolve into a dynamically reversible state after a transient time extending over a number of cycles. At a critical shearing amplitude, the transient time diverges. When the dislocations enter the reversible state they organize into patterns with fragmented domain wall type features.