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1

Screening for congenital dislocation of the hip  

International Nuclear Information System (INIS)

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

1985-12-03

2

Hip dislocation during lengthening of congenital short femur.  

Science.gov (United States)

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

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

2012-05-01

3

MR imaging evaluation of persistent congenital hip dislocation in children  

International Nuclear Information System (INIS)

Persistent congenital hip dislocation is unusual in older children, and closed reduction or surgery is required for treatment. Magnetic resonance (MR) imaging at 1.0 T was performed in children with congenital dislocation, and different pulse sequences were employed to determine the optimal MR imaging technique. Spin-echo T1-weighted balanced, and T2-weighted images as well as partial-flip-angle gradient-moment-refocused field-echo (FLASH [fast low-angle shot]-type) images with various flip angles were obtained with a 17-cm Helmholtz coil. The MR findings were correlated with the surgical and arthrographic findings. Results of the first five cases indicate that the FLASH-type sequences are useful for assessing structures of the hip joint because of high signal-to-noise ratio and good contrast between articular and fibrous cartilage

1988-12-02

4

Weaver syndrome associated with bilateral congenital hip and unilateral subtalar dislocation  

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Background: Weaver syndrome is a congenital paediatric syndrome characterized by mental, respiratory and musculo-skeletal manifestations. The coexisting deformities of the skull, the face, fngers and toes are typical. We report a case of a girl with Weaver syndrome associated with rare bilateral congenital dislocation of the hips associated with congenital hypoplastic talus and subtalar dislocation of her ankle joint. Case Report: A 3-year old girl was admitted in our department with typical ...

Mikalef, Petros; Beslikas, T.; Gigis, I.; Bisbinas, I.; Papageorgiou, T.; Christoforides, I.

2013-01-01

5

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

Science.gov (United States)

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

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

1990-01-01

6

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

Science.gov (United States)

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

Lokietek, W; Legaye, J

1990-01-01

7

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

Directory of Open Access Journals (Sweden)

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

Mukesh Tiwari

2013-04-01

8

Computed tomography in congenital hip dislocation. The role of acetabular anteversion  

International Nuclear Information System (INIS)

Computed tomography usually can provide accurate documentation of the adequacy of a reduction in congenital dislocation of the hip. It should supplement other radiographic examinations when the status of a reduction is in question because the patient is wearing a plaster cast. The computed tomography scan provides a clear image of the reduction in the transverse plane, so that anterior or posterior subluxation of the femoral head can be easily detected. In addition it allows direct measurement of acetabular anteversion which previously had not been possible with non-invasive studies in the living patient. Radiation exposure is less than that for conventional tomography. We used computed tomography in five patients with congenital dislocation of the hip and our study provided new evidence concerning the role of acetabular anteversion in this condition. Acetabular anteversion was increased on the dislocated side in each patient, and returned to normal as treatment progressed

1982-01-01

9

Early diagnosis of congenital dislocation of the hip  

International Nuclear Information System (INIS)

Neonatal hip examination is only effective with the help of a large number of experts. Teamwork between pediatrician, pediatric orthopedic surgeon and general practitioner seems to be essential. Best results can be achieved with a hip examination during the first 4 days of life and controls with 3 months and with 12 months. The technic of clinical examination and diagnosis is described. Because of hip dysplasias without any clinical signs the importance of an x-ray of the hip with an age of 3 months is emphasized. (Author)

1984-01-01

10

A new open reduction treatment for congenital hip dislocation: long-term follow-up of the extensive anterolateral approach.  

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Congenital hip dislocation, which is conservatively unmanageable, has usually been treated using open reduction. However, a long-term follow-up study of the results suggests that this procedure is unsatisfactory. Since 1973, Tanabe has used a new open reduction procedure that circumferentially dissects the joint capsule and produces sufficient concentric reduction of the femoral head in the acetabulum immediately after the surgery. Fifty-six children (65 hips) from the age of 1 to 3 years wer...

Akazawa, Hirofumi; Tanabe, Gozo; Miyake, Yoshimasa

1990-01-01

11

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

12

Dislocation After Total Hip Replacement  

Medline Plus

Full Text Available ... them. For example, you may need to learn new ways to bend down that prevent your hip ... dislocating. Dislocation is when the ball of the new hip implant comes out of the socket. Dislocation ...

13

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

Energy Technology Data Exchange (ETDEWEB)

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

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

1982-08-01

14

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

Science.gov (United States)

The iliopsoas tendon can interpose between the femoral head and the acetabulum, preventing reduction or stability of reduction of a dislocated hip by a closed method. The tendon produces an infolding of the capsule and labrum. This infolding of the capsule and labrum creates an "isthmus" between the capital and the acetabular parts of the capsule. This deformity of the capsule was recognizable on computed tomography (CT) in 10 patients, all of whom had surgical confirmation of the findings. The presence of hypertrophied pulvinar can also be recognized by CT. PMID:6979888

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

1982-08-01

15

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

International Nuclear Information System (INIS)

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

1982-01-01

16

Dislocation After Total Hip Replacement  

Medline Plus

Full Text Available ... is when the ball of the new hip implant comes out of the socket. Dislocation is uncommon. ... orthoinfo.aaos.org/topic.cfm?topic=A00356) Hip Implants Hip Implants (http://orthoinfo.aaos.org/topic.cfm? ...

17

[Dislocations hip arthroplasty].  

Science.gov (United States)

The authors present analysis of dislocation following hip arthroplasty based on their own clinical material of 1985-2005 year. It contain 2712 cases of total hip arthroplasty, 2171 (80.1%) cases were cemented including 64 (2.4%) cases of revised arthroplasty, 541 (19.9%) cases were cement-free stabilized including 7 (0.2%) cases of revised arthroplasty. Obtained outcomes of analysis permit to make assertion that dislocation following hip arthroplasty occurred during first three month after surgery, more frequently in case of revised arthroplasty and following fractures of femoral neck. Requirement of success is appropriate steady of implant and right done supervision of rehabilitation with learned necessary motoric behaviors. PMID:17131724

Golec, Edward; Nowak, Sebastian; Golec, Joanna; Abrowski, Janusz; Jasiak-Tyrkalska, Bozena

2006-01-01

18

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

1982-01-01

19

Dislocation After Total Hip Replacement  

Medline Plus

Full Text Available ... 2012 American Academy of Orthopaedic Surgeons Dislocation After Total Hip Replacement After a total hip replacement, you will be able to resume most ... provides more information about preventing dislocation after a total hip replacement. Last reviewed: December 2012 AAOS does not ...

20

Hip dislocations in chronic osteomyelitis.  

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We present two cases of spontaneous dislocation of the hip joint due to chronic osteomyelitis of the upper femur. Spontaneous hip dislocations occur in certain pathological conditions such as poliomyelitis (Ingram, 1980), cerebral palsy (Howard et al., 1985), osteomyelitis and neurofibromatosis.

Onuba, O.; Langa, J.

1991-01-01

 
 
 
 
21

Morphology of untreated bilateral congenital dislocation of the hips in a seventy-four-year-old man.  

Science.gov (United States)

Two untreated completely dislocated hips were examined pathologically in a 74-year-old male dissecting room cadaver. The femoral heads bilaterally were 9 cm above the acetabular fossae. They lay adjacent to each ilium with no secondary acetabulum formation. A thickened and markedly elongated fibrous capsule appeared to be the major structure that had checked further migration of the femoral heads during weight-bearing. The femoral heads, although slightly flattened medially and somewhat smaller in size than in the normal adult, showed no degenerative arthritis. Dysplastic acetabular fossae were filled with soft tissue. Bone-to-bone contact with secondary degenerative changes was present only where the femurs, at the level of the lesser trochanters, rubbed against the overhanging superior acetabular rims. PMID:954300

Milgram, J W

1976-09-01

22

[Dislocation after total hip arthroplasty].  

Science.gov (United States)

Dislocations after total hip arthroplasties are one of the most common complications of the procedure. According to registers, recurrent hip dislocations account for up to 30 % of the indications for a revision operation. The incidence of a dislocation is influenced by indication-associated, patient-dependent and operation-specific risk factors. 50 % of the dislocations occur within the first 3 months which confirms the high relevance of operation-specific influencing factors. The diagnosis is almost always made with the help of computed tomography, as this is the only method to determine the three-dimensional relationship of the components. A dynamic fluoroscopic examination can verify an increased translation (reduced soft-tissue tension) and thus enables a functional examination to determine the mechanism of the dislocation. By means of a classification of dislocations into five types under consideration of the implant position, the sufficiency of the pelvitrochantar musculature, the presence of an impingement, the congruence of head and acetabular liner as well as combinations of these factors it is possible to plan an adequate therapy. From the therapeutic point of view the correct positioning of the stem and head is of decisive importance. In addition therapeutic success can be realized by using larger head diameters through to tripolar sockets, reconstruction of soft tissues and, last but not least, an adequate postoperative immobilization. Even so, this treatment is associated with a high rate of complications and in the literature failure rates of up to one third, i.e., the reoccurrence of a dislocation, are reported. PMID:22498843

Perka, C; Haschke, F; Tohtz, S

2012-04-01

23

Dislocation After Total Hip Replacement  

Medline Plus

Full Text Available ... Related Links Total Hip Replacement Total Hip Replacement (http://orthoinfo.aaos.org/topic.cfm?topic=A00377) Activities After Hip Replacement Activities After Hip Replacement (http://orthoinfo.aaos.org/topic.cfm?topic=A00356) Hip ...

24

Anterior Hip Dislocation in a Football Player: A Case Report  

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Hip dislocations during sporting activities represent only 2%–5% of all hip dislocations. Most hip dislocations in sports can be categorised as “less complicated traumatic hip dislocations” by the Stewart-Milford classification due to the fact that minimal force is involved. The incidence of avascular necrosis of the femoral head greatly increases if the time to reduction is more than six hours. We report the case of a 38-year-old football player who suffered hip dislocation while kicki...

2009-01-01

25

Tripolar hip replacement for recurrent prosthetic dislocation.  

Science.gov (United States)

An innovative treatment is described for unstable total hip arthroplasty that uses a large inside diameter acetabular cup and a bipolar femoral head sized to approximate the diameter of the normal hip. Eight consecutive patients with recurrent prosthetic dislocations were treated with this tripolar hip. Joint stability was achieved in all patients, who have an average of 4.2-years' followup (range, 2.6-6.3 years). PMID:8020207

Grigoris, P; Grecula, M J; Amstutz, H C

1994-07-01

26

Dislocation After Total Hip Replacement  

Medline Plus

Full Text Available ... Wrist Hip & Thigh Knee & Lower Leg Foot & Ankle Neck & Back Health Centers Broken Bones & Injuries Diseases & Conditions Arthritis Tumors Sports Injuries & Prevention Children ...

