WorldWideScience
1

Ultrasound screening and follow-up of congenital hip dislocation  

International Nuclear Information System (INIS)

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

2

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

3

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

Directory of Open Access Journals (Sweden)

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

Pozdniakova ?.N.

2011-06-01

4

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

International Nuclear Information System (INIS)

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

5

Developmental Dislocation (Dysplasia) of the Hip (DDH)  

Science.gov (United States)

... are stretched. The degree of hip looseness, or instability, varies among children with DDH. • Dislocated. In the ... breech position (especially with feet up by the shoulders). The American Academy of Pediatrics now recommends ultrasound ...

6

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

LENUS (Irish Health Repository)

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

Galbraith, John G

2011-01-01

7

The surgical treatment for congenital atlantoaxial dislocation  

Directory of Open Access Journals (Sweden)

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

WANG Kun

2012-08-01

8

Trauma in congenital atlanto-axial dislocation.  

Science.gov (United States)

Congenital atlanto-axial dislocation (AAD) usually presents with chronically progressive compression of the cervico-medullary junction. However, even a minor trauma can cause acute compression with development of quadruplegia and respiratory impairment. At times these may be transient, or trauma may aggravate the compression and lead to progressive quadriplegia. Of 60 children seen with congenital AAD, in 15 it had been associated with trauma. Nine of these 15 AADs were of the mobile variety, and 6 of the fixed variety with odontoid invagination. In 6 children with mobile and 2 with fixed AAD, trauma led to an acute manifestation with quadriplegia. Three of the children also experienced respiratory distress and needed ventilatory support. All 15 were initially treated with skull traction. Once the condition was stabilised, those with the mobile variety underwent fixation in a reduced position and grafting. One of the children with respiratory distress died within 2 days of admission. In 4 of them, sublaminar wiring between C1 and C2 was carried out, and in 3 others wiring between occiput and base of spinous process of C2 was performed. In 1 case a Hartshill loop was used. Among the children with fixed AAD, reduction of the odontoid invagination was obtained in 2, and they underwent fusion. In 4 cases with unsatisfactory reduction, posterior decompression of the foramen magnum and the fused posterior arch of the atlas was performed. The results depended on the degree of neurological deficit in each child. PMID:9881625

Bhagwati, S N; Deopujari, C E; Parulekar, G D

1998-12-01

9

Paralytic dislocations of the hip in adolescence: Orthopaedic treatment  

Directory of Open Access Journals (Sweden)

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

?obelji? Goran

2009-01-01

10

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

Directory of Open Access Journals (Sweden)

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

Harty James A

2011-03-01

11

Ipsilateral anterior then irreducible posterior hip dislocation without fracture: a case report.  

Science.gov (United States)

Anterior hip dislocations and posterior hip dislocations are injuries that commonly result from high-energy trauma. Different mechanisms of injury and forces are typically required for anterior and posterior hip dislocations. We present the case of a patient who sustained an injury that initially resulted in an anterior hip dislocation. After reduction and without experiencing further significant trauma, the patient dislocated posteriorly while being transferred from a stretcher to a table in radiology some 14 hours later. To our knowledge, there have been no such presentations in the literature. PMID:18448993

Liporace, Frank A; Dasti, Umer R; Raiszadeh, Kian

2008-01-01

12

Acute iatrogenic dislocation following hip impingement arthroscopic surgery.  

Science.gov (United States)

This is the first case report of an iatrogenic anterior hip dislocation after arthroscopic surgery for femoroacetabular impingement with over 1 year of follow-up. This case report describes the clinical course of a patient with symptomatic cam-pincer femoroacetabular impingement. She underwent arthroscopic rim trimming, labral debridement after a failed attempt at labral refixation from suture cut-through, and femoral head-neck resection osteoplasty. The procedure involved supranormal hip distraction for extraction of an iatrogenic loose body (detached metallic radiofrequency probe tip). The patient had an anterior hip dislocation in the recovery room. Immediate closed reduction under general anesthesia and bracing were performed but failed despite the ability to obtain a concentric but grossly unstable reduction. After 3 failed attempts, a mini-open capsulorrhaphy was performed that successfully restored stability. Her postoperative management and outcome are presented. All of the major static stabilizers of the hip (osseous, labral, and capsuloligamentous) were surgically altered, and a multifactorial causation is proposed. Lessons learned are discussed in hopes of minimizing the occurrence of this rare but dramatic complication. PMID:19341927

Matsuda, Dean K

2009-04-01

13

Imaging of traumatic dislocation of the hip in childhood  

Energy Technology Data Exchange (ETDEWEB)

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 injury to assess epiphyseal vascularity. With the use of specific sequences, MRI may be an alternative modality to assess epiphyseal vitality. (orig.)

Vialle, Raphael; Pannier, Stephanie; Odent, Thierry; Glorion, Christophe [Necker Enfants-Malades Hospital, Department of Paediatric Orthopaedics, Paris Cedex 15 (France); Schmit, Pierre [Necker Enfants-Malades Hospital, Department of Paediatric Radiology, Paris (France); Pauthier, Francois [CHI Poissy Saint Germain en Laye, Department of Orthopaedic Surgery, Poissy (France)

2004-12-01

14

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

Directory of Open Access Journals (Sweden)

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

Erdil Mehmet

2012-07-01

15

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

OpenAIRE

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 sub...

Lidder Surjit; Ranawat Vijai S; Ranawat Nitran S; Thomas Tudor L

2009-01-01

16

Congenital medial dislocation of the patella with multiple congenital anomalies: case report and method of treatment.  

Science.gov (United States)

Lateral dislocation of the patella is reported frequently in orthopaedics references but congenital medial patellar dislocation is reported rarely. An 8-year-old girl was referred to our department for knee surgery. She had genuvarum, knee flexion contracture and tibial internal rotation. She had multiple congenital anomalies at birth. The patella was palpated in the medial side of knee and its reduction to the midline was impossible. We performed an operative procedure for her medial dislocation of the patella. At the 1-year follow-up, the patella was in midline and there was no medial subluxation on range of motion of the knee. In infants with genuvarum, knee flexion contracture and tibial internal rotation, the possibility of medial patellar instability should be considered. For correction of patellar tracking and prevention of bone deformities, surgical management should be performed. PMID:24296651

Yazdi, Hamidreza; Monshizadeh, Siamak; Bozorgi, Zahra

2014-03-01

17

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.)

18

TREATMENT OF POSTTRAUMATIC LABRAL INTERPOSITION WITH SURGICAL HIP DISLOCATION AND LABRAL REPAIR  

OpenAIRE

We report a case of a 12-year-old male with delayed presentation of a spontaneous incongruous reduction of a hip dislocation due to labral-chondral acetabular rim fragment entrapment The patient was treated with a staged hip arthroscopy and subsequent surgical dislocation and open repair. At two-year follow-up, the patient had an excellent clinical and radiographic outcome.

Nepple, Jeffrey J.; Schoenecker, Perry L.; Clohisy, John C.

2011-01-01

19

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

LENUS (Irish Health Repository)

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

Brennan, Stephen A

2012-09-01

20

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

Directory of Open Access Journals (Sweden)

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.  

Amin Foroughi

2009-01-01

21

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

Scientific Electronic Library Online (English)

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.

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

22

Bilateral dislocation of the hip in spina bifida: a long-term follow-up study.  

Science.gov (United States)

Nineteen patients with spina bifida and bilateral dislocation of the hips were studied with a minimal follow-up of 10 years. The average age at review was 21 years (range, 10-31). Ten patients had an upper neurologic level (thoracic to L3), and nine had a low lesion (L4 to sacrum). Three patients had no hip surgery. A closed or open reduction was performed in 12 hips, supplemented by one or more surgical procedures. Of these, 10 remained enlocated, and two had redislocated. In all other hips, several surgical procedures were performed, aimed at improvement of hip-flexion deformity or stability. At follow-up, one patient had occasional pain in one hip, which was dysplastic. Of the 10 patients with a high lesion, only two were walkers, but both had bilateral dislocation of the hips at follow-up. In contrast, all nine patients were walkers, but four of these had bilateral dislocation at follow-up. We found that a level pelvis and good range of motion of the hips are more important for ambulation than is reduction of bilateral hip dislocation. PMID:9661846

Heeg, M; Broughton, N S; Menelaus, M B

1998-01-01

23

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

LENUS (Irish Health Repository)

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

Forde, James C

2012-02-01

24

Outcomes after THA in Patients with High Hip Dislocation after Childhood Sepsis  

OpenAIRE

To ascertain whether THA in patients with high dislocation after childhood sepsis would relieve pain and improve function, we assessed the rate of postoperative infection, improvement in Harris hip and WOMAC scores, and improvement in range of motion after the THA in 62 patients (62 hips) with high dislocation (Crowe Type 4) after childhood sepsis. The revision rate and the incidence of complications also were assessed. The mean age of the patients was 47.5 years. The minimum followup was 13...

Kim, Young-hoo; Seo, Hee-soo; Kim, Jun-shik

2008-01-01

25

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

OpenAIRE

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 peop...

Wong King; Sivan Manoj; Matthews Gordon

2008-01-01

26

[Traumatic dislocation of the hip in a 3-year-old boy with a painful knee].  

Science.gov (United States)

A 3-year-old boy had pain on the medial side of his left knee after his father fell on him. When the pain still persisted 4 days later, further diagnostics revealed dislocation of the hip. The pain disappeared and function was restored after closed reposition under fluoroscopic control followed by immobilisation with a plaster cast. Traumatic dislocation of the hip in childhood is a relatively rare injury, but may have far-reaching consequences. As the sensitivity to pain in children differs from that in adults, an examiner must be on the alert for a traumatic dislocation of the hip whenever a child presents with a fitting history and dysfunction ofthe leg, regardless of the localisation of the pain. Pain in the knee is often reported in case of hip disorders. Avascular necrosis of the caput femoris is a well-known and dreaded complication of traumatic dislocation of the hip in children. The risk of complications is certainly increased sharply if the hip luxation goes unnoticed and reposition takes place after more than 6 hours. Closed reposition as rapidly as possible or alternatively open reposition of the dislocated hip under general anaesthesia is the indicated treatment. PMID:17089551

van Ommeren, P M; Castelein, R M; Leenen, L P H

2006-10-21

27

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

Directory of Open Access Journals (Sweden)

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.

Wong King

2008-07-01

28

Congenital joint dislocations caused by carbohydrate sulfotransferase 3 deficiency in recessive Larsen syndrome and humero-spinal dysostosis.  

Science.gov (United States)

Deficiency of carbohydrate sulfotransferase 3 (CHST3; also known as chondroitin-6-sulfotransferase) has been reported in a single kindred so far and in association with a phenotype of severe chondrodysplasia with progressive spinal involvement. We report eight CHST3 mutations in six unrelated individuals who presented at birth with congenital joint dislocations. These patients had been given a diagnosis of either Larsen syndrome (three individuals) or humero-spinal dysostosis (three individuals), and their clinical features included congenital dislocation of the knees, elbow joint dysplasia with subluxation and limited extension, hip dysplasia or dislocation, clubfoot, short stature, and kyphoscoliosis developing in late childhood. Analysis of chondroitin sulfate proteoglycans in dermal fibroblasts showed markedly decreased 6-O-sulfation but enhanced 4-O-sulfation, confirming functional impairment of CHST3 and distinguishing them from diastrophic dysplasia sulphate transporter (DTDST)-deficient cells. These observations provide a molecular basis for recessive Larsen syndrome and indicate that recessive Larsen syndrome, humero-spinal dysostosis, and spondyloepiphyseal dysplasia Omani type form a phenotypic spectrum. PMID:18513679

Hermanns, Pia; Unger, Sheila; Rossi, Antonio; Perez-Aytes, Antonio; Cortina, Hector; Bonafé, Luisa; Boccone, Loredana; Setzu, Valeria; Dutoit, Michel; Sangiorgi, Luca; Pecora, Fabio; Reicherter, Kerstin; Nishimura, Gen; Spranger, Jürgen; Zabel, Bernhard; Superti-Furga, Andrea

2008-06-01

29

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.)

30

Computed tomography in abnormalities of the hip  

Energy Technology Data Exchange (ETDEWEB)

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

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

1982-06-26

31

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

Directory of Open Access Journals (Sweden)

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.

Plate Johannes F

2012-10-01

32

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

Directory of Open Access Journals (Sweden)

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.

Mohammad H Taraz Jamshidi

2014-03-01

33

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

Directory of Open Access Journals (Sweden)

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

Asif S

2004-06-01

34

Surgical Dislocation in the Management of Pediatric and Adolescent Hip Deformity  

OpenAIRE

The surgical dislocation approach is useful in assessing and treating proximal femoral hip deformities commonly due to pediatric conditions. We sought to demonstrate the efficacy and problems associated with this technique. Diagnoses included slipped capital femoral epiphysis, Perthes disease, developmental dysplasia of the hip, osteonecrosis, and exostoses. Through this approach, femoral head-neck osteoplasty (22), intertrochanteric osteotomy (eight), femoral head-neck osteoplasty plus inter...

Rebello, Gleeson; Spencer, Samantha; Millis, Michael B.; Kim, Young-jo

2008-01-01

35

Phenotypic features of carbohydrate sulfotransferase 3 (CHST3) deficiency in 24 patients: congenital dislocations and vertebral changes as principal diagnostic features.  

Science.gov (United States)

We recently reported on the deficiency of carbohydrate sulfotransferase 3 (CHST3; chondroitin-6-sulfotransferase) in six subjects diagnosed with recessive Larsen syndrome or humero-spinal dysostosis [Hermanns et al. (2008); Am J Hum Genet 82:1368-1374]. Since then, we have identified 17 additional families with CHST3 mutations and we report here on a series of 24 patients in 23 families. The diagnostic hypothesis prior to molecular analysis had been: Larsen syndrome (15 families), humero-spinal dysostosis (four cases), chondrodysplasia with multiple dislocations (CDMD "Megarbane type"; two cases), Desbuquois syndrome (one case), and spondylo-epiphyseal dysplasia (one case). In spite of the different diagnostic labels, the clinical features in these patients were similar and included dislocation of the knees and/or hips at birth, clubfoot, elbow joint dysplasia with subluxation and limited extension, short stature, and progressive kyphosis developing in late childhood. The most useful radiographic clues were the changes of the lumbar vertebrae. Twenty-four different CHST3 mutations were identified; 16 patients had homozygous mutations. We conclude that CHST3 deficiency presents at birth with congenital dislocations of knees, hips, and elbows, and is often diagnosed initially as Larsen syndrome, humero-spinal dysostosis, or chondrodysplasia with dislocations. The incidence of CHST3 deficiency seems to be higher than assumed so far. The clinical and radiographic pattern (joint dislocations, vertebral changes, normal carpal age, lack of facial flattening, and recessive inheritance) is characteristic and distinguishes CHST3 deficiency from other disorders with congenital dislocations such as filamin B-associated dominant Larsen syndrome and Desbuquois syndrome. PMID:20830804

Unger, Sheila; Lausch, Ekkehart; Rossi, Antonio; Mégarbané, Andre; Sillence, David; Alcausin, Melanie; Aytes, Antonio; Mendoza-Londono, Roberto; Nampoothiri, Sheela; Afroze, Bushra; Hall, Bryan; Lo, Ivan F M; Lam, Stephen T S; Hoefele, Julia; Rost, Imma; Wakeling, Emma; Mangold, Elisabeth; Godbole, Komudi; Vatanavicharn, Nithiwat; Franco, Luis M; Chandler, Kate; Hollander, Sophia; Velten, Tanja; Reicherter, Kerstin; Spranger, Jürgen; Robertson, Stephen; Bonafé, Luisa; Zabel, Bernhard; Superti-Furga, Andrea

2010-10-01

36

Treatment of developmental dislocation of hip: does changing the hip abduction angle in the hip spica affect the rate of avascular necrosis of the femoral head?  

Science.gov (United States)

Avascular necrosis (AVN) of the femoral head is a serious complication in the management of developmental dislocation of the hip. Increasing the abduction angle increases its stability but compromises the vascularity of the femoral head. From our database of 240 children treated for developmental dislocation of hip by the two senior authors between 1998 and 2008, we defined two groups of children who underwent closed or medial open reduction of the hip after a failed Pavlik treatment or if patients presented late. In group 1, the reduced hip was immobilized in around 90° flexion, 60° abduction, and 0-10° internal rotation. In group 2 the hip was immobilized in around 45° of hip abduction with flexion and internal rotation as before. The first and second authors independently analysed these two groups blinded to the hip abduction angle. Our hypothesis was that a reduction in the hip abduction angle would reduce the incidence of AVN in the second group without compromising the stability. All eligible children were included, and there were 42 children in group 1 and 44 children in group 2. An almost equal number of children underwent closed and medial open reduction in both the groups. The age at reduction was a mode of 6 months (range 6-13 months) and 7 months (range 7-12 months), respectively. The abduction angle in the first group had a mode of 60° (range 52-70°) and the second group had a mode of 45° (range 38-50°). Radiographic evidence of AVN as described by Salter and colleagues was seen in eight children (19%) in the first group and seven children (16%) in the second group (P=0.78). Redislocation occurred in one child in the second group and none in the first group. In summary, the results show a nonsignificant reduction in the incidence of AVN when the hip abduction angle was reduced with no significant increased risk of redislocation. PMID:23407430

Madhu, Tiruveedhula S; Akula, Maheswara; Scott, Brian W; Templeton, Peter A

2013-05-01

37

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

DEFF Research Database (Denmark)

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

Jakobsen, Thomas; Kappel, Andreas

2014-01-01

38

Surgical dislocation in the management of pediatric and adolescent hip deformity.  

Science.gov (United States)

The surgical dislocation approach is useful in assessing and treating proximal femoral hip deformities commonly due to pediatric conditions. We sought to demonstrate the efficacy and problems associated with this technique. Diagnoses included slipped capital femoral epiphysis, Perthes disease, developmental dysplasia of the hip, osteonecrosis, and exostoses. Through this approach, femoral head-neck osteoplasty (22), intertrochanteric osteotomy (eight), femoral head-neck osteoplasty plus intertrochanteric osteotomy (15), femoral neck osteotomy (five), open reduction and internal fixation of an acute slipped capital femoral epiphysis with callus resection (five), open reduction and internal fixation of an acetabular fracture (one), trapdoor procedure (one), and acetabular rim osteoplasty (one) were performed. The average patient age was 16 years. The minimum followup was 12 months (average, 41.6 months; range, 12-73 months). Patients with Perthes disease and SCFE had preoperative and postoperative WOMAC scores of 9.6 and 5.1, and 7.9 and 3.5 respectively. In patients with unstable SCFEs, the average postoperative WOMAC score was 1.2. Seven patients underwent THAs and two patients underwent hip fusion. Complications in the 58 procedures included four cases of osteonecrosis: three after femoral neck osteotomy and one after intertrochanteric osteotomy. The surgical dislocation technique can be utilized to effectively treat these deformities and improve short-term symptoms. Although the technique is demanding, we believe surgical dislocation offers sufficient advantages in assessing and treating these complex deformities that it justifies judicious application. PMID:19002743

Rebello, Gleeson; Spencer, Samantha; Millis, Michael B; Kim, Young-Jo

2009-03-01

39

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

OpenAIRE

Abstract Introduction Posterior dislocation of the elbow is usually associated with trauma to the joint with a reported incidence of 3%to 6%. Chronic instability is usually symptomatic following the initial injury. Case presentation We report a case of posterior dislocation of the elbow occurring in a patient while using her arm to lift herself using a monkey pole on the second day following a total hip replacement. The dislocation was reduced under sedation in the ward. There were no signs o...

Periasamy Kumar; Meek Dominic; Crossman Paul

2008-01-01

40

Dislocated trial femoral head during total hip arthroplasty: review of the literature and the new algorithm for treatment.  

Science.gov (United States)

Dislocation of the trial femoral head is a rare and unpleasant event that can compromise the success of the total hip arthroplasty. A 62-year-old Caucasian woman with osteoarthritis was admitted to our Department and underwent an elective total hip arthroplasty. While performing the dislocation manoeuver the trial femoral head dissociated from the taper in the superior and anterior direction in the soft tissue and could not be retrieved immediately. The operation was then executed and finished in an ordinary manner. Three months after discharge from our department patient presented with the pain in the hip and groin and periprosthetic joint infection was diagnosed. The successful second operation for the retrieval of the dislocated trial femoral head was conducted through ilioinguinal approach. In this paper we reviewed the published literature and developed the algorithm for the decision-making while dealing with the dislocated and lost trial femoral head. PMID:25743866

Bicanic, Goran; Crnogaca, Kresimir; Simunovic, Marko; Delimar, Domagoj

2015-01-01

41

Bilateral pathological dislocation of the hip secondary to tuberculous arthritis following disseminated tuberculosis: a case report and review of the literature.  

Science.gov (United States)

Pathological dislocation of the hip has been reported as a complication in various hip disorders. Several pathomechanisms including capsular laxity, synovial hypertrophy, and acetabular and proximal femur destruction have been described. We report a case of bilateral pathological dislocation of the hip in a 6-year-old girl secondary to tuberculous arthritis following disseminated tuberculosis, which we managed operatively. At the 18-month follow-up, the child had a clinically stable left hip despite radiological subluxation. Bilateral pathological dislocation of the hip associated with tuberculous arthritis is a rare condition and has never been reported in the literature. PMID:22668573

Tahasildar, Naveen; Sudesh, Pebam; Tripathy, Sujit Kumar; Shashidhar, B K

2012-11-01

42

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

Directory of Open Access Journals (Sweden)

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

Göran O. Sjödén

2013-06-01

43

Comparison of Procedural Sedation for the Reduction of Dislocated Total Hip Arthroplasty  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Various types of sedation can be used for the reduction of a dislocated total hip arthroplasty. Traditionally, an Opiate/Benzodiazepine combination has been employed. The use of other pharmacologic agents, such as Etomidate and Propofol, has more recently gained popularity. Currently no studies directly comparing these sedation agents have been carried out. The purpose of this study is to compare differences in reduction and sedation outcomes including recovery times of these three different sedation agents. Methods: A retrospective chart review was performed examining 198 patient’s charts who presented with dislocated total hip arthroplasty at two academic affiliated medical centers. The patients were organized into groups according to the type of sedation agent used during their reduction. The percentages of reduction and sedation complications were calculated along with overall recovery times. Reduction complications included fracture, skin or neurovascular injury, and failure of reduction requiring general anesthesia. Sedation complications included use of bag-valve mask and artificial airway, intubation, prolonged recovery, use of a reversal agent, and inability to achieve sedation. The data were then compared for each sedation agent. Results: The reduction complications rates found were 8.7% in the Propofol group, 24.68% in the Etomidate, and 28.85% in the Opiate/Benzodiazepine groups. The reduction complication rate in the Propofol group was significantly different than those of the other two agents (p?0.01. Sedation complications were found to happen 7.25% of the time in the Propofol group, 11.69% in the Etomidate group, and 21.25% in the Opiate/ Benzodiazepine group with Propofol having complication rates significantly different than that of the Opiate/Benzodiazepine group (p=0.02. Average lengths of recovery were 25.17 minutes for Propofol, 30.83 minutes for Etomidate, and 44.35 minutes for Opiate/ Benzodiazepine with Propofol averaging a significantly less recovery time than the Opiate/Benzodiazepine group (p=0.05. Conclusions: For the purpose of reducing a dislocated total hip arthroplasty under conscious sedation, Propofol appears to have fewer complications and a trend of more rapid recovery than both Etomidate and Opiate/Benzodiazepine. Etomidate does appear to have some advantages over Opiate/Benzodiazepine regarding sedation complications and recovery time; however its rate of reduction complications was similar. This preliminary data supports the use of Propofol as the first line agent for procedural sedation of dislocated total hip arthroplasty as it may lead to few complications and shorter stays in the emergency department. [West J. Emerg Med. 2014;15(1:76-80.

Jonathan E. dela Cruz

2014-02-01

44

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

Scientific Electronic Library Online (English)

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.

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

2012-03-01

45

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

Scientific Electronic Library Online (English)

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.

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

2014-04-01

46

Klippel-Feil syndrome associated with congenital cervical dislocation: report of an autopsy case.  

Science.gov (United States)

Klippel-Feil syndrome is an uncommon congenital anomaly that is characterized by abnormal fusion of the cervical vertebrae and occasionally accompanied by various anomalies of other bones and internal organs. We report the autopsy case of a 5-year-old girl with this syndrome ssociated with congenital cervical dislocation, with special reference to the pathological findings of the vertebral column and spinal cord. Principal anomalies of the cranio-spinal axis were as follows: partial defect of the clivus, scoliosis, hypoplasia of the whole cervical vertebrae, anterior dislocation of C7 with S-shaped deformity of the spinal canal, fusion of the spinous processes of the cervical and thoracic vertebrae, fusion of the vertebral bodies of C6 and C7 with collapse of C7, and spina bifida occulta of L5 and S1. In addition to these skeletal anomalies, subarachnoid vascular malformation in the medulla oblongata, a bronchogenic cyst in the posterior mediastinum, anomalous lobation of the lungs, and the mobile cecum were found at autopsy. The cervical cord showed an increase of the antero-posterior diameter, multifocal spongy changes of the white matter, and partial branching or duplication of the central canal. The brain showed features of anoxic encephalopathy. The partial defect of the clivus, C7 dislocation, and various lesions of the medulla oblongata and cervical cord were interpreted as integral components of, or lesions closely associated with, Klippel-Feil syndrome. PMID:22762890

Shintaku, Masayuki; Wada, Kyosuke; Koyama, Takashi; Kohno, Hiroaki; Sakamoto, Takeshi; Hida, Shinya

2013-01-01

47

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

Science.gov (United States)

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

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

2015-02-01

48

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)

49

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

Directory of Open Access Journals (Sweden)

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.

Stojkovi?-Jovanovi? Tatjana

2013-01-01

50

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)

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

Luis Eduardo Munhoz da Rocha

2010-01-01

51

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

Scientific Electronic Library Online (English)

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

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

52

Prevalence of hip dislocation among children with cerebral palsy in regions with and without a surveillance programme: a cross sectional study in Sweden and Norway  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Hip dislocation is a serious complication among children with cerebral palsy (CP. The aim of this study was to compare the prevalence of hip dislocation among children with CP in an area providing regular care with an area providing hip surveillance services. Methods This is a cross-sectional study in seven Norwegian counties providing regular care and one Swedish healthcare region where a hip surveillance programme was introduced in 1994. Data were provided by the Norwegian Cerebral Palsy Register and the CP Register in Southern Sweden. Children born 1996 - 2003 with moderate to severe CP, defined as Gross Motor Classification System (GMFCS levels III - V, were included. In all, 119 Norwegian and 136 Swedish children fulfilled the criteria. In Norway, data on hip operations and radiographs of the hips were collected from medical records, while these data are collected routinely in the Swedish register. The hip migration percentage was measured on the recent radiographs. Hip dislocation was defined as a migration percent of 100%. Results The proportion of children at GMFCS levels III - V was 34% in the Norwegian and 38% in the Swedish population. In the Norwegian population, hip dislocation was diagnosed in 18 children (15.1%; CI: 9.8 - 22.6 compared with only one child (0.7%; 95% CI: 0.01 - 4.0 in Southern Sweden (p = Conclusions The surveillance programme reduced the number of hip dislocations and the proportion of children undergoing hip surgery was lower. However, with the surveillance programme the first operation was performed at a younger age. Our results strongly support the effectiveness of a specifically designed follow-up programme for the prevention of hip dislocation in children with CP.

Elkamil Areej I

2011-12-01

53

Irreducible dislocated total hip replacement due to intra-articular incarceration of bone cement: A case report  

Science.gov (United States)

INTRODUCTION Dislocation following total hip replacement is a well-documented complication. We present an unusual cause of failure to achieve a concentric closed reduction of a cemented total hip replacement which has never previously been reported. PRESENTATION OF CASE A 78-year-old female patient had an unsuccessful closed reduction of a posteriorly dislocated total hip replacement. Careful review of perioperative radiographs revealed a fragment of bone cement incarcerated within the acetabular component blocking reduction. This was confirmed on a subsequent computed tomography scan. Open reduction via a posterior approach with retrieval of the cement fragment was eventually required. DISCUSSION Observation of important radiological features which may prevent unnecessary further attempts at closed reduction are discussed. We consider reasons for a non-concentric reduction and reflect on the dangers of multiple forced attempts. CONCLUSION This case emphasises the importance of clinical judgement during closed reduction and highlights a previously unreported cause for non-concentric reduction in a dislocated cemented total hip replacement. PMID:25460462

Lim, Hai Fon; Jain, Sameer; Haughton, Ben; Veysi, Veysi; Shaw, David

2014-01-01

54

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

55

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

Directory of Open Access Journals (Sweden)

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

Chatley Anooj

2008-01-01

56

Dislocation  

Science.gov (United States)

... Emergency Medicine Clinics of North America. W.B. Saunders. Feb 2013;31(1). Browner BD, Jupiter JB, ... C., eds. Skeletal Trauma. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2008. Calandruccio JH. Fractures, dislocations, and ligamentous ...

57

Severe metallosis owing to intraprosthetic dislocation in a failed dual-mobility cup primary total hip arthroplasty.  

Science.gov (United States)

We report a case of extensive metallosis owing to an intraprosthetic dislocation of a dual-mobility cup after a primary total hip arthroplasty. A 70-year-old man was referred to us from another center with a painful right hip 3 years after the arthroplasty. Initial investigations were suspicious of osteolysis secondary to metallosis with the characteristic "bubble sign" visualized on plain radiographs. At the revision procedure, widespread black staining of soft tissues and bone was noted. The polyethylene liner had dislodged leading to erosion of the metal socket by the prosthetic head. Histopathology examination of periprosthetic tissue confirmed metallosis. To our knowledge, this is the first reported case of severe metallosis owing to a known complication of dual-mobility sockets. PMID:21752581

Mohammed, Riazuddin; Cnudde, Peter

2012-03-01

58

Bilateral rotational osteotomies of the proximal tibiae and tibial tuberosity distal transfers for the treatment of congenital lateral dislocations of patellae: a case report and literature review.  

Science.gov (United States)

Congenital dislocation of patella (CDP) causes varying degree of disability. Patients may present as late walkers with asymmetric gait, habitual or recurrent dislocators or even non-walkers if the condition is bilateral. Patellar instability is often associated with soft tissue or bony pathology. Soft tissue anomalies include lateral soft tissue contractures, shortened quadriceps as well as vastus medialis dysplasia (abnormal origin and insertion). Bony anomalies include shallow trochlear groove and hypoplastic patella or lateral femoral condyle. Soft tissue etiologies result in an imbalance of the dynamic forces acting on the patella while in bony etiologies the static stabilizers to resist lateral dislocation are compromised. External tibial torsion is an additional etiology, often under diagnosed due to the difficulty in measuring the Q angle of dislocated patella. We report a case of bilateral congenital lateral dislocations of the patellae treated with bilateral tibial rotational osteotomies with an 8 year and a 4 year follow up. PMID:19464186

Ramaswamy, Rajesh; Kosashvili, Yona; Murnaghan, John J; Yau, Cameron Kin-Mo; Cameron, John C

2009-12-01

59

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

Science.gov (United States)

Total hip arthroplasty (THA) for an untreated acetabular fracture is technically challenging and the long-term result is not so favorable. A 45-year-old female patient with untreated column and comminuted posterior wall fracture of the acetabulum was treated in our institution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior column with cancellous grafting and cementless THA in a single stage. At 3 years?follow-up, the patient was independently mobile without limb length discrepancy. Radiological evaluation showed well integrated components and bone grafts. No evidence of aseptic loosening or osteolysis was found. This report aims to emphasize that bony acetabular reconstruction allows the use of primary hip components, which improves prosthesis longevity and preserves bone stock for a future revision. PMID:23186930

Gavaskar, Ashok-S; Tummala, Naveen-Chowdary

2012-01-01

60

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

61

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

OpenAIRE

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...

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

2008-01-01

62

Hip Dislocation Increases Roughness of Oxidized Zirconium Femoral Heads in Total Hip Arthroplasty: An Analysis of 59 Retrievals.  

Science.gov (United States)

The aims of this study were to assess damage on the surface of retrieved oxidized zirconium (OxZr) metal femoral heads, to measure surface roughness of scratches, and to evaluate the extent of surface effacement using scanning electron microscopy (SEM). Ceramic zirconia-toughened alumina heads were analyzed for comparison. OxZr femoral heads explanted for recurrent dislocation had the most severe damage (P<0.001). The median surface roughness of damaged OxZr femoral heads was 1.49?m, compared to 0.084?m for damaged ceramic heads and 0.052?m for undamaged OxZr (P<0.001). This may be of clinical concern because increased surface roughness has the potential to increase the wear of polyethylene liners articulating against these OxZr heads in THA. PMID:25443362

Moussa, Mohamed E; Esposito, Christina I; Elpers, Marcella E; Wright, Timothy M; Padgett, Douglas E

2014-11-11

63

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

Energy Technology Data Exchange (ETDEWEB)

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

Tins, Bernhard, E-mail: Bernhard.Tins@rjah.nhs.uk [Department of Radiology, RJAH Orthopaedic Hospital, Oswestry, Shropshire, SY 107 AG (United Kingdom)

2011-07-15

64

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

International Nuclear Information System (INIS)

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

65

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

Science.gov (United States)

Metal on metal resurfacing hip implants are known to have complications unique to this type of implant. The case presented adds a further previously not described complication, the dislocation and spontaneous reduction of the pin of the femoral component against the femoral neck. The radiographic and CT findings are demonstrated. The dislocation was aided by bone loss due to an infection with a large periarticular collection. Periarticular collections in hip resurfacings are often due to a hypersensitivity type reaction to metal debris. However in the case presented it was due to infection. MRI was not able to discern the infection from a sterile collection. CT demonstrated bone loss and periosteal reaction suggestive of infection. In addition calcification of the pseudocapsule was seen, this is not a recognized feature of sterile collections. PMID:20137875

Tins, Bernhard

2011-07-01

66

Seasonality of congenital anomalies in Europe  

DEFF Research Database (Denmark)

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.

Luteijn, Johannes Michiel; Dolk, Helen

2014-01-01

67

Congenital hyper-extension with subluxation of the knees - report of 2 cases.  

Science.gov (United States)

Congenital dislocation of the knee popularly known as genu recurvatum; is a very rare condition, about 0.45% of all congenital anomalies. Furthermore isolated genu recurvatum is extremely rare because 60% of this condition is associated with other congenital anomalies. Congenital dislocation of hip is the commonest associated anomaly. Two babies 1 male and 1 female were born with severe hyperextension deformity of the knees about 30° degrees. Clinically and radiologically they were diagnosed as isolated genu recurvatum due to congenital dislocation of the knees. Gentle manipulation in the form of passive stretching and knee flexion was started at first day of life. The deformity of male and female baby was corrected in 34 and 30 days respectively. The babies were moving the knees and lower limbs normally at final follow up at 6 months follow up and were confirmed clinically and radiologically. Early recognition and immediate manipulation cures the condition fully in short time without operation. PMID:25481608

Biswas, D; Akter, F A; Roy, A; Aolad, F R; Khan, S A

2014-10-01

68

[Development assessment of a hip ultrasonographic screening program for the early diagnosis of congenital hip dysplasia at the orthopedic university department Homburg/Saar from 1986 to 1990].  

Science.gov (United States)

The results of the hip ultrasound newborn screening at the orthopaedic department of the University Hospital Homburg/Saar underline the necessity of an early diagnosis of Hip dysplasia already during the first days of life. In the course of the following publication the benefit of using abduction-pants in case of physiological unripe and primary pathological hips is described closely. From October 1985 to December 1990 2317 newborns have been examined by ultrasound. The rate of Hip Dysplasia (type IID, IIg, IIIa) was at 104 hips (2.2%). Clinical striking facts were only found in 46.3% of all patients with primary pathological hips. After an precautionary broad swadling (Breitwickeln) or abduction-pants-treatment 331 (90.0%) hips of the 368 regular checked hips with type IIa developed with an average secondary anatomical healing of 2.5 months to Ia- or Ib-hips. After 3 months only just 12 hips corresponded to a diagnosis of type IIb according to Graf. A deterioration to a IIg or IIIa hip was only ascertained in two cases. With all 41 sufficiently controlled primary pathological hips an improvement to type Ia or Ib according to Graf achieved when treated with abduction pants (average duration of treatment: 4.3 months). None of the children had to undergo an operation because of instable hips. PMID:7941683

Deimel, D; Breuer, D; Alaiyan, H; Mittelmeier, H

1994-01-01

69

The minimal invasive direct anterior approach in combination with large heads in total hip arthroplasty - is dislocation still a major issue? a case control study  

Science.gov (United States)

Background There have been increasing numbers of publications in recent years on minimally invasive surgery (MIS) for total hip arthroplasty (THA), reporting results with the use of different head sizes, tribologic and functional outcomes. This study presents the results and early complication rates after THA using the direct anterior approach (DAA) in combination with head sizes???36 mm. Methods A total of 113 patients with THA were included in the study. The Harris Hip Score (HHS) was determined, a radiographic evaluation was carried out, and complications were recorded. The minimum follow-up period was 2 years (means 35?±?7 months). Results The HHS improved from 43.6 (± 12) to 88.2 (± 14; P?dislocations. Conclusion THA with the minimally invasive DAA in combination with large heads is associated with good to very good functional results in the majority of cases. The complication rates are not increased. The rate of dislocation mainly as an complication of the first two years can be markedly reduced in particular. PMID:24621189

2014-01-01

70

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

71

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)

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

José Ricardo Negreiros Vicente

2009-01-01

72

Clinical practice guideline: early detection of developmental dysplasia of the hip. Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip. American Academy of Pediatrics.  

Science.gov (United States)

Developmental dysplasia of the hip is the preferred term to describe the condition in which the femoral head has an abnormal relationship to the acetabulum. Developmental dysplasia of the hip includes frank dislocation (luxation), partial dislocation (subluxation), instability wherein the femoral head comes in and out of the socket, and an array of radiographic abnormalities that reflect inadequate formation of the acetabulum. Because many of these findings may not be present at birth, the term developmental more accurately reflects the biologic features than does the term congenital. The disorder is uncommon. The earlier a dislocated hip is detected, the simpler and more effective is the treatment. Despite newborn screening programs, dislocated hips continue to be diagnosed later in infancy and childhood,(1-11) in some instances delaying appropriate therapy and leading to a substantial number of malpractice claims. The objective of this guideline is to reduce the number of dislocated hips detected later in infancy and childhood. The target audience is the primary care provider. The target patient is the healthy newborn up to 18 months of age, excluding those with neuromuscular disorders, myelodysplasia, or arthrogryposis. PMID:10742345

2000-04-01

73

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)

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

Gilberto Francisco Brandão

2010-01-01

74

An unreported cause of early postoperative dislocation following total hip revision: massive intra-capsular oedema related to inferior vena cava filter thrombosis.  

Science.gov (United States)

Inferior vena cava (IVC) filters are widely used to prevent pulmonary embolism (PE) in patients with an absolute or relative contraindication for anticoagulants, during the peri-operative period of trauma or total joint replacement. No complication specific to the orthopaedic's aspect of this practice has been described. We report the case of a patient who had major femoral head/cup separation mimicking dislocation following revision total hip arthroplasty related to massive intra-capsular oedema produced by IVC filter thrombosis. The patient could be successfully treated non-operatively. Orthopaedic surgeons should identify and refer patients with a complicated IVC filter, to identify any migration or occlusion, and also be aware that removable filters must not be kept in situ, once the high-risk phase of developing PE is past. PMID:23491681

Langlois, J; Nich, C; Courpied, J-P; Hamadouche, M

2013-05-01

75

Small Incision Total Hip Arthroplasty  

Medline Plus

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

76

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

International Nuclear Information System (INIS)

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

77

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

Scientific Electronic Library Online (English)

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

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

2009-09-01

78

Imaging of hip arthroplasty  

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-12-15

79

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

Scientific Electronic Library Online (English)

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

Anderson Luiz de, Oliveira; Eduardo Gomes, Machado.

2014-01-01

80

[Hip arthroscopy].  

Science.gov (United States)

In the last ten years, hip arthroscopy has been developing intensively and it is rapidly gaining primacy in the treatment of various injuries and damages to the hip itself and its immediate vicinity. The basic advantage of hip arthroscopy surgery versus classic open surgery is avoiding an open dislocation of the hip and, thus, reducing patient's morbidity and accelerating his/her rehabilitation, which leads to a quicker return to everyday activities. The success of arthroscopic surgery depends on the correct indication for the surgery and on the experience and the skill of the operator. It also depends on the properly conducted rehabilitation and the patient's compliance, as well as on the patient's realistic expectations. Indications for hip arthroscopy today are the following: injury and damage to acetabular labrum and/or articular cartilage, femoroacetabular impingement syndrome, injuries and damages to the ligament of the femoral head, loose and foreign joint bodies as well as different conditions of synovial membrane (synovial chondromatosis, pigmented villonodular synovitis and other inflammatory arthropathy such as rheumatoid arthritis). In this article we describe the indications, technique, complications and the prospect of hip arthroscopy, with a detailed overview of contemporary literature data. PMID:24364201

Smoljanovi?, Tomislav; Prutki, Maja; Strazar, Klemen; Curi?, Stjepan; Mahnik, Alan; Bojani?, Ivan

2013-01-01

81

Acute effects of hip and knee positions on motor-evoked potentials of the sciatic nerve in total hip arthroplasty  

OpenAIRE

In 23 patients, motor-evoked potentials (MEP) of the sciatic nerve were elicited during total hip arthroplasty by using a stimulating electrode at the level of the acetabulum and recording from the middle portion of the tibialis anterior. The distal motor latencies were determined before dislocation (control), during dislocation, and after reduction with the trial prosthesis. While the hip was dislocated, recording was performed at varying angles of the hip and knee joints. During dislocation...

Shiramizu, Kei; Naito, Masatoshi; Akiyoshi, Yuichiro; Yamaguchi, Tetsu

2003-01-01

82

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

Scientific Electronic Library Online (English)

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

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

83

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

International Nuclear Information System (INIS)

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

84

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 ...

85

The unstable total hip replacement  

OpenAIRE

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 Met...

D?Angelo F; Murena L; Zatti G; Cherubino P

2008-01-01

86

Bipolar hip arthroplasty.  

Science.gov (United States)

Our aim was to compare hip arthroplasty with internal screw fixation in the repair of intertrochanteric fractures in elderly patients with osteoporosis. Of 112 included patient, 70 (81.81 ± 4.88 years) received hip arthroplasty with a prosthesis specially designed for intertrochanteric fractures, and 42 (83.46 ± 5.11 years) underwent plate-screw fixation. The hip arthroplasty group had significantly longer operation time, intraoperative blood loss, and total volume of blood transfused but had shorter time to beginning weight-bearing (5.94 ± 2.76 vs 23.68 ± 22.01 days) and higher postoperative Harris hip score (91.37 ± 4.80 vs 86.14 ± 5.46). In the arthroplasty group, there were 2 dislocations; and in the plate-screw fixation group, there were 5 internal fixation failures. Hip arthroplasty is preferable to internal fixation in elderly patients (age >80 years) with osteoporosis. PMID:21530148

Chang, Qing; Liu, Shubing; Guan, Changyong; Yu, Fangyuan; Wu, Shenguang; Jiang, Changliang

2011-12-01

87

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

Science.gov (United States)

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

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

2013-01-01

88

Hip Replacement  

Science.gov (United States)

Hip replacement is surgery for people with severe hip damage. The most common cause of damage is osteoarthritis. ... therapy, pain medicines, and exercise haven't helped, hip replacement surgery might be an option for you. During ...