27

Computed tomography arthrography in traumatic hip dislocation  

International Nuclear Information System (INIS)

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

1989-01-01

28

Painful Spastic Hip Dislocation: Proximal Femoral Resection  

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The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

Albin?ana, Javier; Gonzalez-moran, Gaspar

2002-01-01

29

Dislocation After Total Hip Replacement  

Science.gov (United States)

... Module: Total Hip Replacement (http://www5.aaos.org/icm/default.cfm?screen=icm001_s01_p1) OrthoInfo The ... Module: Total Hip Replacement (http://www5.aaos.org/icm/default.cfm?screen=icm001_s01_p1) Editorial Board & ...

30

Dislocation After Total Hip Replacement  

Medline Plus

Full Text Available ... Module: Total Hip Replacement (http://www5.aaos.org/icm/default.cfm?screen=icm001_s01_p1) OrthoInfo The ... Module: Total Hip Replacement (http://www5.aaos.org/icm/default.cfm?screen=icm001_s01_p1) Editorial Board & ...

31

Dislocation After Total Hip Replacement  

Medline Plus

Full Text Available ... do them. For example, you may need to learn new ways to bend down that prevent your ... orthoinfo.aaos.org/topic.cfm?topic=A00303) Patient Learning Module: Total Hip Replacement Patient Learning Module: Total ...

32

Bilateral traumatic anterior hip dislocation--a case report.  

Science.gov (United States)

We report a 33-year-old trader with bilateral traumatic anterior hip dislocation following a road traffic accident. Both hip dislocations were reduced under general anesthesia followed by immobilization of the hips with skin traction. He discharged himself against medical advice one week after injury. PMID:16276711

Akinyoola, A L; Abiodun, A A

2005-01-01

33

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

34

Painful spastic hip dislocation: proximal femoral resection.  

Science.gov (United States)

The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despite routine post-operative skeletal traction in all cases and careful soft tissue interposition. One case showed significant heterotopic ossification which restricted prolonged sitting. This patient needed some occasional medication for pain. PMID:12180614

Albiñana, Javier; Gonzalez-Moran, Gaspar

2002-01-01

35

CT findings of traumatic posterior hip dislocation after reduction  

International Nuclear Information System (INIS)

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

2008-06-01

36

Potential contribution of femoroacetabular impingement to recurrent traumatic hip dislocation.  

Science.gov (United States)

A 16-year-old boy sustained a traumatic posterior dislocation of the right hip. After initial closed reduction, the hip spontaneously redislocated within 2 days. Four days after the initial dislocation, the patient was transferred to the authors' institution, where a radiographic workup showed a severe capsular and labral disruption from the posterior aspect of the acetabulum. Subsequently, the patient underwent operative treatment using the technique of surgical hip dislocation through a digastric osteotomy as described by Ganz. Using this approach, the avulsed capsulolabral complex as well as the pathological head-neck junction, which is suspected to be a lever for the femoral head, could be fully addressed. The authors recommend further radiographic studies to evaluate the underlying pathology in traumatic dislocation of the hip as well as the described surgical approach, which leads to successful treatment of the entire pathology. PMID:22871962

Manner, Hans M; Mast, Nicholas H; Ganz, Reinhold; Leunig, Michael

2012-11-01

37

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

38

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

Science.gov (United States)

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

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

1991-04-01

39

The dislocating hip: what to do, what to do.  

Science.gov (United States)

Dislocation complicates between 1% and 3% of primary total hip arthroplasties (THAs) and 7% to 10% of revision procedures. Sixty percent of dislocations occur within the first 5 weeks. Closed reduction is successful in 67% of cases. If the hip keeps dislocating, revision surgery for instability is successful in only about 61% of patients. Many successful techniques have been described to deal with recurrent instability, including trochanteric advancement, modular component exchange, jumbo femoral heads, a bipolar or tripolar arthroplasty, or a constrained acetabular component. This article discusses the results of various surgical interventions and presents a treatment algorithm. PMID:15190564

Bourne, Robert B; Mehin, Ramin

2004-06-01

40

Bone grafting in cementless total hip replacement for congenital dysplasia of the hip  

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We reviewed 27 cementless primary total hip replacements in patients with osteoarthrosis secondary to congenital dysplasia of the hip. Autogenous bone grafting was used as augmentation. On average the follow-up period was 9 years. Two hips were revised and three acetabular components were considered loose. In hips with loose cups the average graft coverage was significantly greater than in stable hips. The use of a cementless acetabular component is encouraging for reconstruction, although ex...

Dai, X.; Omori, H.; Okumura, Y.; Ando, M.; Oki, H.; Hashimoto, N.; Baba, H.

2000-01-01

 
 
 
 
41

Delayed diagnosis of traumatic hip dislocation mimicking Perthes disease in a child  

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Traumatic hip dislocations in children are uncommon, yet even trivial injuries may result in dislocation. Avascular necrosis (AVN) occurs in 3–6% of dislocations if reduction is performed within the first 4 h, however, the incidence rises to 66% if the reduction is performed 24 h after dislocation. Awareness and early identification is therefore critical to long term prognosis. The authors report a case of a relatively trivial trauma resulting in hip dislocation in a 5-year-old boy. This ca...

2011-01-01

42

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

43

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

44

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Introduction: Bilateral hip dislocation (especially asymmetric type) occurs rarely. By review of literature (published since 1951 till 2004), we found 15 cases of bilateral asymmetric hip dislocation (age between 3 and 36 years) that contained 12 cases in males. All of the patients were treated using closed reduction and then traction. There was no considerable difference between the results of treatment in these patients and unilateral hip dislocations.Case Report: The case was a 39 years o...

2006-01-01

45

[Congenital knee dislocation in Larsen syndrome treated by arthroplasty].  

Science.gov (United States)

A 59-year-old woman with bilateral congenital knee dislocation due to Larsen syndrome was treated by arthroplasty. To prevent neurovascular deficiency and major loss of bone substance, a continuous joint distraction was performed by unilateral external fixation. After a period of 25 days and a leg lengthening of 4.5 cm, a constrained total knee endoprosthesis was implanted. Both operations and their postoperative courses were free of complications. A previously planned lengthening of the Achilles tendon was unnecessary. PMID:20091295

Müller, M; Strecker, W

2010-04-01

46

Total hip arthroplasty in high dislocated and severely dysplastic septic hip sequelae.  

Science.gov (United States)

The authors analyzed a consecutive series of 20 total hip arthroplasties performed using a cementless conical stem with shortening osteotomy combined with greater trochanter transfer in cases with a highly dislocated hip secondary to sequelae of a septic hip in childhood. Mean patient age was 47.3 years and the mean follow-up period was 3.4 years. An acetabular metal cup was inserted in 5 cases, and only a liner was inserted after cementing in 15 cases. Mean Harris hip score improved from 42.4 preoperatively to 84.2 at final follow-up. Mean leg lengthening was 36.5 mm, and time to greater trochanter union was 3.72 months. No complete radiolucent line of thickness >2 mm was observed in any case. These surgical methods produced satisfactory clinical and radiological results. PMID:22209158

Park, Kyung-Soon; Yoon, Taek-Rim; Song, Eun-Kyoo; Seon, Jong-Keun; Lee, Keun-Bae

2012-08-01

47

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

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

Erdil Mehmet

2012-07-01

48

Surgical treatment of developmental hip dislocation in children aged 1 to 3 years: a mean 18-year, 9-month follow-up study.  

Science.gov (United States)

Forty-six consecutive patients with 57 congenitally dislocated hips were treated with open reduction and femoral or acetabular procedures as indicated. Patient age ranged from 12 to 36 months at the time of surgery. We evaluated the outcome of 38 of the 46 patients (83%) with 47 hips (83%) at a mean follow-up of 18 years, 9 months (range, 13 years, 7 months to 24 years, 7 months) after all patients had reached skeletal maturity.Using Severin's radiographic classification, 24 hips (52%) were rated as class I, 12 (26%) as class II, 8 (17%) as class III, 2 (4%) as class IV, and 0 as class V. The mean Iowa Hip Score was 92 points. One patient had significant abductor weakness and a Trendelenburg gait. The mean leg-length discrepancy was <1 cm. Disturbance in growth of the proximal aspect of the femur occurred in 10 hips (22%).In our experience, open reduction of the congenitally dislocated hip in children aged 1 to 3 years, combined with femoral or acetabular procedures, leads to successful clinical and radiographic results in most cases. These patients have an opportunity for normal hip function during childhood and the potential for a straightforward reconstructive procedure should they develop severe degenerative hip arthrosis. PMID:20349870

Varner, Kevin E; Incavo, Stephen J; Haynes, Richard J; Dickson, Jesse H

2010-03-01

49

Successful closed reduction after adductor tenotomy in a 14-year-old boy with chronic hip dislocation in Down syndrome.  

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Dislocation or subluxation of the hip is considered as the most common hip problem in patients with Down syndrome. Recommended treatment of chronic dislocation treatment is open reduction combined with femoral and/or pelvis osteotomies. We report a Down syndrome child with chronic hip dislocation who was successfully treated with adductor tenotomy and closed reduction, which has not been reported previously. PMID:24445537

Sadeghilar, Aidin; Rashid, Abdul Halim A; Ibrahim, Sharaf

2014-05-01

50

Successful Closed Reduction of a Dislocated Constrained Total Hip Arthroplasty: A Case Report and Literature Review  

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Many surgeons use acetabular components with constrained polyethylene liners to improve stability after total hip arthroplasty in patients with a history of hip dislocation. Surgical treatment is generally thought to be the only available option for the dislocated constrained liner. The success rate and clinical results of closed reduction for such patients is unclear. This report presents a case of a successful closed reduction of a dislocated constrained liner. Few papers have so far addres...

Sonohata, Motoki; Waewsawangwong, Warit; Goodman, Stuart B.

2012-01-01

51

Iliofemoral distraction and hip reconstruction for the sequelae of a septic dislocated hip with chronic femoral osteomyelitis.  

Science.gov (United States)

We describe a technique of 'cross-hip distraction' to reduce a dislocated hip with subsequent reconstruction of the joint for septic arthritis with extensive femoral osteomyelitis. A 27-year-old woman presented with a dislocated, collapsed femoral head and chronic osteomyelitis of the femur. Examination revealed a leg-length discrepancy of 7 cm and an irritable hip. A staged technique was used with primary clearance of osteomyelitis and secondary reconstruction of the hip. A cross-hip monolateral external fixator was used to establish normal anatomy followed by an arthroplasty. A good functional outcome was achieved. The use of cross-hip distraction avoids soft-tissue and nerve damage and achieved improved abductor function before arthroplasty. PMID:15911675

Nagarajah, K; Aslam, N; McLardy Smith, P; McNally, M

2005-06-01

52

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

53

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

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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

54

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

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

Chun-Chien Cheng

2010-06-01

55

True congenital dislocation of shoulder: A case report and review of the literature  

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The dislocation of a shoulder joint in infancy is extremely rare and is usually the result of traumatic birth injuries, a sequel to brachial plexus injury, or a true congenital dislocation of shoulder. With more advanced obstetric care, the incidence of first two types has drastically decreased. We report a case of true congenital dislocation of shoulder, second of its kind, in a child who was delivered by cesarean section thereby negating any influence of trauma. We report the case because o...

Sudesh Pebam; Rangdal Sushil; Bali Kamal; Kumar Vishal; Gahlot Nitesh; Patel Sandeep

2010-01-01

56

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

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

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

2014-01-01

57

Bilateral traumatic anterior/posterior dislocations of the hip joints: case report.  

Science.gov (United States)

A case of simultaneous traumatic bilateral anterior/posterior hip dislocations in a 28-year-old man is presented. The mechanism and treatment of this injury, as well as its complications, are discussed. PMID:1749044

Gittins, M E; Serif, L W

1991-12-01

58

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

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Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The p...

Vukašinovi? Zoran; Šešlija Igor; Duli? Borislav

2010-01-01

59

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

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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...

2009-01-01

60

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

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

Venkatachalam Santosh; Heidari Nima; Greer Tony

2009-01-01

 
 
 
 
61

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

62

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

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

Venkatachalam Santosh

2009-12-01

63

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

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

Jindal, Nipun; Sankhala, Sohan S.

2012-01-01

64

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

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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

65

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

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

A. Ebrahim Pour

2006-10-01

66

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

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Neglected hip dislocation is a rare situation among children. The coexistence of acetabulum fracture is less common. The result of treatment depends on the time of diagnosis. Early treatment is mandatory in such cases. Seven years old female brought to our outpatient clinic with the complaints of right hip pain and walking difficulty. Her parents said that she had fallen from a horse one month ago. X-ray and CT showed a posterior dislocation of her right hip and a fracture on her right poster...

2011-01-01

67

Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child  

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In traumatic hip dislocation, concentric reduction can be prevented by various causes. Soft-tissue interposition, such as entrapment of the acetabular labrum, is a rare but important cause of failed reduction of a hip. Early diagnosis of incomplete reduction due to interposition of soft tissue is important, because delayed treatment is associated with a greater incidence of avascular necrosis of the femoral head and early onset of osteoarthritis. This report describes a case of acetabular labral entrapment following reduction of traumatic hip dislocation in a child. The importance of CT and MRI in arriving at an early diagnosis is emphasized. (orig.)

Chun, K.A. [The Catholic University of Korea Uijongbu St. Mary' s Hospital, Department of Radiology, Uijongbu, Kyunggi-Do 480-130 (Korea); University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States); Morcuende, J. [University of Iowa Hospitals and Clinics, Department of Orthopaedic Surgery, Iowa City (United States); El-Khoury, G.Y. [University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City (United States)

2004-12-01

68

Anterior dislocation of the hip associated with intertrochanteric fracture of the femur - Case presentation.  

Science.gov (United States)

Dislocations of the hip usually occur following high energy trauma, the coxo-femoral joint being inherently stable, and can be associated with acetabular fractures or fractures of the head, neck or shaft of femur. However, the combination between the anterior hip dislocation and the ipsilateral intertrochanteric fracture is extremely rare, the literature offering only scarce information. We present the case of a patient, aged 44, victim of a trauma by precipitation from height (12m), diagnosed with left hip anterior dislocation and intertrochanteric fracture of the ipsilateral femur. An emergency surgical treatment was applied in less than 3 hours after trauma. The hip dislocation was reduced under general anesthesia and the intertrochanteric fracture was also reduced and internally fixed with a dynamic hip screw. Radiological and functional evaluation at 6 months after surgery, using the modified Merle D'Aubigne hip score was good. The clinical outcome of such a case depends on the quick evaluation and treatment. Providing a stable reduction of the dislocation and a stable internal fixation of the fracture as soon as possible (within the first 6 hours) will allow an early physical rehabilitation and decrease the risk of complications. PMID:24146697

Radulescu, R; Badila, A; Japie, I; Papuc, A; Manolescu, R

2013-09-15

69

Anterior dislocation of the hip associated with intertrochanteric fracture of the femur-Case presentation-  

Science.gov (United States)

Dislocations of the hip usually occur following high energy trauma, the coxo-femoral joint being inherently stable, and can be associated with acetabular fractures or fractures of the head, neck or shaft of femur. However, the combination between the anterior hip dislocation and the ipsilateral intertrochanteric fracture is extremely rare, the literature offering only scarce information. We present the case of a patient, aged 44, victim of a trauma by precipitation from height (12m), diagnosed with left hip anterior dislocation and intertrochanteric fracture of the ipsilateral femur. An emergency surgical treatment was applied in less than 3 hours after trauma. The hip dislocation was reduced under general anesthesia and the intertrochanteric fracture was also reduced and internally fixed with a dynamic hip screw. Radiological and functional evaluation at 6 months after surgery, using the modified Merle D’Aubigne hip score was good. The clinical outcome of such a case depends on the quick evaluation and treatment. Providing a stable reduction of the dislocation and a stable internal fixation of the fracture as soon as possible (within the first 6 hours) will allow an early physical rehabilitation and decrease the risk of complications.

Radulescu, R; Badila, A; Japie, I; Papuc, A; Manolescu, R

2013-01-01

70

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

Science.gov (United States)

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

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

2014-04-01

71

Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation.  

Science.gov (United States)

We performed a retrospective study on 167 primary total hip arthroplasty (THA) procedures in 163 patients at high risk for instability to assess the reliability of unconstrained tripolar implants (press-fit outer metal shell articulating a bipolar polyethylene component) in preventing dislocations. Eighty-four percent of the patients had at least 2 risk factors for dislocation. The mean follow-up length was 40.2 months. No dislocation was observed. Harris hip scores improved significantly. Six hips were revised, and no aseptic loosening of the cup was observed. The tripolar implant was extremely successful in achieving stability. However, because of the current lack of data documenting polyethylene wear at additional bearing, the routine use of tripolar implants in primary THA is discouraged and should be considered at the present time only for selected patients at high risk for dislocation and with limited activities. PMID:17826276

Guyen, Olivier; Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Carret, Jean-Paul; Bejui-Hugues, Jacques

2007-09-01

72

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

International Nuclear Information System (INIS)

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

1987-12-04

73

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

Directory of Open Access Journals (Sweden)

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

Lidder Surjit

2009-08-01

74

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

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

Ray Marks

2009-05-01

75

Changes of the hip joints associated with chronic subluxation and dislocation: CT and plain radiography analysis  

International Nuclear Information System (INIS)

Secondary osteoarthritis of the hip joint is a common disease and is frequently followed by chronic subluxation and dislocation. Twenty four cases of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the osteoarthritis and calcification of the acetabular labrum, 2) the thickness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints

1993-05-01

76

Changes of the hip joints associated with chronic subluxation and dislocation: CT and plain radiography analysis  

Energy Technology Data Exchange (ETDEWEB)

Secondary osteoarthritis of the hip joint is a common disease and is frequently followed by chronic subluxation and dislocation. Twenty four cases of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the osteoarthritis and calcification of the acetabular labrum, 2) the thickness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints.

Yang, Ik; Ryu, Kyung Nam; Lee, Sun Wha; Choi, Woo Suk; Lee, Eil Seong [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1993-05-15

77

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

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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

78

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

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

Asif S

2004-06-01

79

Computed tomography in abnormalities of the hip  

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

1982-06-26

80

Computed tomography in abnormalities of the hip  

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

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

1982-06-26

 
 
 
 
81

Anterior approach according to Ganz--surgical dislocation of hip joint.  

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The surgical technique of an anterior approach to the hip joint according to Ganz is described. The procedure preserves the deep branch of the medial circumflex artery, which, combined with greater trochanter osteotomy, allows for safe hip joint dislocation without a risk of avascular necrosis of the femoral head. This approach makes it possible to inspect the femoral head and the entire acetabulum. It is suitable for the treatment of early stages of coxarthrosis. PMID:21273645

G?ga?a, Jacek

2010-01-01

82

Treatment of Bilateral Recurrent Dislocation of Hip Prosthesis with Malpositioned Well-Fixed Shell: A Case Report  

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Dislocations of total hip prostheses cause pain and patient dissatisfaction. Recurrent dislocations are difficult to treat mainly when the acetabular metal shell is well-fixed. The purpose of this article was to describe the surgical technique used for the treatment of a bilateral recurrent posterior dislocation after a cementless total hip prosthesis, caused by ex- cessive inclination of acetabular components, in a 72-year-old patient. On both sides, acetabular metal shell, porous- coated, w...

Judas, F.; Maximino, L.; Lucas, F.

2013-01-01

83

Surgical dislocation of the hip for reduction of acetabular fracture and evaluation of chondral damage.  

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PURPOSE. To assess the outcome of open reduction and internal fixation combined with surgical dislocation of the hip for displaced acetabular fractures. METHODS. 20 men and 2 women aged 20 to 55 (mean, 28) years underwent open reduction and internal fixation combined with surgical dislocation of the hip for displaced acetabular fracture. The most common fracture pattern was bicolumnar (n=12), followed by transverse (n=6) and T-type (n=4). Femoral head chondral lesions were classified as grade 0 (no defect) to grade 4 (osteochondral defect). Fracture fragments were fixed with titanium plates and screws, and the femoral head was redislocated to inspect for intraarticular screws. The association between functional status and acetabular fracture pattern and femoral head chondral lesions was explored. RESULTS. Nine patients had chondral lesions in the femoral head (mostly in the anterosuperior zone), but none in the acetabulum. All femoral heads were viable. Reduction was anatomic in 6 patients and satisfactory in 16. Functional outcome was very good in 6 patients, good in 13, medium in 2, and fair in one. No patient developed avascular necrosis of the femoral head. Four patients had iatrogenic sciatic nerve palsy. One patient developed early degenerative hip arthritis and underwent total hip arthroplasty 14 months later. CONCLUSION. Surgical dislocation of the hip facilitated anatomic reduction and inspection of any chondral lesions. It did not result in avascular necrosis of the femoral head. PMID:24781607

Maini, L; Batra, S; Arora, S; Singh, S; Kumar, S; Gautam, V K

2014-04-01

84

Application of the surgical dislocation approach to residual hip deformity secondary to Legg-Calvé-Perthes disease.  