89

Hip Ultrasound  

Science.gov (United States)

What is Ultrasound Imaging of the Hip? View larger with caption Ultrasound images of the hip provide pictures of muscles, tendons, ... top of page What are the limitations of Ultrasound Imaging of the Hip? Ultrasound has difficulty penetrating ...

90

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

Science.gov (United States)

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

2011-09-01

91

A Multi-centre Study to Assess the Long-term Performance of the Summit™ Hip in Primary Total Hip Replacement  

Science.gov (United States)

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

2015-02-10

92

Femoral stem dislodgement during bipolar hemiarthroplasty dislocation.  

Science.gov (United States)

Bipolar hemiarthroplasty remains a treatment option for displaced femoral neck fractures in elderly patients without pre-existing hip disease. Implant-related complications associated with this procedure include acetabular erosion, dislocation, disassembly of the modular components, polyethylene debris-induced osteolysis, metallosis from outer cup impingement, and femoral component loosening. This article presents a case of a patient in whom the polished collarless tapered femoral stem dislodged out of the cement mantle during traumatic bipolar hemiarthroplasty dislocation, 28 days after the index procedure. This complication, associated with bipolar hemiarthroplasty dislocation, was adequately managed by driving the stem back to the original cement mantle, followed by reduction of bipolar component dislocation and placing bone cement over the shoulder of the femoral stem to prevent a new dislodgement episode. Although rare, dislodgement of cemented polished collarless tapered stems from the cement mantle has been recently reported either during dislocation or, more frequently, as a complication of reduction of a dislocated total hip arthroplasty. However, its occurrence in association with bipolar hemiarthroplasty dislocation was not found to have been reported in the literature. The occurrence of femoral stem dislodgement during bipolar hemiarthroplasty dislocation should be considered as a possible complication of such a procedure and may be prevented by routinely placing bone cement over the shoulder of the femoral implant. PMID:21667909

Marcelino Gomes, Luiz S; do Carmo, Wellington; de Souza, Wender

2011-06-01

93

Dislocation kinetics  

International Nuclear Information System (INIS)

A series of investigations have been underway to determine in a more rigorous manner the thermally activated motion of a single dislocation and a group of dislocations through a random array of short range barriers (s.r.b.). This was accomplished by developing computer models to stimulate the motion of dislocations. These models require the use of far fewer assumptions in comparison with analytical solutions. The parameters which were investigated were: the strength and density of s.r.b., criterion for thermal fluctuation over the s.r.b., size and shape of slip plane, the magnitude of the lattice resistance, i.e., the Peierl's stress, and in the case of a group of dislocations the criterion for the dislocation source operation, and the differences between single and group motion on a one and two dimensional slip plane. The results obtained from the investigations of the motion of single dislocation indicate that if the s.r.b. is weak, the numerical results are in agreement with analytical results predicted by Friedel. If the Peierl's stress is non-zero then the s.r.b. can produce a reduction in the stress required to maintain a given dislocation velocity. If a multiple group of dislocations are in motion on the slip plane it is possible to have two types of pile-ups. If the dislocations remove s.r.b., as in channeling of irradiated metals, then a normal pile-up occurs. However, if the s.r.b. are not removed, an inverted pile occursccurs

94

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. ...

95

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 ...

96

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)

97

Total hip arthroplasty following failed fixation of proximal hip fractures  

Directory of Open Access Journals (Sweden)

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

Srivastav Shekhar

2008-01-01

98

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

Medline Plus

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

99

Framing Hip Hop: New Methodologies for New Times  

Science.gov (United States)

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

Dimitriadis, Greg

2015-01-01

100

The role for hip surveillance in children with cerebral palsy  

OpenAIRE

Spastic hip displacement is the second most common deformity seen in children with cerebral palsy (CP), and the long-term effects can be debilitating. Progressive hip displacement leading to dislocation can result in severe pain as well as impaired function and quality of life. Recent population-based studies have demonstrated that a child’s Gross Motor Functional Classification System (GMFCS) level is most predictive for identifying hips “at-risk” for progressive lateral displacement. ...

Shore, Benjamin; Spence, David; Graham, Hk

2012-01-01

101

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

Scientific Electronic Library Online (English)

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

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

2012-09-01

102

Hip Implant Systems  

Science.gov (United States)

... and Prosthetics Metal-on-Metal Hip Implants Hip Implants Hip implants are medical devices intended to restore mobility and ... and other hip diseases or injuries. Every hip implant has a distinct set of benefits and risks. ...

103

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.)

104

A Multi-centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Polyethylene-on-metal Bearing in Primary Total Hip Replacement  

Science.gov (United States)

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

2013-02-12

105

A Randomised Single Centre Study to Compare the Long-term Performance of 4 Designs of the DePuy Ultima LX Stem in Primary Total Hip Replacement  

Science.gov (United States)

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

2013-05-29

106

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

Science.gov (United States)

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

2014-08-13

107

A Study to Assess the Long-term Performance of SmartSet® HV and SmartSet® GHV Bone Cements in Primary Total Hip Replacement  

Science.gov (United States)

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

2014-09-04

108

A Two Centre Study to Assess the Stability and Long-term Performance of the C-Stem™ AMT in a Total Primary Hip Replacement  

Science.gov (United States)

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

2011-09-01

109

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

Science.gov (United States)

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

2014-04-29

110

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

Scientific Electronic Library Online (English)

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

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

111

Hip ultrasound  

International Nuclear Information System (INIS)

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

112

Hip Revision  

Medline Plus

Full Text Available ... initial preoperative x-ray, where we see a hybrid hip arthroplasty with a cemented femoral stem and ... is that doesn't always happen. Now this system does give you a lot of choices. I ...

113

Hip ultrasound  

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-12-15

114

Hip Revision  

Medline Plus

Full Text Available ... on the rim. We got a great initial stability. But normally if I put an extra maybe ... say, given your implant and your hip construct stability? I would agree one hundred percent with that. ...

115

Hip Revision  

Medline Plus

Full Text Available ... to the second radiograph, this was Scott's initial postoperative radiograph, which is very reasonable. You can see ... the line, this patient was developing increasing hip pain. And you can see here, there's been an ...

116

Congenital Leukemia  

OpenAIRE

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

Rupali Bargotra, Jyotsna Suri

2010-01-01

117

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

Directory of Open Access Journals (Sweden)

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.

Sharifi Reza

2008-11-01

118

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

International Nuclear Information System (INIS)

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

119

Radiological evaluation of failed total hip replacement  

International Nuclear Information System (INIS)

The retrospective study of 50 operated cases of cemented total hip replacement and a review of the literature enabled the authors to define the radiological features of the above-mentioned condition. These features include one or more of the following signs: calcar reabsorption, lacunar erosions, modified relatioships between the prosthesis components, sepsis and loosening, periarticular calcifications dislocation and fracture of prosthesis components. Careful evaluation of these radiological features is extremely important for both an early diagnosis of failed total hip replacement and the choice of an adequate surgical treatment

120

Continuity of dislocations  

International Nuclear Information System (INIS)

Dislocation continuity is derived from the Bilby--Kondo theory of dislocations using exterior calculus. Dislocation density is represented by the torsion vector-valued two-form. Burgers vectors are associated with the vector part of the torsion while dislocation lines are associated with the two-form part. The exterior derivative of the torsion is shown to vanish when the crystal curvature vanishes. This implies two simultaneous continuity conditions: Burgers vector conservation and continuity of dislocation lines. On the other hand, dislocation continuity is violated when the curvature does not vanish. Since this can occur on grain boundaries it is inferred that grain boundaries are regions where crystal curvature is concentrated

121

Long-term results of metasul metal-on-metal total hip arthroplasty.  

Science.gov (United States)

We assessed 90 total hip arthroplasties (THAs) performed with the Metasul metal-on-metal hip system (Zimmer, Warsaw, Indiana); the patients were monitored for >10 years. The average Harris Hip Score of the patients was 40.5 points preoperatively and 85.8 points at final follow-up. No adverse reactions to the metal debris were observed in patients presenting with symptoms or phenomena such as unexplained pain, joint effusion, bursitis, or pseudotumor. Radiographically, the acetabular component fixation was stable in 86 hips, possibly unstable in 3 hips, and unstable in 1 hip. The unstable hip required revision of the acetabular component. The femoral component was bone-ingrown in 81 hips and stable-fibrous in 9 hips. Distal femoral cortical hypertrophy was seen in 34.4% of hips.Postoperatively, 6 hips dislocated, of which 2 developed recurrent dislocation and required revision of the acetabular component. Dissociation of the polyethylene liner occurred in 2 hips 6 and 12 years postoperatively, respectively, and required revision of the polyethylene liner and the articular head. The survival rate with the endpoint defined as revision surgery and radiologic loosening was 94.4% at mean follow-up (12.3 years). This study found that the Metasul metal-on-metal THA produces excellent long-term results. PMID:20704108

Saito, Shu; Ishii, Takao; Mori, Sei; Hosaka, Kunihiro; Ootaki, Munenori; Tokuhashi, Yasuaki

2010-08-01

122

Congenital toxoplasmosis  

Science.gov (United States)

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

123

Congenital Scoliosis  

Science.gov (United States)

... Query into the Efficacy of Spinal Surgery (PDF) Leadership in Orthopaedic Surgery Neuromonitoring Information Statement (Word) SRS ... Main Patient Stories Kyphosis About Kyphosis Congenital Kyphosis Definition and Classification Evaluation Prognosis Non-Operative Treatments Surgical ...

124

Congenital amastia.  

Science.gov (United States)

A 3-d-old female baby presented with bilateral congenital absence of breast tissue, areolae and nipples. No other anomalies were noted. There was also a history of absence of nipples, areolae and breast tissue in the mother and two other family members of maternal side. Investigations done during the hospital stay including ultrasound of the chest wall, abdomen and head were all normal. Congenital isolated bilateral amastia was diagnosed after complete investigations. PMID:23255076

Patil, Lingaraja Gowda C; Shivanna, Niranjan Hunasanhalli; Benakappa, Naveen; Ravindranath, Hema; Bhat, Rama

2013-10-01

125

Birmingham hip resurfacing: the prevalence of failure.  

Science.gov (United States)

Despite the increasing interest and subsequent published literature on hip resurfacing arthroplasty, little is known about the prevalence of its complications and in particular the less common modes of failure. The aim of this study was to identify the prevalence of failure of hip resurfacing arthroplasty and to analyse the reasons for it. From a multi-surgeon series (141 surgeons) of 5000 Birmingham hip resurfacings we have analysed the modes, prevalence, gender differences and times to failure of any hip requiring revision. To date 182 hips have been revised (3.6%). The most common cause for revision was a fracture of the neck of the femur (54 hips, prevalence 1.1%), followed by loosening of the acetabular component (32 hips, 0.6%), collapse of the femoral head/avascular necrosis (30 hips, 0.6%), loosening of the femoral component (19 hips, 0.4%), infection (17 hips, 0.3%), pain with aseptic lymphocytic vascular and associated lesions (ALVAL)/metallosis (15 hips, 0.3%), loosening of both components (five hips, 0.1%), dislocation (five hips, 0.1%) and malposition of the acetabular component (three hips, 0.1%). In two cases the cause of failure was unknown. Comparing men with women, we found the prevalence of revision to be significantly higher in women (women = 5.7%; men = 2.6%, p metallosis (p < 0.001, p = 0.004, p = 0.008, p = 0.01 respectively). The mean time to failure was 2.9 years (0.003 to 11.0) for all causes, with revision for fracture of the neck of the femur occurring earlier than other causes (mean 1.5 years, 0.02 to 11.0). There was a significantly shorter time to failure in men (mean 2.1 years, 0.4 to 8.7) compared with women (mean 3.6 years, 0.003 to 11.0) (p < 0.001). PMID:20884969

Carrothers, A D; Gilbert, R E; Jaiswal, A; Richardson, J B

2010-10-01

126

Hip Revision  

Medline Plus

Full Text Available ... on that stem? Because it's kind of a cylinder; and in a cylinder you've got an ETO, so your bony ... taper in every hip we do at the head/neck junction. I think if you have motion ...

127

Hip Revision  

Medline Plus

Full Text Available ... unions or escaped trochanters. Because they'll end up kind of scarring in in that anterior margin there, and again that'll act as a lever arm to kind of pop your hip out the back. So even if ...

128

Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty  

Directory of Open Access Journals (Sweden)

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

Shu-Tai Shih

2007-02-01

129

Hip replacement  

International Nuclear Information System (INIS)

Patients with problems following implantation of cemented total hip prostheses must be clinically examined. This examination is followed by a series of diagnostic imaging procedures. These include X-ray diagnosis, 3-phase 99mTc-MDP bone scans, scientigraphy for inflammation, and arthrography, performed singly or as sequential studies. X-ray findings and scientigraphic patterns arousing or confirming a suspicion of aseptic (mechanical) or septic (infectious) loosening of the prosthesis are evaluated and discussed. (orig.)

130

Characteristics of children with hip displacement in cerebral palsy  

Directory of Open Access Journals (Sweden)

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.

Wagner Philippe

2007-10-01

131

Evaluation of reducing postoperative hip precautions in total hip replacement: a randomized prospective study.  

Science.gov (United States)

Currently, many rehabilitation protocols for total hip replacements (THRs) include activity restrictions to prevent postoperative dislocation. There is increasing demand for more efficient and safe rehabilitation protocols. This randomized prospective study evaluates the need for hip restrictions following a modified anterolateral procedure. From 2004 to 2008, 81 patients seeking elective THRs were randomly assigned into a standard rehabilitation group or an early rehabilitation group. The standard group included restrictions to avoid hip flexion >90 degrees and avoidance of riding in a car for the first postoperative month. The early group had no flexion or car riding restrictions. Forty-three patients were in the standard group and 38 patients were in the early group. There were no significant demographic differences between the 2 groups. All patients completed the Short Form 12-question Health Survey and Harris Hip Score preoperatively and at 4 weeks, 1 month, 3 months, and 1 year postoperatively. The time-points at which the patient first drove and ambulated with a cane, without a cane, and without a limp were also collected. No incidents of dislocation occurred. Patients in the early group were faster to ambulate with only a cane (P=.03), without a cane (P<.001), and without a limp (P=.003). They also drove earlier (P=.02). Pace of recovery was the only significant difference between the 2 groups. The early rehabilitation protocol increases the pace of recovery compared to a pathway with hip precautions without increasing complications. PMID:19968217

Ververeli, Prodromos A; Lebby, Eric B; Tyler, Cheryl; Fouad, Carol

2009-12-01

132

[Arthroscopy after hip joint injury. Case studies and indications].  

Science.gov (United States)

Intra-articular injuries are common after dislocation and fracture of the hip joint and can be addressed using hip arthroscopy. The most common indications for this procedure are loose bodies, labral tears and chondral defects. In addition, preexisting femoroacetabular impingement can be addressed at the time of surgery. Arthroscopically guided fracture reduction and fixation has been described. We present two case reports of intra-articular lesions after traumatic hip dislocation. The first is a case of a man with an anterior labral tear and loose bodies after closed hip reduction. The second case is a man with a large anterior labral tear with preexisting femoroacetabular impingement. Both of them were treated by arthroscopic debridement of the unstable labrum. In addition loose bodies were removed in the first patient and a femoral osteoplasty was performed in the second patient. Hip arthroscopy has proven to be a safe and effective surgical technique for treating specific post-traumatic lesions and preexisting femoroacetabular impingement. The current case reports provide an overview of the indication for hip arthroscopy following traumatic injuries to the hip. PMID:21607792

Mella, C; del Río, J; Lara, J; Parodi, D; Moya, L; Schmidt-Hebbel, A; Boettner, F

2012-03-01

133

congenital anomalies  

Directory of Open Access Journals (Sweden)

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

Bernardita Donoso Bernales

2012-10-01

134

Septic arthritis of the hip - current concepts.  

Science.gov (United States)

Septic arthritis of the hip is the commonest septic condition during growth, reaching a distinct peak in frequency during infancy. The aetiology is a haematogenous joint infection. Indicative signs are severe pain when moving the joint, septic appearance and a poor general condition of these small and young patients. The diagnosis often can be difficult in infants since septic temperatures are not always present. An ultrasound scan shows the hip joint effusion and the capsular distension. X-ray investigation helps to exclude defective situations. Therapeutic options are: in patients with short history without radiologically visible complications we recommend repeated arthroscopic irrigation and in patients with long history and a radiologically visible defect of the femoral head or dislocation we recommend arthrotomy and open revision or reduction of the hip joint. PMID:19306242

Rutz, E; Brunner, R

2009-01-01

135

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

136

Neglected intrapelvic dislocation of femoral head  

Directory of Open Access Journals (Sweden)

Full Text Available A 40-year-old man sustained trauma while walking and presented three months after trauma. The attitude of left hip was flexion, neutral rotation, and neutral abduction/adduction with an arc of flexion available from 30° to 90°. No movement was possible in other planes. On roentgenogram and 3D computed tomography, the femoral head was lying inferior and medial to the acetabulum, and it was in the same coronal plane of the acetabulum, neither anterior nor posterior, within the pelvic cavity. An indentation over the superolateral half of femoral head was observed. The acetabulum was found intact except for a small defect in the inferior aspect of its medial wall. Cemented total hip replacement was done without any need to reconstruct the acetabulum, and at the two years follow-up, the patient was having a pain-free, stable hip and was able to walk unaided. We hereby report a late presentation of intrapelvic dislocation of hip in view of rarity.

Singaravadivelu Vaidynathan

2010-01-01

137

Hip joint pain in children with cerebral palsy and developmental dysplasia of the hip: why are the differences so huge?  

Science.gov (United States)

Backgrounds Non-traumatic hip dislocation in children is most often observed in the course of developmental dysplasia of the hip (DDH) and infantile cerebral palsy. The risk of pain sensations from dislocated hip joint differentiates the discussed groups of patients. Will every painless hip joint in children with cerebral palsy painful in the future? Methods Material included 34 samples of joint capsule and 34 femoral head ligaments, collected during open hip joint reduction from 19 children with CP, GMFCS level V and from 15 children with DDH and unilateral hip dislocation. All the children were surgically treated. The density of nociceptive fibres was compared between the children with CP and DDH, using S-100 and substance P monoclonal antibodies. Results More frequent positive immunohistochemical reaction to S-100 protein concerned structures of the femoral head ligaments in children with CP and cartilage losses on the femoral head, when compared to the same structures in children with DDH (p?=?0.010). More frequent were found positive immunohistochemical reactions for S-100 protein in the joint capsules of children with cartilage losses (p?=?0.031) and pain ailments vs. the children with DDH (p?=?0.027). More frequent positive reaction to substance P concerned in femoral head ligaments in CP children and cartilage lesions (p?=?0.002) or with pain ailments (p?=?0.001) vs. the DDH children. Conclusions Surgical treatment of hip joint dislocation should be regarded as a prophylactics of pain sensations, induced by tissue sensitisation, inflammatory process development or articular cartilage defects. PMID:24656137

2014-01-01

138

Total hip replacement in dancers.  

Science.gov (United States)

A case report of a professional contemporary dancer who successfully returned to the stage after bilateral total hip replacements (THR) for osteoarthritis is presented, together with her own commentary and a retrospective cohort study of total hip replacements in dancers. In the presented cohort, there were no post-operative dislocations or infections, the original pain had been relieved, rehabilitation was objectively normal and all resumed their dance (teaching) activities. Nevertheless, they were disappointed about the prolonged rehabilitation. Due to their high demands as professional dancers, post-operative expectations were too optimistic in view of the usual quick and favourable results of THR in the older and less physically active, general population. In all dancers with unilateral osteoarthritis, the left hip was involved, which may reflect the tendency to use the left leg as standing leg and be suggestive that strenuous physical activity may lead to osteoarthritis. Better rehabilitation guidelines are needed for dancer patients undergoing THR, especially drawing their attention to realistic post-operative expectations. PMID:23588878

Buyls, Inge R A E; Rietveld, A B M Boni; Ourila, Tiia; Emerton, Mark E; Bird, H A

2013-04-01

139

Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The epidemiology of acute orthopedic dislocations is poorly understood. A nationwide database provides a valuable resource for examining this issue in the Taiwanese population. Methods A 6-year retrospective cohort study of 1,000,000 randomly-sampled beneficiaries from the year 2005 was used as the original population. Based on the hospitalized and ambulatory data, the concomitant ICD9-CM diagnosis codes and treatment codes were evaluated and classified into 8 and 3 major categories, respectively. The cases matching both inclusive criteria of dislocation-related diagnosis codes and treatment codes were defined as incident cases. Results During 2000-2005, the estimated annual incidence (per 100,000 population of total orthopedic dislocations in Taiwan was 42.1 (95%CI: 38.1-46.1. The major cause of these orthopedic dislocations was traffic accidents (57.4%, followed by accident falls (27.5%. The annual incidence dislocation by location was shoulder, 15.3; elbow, 7.7; wrist, 3.5; finger, 4.6; hip, 5.2; knee, 1.4; ankle, 2.0; and foot, 2.4. Approximately 16% of shoulder dislocations occurred with other concomitant fractures, compared with 17%, 53%, 16%, 76% and 52%, respectively, of dislocated elbow, wrist, hip, knee, and ankle cases. Including both simple and complex dislocated cases, the mean medical cost was US$612 for treatment of a shoulder dislocation, $504 for the elbow, $1,232 for the wrist, $1,103 for the hip, $1,888 for the knee, and $1,248 for the ankle. Conclusions In Taiwan, three-quarters of all orthopedic dislocations were of the upper limbs. The most common complex fracture-dislocation was of the knee, followed by the wrist and the ankle. Those usually needed a treatment combined with open reduction of fractures and resulted in a higher direct medical expenditure.

Yang Nan-Ping

2011-11-01

140

Congenital Defects.  

Science.gov (United States)

There are two general categories (not necessarily mutually exclusive) of congenital defects: (1) abnormalities that have an hereditary basis, such as single and multiple genes, or chromosomal abberration; and (2) abnormalities that are caused by nonhereditary factors, such as malnutrition, maternal disease, radiation, infections, drugs, or…

Goldman, Allen S.; And Others

141

Forecasting minor tectonic dislocations  

Energy Technology Data Exchange (ETDEWEB)

Effects of minor tectonic dislocations on longwall mining and methods for forecasting minor tectonic dislocations in the Donbass are discussed. Minor dislocations with amplitudes to 10 m are analyzed. Comparative evaluations show that core drilling is of limited value as only 1% of minor dislocations is detected by core drilling while 80 to 95% of dislocations in longwall mining has an amplitude to 10 m. Use of statistical methods for forecasting minor dislocations is analyzed. Correlations of dislocation type (folds, faults and thrusts) with coal rank (catagenesis of rock strata), types of sedimentary rocks and occurrence of large dislocations are analyzed. Correlation coefficients are determined. A method for accurately forecasting minor tectonic dislocations with amplitude to 20 m is analyzed. Effects of the following factors are considered: coal rank and catagenesis of sedimentary rocks, types of sedimentary rocks adjacent to coal seams (sandstones, argillites and aleurites), total thickness of 3 rock layers, correlations of fold occurrence with occurrence of faults and thrusts in various zones of the Donbass, geologic structures in the area in which minor dislocations occur. Recommendations for use of the method are made. 3 references.

Zubarev, Yu.P.; Lutsenko, Yu.I.

1985-12-01

142

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

International Nuclear Information System (INIS)

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

143

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

Directory of Open Access Journals (Sweden)

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

Bruno de Castro Paixão Jacobino

2012-08-01

144

Degeneration in dysplastic hips. A computer tomography study  

DEFF Research Database (Denmark)

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

Jacobsen, Steffen; RØmer, Lone

2005-01-01

145

Entropically Stabilized Dislocations  

Science.gov (United States)

Dislocations are line defects that play a key role in the plasticity of crystalline materials and affect their thermal, chemical, and electrical properties. Typically dislocations are treated as stable defects; e.g., the equilibrium core structure of a dislocation is obtained by minimizing the crystal potential energy with respect to atom positions. Here we show for the first time the possibility of "entropically stabilized dislocations" that exist due to entropic effects without a corresponding potential energy well. An entropically stabilized dislocation was discovered in an accelerated multiscale quasicontinuum simulation. Its entropic nature was verified with fully atomistic free energy calculations and explained by a simple continuum-based model. This result has important consequences for the study of dislocations as well as for temporal multiscale methods that use information from the potential energy surface to accelerate time in molecular simulations.

Kim, Woo Kyun; Tadmor, Ellad B.

2014-03-01

146

Geodesics around gravitational dislocations  

OpenAIRE

A technique for generating spherically symmetric dislocation solutions of a direct Poincar\\'{e} gauge theory of gravity based on homogeneous functions which makes Cartan torsion to vanish is presented.Static space supported dislocation and time dependent solutions are supplied.Photons move along geodesics in analogy to geodesics described by electrons around dislocations in solid state physics.Tachyonic sectors are also found.

Andrade, L. C. Garcia

1998-01-01

147

Homogenization of dislocation dynamics  

CERN Document Server

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.

Hajj, A El; Monneau, R

2009-01-01

148

Congenital diplopodia  

Energy Technology Data Exchange (ETDEWEB)

Diplopodia, or duplicated foot, is a rare congenital anomaly. It differs from polydactyly in that supernumerary metatarsal and tarsal bones are present as well as extra digits. Only a few cases of this anomaly have been reported in the literature to date. We present a newborn male without intrauterine teratogen exposure who was born with a duplicate foot of the left lower extremity and imperforate anus. (orig.)

Brower, Jason S.; Wootton-Gorges, Sandra L.; Costouros, John G.; Boakes, Jennette; Greenspan, Adam [University of California, Davis, Department of Radiology, 4860 Y. Street, Suite 3100, CA 95817, Davis (United States)

2003-11-01

149

Congenital Hypothyroidism  

OpenAIRE

Abstract Congenital hypothyroidism (CH) occurs in approximately 1:2,000 to 1:4,000 newborns. The clinical manifestations are often subtle or not present at birth. This likely is due to trans-placental passage of some maternal thyroid hormone, while many infants have some thyroid production of their own. Common symptoms include decreased activity and increased sleep, feeding difficulty, constipation, and prolonged jaundice. On examination, common signs include myxedematous facies, large fontan...

LaFranchi Stephen H; Rastogi Maynika V

1984-01-01

150

Congenital toxoplasmosis.  

Science.gov (United States)

Toxoplasma gondii, a parasite, has three modes of transmission: oral intake of raw or undercooked meat or contaminated fruits and vegetables, ingestion of materials contaminated with cat feces, and transplacental infection. The focus of this article is congenital toxoplasmosis, which is transmitted to the fetus across the placenta. When primary infection of the mother occurs during pregnancy, there is a 40 percent chance of fetal infection; rate of transmission and severity of infection are related to gestational age at the time of infection. The brain and retina are often affected, and there can be a wide range of clinical disease. Amniocentesis or cordocentesis provides the most accurate diagnosis. At birth, 80-90 percent of infants with congenital toxoplasmosis are asymptomatic. But further testing may reveal retinal and central nervous system abnormalities, and there is a risk of long-term sequelae. Chorioretinitis, hydrocephalus, intracranial calcifications, and convulsions are the typical presentation of classic congenital toxoplasmosis. Serology is the most common method of diagnosing neonatal infection, but more complex tests are also utilized. The prognosis for the untreated infant is poor; however, when antibiotic therapy is started early, the rate of sequelae is reduced significantly. PMID:12143899

Martin, S

2001-06-01

151

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

152

Electromechanical simulations of dislocations  

Science.gov (United States)

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.

Skiba, Oxana; Gracie, Robert; Potapenko, Stanislav

2013-04-01

153

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)

154

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 ...

155

Chondrolysis after hip arthroscopy.  

Science.gov (United States)

We report the case of a 58-year-old woman who presented with left hip pain and was diagnosed with femoroacetabular impingement. She underwent hip arthroscopy to repair a degenerative labral tear, as well as radiofrequency debridement and microfracture of the exposed chondral defect, and femoral osteoplasty. Two months after hip arthroscopy, hip pain and limping began. Hip radiography showed a concentric decrease of joint space and no signs of joint incongruity or osteophytosis. Revision surgery 4 months after hip arthroscopy showed that the cartilage of the femoral head was soft and separated from the subchondral bone. PMID:25218006

Más Martínez, Jesús; Sanz Reig, Javier; Morales Santias, Manuel; Bustamante Suarez de Puga, David

2015-01-01

156

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%)

157

Complications after total hip replacement  

International Nuclear Information System (INIS)

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

158

Taper Hip Prosthesis  

Medline Plus

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

159

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. ...

160

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. ...

161

Arthroscopic Hip Labral Repair  

OpenAIRE

Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have bette...

Philippon, Marc J.; Faucet, Scott C.; Briggs, Karen K.

2013-01-01

162

Dislocations in bilayer graphene  

Science.gov (United States)

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

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

2014-01-01

163

Congenital hypothyroidism.  

Science.gov (United States)

Congenital hypothyroidism (CH) is the one of the most common preventable cause of mental retardation. In the majority of patients, CH is caused by an abnormal development of the thyroid gland (thyroid dysgenesis) that is a sporadic disorder and accounts for 85% of cases and the remaining 15% of cases are caused by dyshormonogenesis. The clinical features of congenital hypothyroidism are so subtle that many newborn infants remain undiagnosed at birth and delayed diagnosis leads to the most severe outcome of CH, mental retardation, emphasizing the importance of neonatal screening. Dried capillary blood is used for screening and it is taken from heel prick optimally between 2 and 5 days of age. Blood spot TSH or thyroxine (T4) or both are being used for CH screening in different programs around the world. Neonates with abnormal thyroid screening tests should be recalled immediately for examination and a venipuncture blood sample should be drawn for confirmatory serum testing. Confirmatory serum should be tested for TSH and free T4, or total T4. Serum TSH and T4 undergo dynamic changes in the first weeks of life; it is important to compare serum results with age-normal reference ranges. Treatment should be started promptly and infant should be rendered euthyroid as early as possible, as there is an inverse relationship between intelligence quotient (IQ) and the age at diagnosis. Levothyroxine (l-thyroxine) is the treatment of choice and American academy of pediatrics and European society of pediatric endocrinology recommend 10-15?gm/kg/day as initial dose. The immediate goal of therapy is to normalize T4 within 2 weeks and TSH within one month. The overall goal of treatment is to ensure growth and neurodevelopmental outcomes as close as possible to their genetic potential. PMID:25729683

Agrawal, Pankaj; Philip, Rajeev; Saran, Sanjay; Gutch, Manish; Razi, Mohd Sayed; Agroiya, Puspalata; Gupta, Keshavkumar

2015-01-01

164

Congenital hypothyroidism  

Science.gov (United States)

Congenital hypothyroidism (CH) is the one of the most common preventable cause of mental retardation. In the majority of patients, CH is caused by an abnormal development of the thyroid gland (thyroid dysgenesis) that is a sporadic disorder and accounts for 85% of cases and the remaining 15% of cases are caused by dyshormonogenesis. The clinical features of congenital hypothyroidism are so subtle that many newborn infants remain undiagnosed at birth and delayed diagnosis leads to the most severe outcome of CH, mental retardation, emphasizing the importance of neonatal screening. Dried capillary blood is used for screening and it is taken from heel prick optimally between 2 and 5 days of age. Blood spot TSH or thyroxine (T4) or both are being used for CH screening in different programs around the world. Neonates with abnormal thyroid screening tests should be recalled immediately for examination and a venipuncture blood sample should be drawn for confirmatory serum testing. Confirmatory serum should be tested for TSH and free T4, or total T4. Serum TSH and T4 undergo dynamic changes in the first weeks of life; it is important to compare serum results with age-normal reference ranges. Treatment should be started promptly and infant should be rendered euthyroid as early as possible, as there is an inverse relationship between intelligence quotient (IQ) and the age at diagnosis. Levothyroxine (l-thyroxine) is the treatment of choice and American academy of pediatrics and European society of pediatric endocrinology recommend 10-15?gm/kg/day as initial dose. The immediate goal of therapy is to normalize T4 within 2 weeks and TSH within one month. The overall goal of treatment is to ensure growth and neurodevelopmental outcomes as close as possible to their genetic potential. PMID:25729683

Agrawal, Pankaj; Philip, Rajeev; Saran, Sanjay; Gutch, Manish; Razi, Mohd Sayed; Agroiya, Puspalata; Gupta, Keshavkumar

2015-01-01

165

Minimally-incision total hip arthoplasty: Complications  

Directory of Open Access Journals (Sweden)

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

Baš?arevi? V.

2010-01-01

166

Debridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results.  

Science.gov (United States)

Untreated femoro-acetabular impingement is a common cause of osteoarthrosis of the hip. Surgical debridement of the adult hip with femoro-acetabular impingement recently has been advocated with the aim of relieving symptoms and slowing or halting progression of the arthrosis. At surgery, femoral sources of impingement are relieved by debriding the aspheric peripheral portion of the femoral head and the adjacent femoral neck. Acetabular sources of impingement can be relieved by debridement of the anterior rim. The most fundamental questions concerning these procedures relate to the preoperative and postoperative function, postoperative survivorship of these hips and the incidence of osteonecrosis. The current study assesses a group of 23 hips in 23 patients treated by surgical debridement for impingement. Twenty-two patients were treated by full surgical dislocation and one patient was treated by relief of impingement without dislocation. Followup ranged from a minimum of 2 years to 12 years. At most recent evaluation, seven patients had been converted to total hip arthroplasty, one had arthroscopic debridement of a recurrent labral tear, and 15 patients have had no further surgery. No hips developed osteonecrosis. Of the seven patients who had to have their procedure converted to total hip arthroplasty, three of these hips failed early and four patients' hips recovered and functioned well and subsequently deteriorated with total hip arthroplasty done between 6.4 and 9.5 years after debridement. Hips at greatest risk of failure have advanced arthrosis or a combination of impingement and instability preoperatively. The procedure effectively treats hips with impingement and without considerable secondary arthrosis or instability. PMID:15577484

Murphy, Stephen; Tannast, Moritz; Kim, Young-Jo; Buly, Robert; Millis, Michael B

2004-12-01

167

The radiology of total hip replacement  

International Nuclear Information System (INIS)

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

168

Alumina-on-alumina total hip replacement for femoral neck fracture in healthy patients  

OpenAIRE

Abstract Background Total hip replacement is considered the best option for treatment of displaced intracapsular fractures of the femoral neck (FFN). The size of the femoral head is an important factor that influences the outcome of a total hip arthroplasty (THA): implants with a 28 mm femoral head are more prone to dislocate than implants with a 32 mm head. Obviously, a large head coupled to a polyethylene inlay can lead to more wear, osteolysis and failure of the implant. Ceramic induces le...

Moretti Lorenzo; Mori Claudio M; Piazzolla Andrea; Solarino Giuseppe; Patella Silvio; Notarnicola Angela

2011-01-01

169

Arthrodiastasis for stiff hips in young patients.  

Science.gov (United States)

Joint distraction (arthrodiastasis) with a unilateral fixator was used to treat 9 patients with stiffness of the hip which had followed Perthes' disease (3), epiphysiolysis (2), congenital dysplasia (2), tuberculosis (1) and idiopathic chondrolysis (1). Their average age was 14 years, and they all had pain, limp and shortening of the leg. Distraction of 0.5 to 1 cm was maintained for an average of 94 days. The average range of movement subsequently was 65 degrees compared with 20 degrees before. The articular space was widened by an average of 2.8 mm, and only 3 patients had pain on follow up. PMID:8407045

Cañadell, J; Gonzales, F; Barrios, R H; Amillo, S

1993-01-01

170

Dislocation Dynamics During Plastic Deformation  

CERN Document Server

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

Messerschmidt, Ulrich

2010-01-01

171

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)

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.

Chun-Yang Chen

2003-03-01

172

Dislocations in complex materials.  

Science.gov (United States)

Deformation of metals and alloys by dislocations gliding between well-separated slip planes is a well-understood process, but most crystal structures do not possess such simple geometric arrangements. Examples are the Laves phases, the most common class of intermetallic compounds and exist with ordered cubic, hexagonal, and rhombohedral structures. These compounds are usually brittle at low temperatures, and transformation from one structure to another is slow. On the basis of geometric and energetic considerations, a dislocation-based mechanism consisting of two shears in different directions on adjacent atomic planes has been used to explain both deformation and phase transformations in this class of materials. We report direct observations made by Z-contrast atomic resolution microscopy of stacking faults and dislocation cores in the Laves phase Cr2Hf. These results show that this complex dislocation scheme does indeed operate in this material. Knowledge gained of the dislocation core structure will enable improved understanding of deformation mechanisms and phase transformation kinetics in this and other complex structures. PMID:15692046

Chisholm, Matthew F; Kumar, Sharvan; Hazzledine, Peter

2005-02-01

173

THERAPEUTIC STRATEGY IN THE REHABILITATION OF THE DYSPLASTIC HIP THROUGH ARTHROPLASTY  

Directory of Open Access Journals (Sweden)

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.

Liliana SAVIN

2012-07-01

174

Readmissions after fast-track hip and knee arthroplasty  

DEFF Research Database (Denmark)

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

Husted, Henrik; Otte, Kristian Stahl

2010-01-01

175

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 -- ...

176

Hip arthroscopy in adults.  

Science.gov (United States)

The acceptance and rates of hip arthroscopy are increasing in the United States and abroad and the literature describing it is expanding. Indications for hip arthroscopy include labral tears, loose bodies, femoroacetabular impingement, ruptured ligamentum teres, chondral injuries, adhesive capsulitis, instability, synovial disease, disorders of the iliopsoas tendon, external coxa saltans, tears of the hip abductors, and diagnosis of unresolved intra-articular hip pain. Current techniques in the central and peripheral compartments include, but are not limited to, labral debridement, labral repair, chondroplasty, microfracture, synovectomy, loose body removal, acetabuloplasty, proximal femoral osteoplasty, and iliopsoas release, with other procedures possible in the peritrochanteric space. Long-term outcomes are limited, but early data shows good results for many arthroscopic procedures in the hip when they are performed in the absence of degenerative disease. Improved techniques and technology are allowing for more advanced procedures to become popularized, but long-term outcome data about hip arthroscopy is still relatively sparse. PMID:20632984

Nord, Russell M; Meislin, Robert J

2010-01-01

177

Dislocations Jam At Any Density  

OpenAIRE

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

Tsekenis, Georgios; Goldenfeld, Nigel; Dahmen, Karin A.

2010-01-01

178

Hip Arthroscopy Update  

OpenAIRE

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

Kelly, Bryan T.; Buly, Robert L.

2005-01-01

179

Bullet in Hip Joint  

Science.gov (United States)

Recently, hip arthroscopy has become more popular in the diagnosis and extraction of intraarticular foreign bodies compared to open surgery. If a foreign object such as a bullet is not extracted from the hip joint, it may cause mechanical arthritis, infection and systemic lead toxicity. We present the arthroscopic excision of a bullet from the hip joint of a 33-year-old male patient who sustained a gunshot injury. PMID:25610269

Kaya, Ibrahim; Ugras, Akin; Saglam, Necdet; Sungur, Ibrahim; Cetinus, Ercan

2013-01-01

180

Congenital Intrahepatic Portosystemic Shunts  

Energy Technology Data Exchange (ETDEWEB)

Intrahepatic portosystemic shunts are an anomalous connection between the portal vein and hepatic vein/IVC, which may be either congenital or acquired secondary to liver cirrhosis or portal hypertension. Cases of congenital intrahepatic shunts are usually encountered in children and may spontaneously resolve. We report 5 cases of congenital intrahepatic portosystemic shunts in neonates and an adult

Lee, Woong Hee; Kim, Young Tong; Jou, Sung Shick; Shin, Hyeong Cheol [Soonchunhyang University, Asan (Korea, Republic of)

2008-12-15

181

Congenital Intrahepatic Portosystemic Shunts  

International Nuclear Information System (INIS)

Intrahepatic portosystemic shunts are an anomalous connection between the portal vein and hepatic vein/IVC, which may be either congenital or acquired secondary to liver cirrhosis or portal hypertension. Cases of congenital intrahepatic shunts are usually encountered in children and may spontaneously resolve. We report 5 cases of congenital intrahepatic portosystemic shunts in neonates and an adult

182

[Open talar dislocation].  

Science.gov (United States)

PURPOSE OF THE STUDy Total talar extrusion is a rare injury. It is frequently associated with severe soft tissue injury. There is no consensus about an appropriate treatment for an extruded talus. Total extrusion of the talus has a high possibility of avascular necrosis of the talus or infection. The primary goal of this study is a retrospective evaluation of the patients with open total talar dislocation treated by immediate reimplantation. MATERIALS AND METHODS We evaluated six patients (mean age, 29.6 years) with an open total talar dislocation treated in the Traumatological Hospital Brno. The dislocated talus, after debridement, was reduced, held in the correct position by Kirschner wires and spanned by external fiation, with two pins placed in the calcaneus and two in the distal tibia. The patients were evaluated on the basis of clinical and radiographic examination. Two patients underwent secondary reconstruction procedures. The four remaining patients were evaluated using the AOFAS score. RESULTS The mean follow-up period was 24.2 months (range, 18-32). Two patients had an infection and one developed avascular necrosis of the talus. One patient required arthrodesis of the subtalar joint and one talectomy with tibiocalcaneal arthrodesis and callus distraction of the tibia. CONCLUSIONS A primary reimplantation of the talus can produce good functional outcome. It is reasonable to replace an extruded talus as soon as possible after debridement. Infection and avascular necrosis of the talus seem to be diffiult to predict. Key words: open talar dislocation, talar extrusion, reimplantation. PMID:25748666

Veselý, R; Ko?iš, J; Kelbl, M

2015-01-01

183

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

Directory of Open Access Journals (Sweden)

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

Paji? Miloš

2007-01-01

184

Somatosensory and brainstem auditory evoked potential in congenital craniovertebral anomaly; effect of surgical management.  

OpenAIRE

Clinical features and evoked potential recordings were analysed in 32 patients with congenital atlantoaxial dislocation before and after surgery. Seven patients (group 1) had atlantoaxial dislocation, while 22 patients had associated basilar invagination (group 2). In both groups, pyramidal tract signs, posterior column signs, wasting of the upper limbs, and abnormality of somatosensory evoked potentials (SSEP) were similar. Conversely, lower cranial nerve involvement and abnormal brainstem a...

Sood, S.; Mahapatra, A. K.; Bhatia, R.

1992-01-01

185

Total Hip Replacement  

Science.gov (United States)

... them to move easily. A thin tissue called synovial membrane surrounds the hip joint. In a healthy hip, this membrane makes a ... may require more surgery and removal of the prosthesis. Any infection in your body can spread to your joint replacement. Blood Clots Blood clots in the leg ...