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Long-term prognosis after Legg-Calvé-Perthes disease (LCPD) depends on the severity of residual hip deformities including a nonspherical femoral head, a short and wide femoral neck, a high riding greater trochanter, and secondary changes in the acetabulum. Hip deformity after healed LCPD may lead to abnormal hip mechanics including femoroacetabular impingement and hip instability secondary to acetabular dysplasia. The surgical dislocation approach has recently been applied to LCPD hip deformity with encouraging short-term results. This approach allows complete dynamic evaluation of the hip joint, identification, and correction of the most common residual deformities. The purpose of this paper is to describe the application of the surgical hip dislocation approach to LCPD deformity and to evaluate the current available literature on the results of this approach to the healed LCPD hip. PMID:23764795

Novais, Eduardo N

2013-01-01

85

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

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

2002-06-01

86

Pathological dislocation of the hip due to coxotuberculosis in children: a 29-case report  

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Background The aim of this study is to evaluate the clinical outcome of various surgery methods in children suffering pathological dislocation of the hip joint due to coxotuberculosis. Patients and methods From January 2006 to January 2011, 29 children with coxotuberculosis hip dislocation were treated with open reduction (4 children) and acetabular reconstruction (25 children). According to degree of dislocation and age, acetabular reconstructions included Salter osteotomy (nine children), Pemberton operation (six children), Dega operation (seven children), the hip shelf arthroplasty (two children), and Chiari operation (one child). During acetabular reconstruction, 16 children underwent upper femoral rotational shortening osteotomies simultaneously, 6 children underwent the femoral head and neck reconstruction simultaneously, and 3 children were underwent corrective osteotomy. After operation, children were immobilized with plaster external fixation for 1–3 months and treated with routine anti-infective therapy for 3 days. During follow-up study (12–18 months), the hip stability was examined via X-ray. The recovery was evaluated via acetabular index (AI) and Harris hip score. Results Postoperative X-ray films of 29 children showed concentric reduction of all hips. Total 25 children healed I incision surgery, while 4 children with skin antrum of incision were further treated leading to 1–3 months delay of healing. Total 24 children were followed up for 2–5 years. X-ray examination revealed no redislocation after 2 years postoperative. The postoperative AI was normal (15°–20°) in 22 children and increased to 25°– 30° in 2 children. After 2 years postoperative, 8 children had normal function of hip joint, 13 children had mild limitation of flexion and rotation, and 3 children had fibrous ankylosis. The average of Harris hip score was 83 (ranged, 62–90). Conclusion In our study, pathological hip dislocations of children attributed to coxotuberculosis were treated via open reduction and acetabular reconstruction and the outcomes were both excellent. Individual characteristic should be taken into consideration during treatment, and proper surgery approach should be adopted according to pathological changes of the hip.

2014-01-01

87

Cervical vertebral dislocation in a rugby player with congenital vertebral fusion.  

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Congenital cervical vertebral fusion is an anomaly which decreases the normal range of spinal movement and predisposes to trauma. The case history of a rugby player with a congenital fusion who sustained permanent quadriplegia after dislocation of the lower cervical spine is presented. The mechanism of injury is discussed. A plea is made for routine radiographic examination of the cervical spines of all rugby players in order to detect the presence of vertebral fusion and other conditions whi...

Scher, A. T.

1990-01-01

88

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

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

Samet Karabulut

2011-06-01

89

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

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

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

2009-01-01

90

Salvaging unstable or recurrent dislocating total hip arthroplasty with the constrained acetabular component.  

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Full Text Available PURPOSE: To review cases of implantation of constraining acetabular components for unstable or recurrent dislocating total hip arthroplasty at the Department of Orthopaedics, Concord Hospital, Sydney. METHODS: A retrospective analysis was performed on prospectively collected data of 13 consecutively enrolled patients. RESULTS: From 1989 to 2000, 13 constraining acetabular components were implanted into 13 patients as a revision procedure. The surgical approach for the implantation of the constrained liner was posterolateral in 11 cases; a modified Hardinge approach was applied in 2 cases. The mean clinical follow-up duration was 43 months (range, 14-121 months and the mean age at the time of surgery was 73 years (range, 52-84 years. No patients were lost to follow-up. Indications for using the constrained acetabular component were recurrent dislocation in revision hip replacements (n=8, and intra-operative instability (n=5. There were no episodes of dislocation of the constrained arthroplasty. In 7 cases, the constrained component was implanted into a previously well-fixed shell. CONCLUSION: We recommend the judicious use of the constrained component in cases of hip instability during or after total hip arthroplasty when other methods are not successful.

Stanton DA

2002-12-01

91

[Treatment of hip joint dislocation with the Hanausek apparatus].  

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The Hanausek apparatus has been used for reposition and retention of luxation of the hip joint in the Orthopädische Klinik Hessisch Lichtenau in 37 cases aged up to 2 years, if there was no hindrance of reposition in arthrography. It is a functional method which avoids the extreme Lorenz position that is claimed to endanger the caput femoris respecting necrosis. In a retrospective roentgenological observation it became evident, that the method of Hanausek leads generally to a good development of the acetabulum. The rate of necrosis in our patients was high (17%). Our patients started treatment later (38% aged more than one year). 2/3 of the patients had a high luxation of the hip joint. PMID:3751236

Sinn, W

1986-01-01

92

Entwinement of sciatic nerve around a total hip prosthesis following closed reduction of dislocated total hip replacement.  

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The usual causes of injury to sciatic nerve during total hip replacement are intraoperative direct nerve injury, significant leg lengthening, improper retractor placement, cement extravasation, cement-related thermal damage, patient positioning, manipulation and postoperative hematoma. We present a case of early sciatic nerve injury with entrapment of sciatic nerve around the prosthetic femoral neck following repeated manipulation of dislocated total hip replacement. This case emphasises the importance of soft tissue in dealing with orthopedic problem. Limited number of attempts at closed reduction should be made as prolonged manipulation may place surrounding soft-tissue structures particularly nerve at risk of injury. If a closed reduction with the patient under general anesthesia is difficult, there should be a low threshold for open exploration and reduction. Documentation of neurovascular status before and after manipulation is essential. PMID:24378379

Haque, Syed; Sundararajan, Sabapathy

2013-01-01

93

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

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

Slavkovi? N.

2006-01-01

94

Congenital dislocation of the knee in a 16-year-old girl.  

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Congenital dislocation of the knee ranges from hyperextension of the knee to translation of the femur on the tibia. Treatment options include bracing, splinting, manipulation and casting, and surgery. A 16-year-old girl presented with an inability to walk, stand upright, or bend her knees. She exhibited deformity of both lower extremities. She had deformed knees from birth, and they had been put in a cast for 2 months. No other therapeutic measures were taken. The patient walked on her abnormally hyperextended knees and could hyperextend the knees to 150 degrees recurvatum. She was diagnosed with a grade III congenital dislocation of the knee, and a flexion-shortening osteotomy at the distal femur above the trochlear level was performed on her knees in 2 sessions. Postoperatively, range of motion changed from hyperextention to 80 degrees flexion. A femoral supracondylar osteotomy was also performed 2 years later, and as a result, a 15 degrees flexion and 15 degrees valgus were added to the limb. The patient is now able to stand and walk without a knee brace and has 90 degrees passive and 80 degrees active knee flexion on both sides. Congenital dislocation of the knee is a rare congenital disorder. The results of treatment are favorable if started before age 3 months, or sometimes before age 2 years, but there is no effective treatment for older, neglected cases; therefore, we believe this case report demonstrates a novel surgical approach. PMID:20506946

Kazemi, Seyyed Morteza; Abbasian, Mohammad Reza; Hosseinzadeh, Hamid Reza Seyyed; Zanganeh, Ramin Farhang; Eajazi, Alireza; Daftari Besheli, Laleh

2010-05-01

95

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

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

Junko Sato

2012-03-01

96

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

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

Karthik K; Sundararajan S; Dheenadhayalan J; Rajasekaran S

2011-01-01

97

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

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

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

2009-01-01

98

Medial and lateral retinaculum plasty for congenital patellar dislocation due to small patella syndrome.  

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The objective of this study was to explore the clinical effect of medial and lateral retinaculum plasty for congenital patellar dislocation due to small patella syndrome. Twelve patients with congenital patellar dislocation due to small patella syndrome treated at the authors' hospital between January 2005 and February 2010 were enrolled in the study. The study group comprised 4 men (4 knees) and 8 women (8 knees) with an average age of 10.58±6.91 years. All patients underwent medial and lateral retinaculum plasty. Clinical evaluation included the number of patellar redislocations, patellar apprehension sign, Kujala score, subjective questionnaire score, and patella lateral shift and patellar tilt angle measured using a cross-sectional computed tomography scan. All patients were followed up, and the shortest follow-up time was 2 years. Kujala scores improved from 49.20±6.20 preoperatively to 80.10±5.80 postoperatively. Subjective questionnaire scores indicated that the excellent and good rate was 75%. In addition, a significant difference existed in the patellar tilt angle and patella lateral shift between pre- and postoperative results (P<.05). Medial and lateral retinaculum plasty for patients with congenital patellar dislocation due to small patella syndrome can be effective to correct the tracking of the patellofemoral joint and improve knee function. PMID:24200447

Wang, Cheng-hai; Shu, Lei; Ma, Long-fei; Zhou, Jian-wei; Ji, Gang; Wang, Fei; Wang, Juan

2013-11-01

99

Concordance between hip ultrasonography and hip arthrography in the assessment of developmental dysplasia of the hip.  

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Controversy exists regarding the possibility of predicting hip reducibility in the congenitally dislocated hip, with arthrography still regarded as the gold standard in this situation. This study aims at assessing the degree of concordance between ultrasonography and arthrography in the detection of anatomic elements obstructing hip reduction. Forty-nine hips were studied both by ultrasonography and arthrography. Three anatomic sources of obstruction to reduction were assessed in each hip: ligamentum teres hypertrophy, inverted labrum, and the presence of soft tissue in the acetabulum. For each variable, congruence between ultrasound and arthrography was measured by kappa analysis. Values > 0.40 expressed sufficient concordance, and they were detected with regard to inverted labrum and the presence of soft tissue in the acetabulum. The results of this study suggest that ultrasonography may be considered a reliable technique for the prediction of the main causes of obstruction in the congenitally dislocated hip, such as inverted labrum and soft tissue in the acetabulum. PMID:10513361

Abril, J C; Berjano, P; Díaz, A

1999-10-01

100

Diagnosis and imaging studies of traumatic hip dislocations in the adult.  