186

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

Science.gov (United States)

A hip fracture dislocation with contralateral femur fracture is a rare combination. We report a case of neglected posterior dislocation of hip with Pipkins-II femoral head and medial condylar fractures associated with a contralateral femoral shaft fracture. Right hip joint was approached via the Kocher-Langenbeck, following reduction, femoral head fragments were fixed with two 4-mm cannulated cancellous screws with open reduction internal fixation plating of ipsilateral femoral condylar fracture and closed reduction internal fixation nailing of left femur in the same sitting. Immediate postoperative X-rays were satisfactory. Postoperative period was uneventful. Over 7-year follow-up, patient is successfully performing his duties with X-rays bearing no signs of avascular necrosis (AVN) or hip arthritis. Thus, complex femoral fractures require a multidisciplinary approach for successful treatment. Early congruous reduction, anatomical fixation and early rehabilitation help in reducing the incidence of AVN and postoperative arthritis. Successful diagnosis of Pipkin's fracture dislocations requires use of CT, MRI and ultrasound in adjunct to X-rays. PMID:25759170

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

2015-01-01

187

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

Science.gov (United States)

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

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

2014-11-01

188

[Patella dislocation in athletes].  

Science.gov (United States)

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

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

2014-10-01

189

Results of Charnley total hip arthroplasty at a minimum of thirty years. A concise follow-up of a previous report.  

Science.gov (United States)

The purpose of the current study was to update the results of a prospective, single-surgeon series of primary Charnley total hip arthroplasties performed with cement. This investigation is one of the first studies in which hips treated with total hip arthroplasty with cement were followed for a minimum of thirty years. Twenty-seven patients (thirty-four [10.3%] of the hips in the initial study group) were alive at a minimum of thirty years postoperatively. These patients served as the focus of the present study. Revision because of aseptic loosening of the acetabular component was performed in 7.3% (twenty-three) of the hips from the original study group (excluding those revised because of infection or dislocation) and 26% (eight) of the hips in the living cohort. Revision because of aseptic loosening of the femoral component was performed in 3.2% (ten) of the hips from the original study group (excluding those revised because of infection or dislocation) and 10% (three) of the hips in the living patients. Since the twenty-five-year review, three hips were revised (one because of acetabular loosening, one because of femoral loosening, and one because of instability). This end-result study demonstrated the remarkable durability of cemented Charnley total hip replacements over a span of three decades, with 88% of the original prostheses intact at the time of the final follow-up or at the patient's death. PMID:15069131

Callaghan, John J; Templeton, Jesse E; Liu, Steve S; Pedersen, Douglas R; Goetz, Devon D; Sullivan, Patrick M; Johnston, Richard C

2004-04-01

190

The Learning Curve for Adopting Hip Resurfacing Among Hip Specialists  

OpenAIRE

Patient demand and surgeon interest in hip resurfacing has recently increased, but surgeons in the United States are relatively inexperienced with this procedure. We determined the learning curve associated with hip resurfacing and compared the rate of early complications of the first 650 hip resurfacings between five experienced hip surgeons and a national safety survey database study we previously published, which included 89 surgeons and 537 hip resurfacings. Patient demographics and adver...

Nunley, Ryan M.; Zhu, Jinjun; Brooks, Peter J.; Anderson Engh, C.; Raterman, Stephen J.; Rogerson, John S.; Barrack, Robert L.

2009-01-01

191

Small Incision Total Hip Arthroplasty  

Medline Plus

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

192

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

Directory of Open Access Journals (Sweden)

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

Mantu Jain

2013-10-01

193

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

OpenAIRE

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

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

2003-01-01

194

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

OpenAIRE

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

Geringer, Jean; Boyer, Bertrand; Farizon, Fre?de?ric

2011-01-01

195

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)

196

Metal-on-metal hip resurfacings. A radiological perspective  

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-03-15

197

Supernumerary nostril: Congenital adrenal hyperplasia with a rare congenital anomaly  

Science.gov (United States)

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

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

2014-01-01

198

Genetics of congenital hypothyroidism  

OpenAIRE

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...

Park, S.; Chatterjee, V.

2005-01-01

199

Neglected locked vertical patellar dislocation  

OpenAIRE

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 ...

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

2012-01-01

200

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

201

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 ...

202

Head-shaft angle is a risk factor for hip displacement in children with cerebral palsy.  

Science.gov (United States)

Background and purpose - Hip dislocation in children with cerebral palsy (CP) is a common and severe problem. The Swedish follow-up program for CP (CPUP) includes standardized monitoring of the hips. Migration percentage (MP) is a widely accepted measure of hip displacement. Coxa valga and valgus of the femoral head in relation to the femoral neck can be measured as the head-shaft angle (HSA). We assessed HSA as a risk factor for hip displacement in CP. Patients and methods - We analyzed radiographs of children within CPUP from selected regions of Sweden. Inclusion criteria were children with Gross Motor Function Classification System (GMFCS) levels III-V, MP of 40% of either hip within 5 years. Risk ratio between children who differed in HSA by 1 degree was calculated and corrected for age, MP, and GMFCS level using multiple Poisson regression. Results - 145 children (73 boys) with a mean age of 3.5 (0.6-9.7) years at the initial radiograph were included. 51 children developed hip displacement whereas 94 children maintained a MP of GMFCS level, and MP, a 10-degree difference in HSA results in a 1.6-times higher risk of hip displacement in the child with the higher HSA. Interpretation - A high HSA appears to be a risk factor for hip displacement in children with CP. PMID:25428756

Hermanson, Maria; Hägglund, Gunnar; Riad, Jacques; Wagner, Philippe

2015-04-01

203

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 ...

204

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 ...

205

Taper Hip Prosthesis  

Medline Plus

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

206

Taper Hip Prosthesis  

Medline Plus

Full Text Available ... a capsular release if you have a very stiff hip and you're having problems mobilizing the ... with a minimum of holes, called the cluster pattern. And in terms of your placement, what’s your ...

207

Arthroscopic hip labral repair.  

Science.gov (United States)

Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have better results than debridement. Labral refixation is achieved with sutures anchored into the acetabular rim. The acetabular rim is trimmed either to correct pincer impingement or to provide a bleeding bed to improve healing. Labral repair has shown excellent short-term to midterm outcomes and allows patients to return to activities and sports. Arthroscopic rim trimming and labral refixation comprise an effective treatment for labral tears with an underlying diagnosis of femoroacetabular impingement and are supported by the peer-reviewed literature. PMID:23875153

Philippon, Marc J; Faucet, Scott C; Briggs, Karen K

2013-05-01

208

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 ...

209

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 ...

210

Atlanto-occipital dislocation.  

Science.gov (United States)

Atlanto-occipital dislocation (AOD) is being increasingly recognized as a potentially survivable injury as a result of improved prehospital management of polytrauma patients and increased awareness of this entity, leading to earlier diagnosis and more aggressive treatment. However, despite overall improved outcomes, AOD is still associated with significant morbidity and mortality. The purpose of this paper is to review the biomechanical aspects, clinical features, radiologic criteria, and treatment strategies of AOD. Given that the diagnosis of AOD can be very challenging, a high degree of clinical suspicion is essential to ensure timely recognition and treatment, thus preventing neurological decline or death. PMID:25793163

Hall, Graham C; Kinsman, Michael J; Nazar, Ryan G; Hruska, Rob T; Mansfield, Kevin J; Boakye, Maxwell; Rahme, Ralph

2015-03-18

211

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

Directory of Open Access Journals (Sweden)

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

van Raaij Jos JAM

2008-10-01

212

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

Scientific Electronic Library Online (English)

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

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

2008-09-01

213

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

Directory of Open Access Journals (Sweden)

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

Luciane Zanusso Pagnossim

2008-09-01

214

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

Directory of Open Access Journals (Sweden)

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

Takahashi,Tsuneo

1985-10-01

215

Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes  

Science.gov (United States)

Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of THA, although their relative risk varies by approach. Numerous clinical trials have sought to elicit differences in patient-reported outcomes, complication rates and return to function among the surgical approaches. This review outlines some of the technical pearls of performing a THA through either a direct anterior, direct lateral or posterior approach. A literature review outlines the impact of surgical approach on clinical outcomes and clinically relevant complication rates. PMID:25799249

Petis, Stephen; Howard, James L.; Lanting, Brent L.; Vasarhelyi, Edward M.

2015-01-01

216

Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes.  

Science.gov (United States)

Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of THA, although their relative risk varies by approach. Numerous clinical trials have sought to elicit differences in patient-reported outcomes, complication rates and return to function among the surgical approaches. This review outlines some of the technical pearls of performing a THA through either a direct anterior, direct lateral or posterior approach. A literature review outlines the impact of surgical approach on clinical outcomes and clinically relevant complication rates. PMID:25799249

Petis, Stephen; Howard, James L; Lanting, Brent L; Vasarhelyi, Edward M

2015-04-01

217

Dislocations and dislocation reduction in space grown GaSb  

Energy Technology Data Exchange (ETDEWEB)

The behaviour of dislocations in GaSb crystals grown in space both from a stoichiometric melt (floating zone method, FZ) and a Bi solution (floating solution zone, FSZ) respectively, is studied. Predominantly straight 60 dislocations with Burgers vectors of the type b=a/2 <110> in (111) glide planes are identified. In the 20 mm long FZ single crystal the linear growing out of the dislocations is observed which reduces the dislocation density in the centre of the crystal to values below 300 cm{sup -2}. The Bi incorporation in the FSZ crystal results in a misfit between seed and grown crystal and in a network of misfit dislocations at the interface. Thermocapillary convection during growth as well as the surface tension may be the reasons for the presence of curved dislocations and the higher dislocation density within a 1-2 mm border region at the edges of both of the crystals. (copyright 2009 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

Croell, A.; Tonn, J.; Schweizer, M.; Lauer, S. [Kristallographie, Institut fuer Geowissenschaften, Universitaet Freiburg (Germany); Benz, K.W. [Freiburger Materialforschungszentrum, Universitaet Freiburg (Germany); Tuomi, T.; Rantamaeki, R. [Optoelectronics Laboratory, Helsinki University of Technology, Espoo (Finland); McNally, P.; Curley, J. [Research Institute for Networks and Communications Engineering, Dublin City University, Dublin (Ireland); Danilewsky, A.N.

2009-10-15

218

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2003-05-01

219

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

International Nuclear Information System (INIS)

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

220

Small Incision Total Hip Arthroplasty  

Medline Plus

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

221

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... hip joint. And the hip joint in this particular patient is pretty destroyed. There's no space between ... amount of bone that has grown into that particular implant, and they've quantitated the optimal time ...

222

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... can see how deformed it is. On a normal patient that doesn't have hip arthritis, the ... is the femoral head. That white cartilage, that's normal cartilage. That is a non-arthritic hip of ...

223

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 ...

224

Hip Fractures among Older Adults  

Science.gov (United States)

... and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 ... 62. Scott JC. Osteoporosis and hip fractures. Rheumatic Diseases Clinics of North America 1990;16(3):717– ...

225

Small Incision Total Hip Arthroplasty  

Medline Plus

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

226

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... very atraumatically go through -- go through muscle and tendon and get that approach to that hip in ... a little bit in a position where a tendon snaps over it as you move your hip, ...

227

Small Incision Total Hip Arthroplasty  

Medline Plus

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

228

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 ...

229

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 ...

230

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 ...

231

Congenital anomalies associated with hypothyroidism.  

OpenAIRE

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.

Chanoine, J. P.; Bourdoux, P.; Delange, F.

1986-01-01

232

Chondrofibrosis of adolescent hip  

Directory of Open Access Journals (Sweden)

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

Tomi? S.

2006-01-01

233

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

Scientific Electronic Library Online (English)

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

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

2001-01-01

234

Clinical practice: the hip from birth to adolescence.  

Science.gov (United States)

Hip problems in children are relatively rare but usually serious, potentially causing lifelong disability. Early diagnosis and treatment is, therefore, mandatory. The aim of this review is to discuss the most frequent diseases of the hip from birth to adolescence. The different affections are relatively closely related to age periods. After birth and in infancy, developmental dislocation of the hip (DDH) and septic arthritis are more prominent. DDH is not always present at birth and should regularly be checked for in the first 6 months of life. Septic arthritis is an emergency and should be adequately treated within 4 days of the beginning of the infection with open drainage of the hip. Transient synovitis and Legg-Calvé-Perthes disease (LCPD) are mostly found between 4 and 10 years of age. Transient synovitis is the most frequent hip disorder in that age group. It is a self-limiting noninfectious effusion in the joint without serious consequences. Differential diagnosis with septic arthritis should, however, be made. LCPD is an idiopathic avascular necrosis of the hip causing flattening and deformity of the femoral head, depending on the extent of the necrosis. Treatment by containment is aimed at favoring the remodeling of the deformed femoral head. Finally, between the age of 10 and 15 years, slipped capital femoral epiphysis (SCFE) should be the preferential diagnosis, especially in the limping obese boy. SCFE is an inferior and posterior displacement of the proximal epiphysis of the femur in the growth plate. It should be treated as an emergency with a screw fixation. PMID:19727813

Fabry, Guy

2010-02-01

235

Dislocation jamming and Andrade creep  

CERN Document Server

We simulate the glide motion of an assembly of interacting dislocations under the action of an external shear stress and show that the associated plastic creep relaxation follows Andrade's law. Our results indicate that Andrade creep in plastically deforming crystals involves the correlated motion of dislocation structures near a dynamic transition separating a flowing from a jammed phase. Simulations in presence of dislocation multiplication and noise confirm the robustness of this finding and highlight the importance of metastable structure formation for the relaxation process.

Miguel, M C; Zaiser, M; Zapperi, S; Vespignani, Alessandro; Zaiser, Michael; Zapperi, Stefano

2002-01-01

236

Hip supporting device  

DEFF Research Database (Denmark)

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

BrØndsted, Povl Technical University of Denmark,

237

IDIOPATHIC CHONDROLYSIS OF HIP  

Directory of Open Access Journals (Sweden)

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.

ShanmugaRaju P

2014-06-01

238

Dislocation motion in tungsten: Atomistic input to discrete dislocation simulations  

OpenAIRE

A computational framework for the discrete dislocation dynamics simulation of body-centered cubic (bcc) metals which incorporates atomistic simulation results is developed here on the example of tungsten. Mobility rules for the a/2111 screw dislocations are based on the kink-pair mechanism. The fundamental physical quantity controlling the kink-pair nucleation, the stress-dependent activation enthalpy, is obtained by fitting the line-tension model to atomistic data extending the approach by G...

Srivastava, K.; Gro?ger, R.; Weygand, D.; Gumbsch, P.

2013-01-01

239

Greater trochanteric hip pain.  

Science.gov (United States)

In the patient with lateral hip pain, there is a broad differential diagnosis, making appropriate evaluation and management challenging. Greater trochanteric pain syndrome is a term used to denote chronic lateral hip pain and encompasses several painful soft tissue diagnoses including coxa saltans, trochanteric bursitis, and gluteus minimus and medius tendon tears. An overview of these common causes is presented through a series of cases that encompass the anatomic associations, classic presentations, diagnostic tests, and management strategies unique to each disorder. By reviewing this information, we hope to provide clinicians with the tools to evaluate greater trochanteric pain syndrome efficiently and effectively. PMID:24651142

Kimpel, Diane M; Garner, Chadwick C; Magone, Kevin M; May, Jedediah H; Lawless, Matthew W

2014-01-01

240

Congenital Hypomyelinating Neuropathy (CHN)  

Science.gov (United States)

... that influence the formation of myelin, an insulating coating on nerve fibers (axons). CHN is inherited in ... these effects. Disease: Congenital Hypomyelinating Neuropathy Charcot-Marie-Tooth Disease (CMT) Peripheral Neuropathies Printer-friendly version Send ...

241

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

242

The athlete's hip and groin.  

Science.gov (United States)

Groin and hip injuries are seen in athletes who perform quick directional changes and cutting movements. Because forces generated through athletic performance are transferred through the hip, injuries to these areas may limit athletes with mild pain or lead to career-ending injuries. The anatomy of the hip and groin is complex and symptoms often overlap. This article discusses some athletic causes, but other medical conditions may be associated with hip and groin pain as well. Updates in evaluation and treatment are discussed for adductor strains, hip osteoarthritis, femoroacetabular impingement, sports hernia, osteitis pubis, and obturator nerve entrapment. PMID:23668647

Tammareddi, Kumar; Morelli, Vincent; Reyes, Miguel

2013-06-01

243

The painful hip: new concepts  

International Nuclear Information System (INIS)

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

244

Congenital Intranasal Glioma  

OpenAIRE

Congenital midline swellings of nose are encountered rarely, and nasal gliomas constitute about 5% of such lesions. Various theories have been suggested to explain the pathogenesis. Imaging preferably by MRI is mandated to study the extent and to rule out intracranial extension. Treatment is complete excision, and the approach depends upon the extent of the lesion and availability of expertise. We present the management of one such case of congenital intranasal glioma without any intracranial...

Sajad Ahmad Salati; Ajaz Ahmad Rather

2011-01-01

245

Congenital muscular torticollis  

OpenAIRE

Congenital muscular torticollis (CMT) is a rare congenital musculoskeletal disorder characterized by unilateral shortening of the sternocleidomastoid muscle (SCM). It presents in newborn infants or young children with reported incidence ranging from 0.3% to 2%. Owing to effective shortening of SCM on the involved side there is ipsilateral head tilt and contralateral rotation of the face and chin. This article reports a case of CMT in a 3½-year-old male child successfully managed by surgical ...

Nilesh, Kumar; Mukherji, Srijon

2013-01-01

246

Screening for congenital hypothyroidism.  

OpenAIRE

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...

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

1980-01-01

247

Neglected locked vertical patellar dislocation  

Science.gov (United States)

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 lateral extensor retinaculum kept the patella locked in the lateral gutter even with the knee in full extension. Traumatic patellar dislocation with rotation around a vertical axis has been described earlier, but no such neglected case has been reported to the best of our knowledge. PMID:23162154

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

2012-01-01

248

Continuum theory of evolving dislocation fields  

OpenAIRE

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...

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

2007-01-01

249

Bipolar dislocation of the clavicle  

OpenAIRE

Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery ...

Jiang, Wei; Gao, Shu-guang; Li, Yu-sheng; Lei, Guang-hua

2012-01-01

250

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

Science.gov (United States)

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

2010-04-01

251

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 ...

252

Treatment of hip instability.  

Science.gov (United States)

Instability after total hip arthroplasty is a major source of patient morbidity, second only to aseptic loosening. Certain patient groups have been identified as having a greater risk of instability, including patients undergoing revision arthroplasty as early or late treatment for proximal femoral fractures. PMID:11689373

Robbins, G M; Masri, B A; Garbuz, D S; Greidanus, N; Duncan, C P

2001-10-01

253

Taper Hip Prosthesis  

Medline Plus

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

254

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 ...

255

Idiopathic chondrolysis of hip.  

Science.gov (United States)

An uncommon case of idiopathic chondrolysis of the hip in an 11-year-old girl is reported. It was characterized by clinical presentation, laboratory tests, and imaging techniques. A differential diagnosis is discussed highlighting the radiological features for quick diagnosis. PMID:21607844

Sureka, Jyoti; Jakkani, Ravi Kanth; Inbaraj, Alfred; Panwar, Sanuj

2011-05-01

256

Aseptic hip pneumarthrosis following modular total hip arthroplasty: a potential mimic of hip infection.  

Science.gov (United States)

Pneumarthrosis following total hip arthroplasty accompanied by acute hip symptoms is a potentially ominous finding suggesting infection with gas-forming bacteria, a medical emergency. We describe a case of a 61-year-old male presenting to the Emergency Department 43 months following a titanium/titanium (Ti/Ti) modular neck-stem total hip arthroplasty (MTHA) (Wright Medical Systems, Arlington, Tennessee) with acute presentation of hip symptoms and joint gas on radiographs proven to be aseptic hip pneumarthrosis. We review the imaging features of aseptic hip pneumarthrosis following MTHA which have not been elaborated on previously and suggest a less aggressive workup in select cases. We believe emergency radiologists should be aware of this unusual complication as it may mimic a septic hip which may entail an unnecessarily aggressive workup. PMID:25491939

Morag, Yoav; Yablon, Corrie M; Weber, Alexander E; Brandon, Catherine; Blaha, David J

2015-04-01

257

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

Science.gov (United States)

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

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

2014-03-01

258

Luxación carpometacarpiana Carpometacarpal dislocation  

Directory of Open Access Journals (Sweden)

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

Humberto Villalobos Pedroso

2009-04-01

259

Luxación carpometacarpiana / Carpometacarpal dislocation  

Scientific Electronic Library Online (English)

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

Humberto, Villalobos Pedroso; Alejandro, Bermúdez Fajardo; Rubén, Fornaris Hung; Eduardo, Carrera Ramírez; Alejandro, Martínez Álvarez.

2009-04-01

260

Conus hip prosthesis.  

Science.gov (United States)

50 years ago, prosthetic replacement of the hip joint ushered in a new epoch in orthopaedics. Total hip replacement made it possible to remove a severely diseased, painful hip and restore normal function and a normal quality of life to the afflicted patient. The early results of total hip replacement are almost all spectacular and hip replacement has become the most successful type of orthopaedic surgery. These good results using an approach that was technically relatively simple resulted in a temptation to implant prosthetic hip joints with ever increasing frequency in ever younger patients. This led to the emergence of new problems, which were not so clearly recognised at the outset: it emerged that the stability of prosthetic hip joints was of limited duration. This had the following consequence: If a total hip prosthesis is implanted in an elderly person whose remaining life-expectancy is shorter than the longevity of the prosthesis, hip replacement is a life-long solution. We can therefore say that, for a patient who has only 10 to 15 years left to live, their hip problem is solved by total hip replacement. For young people, who still have a long life expectancy in front of them, it is different. They will experience failure of the artificial joint and require further surgery. The commonest and most important type of failure in total hip prostheses is aseptic loosening, which is associated with resorption of bone at the site of the prosthesis. The cause of this phenomenon has only gradually been recognised in the course of the years. Initially, the unanimous opinion was that the methacrylate cement, used to fix the components of the prosthesis in the bone, was the definitive cause of aseptic loosening because fissures and fractures of the cement were almost always found during surgical revision of loosened joints. There was talk of "cement disease" and great efforts were made to improve the quality of the cement and the cementing technique. Moreover, even today, there is no established answer to the question whether, over the course of many years, cement ages and becomes friable, a process that may have major implications for young patients. For this reason, ways of reliably fixing the prosthesis in the bone without methacrylate cement were also explored at the same time. Valuable pioneering work in this field was carried out with uncemented dental implants made of titanium and with a roughened surface. With these implants, the phenomenon of osseointegration, i.e. the deposition of bone directly on the roughened metal surface without any intervening connective tissue, was observed. This phenomenon has also been utilised successfully in hip prostheses: if artificial hips made of titanium alloy with a coarse-blasted surface and with a high primary mechanical stability are placed in the bone, osseointegration also occurs. In parallel with this development, Willert, from Göttingen, identified the most important cause of loosening of the prosthesis: he established that, when an artificial joint articulates, very fine particles of polyethylene are eroded from the prosthetic cup when the surfaces of the joint glide over one another and that these are only partially removed by the lymphatic system. A large proportion of the particles accumulates in the artificial joint and in the gap between the prosthesis and the bone, giving rise to foreign body granulomata, which resorb bone thus leading to loosening. The number of eroded particles is considerable. In 1998, Patricia Campbell, from Los Angeles, showed that 470,000 particles per step were produced from an articulation between a metal head and a polyethylene cup. This huge number gives an indication how small these particles are, since the linear erosion of the polyethylene surface only amounts to about 0.1 to 0.2 mm a year. This relatively recent recognition of "particle disease" has led to the investigation of other materials, which produce fewer erosion particles, for artificial joint articulations. Three possible options are available today, but it

Wagner, H; Wagner, M

2001-01-01

261

Bilateral hip osteonecrosis: influence of hip size on outcome  

OpenAIRE

OBJECTIVE—To measure the volume of osteonecrosis in 30 patients with disease in both hips (one side with collapse and the other without at Ficat stage I).?METHOD—The volume of the osteonecrosis was measured by magnetic resonance imaging.?RESULTS—The progression to collapse was influenced by the size of the lesion in each patient. The first collapsed hip was that with the largest volume of osteonecrosis.?CONCLUSION—The volume of the osteonecrotic lesion on the second hip (stage ...

Hernigou, P.; Lambotte, J.

2000-01-01

262

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 ...

263

The climb of dissociated dislocations  

International Nuclear Information System (INIS)

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

264

Femoroacetabular impingement due to synovial chondromatosis of the hip joint.  

Science.gov (United States)

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

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

2009-12-01

265

Prevention of hip dysplasia in children and adults.  

Science.gov (United States)

Klisic and Pajic summarized the history of early diagnosis and treatment of hip dysplasia when they wrote, Devising the preventive approach to developmental dysplasia of the hip (DDH) required much time.... Despite the 2400-year-old suggestion made by Hippocrates that children's hip dislocations are curable if treatment is started very early, the preventive approach was proposed by Roser only in 1879 [who] described early diagnosis in newborns and performed reduction by abduction... He also advocated early treatment by fixing babies' hips in abduction. However, surgeons did not readily accept these proposals, despite the good results shown by Froelich in 1906 and Le Damany in 1911. In 1927, Putti succeeded in interesting some orthopedic surgeons in the procedure by showing the results of early treatment. But the practical problem remained: ie, how to detect the DDH in patients at an early age. The turning point came in 1935 when pediatrician Ortolani introduced early detection of DDH by “early clinical search” shortly after a child's birth, instructing obstetricians, pediatricians, and midwives to perform the search. Rediscovering the diagnostic “segno della scatto,” ie, reducible displacement, he popularized the prophylactic approach to DDH by early detection and treatment. Fifteen years later, another pediatrician, Palmen, organized systematic screening in nurseries by pediatricians. Since Klisic and Pajic wrote this in 1993, the use of ultrasound, albeit still controversial in some ways, has influenced the treatment and prevention of DDH. Klisic's attempts to universally prevent the disease may still be able to be incorporated into further efforts at disease prevention through education and the systematic trials of hip abduction pillows or braces similar to his wide-diaper diapering technique. The goal of prevention is to eradicate a disease so that it does not present to the physician. For DDH, this goal may be tenable. PMID:22819156

Price, Charles T; Ramo, Brandon A

2012-07-01

266

HYDROGEN-DISLOCATION INTERACTIONS AND INTRINSIC DISLOCATION RELAXATION IN NIOBIUM  

OpenAIRE

The dislocation relaxation between 100 K and 200 K (1kHz) in plastically deformed niobium, formerly named "?-relaxation" is a hydrogen Snoek-Köster relaxation (cold work relaxation). This is shown by experiments on extremely degassed samples, which contained controlled amounts of hydrogen and/or oxygen. The intrinsic, hydrogen-free dislocation relaxation appears between 30 K and 70 K (1kHz), the exact peak location depends on the interstitial (O,N) content. This relaxation is probably ident...

Maul, M.; Schultz, H.

1981-01-01

267

Aberrant pelvis and hip kinematics impair hip loading before and after total hip replacement.  

Science.gov (United States)

Musculoskeletal loading is an important factor affecting the development of osteoarthritis, bone remodelling and primary fixation of total hip replacement (THR). In this study, we analyzed the relation between muscular force, gait kinematics and kinetics and hip loading in 20 patients before and six weeks after THR. Hip contact forces were calculated from gait analysis data using musculoskeletal modelling, inverse dynamics and static optimization. We found aberrant pelvis and hip kinematics and kinetics before and six weeks after surgery, confirming previous findings in literature. Furthermore, we found a decrease in the total contact force and its vertical component. These changes result in a decrease of the associated inclination angles of the total hip contact force in the sagittal and transverse planes, changing the orientation towards more vertical implant loading after THR. These changes in hip loading were related to observed gait kinematics and kinetics. Most importantly, excessive pelvic obliquity and associated hip adduction related to impaired implant loading. We concluded, therefore, that physical therapy in the early post-operative phase should primarily focus on stretching of anterior and medial structures and strengthening of hip flexors and abductors to achieve normalization of the hip and pelvis kinematics and consequently normalize hip loading. PMID:19560359

Lenaerts, G; Mulier, M; Spaepen, A; Van der Perre, G; Jonkers, I

2009-10-01

268

Transmission electron microscopy analysis of worn alumina hip replacement prostheses  

International Nuclear Information System (INIS)

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

269

Congenital syphilis in the newborn.  

OpenAIRE

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.

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

1988-01-01

270

Congenital Intranasal Glioma  

Science.gov (United States)

Congenital midline swellings of nose are encountered rarely, and nasal gliomas constitute about 5% of such lesions. Various theories have been suggested to explain the pathogenesis. Imaging preferably by MRI is mandated to study the extent and to rule out intracranial extension. Treatment is complete excision, and the approach depends upon the extent of the lesion and availability of expertise. We present the management of one such case of congenital intranasal glioma without any intracranial extension that presented as a septal polyp. PMID:22606573

Salati, Sajad Ahmad; Rather, Ajaz Ahmad

2011-01-01

271

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.)

272

Ullrich Congenital Muscular Dystrophy  

Directory of Open Access Journals (Sweden)

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

Goknur Haliloglu

2011-06-01

273

Total hip replacement  

International Nuclear Information System (INIS)

A historical digest deals with development of alloplastic total hip replacement (THR) from the beginning to cementless partial prostheses, cemented total prostheses, and modern uncemented alloplasties with biomaterials of low wear rate. Nowadays, there is no more restriction of THR in younger patients; conventional cemented THR is reserved to aged people. Modern uncemented THR shows mostly excellent middle-term results, thus avoiding the wellknown long-term risks of conventional cemented THR with metal-PE-joint-pairing. (orig.)

274

IDIOPATHIC CHONDROLYSIS OF HIP  

OpenAIRE

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

ShanmugaRaju P; Raghuram C; Naveen Kumar S

2014-01-01

275

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

276

Bipolar dislocation of the clavicle.  

Science.gov (United States)

Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup. PMID:23325981

Jiang, Wei; Gao, Shu-Guang; Li, Yu-Sheng; Lei, Guang-Hua

2012-11-01

277

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

Science.gov (United States)

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 used for revision surgery. Nevertheless, this technique is not suitable for all hip revisions, and the indications and various possible procedures and devices should be carefully considered to select the best treatment for each patient. We believe that the current report provides evidence supporting a new technical option for complex cases during revision THA. PMID:24683429

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

2014-01-01

278

Clinical reasoning in the evaluation and management of undiagnosed chronic hip pain in a young adult.  

Science.gov (United States)

This case report describes the clinical reasoning used to manage chronic left hip pain in a 21-year-old woman who was recreationally active. The patient had a history of possible congenital hip dysplasia (CHD) and known recurrent lateral (external) patellar subluxations on the left side. She complained of experiencing hip pain when walking, sitting, playing soccer, and doing "step aerobics." Hip range of motion (ROM), muscle force, and joint stability problems were assessed. Abnormal movement patterns were observed during gait and step aerobics. Intervention was based on the working hypothesis that periarticular stiffness and muscle weakness from earlier trauma were superimposed on joint instability from CHD. Following intervention, the patient's hip ROM and muscle force improved concurrently with reduction of hip pain, increased ability to participate in recreational activities, and improvement in the movement pattern during step aerobics. An eclectic approach to analysis of the problem was used, combining data unique to the patient with knowledge of CHD and concepts proposed by Cyriax, Maitland, Sahrmann, and others. The clinical reasoning used to establish a basis for treatment and its limitations are discussed. PMID:9442197

Zimny, N J

1998-01-01

279

Intermittent dislocation flow in viscoplastic deformation  

CERN Document Server

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

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

2001-01-01

280

Congenitally palliated scimitar syndrome.  

Science.gov (United States)

We present a rare case of scimitar syndrome in which the scimitar vessel, collecting all the right pulmonary veins, was stenotic at its junction, with the inferior caval vein and two anomalous vessels, connecting to the same venous collector, draining most of the flow to the left atrium. We arbitrarily defined this rare anatomical variant as a congenitally palliated scimitar syndrome. PMID:25341362

Cantinotti, Massimiliano; Giordano, Raffaele; Spadoni, Isabella

2014-10-24

281

Congenital aggressive lipomatosis  

Energy Technology Data Exchange (ETDEWEB)

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

Lachmann, R.S.; Mehringer, C.M.; Finklestein, J.; Maenza, R.

1983-05-01

282

Congenital aggressive lipomatosis  

International Nuclear Information System (INIS)

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

283

Congenital hemifacial hyperplasia.  

Science.gov (United States)

A case of true hemifacial hyperplasia is described. This is an unusual condition which produces facial asymmetry by a marked, unilateral, localised overgrowth of all the tissues in the affected area, including, the facial soft tissues, bones and teeth. The patient is an eight-year-old Caucasian girl with congenital hemihyperplasia of the right side of her face. PMID:3166970

Antoniades, K; Letsis, I; Karakasis, D

1988-08-01

284

Congenital temporal triangular alopecia.  

OpenAIRE

Congenital temporal triangular alopecia is a form of nonscarring alopecia that, as its name suggests, is present at birth. Four cases are reported. One patient underwent hair transplantation, which was successful and might be useful in other patients. Cases occurring in a father and his son suggest for the first time a genetic link.

Bargman, H.

1984-01-01

285

Formation of dislocation dipoles in irradiated graphite  

International Nuclear Information System (INIS)

Recently, we have proposed a dislocation dipole accumulation model to explain the irradiation-induced amorphization of graphite. However, the structure of dislocation dipole in the hexagonal networks is still an open question at the atomic-level. In this paper, we propose a possible formation process of the dislocation dipole

286

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

287

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

Science.gov (United States)

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

Fisher, Kimberly A; Fisher, David A

2014-04-01

288

Hip joint replacement - series (image)  

Science.gov (United States)

... will take from 2 months to a year. Hip replacement surgery results are usually excellent. Most or all ... sometimes as long as 20 years -- the artificial hip joint will loosen. A second replacement may be needed. Younger, more active, people may ...

289

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... and E-poly antioxidant-infused technology during a hip replacement through the anterior supine intramuscular approach. “OR-Live,” ... Dr. Keith Berend perform an anterior approach total hip replacement with the patient on a regular OR table ...

290

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... Hospital in New Albany, Ohio. We’ll be doing a right hip tonight. This is a 59-year-old ... Microplasty Taperloc stem, you can see we’re doing a right hip. She has mild dysplasia with cystic changes ...

291

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... little bit in a position where a tendon snaps over it as you move your hip, those patients can actually undergo an arthroscopic release of that tendon. So that's a couple small portals on the side of the hip to -- to -- you know, rather than going back in through an incision, a larger incision. So ...

292

Medial subtalar dislocation: Case report  

Directory of Open Access Journals (Sweden)

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

Manojlovi? Radovan

2010-01-01

293

Discrete dislocation dynamics simulations in a cylinder  

Science.gov (United States)

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.

Li, Maosheng; Gao, Chan; Xu, Jianing

2015-02-01

294

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

Czech Academy of Sciences Publication Activity Database

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

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

2013-01-01

295

Congenital pulmonary lymphangiectasis.  

Science.gov (United States)

Congenital pulmonary lymphangiectasis (CPL) is a rare vascular malformation causing dilated lymph vessels and disturbed drainage of lymph fluid. Based on the pathogenesis and clinical phenotype it can be classified as primary or secondary CPL. Associated genetic syndromes with or without lymphedema, familial occurrence and gene mutations have been described. In utero, it may present as non-immune hydrops with pleural effusions. At birth neonates may have respiratory failure due to chylothorax and pulmonary hypoplasia, causing very high short term mortality rates. Other cases may become symptomatic any time later in childhood or even during adult life. CPL is usually diagnosed based on the combination of clinical signs, imaging and histological findings. Open-lung biopsy is considered the gold standard for the diagnosis of CPL. Treatment is primarily supportive featuring aggressive mechanical ventilation and the management of problems associated with congenital chylothorax including chest-drainage, medium-chain triglycerides (MCT) diet, and octreotide. PMID:24997116

Reiterer, Friedrich; Grossauer, Karin; Morris, Nicholas; Uhrig, Sabine; Resch, Bernhard

2014-09-01

296

Congenital intestinal lymphangiectasia  

Directory of Open Access Journals (Sweden)

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.

Popovi? Dušan ?.

2011-01-01

297

Congenital diaphramatic hernia  

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-01-15

298

Autosomal recessive congenital ichthyosis.  

Science.gov (United States)

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

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

2013-05-01

299

Congenital diaphramatic hernia  

International Nuclear Information System (INIS)

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

300

Outcome for congenital hypothyroidism.  

OpenAIRE

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

Frost, G. J.; Parkin, J. M.

1985-01-01

301

Congenital long QT syndrome  

OpenAIRE

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

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

2008-01-01

302

Congenital hypothyroidism: Screening dilemma  

OpenAIRE

Primary sporadic congenital hypothyroidism (CH) is the most common cause of hypothyroidism infancy early childhood in iodine sufficient region. Screening for neonatal CH began in 1970s. The rationale and reason for neonatal screening for CH (NSCH) are well established. It is mandatory in most developed countries along with the screen for metabolic disorder. The possibility of measuring TSH and thyroid hormones in cord blood paved the way for newborn screening (NS) for CH. Worldwide it is esti...

Desai, Meena P.

2012-01-01

303

Congenital adrenal hyperplasia.  

OpenAIRE

Congenital adrenal hyperplasia consists of a heterogenous group of inherited disorders due to enzymatic defects in the biosynthetic pathway of cortisol and/or aldosterone. This results in glucocorticoid deficiency, mineralocorticoid deficiency, and androgen excess. 95% of CAH cases are due to 21-hydroxylase deficiency. Clinical forms range from the severe, classical CAH associated with complete loss of enzyme function, to milder, non-classical forms (NCAH). Androgen excess affe...

Raiti, S.; Newns, G. H.

2003-01-01

304

Congenital Pulmonary Alveolar Proteinosis  

OpenAIRE

Pulmonary alveolar proteinosis (PAP) is a rare syndrome characterized by pulmonary surfactant accumulation within the alveolar spaces. It occurs with a reported prevalence of 0.1 per 100,000 individuals. Two clinically different pediatric types have been defined as congenital PAP which is fatal and a late-onset PAP which is similar to the adult form and less severe. The clinical course of PAP is variable, ranging from spontaneous remission to respiratory failure. Whole-lung lavage is the curr...

Saber Hammami; Khaled Harrathi; Khaled Lajmi; Samir Hadded; Chebil Ben Meriem; Amp Xe Ji Gu Amp Xe Diche, Mohamed N.

2013-01-01

305

[Congenital syphilis (author's transl)].  

Science.gov (United States)

Authors present a study on eleven patients affected with congenital syphillis treated during the last six years. All of them presented bone lesions in one or more locations. Familiar antecedents, mechanism of infection, clinical symptoms and radiological findings are analized, emphasizing the importance of prophylaxis and early treatment with procaine penicillin in a dosage of 50,000 U./Kg. day for at least ten days. PMID:533054

Arrate, J K; García Rodrigo, S; Ugidos, M; Saitúa, G; Gárate, J

1979-12-01

306

10-year experience with short stem total hip arthroplasty.  

Science.gov (United States)

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

von Lewinski, Gabriela; Floerkemeier, Thilo

2015-03-01

307

The heart: Congenital disease  

International Nuclear Information System (INIS)

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

308

Congenital Cytomegalovirus Infection: Audiologic Outcome  

OpenAIRE

The association between congenital cytomegalovirus (CMV) infection and sensorineural hearing loss (SNHL) was first described almost 50 years ago. Studies over the intervening decades have further described the relationship between congenital CMV infection and SNHL in children. However, congenital CMV infection remains a leading cause of SNHL in children in the United States and the world today. As more CMV infections are identified, it is important to recognize that infants who are born to se...

Fowler, Karen B.

2013-01-01

309

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

Science.gov (United States)

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

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

2015-01-01

310

Fully hydroxyapatite-coated total hip replacement: ten-year results.  

Science.gov (United States)

We assess 254 consecutive primary total hip replacements (THRs) using a fully hydroxyapatite (HA)-coated stem and socket (Furlong; JRI, London, UK). Minimum follow-up was 10 years. Harris hip score (HHS) increased from 49.8 preoperatively to 86.2 at follow-up. The most remarkable clinical finding was the near absence of thigh pain. After 10 years of follow-up, all stems met stability criteria and none needed revision for aseptic loosening. Three cups (1.2%) were revised for aseptic loosening. Two more cups were revised for recidivant dislocation. Varus placement of the femoral stem was present in 63 hips (24.8%) and valgus in 13 hips (5%). None of these technical defects showed radiologic progression, and there was no measurable correlation between them and the clinical score. Intraoperative femoral fractures occurred in 25 cases (9.8%) with no further influence on implant evolution. These findings strongly support the use of the JRI Furlong system for primary THR because it provides excellent clinical and radiologic results, with 0% and 1.2% cup and stem aseptic loosening, respectively, at 10 years. In addition, its tolerance to technical implantation defects makes it suitable even for less experienced hip surgeons. PMID:20512777

Valera Pertegàs, Màrius; Vergara-Valladolid, Pedro; Crusi-Sererols, Xavier; Sancho-Navarro, Rogelio

2010-01-01

311

Surviving atlanto-occipital dislocation.  

Science.gov (United States)

Traumatic atlanto-occipital dislocation carries a significant mortality and morbidity. We present the clinical and radiological features of a case of traumatic skeletal and central nervous system disunion. Thanks to a combination of early resuscitation and luck, the patient survived an improbably severe injury to leave hospital and enjoy a degree of independent life. Such severe injuries are usually fatal and the literature on such extensive cervical disruption is often confined to postmortem evidence. PMID:17655644

Bloom, Benjamin M; Powell, Bruce P

2007-08-01

312

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

International Nuclear Information System (INIS)

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

313

Traumatic injuries of the hip.  

LENUS (Irish Health Repository)

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.

Marshall, Nina

2009-11-01

314

Genetics Home Reference: Leber congenital amaurosis  

Science.gov (United States)

... literature OMIM Genetic disorder catalog Conditions > Leber congenital amaurosis On this page: Description Genetic changes Inheritance Diagnosis ... definitions Reviewed August 2010 What is Leber congenital amaurosis? Leber congenital amaurosis is an eye disorder that ...

315

The fundamentals of non-singular dislocations in the theory of gradient elasticity: dislocation loops and straight dislocations  

CERN Document Server

The fundamental problem of non-singular dislocations in the framework of the theory of gradient elasticity is presented in this work. Gradient elasticity of Helmholtz type and bi-Helmholtz type are used. A general theory of non-singular dislocations is developed for linearly elastic, infinitely extended, homogeneous, and isotropic media. Dislocation loops and straight dislocations are investigated. Using the theory of gradient elasticity, the non-singular fields which are produced by arbitrary dislocation loops are given. `Modified' Mura, Peach-Koehler, and Burgers formulae are presented in the framework of gradient elasticity theory. These formulae are given in terms of an elementary function, which regularizes the classical expressions, obtained from the Green tensor of the Helmholtz-Navier equation and bi-Helmholtz-Navier equation. Using the mathematical method of Green's functions and the Fourier transform, exact, analytical, and non-singular solutions were found. The obtained dislocation fields are non-s...