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Traumatic dislocation of the hip represents a major injury that is associated with significant morbidity. In particular, the risk of osteonecrosis of the femoral head is greatly affected by the time it takes to reduce the hip. Therefore, thorough understanding of the clinical and radiologic features is essential if this injury is to be recognized and treated promptly. Most patients present in severe distress after a high-energy injury such as a motor vehicle accident. Associated injuries, particularly of the knee, are common and the leg usually is held in a specific posture characteristic of the direction of dislocation. Plain anteroposterior radiographs of the pelvis will clearly show the dislocation in most patients but lateral views or a computed tomography scan may be required to confirm the diagnosis and to show the direction if the signs are subtle. Associated acetabular wall fractures and femoral head fractures also may be identified by computed tomography scans. After reduction, plain radiographs alone are not adequate to assess reduction; computed tomography is more sensitive in detecting osteochondral fragments and may reliably detect residual subluxation of 2 mm in any part of the joint. Magnetic resonance imaging is useful in detecting changes of osteonecrosis but rarely is indicated in the early treatment of this condition. PMID:10943181

Brooks, R A; Ribbans, W J

2000-08-01

 
 
 
 
101

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

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

Göran O. Sjödén

2013-06-01

102

Dual Mobility Cups for Preventing Early Hip Arthroplasty Dislocation in Patients at Risk: Experience in a County Hospital  

Science.gov (United States)

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.

Mukka, Sebastian S.; Mahmood, Sarwar S.; Sjoden, Goran O.; Sayed-Noor, Arkan S.

2013-01-01

103

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

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

Jäger M

2011-05-01

104

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

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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

105

Comparison of procedural sedation for the reduction of dislocated total hip arthroplasty.  

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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, have 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 3 sedation agents. Methods: We performed a retrospective chart review examining 198 patients who presented with dislocated total hip arthroplasty at 2 academic affiliated medical centers. The patients were grouped according to the type of sedation agent. We calculated percentages of reduction and sedation complications along with 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. We then compared the data for each sedation agent. Results: We found reduction complications rates of 8.7% in the propofol, 24.7% in the etomidate, and 28.9% in the opiate/benzodiazepine groups. The propofol group was significantly different from the other 2agents (p ? 0.01). Sedation complications were found 7.3% of the time in the propofol , 11.7% in the etomidate , and 21.3% in the opiate/benzodiazepine group, (p=0.02 propofol vs. others) . Average recovery times were 25.2 minutes for propofol, 30.8 minutes for etomidate, and 44.4 minutes for opiate/benzodiazepine (p = 0.05 for propofol vs. other agents). Conclusion: For reduction of dislocated total hip arthroplasty under procedural sedation, propofol appears to have fewer complications and a trend toward more rapid recovery than both etomidate and opiate/benzodiazepine. These data support the use of propofol as first line agent for procedural sedation of dislocated total hip arthroplasty, with fewer complications and a shorter recovery period. PMID:24696752

Dela Cruz, Jonathan E; Sullivan, Donald N; Varboncouer, Eric; Milbrandt, Joseph C; Duong, Myto; Burdette, Scott; O'Keefe, Daniel; Scaife, Steven L; Saleh, Khaled J

2014-02-01

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

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

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

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

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

Luísa Neiva, Araújo; Eduardo, Almeida.

108

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

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In 1957, Pavlik introduced the Pavlik harness as a useful treatment for developmental dislocation of the hip (DDH), and subsequent studies have documented favorable outcomes among patients treated with this device. However, there are only a few articles reporting how early radiographic measurements can be used to determine the prognosis after treatment with the Pavlik harness. In this study, 217 hips from 192 patients whose DDH treatment with the Pavlik harness was initiated before they we...

2009-01-01

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

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"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 cong...

Amin Foroughi; Reza Jalli; Mehrdad Mohammadhoseini

2009-01-01

110

Neurofibromatosis induced hip arthritis. An unusual presentation  

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Patient: Male, 43 Final Diagnosis: Neurofibromatosis Symptoms: Hip pain Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Neurofibromatosis type 1 is a disease known for orthopedic manifestations such as spine deformities, congenital pseudarthrosis of the tibia and other bony dysplasias; joint dislocations are rare. Joint arthritis caused by neurofibromatosis, with a stable hip, has never been reported in the English literature before. Case Report: A 43-year-old man diagnosed with neurofibromatosis type 1 (NF-1) presented with hip pain of 5 years duration, with no history of trauma and no clinical or radiological signs of dislocation. He had classical clinical and radiological signs of hip arthritis, with acetabular erosions and femoral head arthritis. The patient was treated with total hip arthroplasty metal-on-metal (MoM). Conclusions: Hip arthritis alone without subluxation or dislocation due to NF-1 is an extremely rare presentation. This is the first reported presentation and provisional treatment with total hip arthroplasty.

Alrumaih, Husam; Ilyas, Imran; Kashif, Syed

2014-01-01

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

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Full Text Available Background: Intra-articular loose bodies following simple dislocations can lead to early degeneration. Nonconcentric reduction may indicate retained loose bodies and offer a method to identify patients requiring exploration so that this undesirable outcome can be avoided. Materials and Methods: One hundred and seventeen consecutive simple dislocations of the hip presenting to the hospital from January 2000 to June 2006 were assessed for congruency after reduction by fluoroscopic assessment of passive motion in the operating room as well as with good quality radiographs. Computerized tomography (CT scan with 2-mm cuts was done for confirmation of reduction and to identify the anatomy of loose bodies. Patients with nonconcentric reduction underwent open exploration to identify the etiology of the dislocation and for removal of loose bodies. Thomson and Epstein clinical and radiological criteria were used to assess the outcome. Results: Twelve of the one hundred and seventeen (10% dislocations had incongruent reduction, which was identified by the break in Shenton?s line and increase in medial joint space in seven patients, increase in the superior joint space in three patients, or increase in the joint space as a whole in two patients. CT scan identified the origin of the osteocartilaginous fragment as being from the acetabulum in six patients, the femoral head in four, and from both in one. One patient had an inverted posterior labrum. Following debridement, congruent reduction was achieved in all patients. At an average follow-up of 5 years (range: 2 years 5 months to 8 years, the outcome as evaluated by Thompson and Epstein clinical criteria was excellent in eleven cases and good in one case; the radiological outcome was excellent in eight cases and good in four cases. Conclusions: Intra-articular loose bodies were identified by nonconcentric reduction in 12 out of 117 patients with simple hip dislocation. Careful evaluation by fluoroscopy and good quality radiographs are indicated following reduction of hip dislocations.

Karthik K

2011-01-01

112

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

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Background: Intra-articular loose bodies following simple dislocations can lead to early degeneration. Nonconcentric reduction may indicate retained loose bodies and offer a method to identify patients requiring exploration so that this undesirable outcome can be avoided. Materials and Methods: One hundred and seventeen consecutive simple dislocations of the hip presenting to the hospital from January 2000 to June 2006 were assessed for congruency after reduction by fluoroscopic assessment of passive motion in the operating room as well as with good quality radiographs. Computerized tomography (CT) scan with 2-mm cuts was done for confirmation of reduction and to identify the anatomy of loose bodies. Patients with nonconcentric reduction underwent open exploration to identify the etiology of the dislocation and for removal of loose bodies. Thomson and Epstein clinical and radiological criteria were used to assess the outcome. Results: Twelve of the one hundred and seventeen (10%) dislocations had incongruent reduction, which was identified by the break in Shenton’s line and increase in medial joint space in seven patients, increase in the superior joint space in three patients, or increase in the joint space as a whole in two patients. CT scan identified the origin of the osteocartilaginous fragment as being from the acetabulum in six patients, the femoral head in four, and from both in one. One patient had an inverted posterior labrum. Following debridement, congruent reduction was achieved in all patients. At an average follow-up of 5 years (range: 2 years 5 months to 8 years), the outcome as evaluated by Thompson and Epstein clinical criteria was excellent in eleven cases and good in one case; the radiological outcome was excellent in eight cases and good in four cases. Conclusions: Intra-articular loose bodies were identified by nonconcentric reduction in 12 out of 117 patients with simple hip dislocation. Careful evaluation by fluoroscopy and good quality radiographs are indicated following reduction of hip dislocations.

Karthik, K; Sundararajan, SR; Dheenadhayalan, J; Rajasekaran, S

2011-01-01

113

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

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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)

2012-08-01

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The blood supply to the femoral head after posterior fracture/dislocation of the hip, assessed by CT angiography.  

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The femoral head receives blood supply mainly from the deep branch of the medial femoral circumflex artery (MFCA). In previous studies we have performed anatomical dissections of 16 specimens and subsequently visualised the arteries supplying the femoral head in 55 healthy individuals. In this further radiological study we compared the arterial supply of the femoral head in 35 patients (34 men and one woman, mean age 37.1 years (16 to 64)) with a fracture/dislocation of the hip with a historical control group of 55 hips. Using CT angiography, we identified the three main arteries supplying the femoral head: the deep branch and the postero-inferior nutrient artery both arising from the MFCA, and the piriformis branch of the inferior gluteal artery. It was possible to visualise changes in blood flow after fracture/dislocation. Our results suggest that blood flow is present after reduction of the dislocated hip. The deep branch of the MFCA was patent and contrast-enhanced in 32 patients, and the diameter of this branch was significantly larger in the fracture/dislocation group than in the control group (p = 0.022). In a subgroup of ten patients with avascular necrosis (AVN) of the femoral head, we found a contrast-enhanced deep branch of the MFCA in eight hips. Two patients with no blood flow in any of the three main arteries supplying the femoral head developed AVN. PMID:24151262

Zlotorowicz, M; Czubak, J; Caban, A; Kozinski, P; Boguslawska-Walecka, R

2013-11-01

115

Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty  

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Background and purpose Previous population-based registry studies have shown that larger femoral head size is associated with reduced risk of revision for dislocation. However, the previous data have not included large numbers of hip resurfacing arthroplasties or large metal-on-metal (> 36-mm) femoral head arthroplasties. We evaluated the association between femoral component head size and the risk of revision for dislocation after THA by using Finnish Arthroplasty Register data. Patients and methods 42,379 patients who were operated during 1996–2010 fulfilled our criteria. 18 different cup/stem combinations were included. The head-size groups studied (numbers of cases) were 28 mm (23,800), 32 mm (4,815), 36 mm (3,320), and > 36 mm (10,444). Other risk factors studied were sex, age group (18–49 years, 50–59 years, 60–69 years, 70–79 years, and > 80 years), and time period of operation (1996–2000, 2001–2005, 2006–2010). Results The adjusted risk ratio in the Cox model for a revision operation due to dislocation was 0.40 (95% CI: 0.26–0.62) for 32-mm head size, 0.41 (0.24–0.70) for 36-mm head size, and 0.09 (0.05–0.17) for > 36-mm head size compared to implants with a head size of 28 mm. Interpretation Larger femoral heads clearly reduce the risk of dislocation. The difference in using heads of > 36 mm as opposed to 28-mm heads for the overall revision rate at 10 years follow-up is about 2%. Thus, although attractive from a mechanical point of view, based on recent less favorable clinical outcome data on these large heads, consisting mainly of metal-on-metal prostheses, one should be cautious using these implants.