Lazar, Markus

2012-01-01

316

Ceramic-on-ceramic total hip arthroplasty: incidence and risk factors of bearing surface-related noises in 125 patients.  

Science.gov (United States)

The ceramic-on-ceramic bearing surface has high wear resistance and good biocompatibility in total hip arthroplasty (THA). However, the postoperative noise problem has been an important issue. The purpose of this retrospective study was to determine the incidence and risk factors of bearing surface-related noises in patients with third-generation ceramic-on-ceramic THAs. One hundred twenty-five patients (143 hips) with ceramic-on-ceramic THAs were included in the study and followed to obtain noise and functional results. Patient factors, including sex, age, height, weight, body mass index, diagnosis, and postoperative range of motion, and surgical factors, including cup inclination, ceramic head size and length, and size of cup related to noises, were recorded. Mean follow-up was 4.2 years (range, 2-10 years). Mean Harris Hip Score was 94 points (range, 68-100 points) at latest follow-up. One (0.8%) patient had radiological evidence of osteolysis, and 4 (3.2%) patients had hip dislocation. No hip sustained a fracture of the ceramic component. Eight (6.4%) patients developed noise at their hips, including clicking in 4, grinding in 2, and snapping in 2. No patient developed squeaking hips or underwent revision surgery because of noisy hips. Younger patients (P=.01), a diagnosis of osteonecrosis (P=.014), a 28-mm ceramic head (P=.042), and a higher hip range of motion postoperatively (P=.001) were related to noise in ceramic-on-ceramic THAs. The study showed third-generation ceramic-on-ceramic THAs had a low incidence of noise problems. However, long-term follow-up is necessary to determine the clinical relevance. PMID:23127446

Kuo, Feng-Chih; Liu, Hao-Chen; Chen, Wun-Schen; Wang, Jun-Wen

2012-11-01

317

Small Incision Total Hip Arthroplasty  

Medline Plus

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 ...

318

Anterior Approach Total Hip Replacement  

Medline Plus

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

319

Anterior Approach Total Hip Replacement  

Medline Plus

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

320

Small Incision Total Hip Arthroplasty  

Medline Plus

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

321

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. ...

322

Small Incision Total Hip Arthroplasty  

Medline Plus

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

323

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... it's called, right before I go to the skin. 00:49:14 PIETER J. HOMMEN, MD: And ... ultimate and the newest panacea to resolve the problem of hip arthritis, and if you really look ...

324

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... mild dysplasia with cystic changes and loss of joint space. No real significant osteophytes we’re going ... inclination to her hips and her slightly dysplastic joint; otherwise having excellent and relatively normal anatomy. Any ...

325

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 ...

326

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... primitive little string how this hip is now compared to what it was before in terms of ... terms of lengthening or shortening the leg as compared to only two or three options with a ...

327

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... yellow wand in his hand, that's a Bovie device, and he can actually very atraumatically go through -- ... Dr. Hommen has a sample of the hip device that I utilize, and I'm putting a ...

328

Small Incision Total Hip Arthroplasty  

Medline Plus

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 ...

329

Small Incision Total Hip Arthroplasty  

Medline Plus

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

330

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... okay, a titanium aluminum alloy type stem as well. All right, and it's got this -- this sort ... expertise in implant surgery. Most orthopedic surgeons are well-trained in doing total hip replacement, and -- but ...

331

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... pain. The hip joint is a ball-and-socket joint that on occasion will carry pretty close ... appreciate on that picture, that's a ball-and-socket. The big long bone is called the femur ...

332

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... bone will be in what we call a bleeding-bed fashion to allow that metal that I' ... keep this hip from developing what's called a hematoma because there will be some bleeding inside after ...

333

Small Incision Total Hip Arthroplasty  

Medline Plus

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

334

Small Incision Total Hip Arthroplasty  

Medline Plus

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

335

Small Incision Total Hip Arthroplasty  

Medline Plus

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

336

Small Incision Total Hip Arthroplasty  

Medline Plus

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

337

Anterior Approach Total Hip Replacement  

Medline Plus

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 ...

338

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... about 36 cases, but that did not include five or six hip cadavers, many of which I ... I think that’s good. I think, you know, five to ten, you’re fairly comfortable with a ...

339

Abstract: Lightweight Authentication for HIP  

Science.gov (United States)

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

Heer, Tobias

340

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available SMALL INCISION TOTAL HIP REPLACEMENT ARTHROPLASTY MERCY HOSPITAL MIAMI, FLORIDA May 3, 2007 00:00:08 ANNOUNCER: Welcome to Mercy Hospital in Miami, Florida. Over the next hour, you will see ...

341

Small Incision Total Hip Arthroplasty  

Medline Plus

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

342

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... arthroscopic hip femoroacetabular impingement resection. Remember, OR-Live makes it easy for you to learn more. Just ... I'm using a regular old saw to make that initial cut. And now I'm able ...

343

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... protruded and/or deformed hip to have to release any posterior capsule. It will come right up ... preserve that. And even if you have to release part of it, you don’t have to ...

344

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... a lot of good questions. A lot of interest in this type of procedure. How many hip ... Avascular necrosis is actually one of my research interests, and it's a disease in which the blood ...

345

Small Incision Total Hip Arthroplasty  

Medline Plus

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 ...

346

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 ...

347

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... the hip would move, okay? It's a very low coefficient of friction and this fits inside the ... a patient not have these huge highs and lows, and therefore they rehab a lot better. Let's ...

348

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... HIP REPLACEMENT ARTHROPLASTY MERCY HOSPITAL MIAMI, FLORIDA May 3, 2007 00:00:08 ANNOUNCER: Welcome to Mercy ... being in some pain for probably two to three weeks after the surgery. Although I have a ...

349

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... intact. I mean there’s a lot of stuff holding this hip in. These people are just totally ... we have a table made by Amsco that works very well for this. Save that. Flip it ...

350

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... hip injuries, are fairly common depending on the type of sports that patients are involved in, anywhere ... what it does is it -- through a certain type of procedure, it's able to prevent the progression ...

351

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... indications and expected outcomes, primarily because of recent advances in surgical instrumentation and techniques. In addition to ... got really bad. One of the most important advances in hip surgery, which I think -- another one? ...

352

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... one-third mat finished. This is a lateralized version, and this is porous plasma spray. It is ... have any adjustment on the femoral side for version. If this was a cemented hip, of course ...

353

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... I don’t think these patients need any postoperative restrictions for the average person. I’m able ... hips. Is she going to get some injectable pain medicine or just oral medicine? We use oral ...

354

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... for most of my primary and even some revision hip procedures. I would like to acknowledge the ... and I’d certainly rather do a modular revision than not. Right. I agree with you. Now ...

355

Fracture After Total Hip Replacement  

Science.gov (United States)

... The same fracture a er treatment with joint revision surgery. Reproduced with permission from Della Valle CJ, Haidukewych GJ, Callaghan JJ: Periprosthetic fractures of the hip and knee: a problem on the rise but better solutions. ...

356

Small Incision Total Hip Arthroplasty  

Medline Plus

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

357

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 ... we call this, this is a fiber-metal titanium shell. If you would show that -- here, this ...

358

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... my colleague, Dr. Carlos Lavernia is here behind me doing a -- about to start a total hip ... anesthetic in these procedures, and what you see me holding in my hand is a local anesthetic ...

359

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... request information" button on your webcast screen and open the door to informed medical care. Now let's ... doing it, but they were doing the procedure open like I'm doing this hip replacement, and ...

360

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... pain. And it can -- it can be as mild as just an occasional groin feeling that something's ... hip disease varies quite a bit from very mild to extremely severe and very, very limiting to -- ...

361

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... we’re doing a right hip. She has mild dysplasia with cystic changes and loss of joint ... different. Yeah. But, you know, even with this mild dysplasia and slight anteversion. Yeah. The point here ...

362

Small Incision Total Hip Arthroplasty  

Medline Plus

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

363

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... during a hip replacement through the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. ... the approach are operating through an internervous and intramuscular anatomic interval. It’s not necessary to detach any ...

364

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... can imagine, the patient's not feeling anything because he is already under a regional block. Everything from ... started. This patient needs a hip replacement because he has a disease called osteoarthritis, which is essentially ...

365

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... of the Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the ... just choice of bearing based on a patient activity? Are you comfortable with the E-poly on ...

366

Dislocation climb in GaAs  

International Nuclear Information System (INIS)

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

367

Mobility laws in dislocation dynamics simulations  

International Nuclear Information System (INIS)

Prediction of the plastic deformation behavior of single crystals based on the collective dynamics of dislocations has been a challenge for computational materials science for a number of years. The difficulty lies in the inability of existing dislocation dynamics (DD) codes to handle a sufficiently large number of dislocation lines, to establish a statistically representative model of crystal plasticity. A new massively parallel DD code is developed that is capable of modeling million-dislocation systems by employing thousands of processors. We discuss an important ingredient of this code - the mobility laws dictating the behavior of individual dislocations. They are materials input for DD simulations and are constructed based on the understanding of dislocation motion at the atomistic level

368

Developmental dysplasia of the hip  

OpenAIRE

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 ...

Haq Nawaz; Kamran Hafeez; Masood Umer; Shahryar Noordin

2010-01-01

369

Mean 5-Year Clinical and Radiographic Outcomes of Cementless Total Hip Arthroplasty in Patients under the Age of 30  

OpenAIRE

We performed a retrospective review of 40 consecutive modern cementless THAs with 65-month mean followup in 34 patients under the age of 30 primarily for diagnoses other than inflammatory arthritis. We found acceptable functional improvement and radiographic outcomes at mean 5-year followup. We found a high transfusion rate, dislocation rate (10%), and midterm overall aseptic revision rate (17%). Twenty-eight (67.5%) of hips in this series were metal on metal, with a large percentage of asept...

Peters, Christopher L.; Pelt, Christopher E.; Gililland, Jeremy M.; Jill Erickson; Anderson, Lucas A.

2013-01-01

370

ELECTRICAL TRANSPORT IN THE DISLOCATION CORE  

OpenAIRE

From our limited knowledge about the core structure and the electronic levels of dislocations in semiconductors and from a theoretical analysis we arrive at the conclusion that one-dimensional conduction in the dislocation core may be expected in a few cases. The problems of experimental detection are discussed. Evidence for this kind of conduction has been obtained or claimed so far from microwave measurements, from D.C.-measurements with microscopie contacts at single dislocations and from ...

Labusch, R.

1983-01-01

371

Modeling of Dislocation Structures in Materials  

OpenAIRE

A phenomenological model of the evolution of an ensemble of interacting dislocations in an isotropic elastic medium is formulated. The line-defect microstructure is described in terms of a spatially coarse-grained order parameter, the dislocation density tensor. The tensor field satisfies a conservation law that derives from the conservation of Burgers vector. Dislocation motion is entirely dissipative and is assumed to be locally driven by the minimization of plastic free e...

Rickman, J. M.; Vinals, Jorge

1996-01-01

372

Room temperature dislocation plasticity in silicon  

Science.gov (United States)

We present direct observations of room temperature dislocation plasticity in single crystalline silicon. Previous studies have shown that phase transformation and fracture are the relevant mechanisms of deformation in silicon. In contrast, using in-situ nanoindentation in a transmission electron microscope we find dislocation nucleation and metal-like flow. The results of finite-element modelling suggest that the presence of free surfaces in our unique sample geometry leads to preferential surface nucleation of dislocations and the suppression of phase transformation.

Minor, A. M.; Lilleodden, E. T.; Jin, M.; Stach, E. A.; Chrzan, D. C.; Morris, J. W.

2005-01-01

373

[Idiopathic chondrolysis of the hip].  

Science.gov (United States)

Between 1993-2003 the authors treated 5 girls with idiopathic chondrolysis of the hip joint. Their mean age at first symptoms were 9 years (range 6-11 years). In all initial symptoms were pain and a hip flexion contracture of a mean 33 degrees (range 30-40 degrees). All were treated with multiple stationary rehabilitation including traction, range of motion exercises, analgetic physical therapy and longlasting walking with crutches. At the follow up examination only one hip was I 10 degree. Remaining 4 children were painfree. In 2 of them an acetabular protrusion, hip joint space narrowing and degenerative changes were observed on anteroposterior radiographs and clinically the hips were stiff in functional position. In the remaining 2 children, the hip range of motion was limited, with 30 and 90 degree of flexion, but joint space became wider on radiographs. Results were bad, because we do not know neither effective causative non symptomatic methods of treatment. Maybe the new technics of treatment, like arthrodiastasis, will bring better results. PMID:16158864

Lejman, Tadeusz; Sulko, Jerzy

2005-01-01

374

Congenital indifference to pain  

Directory of Open Access Journals (Sweden)

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.

Kapasi A

1992-01-01

375

Congenital uveal malignant melanoma.  

Science.gov (United States)

We report the clinical and pathological findings of a rare case of congenital uveal melanoma. A 7-week-old girl presented with history of a black area at the inner corner of her left eye since birth. Examination revealed an enlarged globe with an area of visible uveal pigment nasal to the cornea, an iris mass, and shallow anterior chamber in the left eye. Magnetic resonance imaging revealed an intraocular mass. Enucleation was performed when the girl was 2 months of age. Pathologic examination confirmed a malignant melanoma epithelioid cell type with extraocular extension. She was treated with chemotherapy and subtotal exenteration. PMID:24698625

Pukrushpan, Parnchat; Tulvatana, Wasee; Pittayapongpat, Rosana

2014-04-01

376

Congenital acute megakaryocytic leukemia  

OpenAIRE

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

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

2011-01-01

377

Infantile and congenital hemangiomas.  

Science.gov (United States)

Infantile hemangiomas (IHs) are the most common benign vascular tumors of infancy. Since they predominantly involute without significant residua, the majority do not require treatment. Indications for intervention include ulceration, prevention of disfigurement, and impairment of function or vital structures. Some IHs have associated structural anomalies. When and which IH to treat requires knowledge of the natural history and clinical findings of increased risk. Congenital hemangiomas (CHs) are fully formed at birth. They also differ from IHs in their histological and immunohistochemical findings and thus represent a distinct clinical entity. Their clinical characteristics and management are also discussed. PMID:25241092

Liang, Marilyn G; Frieden, Ilona J

2014-08-01

378

Congenital erythrocyte enzyme deficiencies.  

Science.gov (United States)

Congenital hemolytic anemias resulting from PK, PFK, and G6PD enzyme deficiencies have been reported in domestic animals. Dogs with PFK deficiency may have episodes of intravascular hemolysis with hemoglobinuria in addition to a persistent compensated hemolytic anemia. Patients with mild G6PD deficiency are not anemic but may show increased susceptibility to oxidant-induced erythrocyte injury. Persistent methemoglobinemia has been reported in dogs and cats with methemoglobin reductase enzyme deficiency. Affected animals have cyanotic-appearing mucous membranes but show no or only mild clinical signs attributable to hypoxemia. Enzyme assays are usually done after acquired causes of hemolytic anemia and methemoglobinemia have been ruled out. PMID:8863387

Harvey, J W

1996-09-01

379

REFLECTION ELECTRON-MICROSCOPY OBSERVATIONS OF DISLOCATIONS AND DISLOCATION-MOTION IN ZINC-OXIDE  

OpenAIRE

Low index surfaces of zinc oxide have been examined using reflection electron microscopy (REM). Individual dislocations have been observed and identified using both the diffraction and phase contrast mechanisms. Sub-surface dislocations lying at least 2 ?m beneath the surface have also been imaged. Most of the dislocations lie on the basal plane, but some were also observed on pyramidal planes. Under the action of the incident electron beam, abrupt dislocation motion was observed. This effec...

Peng, L.; Czernuszka, J.

1991-01-01

380

Congenital Median Upper Lip Fistula  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital median upper lip fistula (MULF is an extremely rare condition resulting from abnormal fusion of embryologic structures. We present a new case of congenital medial upper lip fistula located in the midline of the philtrum of a 6 year old girl.

Sajad Ahmad Salati

2012-05-01

381

Congenital Median Upper Lip Fistula  

OpenAIRE

Congenital median upper lip fistula (MULF) is an extremely rare condition resulting from abnormal fusion of embryologic structures. We present a new case of congenital medial upper lip fistula located in the midline of the philtrum of a 6 year old girl.

Sajad Ahmad Salati; Bandar al Aithan

2012-01-01

382

Elasticity and dislocation anelasticity of crystals  

Science.gov (United States)

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

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

383

Dislocation pickling pits near iron grain boundaries  

International Nuclear Information System (INIS)

Distribution of dislocations (DD) in f.c.c. crystals has been studied (using iron as an example). Distribution of rectilinear dislocations close to subboundaries and boundaries of grains has been estimated. It has been shown that dislocation density on grain boundaries is higher than a mean level; but in the region directly close to the boundary it drops abnormally. Selectivity of solubility of dislocation outcome to the surface causes an appearance of wide non-etched zones under the corrosion-electrochemical action on a polycrystal

384

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... to struggle with. Although they do have a power corkscrew, I understand, works much better. Yeah. But ... dislocations aside, what about just choice of bearing based on a patient activity? Are you comfortable with ...

385

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-08-15

386

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

International Nuclear Information System (INIS)

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

387

Congenital Leukemia in Down's syndrome  

International Nuclear Information System (INIS)

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

388

Congenital nystagmus and negative electroretinography  

Directory of Open Access Journals (Sweden)

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

Roussi M

2011-04-01

389

Complications after total hip replacement. Komplikationen nach Hueftgelenksendoprothesen  

Energy Technology Data Exchange (ETDEWEB)

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

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

1989-10-01

390

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

391

Arthroscopic findings after shoulder dislocation  

Directory of Open Access Journals (Sweden)

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.

Medenica Ivica

2009-01-01

392

CURBSIDE CONSULTATION IN HIP ARTHROPLASTY  

Directory of Open Access Journals (Sweden)

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

Scott M. Sporer

2009-03-01

393

Congenital extrahepatic portosystemic shunts  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

2003-09-01

394

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.)

395

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

396

Idiopathic Cardiomyopathy Following Metal-on-Metal Hip Arthroplasty: The New Face of “Beer Drinker’s Cardiomyopathy”  

OpenAIRE

In 1966, the “beer drinker’s cardiomyopathy” was described in Quebec City, Canada among heavy drinkers following the addition of cobalt by breweries for foam stabilisation. Almost half of those affected died. A similar process has been proposed for cardiovascular periprosthetic metallosis in patients receiving cobalt-containing hip prostheses. This case describes a young man with congenital osteonecrosis treated with cobalt containing prosthetic arthroplasty. Postoperatively, he develop...

Erik O’Connell,; Nicolas Mead; Henry Fesniak

2013-01-01

397

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-11-15

398

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

International Nuclear Information System (INIS)

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

399

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

International Nuclear Information System (INIS)

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.

400

Neurologic complications of craniovertebral dislocation.  

Science.gov (United States)

Craniovertebral dislocation is uncommon, but its diagnosis is important taking into account the potential severity of the neurologic complications. A number of causes are known; the most common are Down syndrome, rheumatoid arthritis, Paget's disease, other metabolic bone diseases, and craniocervical trauma. Down's syndrome is a relatively common clinical condition but craniovertebral subluxation is only observed in a small percentage of patients. About half of all cervical spine injuries affect the atlanto-occipital region and C2 vertebra. In rheumatoid arthritis, craniocervical dislocation occurs in up to 40% of patients with severe disease. In Paget's disease, involvement of the craniovertebral region occurs in about 30% of all cases. The clinical neurologic syndrome is characterized by local pain, features of upper spinal cord and medullary compression, positive Lhermitte phenomenon, syncope associated with neck flexion, vertebral artery obstruction or dissection leading to stroke, and asymmetrical lower cranial nerve palsies. Neuroimaging is essential to confirm the clinical diagnosis and to categorize severity. The treatment of this disorder is usually surgical, but traction and external immobilization is relevant in some cases. Specific conditions may require additional treatments such as radiotherapy, antibiotics, or chemotherapy. PMID:24365311

de Carvalho, Mamede; Swash, Michael

2014-01-01

401

The nucleation of dislocation loops  

International Nuclear Information System (INIS)

This experimental work is mainly devoted to the first stages of the interstitial dislocation loops formation. In chapter I what is meant by nucleation of defect aggregates is reviewed. Experimental results on void - and loop - nucleation in quenched aluminium, and stacking fault tetrahedra and Frank loop - nucleation in quenched gold are discussed. In chapters II and III the results of such experiments are described and discussed. Length and resistivity changes of uniaxially stressed molybdenum samples have been recorded during irradiations by fission fragments, in the temperature range 20-30 K. Fifteen deformation vs. dose curves are shown. They are obtained with cold-rolled, and annealed molybdenum ribbons irradiated under fixed and variable stress at fluences up to 1.5 d.p.a. At low temperature there is no steady state creep prior to 1.5 d.p.a. Stress oriented nucleation of the dislocation loops is the predominant primary creep mechanism. The deformation rate values and a simple stress oriented nucleation model are used to determine the interstitial loop nucleus size. In irradiated molybdenum it contains probably less then 10 interstitials

402

On the range of 3D dislocation pair correlations  

OpenAIRE

Numerical studies of dislocation pair correlations have played a central role in deriving a continuum theory from the equations of motion of 2D dislocation systems in a mathematically rigorous way. As part of an effort to extend this theory into the full 3D dislocation problem, 3D dislocation pair correlations were studied with discrete dislocation dynamics simulation. As a first approximation, dislocations were modeled as uncharged curves in space (their Burgers vectors wer...

Csikor, Ferenc F.; Groma, István; Hochrainer, Thomas; Weygand, Daniel; Zaiser, Michael

2008-01-01

403

The interaction of Lomer-Cottrell locks with screw dislocations  

OpenAIRE

Abstract In fcc crystals dislocations are dissociated into partial dislocations and therefore restricted to move on {111} glide planes. By junction reactions with dislocations on two intersecting {111} planes Lomer-Cottrell dislocations along directions can be formed which are barriers for approaching screw dislocations. Treating conventionally the interaction between a dissociated screw dislocation and a LC lock using classical continuum theory assuming the partials to be Vol...

Schoeck, Gunther

2010-01-01

404

Hip Replacement - Multiple Languages: MedlinePlus  

Science.gov (United States)

... JavaScript. Hip Replacement - Multiple Languages Arabic (???????) Bosnian (Bosanski) Chinese - Simplified (????) Chinese - Traditional (????) French (français) ... Arabic) ??????? Bilingual PDF Health Information Translations Bosnian (Bosanski) Total Hip Replacement Potpuna zamjena kuka - Bosanski (Bosnian) ...

405

Analysis of some networks of interfacial dislocations  

International Nuclear Information System (INIS)

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

406

Dislocations in Pt8V ordered alloys  

International Nuclear Information System (INIS)

Platinum 11 at.% vanadium undergoes an ordering transformation to form a Pt8V superlattice. Deformation of the alloy results in the formation of single dislocations or superdislocations, depending on the degree of order. The superdislocations take the form of triple dislocations with a separation of 20 nm in the fully ordered alloy.

407

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.

408

Emerging topics on the hip: Ligamentum teres and hip microinstability  

Energy Technology Data Exchange (ETDEWEB)

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.

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

409

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.

410

A nonsingular solution of the edge dislocation in the gauge theory of dislocations  

CERN Document Server

A (linear) nonsingular solution for the edge dislocation in the translational gauge theory of defects is presented. The stress function method is used and a modified stress function is obtained. All field quantities are globally defined and the solution agrees with the classical solution for the edge dislocation in the far field. The components of the stress, strain, distortion and displacement field are also defined in the dislocation core region and they have no singularity there. The dislocation density, moment and couple stress for an edge dislocation are calculated. The solution for the stress and strain field obtained here is in agreement with those obtained by Gutkin and Aifantis through an analysis of the edge dislocation in the strain gradient elasticity. Additionally, the relation between the gauge theory and Eringen's so-called nonlocal theory of dislocations is given.

Lázár, M

2003-01-01

411

Dislocation Configurations in an Extruded ZK60 Magnesium Alloy  

Science.gov (United States)

Transmission electron microscopy (TEM) was performed to study the types of dislocations and their configurations in a commercially extruded ZK60 magnesium (Mg) alloy. We mainly employed the weak-beam dark-field (WBDF) technique with left dislocations and dislocations were predominant. No was observed. Rearrangement of these dislocations, due to dynamic recovery during extrusion, led to cell walls and low-angle grain boundaries with relatively high density dislocations. Dissociation of the dislocations with a relatively narrow split distance was observed. The dissociated dislocations could form a nodular structure. Fringes of stacking faults from the dislocation dissociation were observed.

Li, B.; Ma, E.; Ramesh, K. T.

2008-11-01

412

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)

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.

Regina Toni Loureiro de Freitas

2005-06-01

413

Developmental dysplasia of the hip  

Directory of Open Access Journals (Sweden)

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.

Haq Nawaz

2010-09-01

414

Transient Osteoporosis of the Hip  

Directory of Open Access Journals (Sweden)

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.   

Farideh Shahandeh

2009-01-01

415

Cellular dislocation patterning during plastic deformation  

Science.gov (United States)

A simulation of dislocation patterning in a two-dimensional multislip configuration is carried out by means of coarse graining in the presence of plastic strain. In order to study the influence of climb on the dislocation cell pattern formation, fatigue simulations with and without climb mobility are performed and compared. The main result is that, in the presence of climb, cellular structures with well-defined characteristic length emerge, in contrast to the self-similar dislocation patterns developing under similar deformation conditions in the absence of climb. Despite the simplicity of our model, the fractal dimension of the self-similar dislocation patterns emerging without climb confirms the previous results for fcc crystals deformed in a multislip configuration. The cell structures emerging when climb is not negligible (in our simulations a climb mobility 1000 times smaller than the glide mobility was considered) resemble the dislocation patterns seen in thermal recovery or melt-grown experiments.

Bakó, Botond; Hoffelner, Wolfgang

2007-12-01

416

Complications of pediatric elbow dislocations and monteggia fracture-dislocations.  

Science.gov (United States)

Pediatric elbow dislocations and Monteggia lesions are prone to acute and chronic complications. A pediatric patient's cartilaginous and unossified distal humerus contributes to the risks of inaccurate diagnoses resulting from the misinterpretation of findings on plain radiographs. The debate continues regarding the amount of acceptable displacement for medial epicondyle fractures. In contrast, the radial head should always point directly to the capitellum. Chronic complications include instability and arthritis. Instability, which can be subtle and difficult to diagnose, can occur in the medial or the posterolateral direction, depending on the injured stabilizer. Restoration of stability remains the mainstay of treatment. Pediatric traumatic arthritis is extremely difficult to manage with surgery because of the limited number of reliable treatment options. PMID:25745932

Kozin, Scott H; Abzug, Joshua M; Safier, Shannon; Herman, Martin J

2015-01-01

417

Congenital pyriform aperture stenosis  

International Nuclear Information System (INIS)

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.)

418

Congenital pyriform aperture stenosis  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

419

Congenital parameatal urethral cyst  

Directory of Open Access Journals (Sweden)

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

U?ur Öztürk

2012-03-01

420

Neutropenias congénitas Congenital neutropenias  

Directory of Open Access Journals (Sweden)

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

Aramís Núñez Quintana

2004-04-01

421

The peritrochanteric space of the hip.  

Science.gov (United States)

The field of hip arthroscopy continues to grow as surgeons become more familiar with disorders of the intra-articular and extra-articular compartments of the hip. Recent studies have described the endoscopic treatment of injuries to the lateral peritrochanteric compartment of the hip, including recalcitrant trochanteric bursitis, external coxa saltans, and tears of the gluteus medius and minimus tendons. PMID:19385533

Voos, James E; Ranawat, Anil S; Kelly, Bryan T

2009-01-01

422

Bone scanning in hip arthroplasty  

International Nuclear Information System (INIS)

Loosening, infection and the presence of heterotopic bone are the most frequent and serious late complications of total hip replacement. Radioisotope methods enable the surgeon to follow-up post-therapy course as early and exactly as possible and sometimes to make differential diagnosis between infected and loose prosthesis. From the diagnostic standpoint, increased radioisotope uptake around the prosthesis component persisting or rising later than the 8th month after surgery is an index of complication. Bimonthly or quarterly examination starting from the 8th month after hip arthroplasty is the best way to follow-up total hip replacement. When femoral shaft, trochanters and acetabulum fail to show any increased activity, this indicates that no complication is present. (author)

423

Radiology of the resurfaced hip  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

424

Hip arthroscopy technique and indications.  

Science.gov (United States)

The recent advances in hip arthroscopy have made it a useful minimally invasive approach to the diagnosis and treatment of intra-articular hip pathology. It offers the benefits of being an outpatient procedure with short rehabilitation and few reported complications and does not hinder opportunities for future surgical interventions. The lateral approach has been widely accepted, and technical details are discussed. Patients typically present with mechanical symptoms and persistent pain resistant to a reasonable trial of conservative treatment and are without significant joint space narrowing. Indications include debridement of labral lesions and loose bodies as well as treatment of impingement syndrome and avascular necrosis. Arthroscopy has also proven a useful tool in evaluation components in symptomatic patients after hip arthroplasty and in the treatment of native and replacement joint infections. PMID:16781433

Diulus, Carrie A; Krebs, Viktor E; Hanna, George; Barsoum, Wael K

2006-06-01

425

Idiopathic chondrolysis of the hip.  

Science.gov (United States)

Idiopathic chondrolysis of the hip is a rare disease in which gradual necrosis of the hyaline cartilage covering the femoral head and acetabulum leads to joint space narrowing and motion restriction. Pain, motion range limitation, and radiographic joint space narrowing are the main manifestations. We report 2 cases in 15-year-old girls, one black and the other Caucasian. Unexplained pain and motion restriction in the left hip were the presenting manifestations. Narrowing of the hip joint space was noted on standard radiographs. Magnetic resonance imaging showed a joint effusion in 1 patient and unevenness of the femoral head contour in the other. Laboratory tests including microbiological studies were normal or negative. Nonspecific synovitis was found in biopsy specimens. Immobilization and traction were the main components of the treatment strategy. PMID:17892963

Mounach, Aziza; Nouijai, Abderrazak; Ghozlani, Imad; Ghazi, Miriam; Bezza, Ahmed; Achemlal, Lahcen; El Maghraoui, Abdellah

2007-12-01

426

Long-Term Effectiveness of Total Hip Replacement with the Collum Femoris Preserving Prosthesis.  

Science.gov (United States)

The objective of this study was to follow-up long term (5-12 years) patients with total hip arthroplasty with the collum femoris preserving prosthesis to evaluate clinical outcome and potential complications. Forty-six of 152 patients who underwent this procedure between September 2000 and September 2012 were followed up. The average follow-up time was 7.6 years, and assessed were radiographs, Harris score, limb length, hip function, and complications. Six patients had perioperative complications including five cases of femoral shaft fracture and one case of dislocation 1 week after the operation. No infections of the surgical site, no deep venous thrombosis or pulmonary embolism were observed. The last recorded Harris hip score improved from a preoperative average of 41.2 (range 17-60) to an average of 82.3 (74-96), with the score >80 in 38 patients, 70-80 in six patients, and neck. Total hip arthroplasty with the collum femoris preserving prosthesis is a good option for younger patients who need prosthesis revision. This arthroplasty achieves satisfactory long-term effectiveness. PMID:25480429

You, Rui-Jin; Zheng, Wen-Zhong; Chen, Kun; Lv, Hong-Sheng; Huang, Dian-Feng; Xiao, Yi-Zeng; Yang, De-Yu; Su, Zhai-Quan

2014-12-01

427

Medium-term results of a modern metal-on-metal system in total hip replacement.  

Science.gov (United States)

Since 1988, metal-on-metal articulation from cobalt-chromium-molybdenum alloy was reintroduced into hip arthroplasty as an alternative to metal-on-polyethylene or ceramic-on-polyethylene components. Modular joint surfaces were developed for the second generation metal-on-metal articulation using newly introduced and proven prosthetic implants. Since 1990, 78 patients with 78 uncemented total hip replacements were followed up in a prospective study. The mean followup was 60 months. Three patients were lost to followup. The average age of the patients at the time of surgery was 48.8 years. Thirty-three patients had been operated on previously. No early infections occurred; one late infection occurred after 3 years. Dislocation of the prosthesis occurred in one patient who was lost to followup. In two patients ectopic ossifications were removed 17 and 27 months postoperatively. At revision surgery no metallosis could be identified. At the last followup examination, the Harris hip score was 96.8 points on average. There was no evidence that the metal-on-metal articulation gave rise to new problems or complications. Metal-on-metal articulation reduced wear considerably in the authors' previous experience. It is hoped that foreign body reactions are reduced significantly so that an alternative for total hip replacement in younger and active patients will be available. PMID:11039799

Wagner, M; Wagner, H

2000-10-01

428

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

DEFF Research Database (Denmark)

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.

Lauritzen, J B

1997-01-01

429

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

430

Radiographic evaluation of hip implants.  

Science.gov (United States)

Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs. This article addresses the role of radiography following hip arthroplasty. PMID:25633021

Chang, Connie Y; Huang, Ambrose J; Palmer, William E

2015-02-01

431

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)

432

Mortality, morbidity, and 1-year outcomes of primary elective total hip arthroplasty.  

OpenAIRE

No representative data exist on the risks of adverse outcomes of total hip arthroplasty (THA) in the United Kingdom. A prospective observational study of unselected THA operations was carried out in 5 U.K. regions. Adverse outcomes were assessed from the hospital case notes and general practitioners of 1,100 randomly selected patients and from 7,151 patient-completed questionnaires 3 and 12 months after THA. Three-month mortality was 0.4% to 0.7%. Dislocation and thromboembolic complications ...

Williams, O.; Fitzpatrick, R.; Hajat, S.; Reeves, Bc; Stimpson, A.; Morris, Rw; Murray, Dw; Rigge, M.; Gregg, Pj

2002-01-01

433

Diffusion along and around dislocations  

International Nuclear Information System (INIS)

We have gathered together in this text some solutions for Fick's equations applicable to diffusion in dislocations. The problems is fairly similar to that of grain boundaries but in this case a further difficulty arises, purely mathematical in fact, due to the supposedly cylindrical shape of the perturbed region around a dislocation. It follows that Fick's equation is used in the form: ?C/?t=D[?2C/?r2+1/r?C/? r + ?2C/?z2] in order to express simply the limiting conditions and so that the solution takes into account the symmetry of revolution of the system. This very much complicates the final form of the results. We give here as an illustration a solution obtained using the same hypotheses and making the same approximations as those employed by WHIPPLE for his grain boundary work. Unfortunately the final form is not suitable for a numerical calculation. By making grosser approximations, such a those used by FISHER, it is possible to determine the parameter D/(a2D'); the same result as for grain boundary is found i.e that the logarithm of the mean concentration varies linearly with penetration, the slope of this straight line is proportional to ?(D/(a2D')) Finally we give the exact solution for a platelet of finite thickness assuming that the diffusion in the defect less crystal is negligible and that the surface diffusion is infinitely fast. This is the problem dealt with by HENDRIGKSON and MACHLIN. We arrive at conclusions different to those obtained by these two authors. (author)

434

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

Energy Technology Data Exchange (ETDEWEB)

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.

Qian Chen

2008-08-18

435

Congenital nystagmus and negative electroretinography  

OpenAIRE

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 mon...

Roussi M; Dalens H; Jj, Marcellier; Bacin F

2011-01-01

436

Congenital malaria in Urabá, Colombia  

OpenAIRE

Abstract Background Congenital malaria has been considered a rare event; however, recent reports have shown frequencies ranging from 3% to 54.2% among newborns of mothers who had suffered malaria during pregnancy. There are only a few references concerning the epidemiological impact of this entity in Latin-America and Colombia. Objective The aim of the study was to measure the prevalence of congenital malaria in an endemic Colombian region and to determine some of its characteristics. Methods...

Arboleda Margarita; Tobón Alberto; Álvarez Gonzalo; Piñeros-Jiménez Juan G; Carrero Sonia; Blair Silvia

2011-01-01

437

Population screening for congenital hypothyroidism.  

OpenAIRE

A pilot screening programme for congenital hypothyroidism covering most of North London, Essex, Bedfordshire, and Hertfordshire entailed carrying out an assay of thyroid-stimulating hormone on single Guthrie dried blood spots. During one year 87 444 babies were screened and 26 cases of primary congenital hypothyroidism detected, giving an incidence of 1:3363. Only two cases (7.7%) had already been diagnosed on clinical grounds before the results of screening became available. In two other bab...

Hulse, J. A.; Grant, D. B.; Clayton, B. E.; Lilly, P.; Jackson, D.; Spracklan, A.; Edwards, R. W.; Nurse, D.

1980-01-01

438

Congenital and perinatal cytomegalovirus infection  

OpenAIRE

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 involvem...

Chun Soo Kim

2010-01-01

439

Congenital trochlear-oculomotor synkinesis.  

Science.gov (United States)

Synkinesis of the extraocular muscles forms a subset of congenital ocular motility abnormalities termed congenital cranial dysinnervation disorders. Synkinesis most frequently involves the abducens or oculomotor nerves and rarely the trochlear nerve. Only 3 such patients have been described in the literature. We report an isolated case of trochlear-oculomotor synkinesis in a healthy 6-year-old boy and discuss the proposed pathophysiology of this disorder. PMID:24413161

Bursztyn, Lulu L C D; Makar, Inas

2014-03-01

440

Cumulative Hip Contact Stress Predicts Osteoarthritis in DDH  

OpenAIRE

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 ...

Mavc?ic?, Blaz?; Iglic?, Ales?; Kralj-iglic?, Veronika; Brand, Richard A.; Vengust, Rok

2008-01-01

441

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)

442

Thermodynamic forces in single crystals with dislocations  

Science.gov (United States)

A simple model for the evolution of macroscopic dislocation regions in a single crystal is presented. This model relies on maximal dissipation principle within Kröner's geometric description of the dislocated crystal. Mathematical methods and tools from shape optimization theory provide equilibrium relations at the dislocation front, similarly to previous work achieved on damage modelling (J Comput Phys 33(16):5010-5044, 2011). The deformation state variable is the incompatible strain as related to the dislocation density tensor by a relation involving the Ricci curvature of the crystal underlying elastic metric. The time evolution of the model variables follows from a novel interpretation of the Einstein-Hilbert flow in terms of dislocation microstructure energy. This flow is interpreted as the dissipation of non-conservative dislocations, due to the climb mechanism, modelled by an average effect of mesoscopic dislocations moving normal to their glide planes by adding or removing points defects. The model equations are a fourth-order tensor parabolic equation involving the operator "incompatibility," here appearing as a tensorial counterpart of the scalar Laplacian. This work encompasses and generalizes results previously announced (C R Acad Sci Paris Ser I 349:923-927, 2011), with in addition a series of physical interpretations to give a meaning to the newly introduced concepts.

Van Goethem, Nicolas

2014-06-01

443

Chronic bilateral dislocation of temporomandibular joint.  

Science.gov (United States)

Dislocation of the condyle of the mandible is a common condition that may occur in an acute or chronic form. It is characterised by inability to close the mouth with or without pain. Dislocation has to be differentiated from subluxation which is a self reducible condition. Dislocation can occur in any direction with anterior dislocation being the commonest one. Various predisposing factors have been associated with dislocation like muscle fatigue and spasm, the defect in the bony surface like shallow articular eminence, and laxity of the capsular ligament. People with defect in collagen synthesis like Ehler Danlos syndrome, Marfan syndrome are said to be genetically predisposed to this condition. Various treatment modalities have been used ranging from conservative techniques to surgical methods. Acute dislocations can be reduced manually or with conservative approach and recurrent and chronic cases can be reduced by surgical intervention. Though the dislocation in our case was 4 months a simple manual reduction proved to be successful. We believe that manual reduction can be attempted as first line of treatment prior to surgical intervention. PMID:21209547

Shakya, S; Ongole, R; Sumanth, K N; Denny, C E

2010-01-01

444

Congenital and perinatal cytomegalovirus infection  

Directory of Open Access Journals (Sweden)

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.

Chun Soo Kim

2010-01-01

445

Dislocations and properties of real metals  

International Nuclear Information System (INIS)

These paper were presented at the commemorative meeting held to mark the fiftieth anniversary of the concept of dislocations in crystals. The word ''real'' was used in the title of the conference in order to emphasize the role played by the concept of dislocations in enlarging our understanding of everyday materials. The aim of the meeting was to highlight the important contribution made by the experimental and theoretical study of dislocations to our knowledge of the behaviour of materials, and to look to future developments in the subject. (author)

446

Electron paramagnetic resonance at dislocations in germanium  

International Nuclear Information System (INIS)

The first observation of the paramagnetic resonance of electrons at dislocations in germanium single crystals is reported. Under subband gap optical excitation, two sets of lines are detected: four lines about the axes with g/sub perpendicular to/ = 0.34 and g/sub parallel/ = 1.94, and 24 lines with g/sub perpendicular to/ = 0.73 and g/sub parallel/ = 1.89 about axes with the six-fold 1.20 distortion. This represents the first measurement of the disortion angle of a dislocation dangling bond. The possibility that the distortion results from a Peierls transition along the dislocation line is discussed

447

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.

448

Dislocation interactions in the presence of cracks  

International Nuclear Information System (INIS)

The elastic interaction between dislocations is affected by the presence of surfaces, cracks, etc., which introduce a variety of image-like effects. In deriving analytic expressions for the forces on dislocations in two-dimensional elastic mediums, it is convenient to introduce the Goursat potentials. In terms of these potentials, forces on the dislocations can be expressed relatively simply in terms of the residues of the complex potential functions. The potentials must then be found by any of the standard techniques of analysis

449

Elasticity and dislocation inelasticity of crystals  

Science.gov (United States)

The use of methods of physical acoustics for studying the elasticity and dislocation inelasticity of crystals is discussed, as is the application of the results of such studies to the analysis of interatomic and lattice defect interactions. The analysis of the potential functions determining the energy of interatomic interactions is based on an analysis of the elastic properties of crystals over a wide temperature range. The data on the dislocation structure and the interaction between dislocations and point defects are obtained from a study of inelastic effects. Particular attention is given to the relationship between microplastic effects under conditions of elastic oscillations and the initial stage of plastic deformation.

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

450

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... any kind of cartilage-regrowing type techniques. 00:16:18 CARLOS J. LAVERNIA, MD, FAAOS: Now I' ... labrum here from the hip joint. 00:21:16 CARLOS J. LAVERNIA, MD, FAAOS: Okay, we're -- ...

451

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... and I’m able to use a modern generation highly cross-linked, highly eradiated, and then vitamin ... commode. Delta ceramic hip, this is the next generation ceramic. 32 enlarger, there’s been no reported fractures. ...

452

Anterior Approach Total Hip Replacement  

Medline Plus

Full Text Available ... my hands, I thought it was about 36 cases, but that did not include five or six hip cadavers, many of which I did with you, Roger. So now I’ve pretreated the capsule. Yeah, that’s important. You were treating that capsule there. Right. And ...

453

Small Incision Total Hip Arthroplasty  

Medline Plus

Full Text Available ... hip arthroplasty surgery. This is a very special program. Not only are we broadcasting this in English ... something relatively new. When I was doing my training in orthopedics, that ... he's doing a great job, almost a completely cosmetic type procedure, and do ...