Kostensalo, Inari; Junnila, Mika; Virolainen, Petri; Remes, Ville; Matilainen, Markus; Vahlberg, Tero; Pulkkinen, Pekka; Eskelinen, Antti; Makela, Keijo T

2013-01-01

116

Adult Congenital Permanent Bilateral Dislocation of the Patella with Full Knee Function: Case Report and Literature Review  

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Congenital permanent dislocation of the patella is a rare disorder of the knee joint in which the patella is permanently displaced, even in extension and is fixed on the lateral aspect of the femoral condyle. The dislocation is irreducible without surgical techniques. This rare condition is usually detected within the first decade of life, because of inability of active extension in the knee and impaired ability during walking. This report presents an unusual case of a 51-year-old man with bi...

Bistolfi, Alessandro; Massazza, Giuseppe; Backstein, David; Ventura, Stefano; Cerlon, Raul; Crova, Maurizio

2012-01-01

117

Neglected surgically intervened bilateral congenital dislocation of knee in an adolescent.  

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Neglected bilateral congenital dislocation of knee is unusual. A 12 year old boy presented with inability to walk due to buckling of the knee. The symptoms were present since the child learnt walking. He preferred not to walk. Bilateral supracondylar femoral osteotomy was done at the age of 6 years. Patient had a fixed flexion deformity of both knees, 30° in the right (range of flexion from 30° to 45°) and 45° fixed flexion deformity in left knee respectively (range of flexion from 45° to 65°) when presented to us. The radiological examination revealed bilateral congenital dislocation of knee (CDK). No syndromic association was observed. He was planned for staged treatment. In stage I, the knee joints were distracted by Ilizarov ring fixators and this was followed by open reduction of both the knee joints in stage II. A bilateral supracondylar extension osteotomy was done 18 months after the previous surgery (stage III). The final followup visit at 4 years the patient presented with range of motion 5-100° and 5-80° on the right and left knee respectively with good functional outcome. The case is reported in view of lack of treatment guidelines for long standing neglected CDK in an adolescent child. PMID:24600070

Kumar, Jaswant; Dhammi, Ish Kumar; Jain, Anil K

2014-01-01

118

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

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

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

119

Surgical hip dislocation for anatomic reorientation of slipped capital femoral epiphysis: preliminary results.  

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Controversies exist regarding the best treatment for slipped capital femoral epiphysis (SCFE). Subcapital anatomical reorientation of the epiphysis by surgical dislocation and a retinacular soft tissue flap has been described recently as an effective approach. We evaluated the clinical and radiographic efficacy of this technique and compared these to published results. A series of 20 SCFE (18 stable, 2 unstable) treated by subcapital re-orientation through surgical hip dislocation and an extended retinacular soft tissue flap was reviewed retrospectively. Preoperatively and at most recent follow-up, patients were clinically examined with regard to pain and function according to the Harris hip score and to the Western Ontario and McMaster universities (WOMAC) score. Radiological examination included measurement of preoperative and postoperative anteroposterior (AP) and lateral (L) Southwick angles; and at follow-up the alpha angle was measured. The average follow-up time was 24 months. The mean WOMAC score was 2.80 post-operatively. The mean pre-operative slip angle was 40.2 degrees on the AP view and 50.65 degrees on the lateral view. Post-operatively, the mean values were 7,20 degrees on the AP view and 9,45 degrees on the lateral view. The mean post-operative average alpha angle was 43,11 degrees. No cases of avascular necrosis were seen. Our short term clinical and radiographic results are similar to outcomes published in the recent literature. The small number of technical complications appears favourable considering the surgical complexity of the procedure, and our technique offers clear advantages in treating these complex deformities. PMID:22505180

Massè, Alessandro; Aprato, Alessandro; Grappiolo, Guido; Turchetto, Luigino; Campacci, Antonio; Ganz, Reinhold

2012-01-01

120

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  

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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

 
 
 
 
121

Avascular necrosis of the femoral head in the patients with posterior wall acetabular fractures associated with dislocations of the hip  

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Full Text Available Introduction: Acetabular fractures are severe injuries, mostly occured in young patients after traffic accident or fall from heights. Of the all acetabular fractures, posterior wall acetabular fractures are the most often observed. Regarding to mechanism of the injury, about 30% of these fractures are associated with posterior hip dislocation. Material and methods: The incidence of AVN in 18 patients with posterior wall acetabular fractures associated with dislocations of the hip is presented. Thompson-Epstein Scale (type I-V was used as the classification of the injury. Kocher-Langenbeck surgical approach was achieved in all patients. Results: Average following time after surgery was 22,66 months (8-36 months. After that period the incidence of femoral head AVN was observed in 33,3%6. Femoral head AVN was observed in 5,55%1 of patient who was treated by the reduction of hip dislocation in first 24 hours after injury, while in patients with later reduction, femoral head AVN were observed in 27,77%5. Conclusion: Posterior wall acetabular fractures associated with hip dislocation are severe injuries. Urgent, closed reduction of the hip, early definitive stable osteosynthesis of acetabulum and the experience of surgical team are factors that greatly decrease the possibility for AVN occurrence. Later reduction, comminution of posterior wall of the acetabulum (Thompson-Epstein III et IV, impaction, chondral lesion of the femoral head and associated fractures of femoral head, increase the possibility for AVN occurrence. [Projekat Ministarstva nauke Republike Srbije, br. III41017: Virtuelni koštano-zglobni sistem ?oveka i njegova primena u pretklini?koj i klini?koj praksi

Milenkovi? Saša

2013-01-01

122

Spontaneous recurrent dislocation after primary Birmingham hip resurfacing: a rare complication in a 44-year-old man.  

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Dislocation is a rare complication of hip resurfacing in young people. This is thought to be due to the stability imposed by a large-diameter head [Stulberg BN, Trier KK, Naughton M, et al. Results and Lessons Learned from a United States Hip Resurfacing Investigational Device Exemption Trial. J Bone Joint Surg Am 2008;90:21]. We report an isolated case 1 week post-Birmingham hip resurfacing in a 44-year-old man without any history of trauma or infection. We note that due to massive periacetabular and femoral neck osteophyte formation and loss of normal bony anatomical landmarks, the version of the acetabular component may have been slightly retroverted. Due to marked narrowing of the femoral neck and head proximally, a cone-shaped proximal femur was found and felt to be unsuitable for direct resurfacing without prior shortening to allow fitting of the appropriate-sized Birmingham hip resurfacing femoral component. This was done successfully, but resulted in slightly reduced femoral neck offset of approximately 10 mm, compared to the native hip. We suspect this reduced offset contributed significantly to the 2 dislocations. We recommend careful preoperative planning and case selection to avoid this complication in similar patients. PMID:19464846

Nall, Amy; Robin, Joseph

2010-06-01

123

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

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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

2006-06-01

124

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

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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

125

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

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

Skand Sinha

2013-10-01

126

Conservative versus surgical management of Pipkin type I fractures associated with posterior dislocation of the hip: a randomised controlled trial  

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The aim of this study was to evaluate the long-term results of conservative and surgical fragment excision treatment in patients with Pipkin type 1 fractures of the femoral head associated with posterior dislocation of the hip by a randomised controlled trial. Sixteen patients were randomly divided into two groups: the conservative group was treated by closed reduction, and the surgical group was treated by closed reduction followed with fragment excision. Functional outcome was determined us...

2011-01-01

127

Ipsilateral intertrochantric and femoral head fracture without dislocation of the hip. Potentially misleading radiograph: A case report and review of literature.  

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Background Traumatic femoral head fracture without dislocation with ipsilateral intertrochanteric fracture is an extremely rare injury and has not been reported in the literature. Case Report We reported a case of simultaneous ipsilateral femoral head and intertrochantric fracture without dislocation of the hip in a 74-year-old woman. The patient presented with a history of road traffic accident. Radiographs and computerised tomography scans revealed a right intertrochantric fracture and femoral head fracture without dislocation of the hip. Conclusions The case was managed by uncemented modular bipolar arthroplasty using LINK reconstruction prosthesis. In the case report we described this unusual pattern, mechanism of injury, and management of such cases. PMID:24940941

Tanwar, Yashwant; Gulati, Yash; Jaiswal, Atin; Jharia, Trambak

2014-01-01

128

Use of a constrained tripolar acetabular liner to treat intraoperative instability and postoperative dislocation after total hip arthroplasty: a review of our experience.  

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Constrained acetabular components have been used to treat certain cases of intraoperative instability and postoperative dislocation after total hip arthroplasty. We report our experience with a tripolar constrained component used in these situations since 1988. The outcomes of the cases where this component was used were analyzed for component failure, component loosening, and osteolysis. At average 10-year followup, for cases treated for intraoperative instability (2 cases) or postoperative dislocation (4 cases), the component failure rate was 6% (6 of 101 hips in 5 patients). For cases where the constrained liner was cemented into a fixed cementless acetabular shell, the failure rate was 7% (2 of 31 hips in 2 patients) at 3.9-year average followup. Use of a constrained liner was not associated with an increased osteolysis or aseptic loosening rate. This tripolar constrained acetabular liner provided total hip arthroplasty construct stability in most cases in which it was used for intraoperative instability or postoperative dislocation. PMID:15577475

Callaghan, John J; O'Rourke, Michael R; Goetz, Devon D; Lewallen, David G; Johnston, Richard C; Capello, William N

2004-12-01

129

Salvage of a recurrently dislocating total hip prosthesis with use of a constrained acetabular component. A concise follow-up of a previous report.  

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We previously reported the results at a mean of five years following the use of a tripolar constrained acetabular component to treat recurrently dislocating total hip prostheses. In this study, we report the results after longer follow-up, with emphasis on the prevalence of implant loosening, osteolysis, and later recurrent instability. Fifty-five patients treated with a total of fifty-six constrained acetabular components because of recurrent dislocations of a total hip prosthesis (average, six dislocations; range, two to twenty dislocations) were followed for an average of 10.2 years (range, 7.0 to 13.2 years) or until death. Four (7%) of the fifty-six hips had a subsequent dislocation or failure of the device. Three femoral components (5%) and two acetabular components (4%) were revised because of aseptic loosening. One hip was revised because of osteolysis. We concluded that this constrained acetabular component provides durable protection against additional dislocations without substantial deleterious effects on component fixation. We use this device to treat recurrent dislocation when other modalities are unlikely to be effective. PMID:15523012

Goetz, Devon D; Bremner, Barron R B; Callaghan, John J; Capello, William N; Johnston, Richard C

2004-11-01

130

[Surgical treatment of dislocations and subdislocations of the hip in patients with cerebral palsy by femoral and pelvic osteotomy].  

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Fifty-one skeletally immature cerebral palsied (C.P.) children with 70 subluxated or dislocated hips were treated by conservative methods: femoral osteotomy (65 hips), pelvic osteotomy (52 hips) and arthrotomy when necessary (19 cases). 31 children were less than 10 years of age when operated on (mean 6 years, 6 months), 20 children were more than 10 years of age (mean 13 years, 13 months); mean follow-up was 4 years. Reduction and coverage were achieved and maintained in all patients, except for 6 redislocations: a pelvic obliquity was neglected in 3 cases; femoral shortening was not performed in 2 cases. Post-operative course was difficult in eldest patients with pain and stiffness but functional result was acceptable at follow-up in all cases except redislocations. Open reduction was related to a higher rate of postoperative rehabilitation problems. Modeling of previously deformed femoral heads and improvement of hip mobility were consistently seen at last follow-up, except for 3 redislocations. It is concluded that conservative methods are quite advisable in CP children and adolescents. Hip reduction should be preferred to femoral resection even in adolescent. PMID:1410725

Onimus, M; Manzone, P; Cahuzac, J P; Laurain, J M; Lebarbier, P

1992-01-01

131

The use of abduction bracing for the prevention of early postoperative dislocation after revision total hip arthroplasty.  

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One potential strategy to decrease the risk of dislocation after revision total hip arthroplasty (THA) is the use of an abduction brace to limit flexion and adduction. The purpose of this study was to compare the dislocation rate after revision THA between patients treated with or without an abduction brace. Data were obtained from 1211 revision THAs performed in 610 women and 518 men who had a mean age of 64.7 years (range, 22-95 years) and were followed up for a minimum of 90 days. Five hundred two patients were braced, whereas 650 were not. The 90-day dislocation rate among patients who wore a brace was 5.2% compared with 5.7% in the nonbrace group (P = .70). Multivariate regression found no benefit to bracing (P = .37), while controlling for factors found to significantly affect dislocation rate in this population. Our data do not support the routine use of an abduction brace to aid in the prevention of dislocation. PMID:22608688

Murray, Trevor G; Wetters, Nathan G; Moric, Mario; Sporer, Scott M; Paprosky, Wayne G; Della Valle, Craig J

2012-09-01

132

Case Report: Congenital Knee Dislocation in a Patient with Larsen Syndrome and a Novel Filamin B Mutation  

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We treated a patient with multiple congenital joint dislocations and facial dysmorphisms consistent with Larsen syndrome. Sequencing of the FLNB gene resulted in identification of a novel, de novo 508G>C point mutation resulting in substitution of proline for a highly conserved alanine (A170P). This mutation has not been described previously but is likely causative because this alanine is highly conserved and is located in the calponin homology domain where other mutations have been described...

Dobbs, Matthew B.; Boehm, Stephanie; Grange, Dorothy K.; Gurnett, Christina A.

2008-01-01

133

Congenital Joint Dislocations Caused by Carbohydrate Sulfotransferase 3 Deficiency in Recessive Larsen Syndrome and Humero-Spinal Dysostosis  

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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 individua...

2008-01-01

134

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

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

2009-01-01

135

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

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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

136

Clinical experience of Ganz surgical dislocation approach for metal-on-metal hip resurfacing.  

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Although the posterior approach is the most commonly used for hip resurfacing, concerns remain in terms of risk of femoral neck fracture secondary to an osteonecrotic event. The purpose of this study was to look at the short-term results of metal-on-metal hip resurfacing done by the vascular-preserving surgical approach as developed by Ganz in 116 hip resurfacing arthroplasties performed in 106 patients (86 men, 20 women; mean age, 46.5 years; range, 19-62). At a mean follow-up of 38.3 months (range, 12-84), Harris Hip Scores improved significantly from 53.1 to 90.16 (P hips (18.3%) requiring screw removal for painful bursitis. Two hips underwent conversion to total hip arthroplasty: one at 18 months for femoral loosening and one at 7 years for acetabular loosening. Although the trochanteric slide approach as developed by Ganz provides excellent exposure to the hip joint and preserves femoral head vascularity, it does carry some inherent morbidity in regard to the greater trochanter. PMID:19553070

Beaulé, Paul E; Shim, Paul; Banga, Kamlajeet

2009-09-01

137

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

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

Tetsunaga,Tomonori

2009-06-01

138

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

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

Porter, David; Michael, Shona; Kirkwood, Craig

2007-01-01

139

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

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

1981-01-01

140

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

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

I.Y. Ezhov

2013-06-01

 
 
 
 
141

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

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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.

2011-07-01

142

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

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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

143

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

144

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

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

Pedro, González González; Tamara, Morales Perez.

145

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

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

M Jabalameli

2012-08-01

146

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

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

José Ricardo Negreiros Vicente

2009-01-01

147

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

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Full Text Available 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.

148

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

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Developmental Dysplasia of the Hip (DDH) is a common congenital malformation. Avascular necrosis of femoral head is the major complication of both close and open reduction of the dislocated joint. Aim of this study was to determine the incidence and influencing factors in different types of a vascular necrosis of femoral head, following surgical treatment of developmental dysplasia of hip in 1-7 years patients. In this study, 120 patients aged from 1 to 7 years old with DDH who had been...

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

2012-01-01

149

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

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

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

150

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

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

2012-01-01

151

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

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

Das Rupant

2007-01-01

152

Humoral immunodeficiency in congenital insensitivity to pain with anhidrosis.  

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

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

2009-04-01

153

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.

154

Hip Revision Surgery  

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Full Text Available ... this live Webcast demonstration of the Trabecular Metal Acetabular Reconstruction System, also known as TMARCS. It is ... vehicle accident and had some type of pelvis acetabular, possibly a fracture dislocation of her hip. At ...

155

[Hip arthroscopy].  

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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

156

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

Scientific Electronic Library Online (English)

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

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

157

Unstable total hip arthroplasty: detailed overview.  

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Hip dislocation is one of the most common complications of THA. Good preoperative planning, good postoperative patient education, accurate intraoperative component positioning, rigorous intraoperative testing of hip stability, and good repair of soft tissues during closure all help prevent dislocation. Early postoperative dislocations and first or second dislocations usually are treated with closed reduction and a hip guide brace or hip spica cast, but when dislocation becomes recurrent, surgical treatment usually is needed. When possible, surgical treatment is based on identifying and treating a specific problem leading to the dislocation, such as implant malposition, inadequate soft-tissue tension, or impingement. In selected circumstances, constrained implants or bipolar or tripolar implants provide powerful tools to restore hip stability. PMID:11372323

Berry, D J

2001-01-01

158

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

1991-01-01

159

Total Hip Arthroplasty for Hip Fractures  

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

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

2014-01-01

160

Arthroscopic management of an intraarticular osteochondroma of the hip  

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

Feeley, Brian T.; Kelley, Bryan T.

2009-01-01

 
 
 
 
161

Arthroscopic management of an intraarticular osteochondroma of the hip  

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

Feeley, Brian T.; Kelly, Bryan T.

2009-01-01

162

Appendicular joint dislocations.  

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This study defines the incidence and epidemiology of joint dislocations and subluxations of the appendicular skeleton. All patients presenting acutely to hospital with a dislocation or subluxation of the appendicular skeleton from a defined population were included in the study. There were 974 dislocations or subluxations over one year between the 1st November 2008 and the 31st October 2009. There was an overall joint dislocation incidence of 157/10(5)/year (188/10(5)/year in males and 128/10(5)/year in females). Males demonstrated a bimodal distribution with a peak incidence of 446/10(5)/year at 15-24 years old and another of 349/10(5)/year in those over 90 years. Females demonstrate an increasing incidence from the seventh decade with a maximum incidence of 520/10(5)/year in those over 90 years. The most commonly affected joints are the glenohumeral (51.2/10(5)/year), the small joints of the hand (29.9/10(5)/year), the patellofemoral joint (21.6/10(5)/year), the prosthetic hip (19.0/10(5)/year), the ankle (11.5/10(5)/year), the acromioclavicular joint (8.9/10(5)/year) and the elbow (5.5/10(5)/year). Unlike fractures, dislocations are more common in the both the most affluent and the most socially deprived sections of the population. Joint disruptions are more common than previously estimated. PMID:23433660

Hindle, Paul; Davidson, Eleanor K; Biant, Leela C; Court-Brown, Charles M

2013-08-01

163

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

Science.gov (United States)

Proximal femoral resection (PFR) is a proven pain-relieving procedure for the management of patients with severe cerebral palsy and a painful displaced hip. Previous authors have recommended post-operative traction or immobilisation to prevent a recurrence of pain due to proximal migration of the femoral stump. We present a series of 79 PFRs in 63 patients, age 14.7 years (10 to 26; 35 male, 28 female), none of whom had post-operative traction or immobilisation. A total of 71 hips (89.6%) were reported to be pain free or to have mild pain following surgery. Four children underwent further resection for persistent pain; of these, three had successful resolution of pain and one had no benefit. A total of 16 hips (20.2%) showed radiographic evidence of heterotopic ossification, all of which had formed within one year of surgery. Four patients had a wound infection, one of which needed debridement; all recovered fully. A total of 59 patients (94%) reported improvements in seating and hygiene. The results are as good as or better than the historical results of using traction or immobilisation. We recommend that following PFR, children can be managed without traction or immobilisation, and can be discharged earlier and with fewer complications. However, care should be taken with severely dystonic patients, in whom more extensive femoral resection should be considered in combination with management of the increased tone. Cite this article: Bone Joint J 2014; 96-B:701-6. PMID:24788508

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

2014-05-01

164

Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis.  

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Based on the recognition that even minor slip displacement in patients with slipped capital femoral epiphysis can regularly produce acetabular cartilage damage and early clinical symptoms, subcapital realignment of the epiphysis should be considered, although a substantial risk of osteonecrosis has been reported. A modified surgical technique can be used in which the perfusion of the epiphysis via the medial femoral circumflex artery is actively protected during surgery by executing surgical dislocation of the joint and by developing a soft-tissue flap consisting of the retinaculum and the external rotator muscles. This flap allows mobilization of the epiphysis within the growth plate as well as complete callus resection of the neck without stretching the retinaculum. The dislocation of the head allows manual fixation of the epiphysis while curettage of the residual growth plate is performed, as well as manual reduction of the epiphysis onto the metaphysis under visual control of the retinaculum. With the head dislocated, any uncontrolled manipulation of the leg will result in less risk to the integrity of the retinaculum than would be the case if the head was reduced in the socket. PMID:18399604

Leunig, Michael; Slongo, Theddy; Ganz, Reinhold

2008-01-01

165

Subtalar dislocation  

International Nuclear Information System (INIS)

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

1982-01-01

166

Functional results and complications following conversion of hip fusion to total hip replacement.  

Science.gov (United States)

Eighteen hip fusions were converted to total hip replacements. A constrained acetabular liner was used in three hips. Mean follow up was five years (two to 15). Two (11%) hips failed, requiring revision surgery and two patients (11%) had injury to the peroneal nerve. Heterotopic ossification developed in seven (39%) hips, in one case resulting in joint ankylosis. No hips dislocated. Conversion of hip fusion to hip replacement carries an increased risk of heterotopic ossification and neurological injury. We advise prophylaxis against heterotropic ossification. When there is concern about hip stability we suggest that the use of a constrained acetabular liner is considered. Despite the potential for complications, this procedure had a high success rate and was effective in restoring hip function. PMID:23118378

Aderinto, J; Lulu, O B; Backstein, D J; Safir, O; Gross, A E

2012-11-01

167

Hip sonography in the newborn  

International Nuclear Information System (INIS)

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

1991-01-01

168

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

169

Finger Dislocation  

Science.gov (United States)

... the medical terms phalanges and metacarpal bones. Every knuckle in the hands and fingers contains a joint ... injury: Distal interphalangeal joints are in the finger knuckles closest to the fingernails. Most dislocations in these ...

170

Kneecap dislocation  

Science.gov (United States)

... patella) dislocates to the outside of the knee Knee pain and tenderness Knee swelling "Sloppy" kneecap -- you can ... knee and you notice: Increased instability in your knee Pain or swelling return after they went away Your ...

171

New Hip, - Nursing Care of the Patient with the Total Hip Arthroplasty.  

Science.gov (United States)

Describes how nursing care measures important in preoperative, postoperative, and discharge planning care of the total hip arthroplasty patient. These include prevention of the dislocation, occupied bed-making, patient transfer, and positioning and exerci...

1994-01-01

172

[Orthopedic problems in children with congenital insensitivity to pain].  

Science.gov (United States)

Three children with congenital insensitivity to pain are described. Self-injuries of the tongue and fingers occurred during dentition. At infancy and early childhood fever of unknown origin and/or pneumoniae were observed in all children. All of them also suffered from osteomyelitis of various bones treated with antibiotics and surgery. The tibia and metatarsals were involved in one case, the tibia, metatarsals and the femur in second child and the jaw plus metatarsals in the third case. In one child the hip has been dislocated twice after minor trauma, lumbar arthropathy, distal femoral epiphyseal fusion causing shortening of the extremity by 4.5 cm, osteochondritis dissecans of the medial femoral condyle, elbow deformity after displaced fracture of the lateral humeral condyle and post-traumatic cataract were observed. PMID:10423911

Lejman, T; Su?ko, J

1999-01-01

173

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

174

Hip disease and the prognosis of total hip replacements. A review of 53,698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987-99.  

Science.gov (United States)

We studied the rates of revision for 53,698 primary total hip replacements (THRs) in nine different groups of disease. Factors which have previously been shown to be associated with increased risk of revision, such as male gender, young age, or certain types of uncemented prosthesis, showed important differences between the diagnostic groups. Without adjustment for these factors we observed an increased risk of revision in patients with paediatric hip diseases and in a small heterogeneous 'other' group, compared with patients with primary osteoarthritis. Most differences were reduced or disappeared when an adjustment for the prognostic factors was made. After adjustment, an increased relative risk (RR) of revision compared with primary osteoarthritis was seen in hips with complications after fracture of the femoral neck (RR = 1.3, p = 0.0005), in hips with congenital dislocation (RR = 1.3, p = 0.03), and in the heterogenous 'other' group. The analyses were also undertaken in a more homogenous subgroup of 16,217 patients which had a Charnley prosthesis implanted with high-viscosity cement. The only difference in this group was an increased risk for revision in patients who had undergone THR for complications after fracture of the femoral neck (RR = 1.5, p = 0.0005). THR for diagnoses seen mainly among young patients had a good prognosis, but they had more often received inferior uncemented implants. If a cemented Charnley prosthesis is used, the type of disease leading to THR seems in most cases to have only a minor influence on the survival of the prosthesis. PMID:11380136

Furnes, O; Lie, S A; Espehaug, B; Vollset, S E; Engesaeter, L B; Havelin, L I

2001-05-01

175

Screening programmes for developmental dysplasia of the hip in newborn infants  

Scientific Electronic Library Online (English)

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

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

2013-04-01

176

Evaluation of the patient with hip pain.  

Science.gov (United States)

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

Wilson, John J; Furukawa, Masaru

2014-01-01

177

The dislocator, early and late: the role of large heads.  

Science.gov (United States)

Dislocation after total hip arthroplasty (THA) is a potentially devastating complication that can be difficult to manage. Many patient and mechanical factors have been associated with an increased risk of dislocation. Conservative treatments such as abduction bracing have not proven effective at treating this difficult problem. Surgical options include the use of larger femoral heads, unconstrained tripolar femoral heads, and constrained devices. While each device has its merits, there is no one-size-fits-all solution to this problem. With the development of highly cross-linked polyethylene and its superior wear characteristics and mechanical properties, the use of larger femoral heads is now available. Twenty-six hips in 25 patients who underwent revision surgery for recurrent dislocation were treated with a femoral head =/>36 mm in diameter. The direct lateral surgical approach was used in 24 hips, and the posterior and anterior supine intermuscular approaches were used in 1 hip each. One patient died 5 years after revision surgery, and 3 patients have not returned for clinical follow-up over the past 2 years. Four hips subsequently suffered a repeat dislocation, for a dislocation rate of 17%. Two patients underwent a subsequent surgery: 1 irrigation and debridement and 1 hardware removal. There have been no other revisions to date. Mean time to follow-up is 17.2 months. While the use of large femoral heads for the treatment of dislocation is warranted, continued follow-up is necessary. PMID:19751014

Skeels, Michael D; Berend, Keith R; Lombardi, Adolph V

2009-09-01

178

Arthroscopic management of an intraarticular osteochondroma of the hip  

Directory of Open Access Journals (Sweden)

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

Bryan T. Kelley

2009-06-01

179

CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

A. Shahla

2008-06-01

180

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

Directory of Open Access Journals (Sweden)

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

Fernando Farcetta Junior

2010-01-01

 
 
 
 
181

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

Directory of Open Access Journals (Sweden)

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

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

2009-01-01

182

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. ...

183

Hip arthroscopy  

Science.gov (United States)

... Hip impingement syndrome - arthroscopy; Femero-acetabular impingement - arthroscopy; FAI - arthroscopy; Labrum - arthroscopy ... impingement syndrome (also called femero-acetabular impingement, or FAI), when no other treatment has helped. Hip pain ...

184

[Ultrasound diagnosis of congenital knee dislocation].  

Science.gov (United States)

Since 1990, more than 50 children with hyperextended knee joints have been treated based on sonographic assessment. Ultrasound imaging has been useful for primary diagnosis, classification, and follow-up of conservative treatment. The image quality of sonographic documentation more or less equates the more expensive magnetic resonance imaging (MRI) and has become the golden standard of imaging hyperextended knee joints. There is almost no more need for plain X-rays. PMID:12017861

Parsch, K

2002-03-01

185

Operative treatment of FAI: open hip preservation surgery.  

Science.gov (United States)

Femoroacetabular Impingement (FAI) is characterized by abnormal contact of the hip joint. Many etiologies cause this painful condition, which leads to early osteoarthritis. While hip arthroscopy has become the most prevalent way to surgically correct a hip, some presentations of FAI require open surgical hip preservation techniques to fully address the pathology at hand. Certain head neck deformities may require open surgical hip dislocation utilizing a trochanteric slide osteotomy. A retroverted acetabulum may require an open periacetabular osteotomy to gain anteversion and eliminate impingement in the hip joint. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanter osteotomy. The sequelae of Legg-Calvé-Perthes disease causes complex abnormalities about the hip joint, which may require open surgery to address both the intra-articular pathology and the extra-articular pathology. Osteotomies of the proximal femur and acetabulum may all be necessary to restore a hip back to normal morphology. Chronic slipped capital femoral epiphysis (SCFE) may also require open surgical hip dislocations and complex intertrochanter osteotomies to recreate normal morphology. PMID:23893256

Hellman, Michael D; Riff, Andrew J; Haughom, Bryan D; Patel, Rikesh; Stover, Michael D; Nho, Shane J

2013-09-01

186

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.

187

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

Science.gov (United States)

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

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

2009-01-01

188

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)

1997-11-01

189

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 ...

190

Kneecap dislocation - aftercare  

Science.gov (United States)

Patellar subluxation - aftercare; Patellofemoral subluxation - aftercare; Kneecap subluxation- aftercare ... T, Parker RD. Patella: subluxation and dislocation. 2. Patellofemoral instability: recurrent dislocation of the patella. In: DeLee ...

191

Congenital Myopathy  

Science.gov (United States)

NINDS Congenital Myopathy Information Page Synonym(s): Myopathy - Congenital Table of Contents (click to jump to sections) What is Congenital Myopathy? Is ... Organizations Additional resources from MedlinePlus What is Congenital Myopathy? A myopathy is a disorder of the muscles ...

192

Use of constrained acetabular components for hip instability: an average 10-year follow-up study.  

Science.gov (United States)

The short-term efficacy of using constrained acetabular components for hip instability in the total hip arthroplasty construct has been documented. However, long-term concerns including late dislocation, loosening of components, and osteolysis have not been addressed. The authors evaluated, at an average 10.3-year follow-up, 101 tripolar constrained components (Stryker Howmedica Osteonics) used in the total hip arthroplasty construct. At final follow-up, 6 hips had dislocated or had failure of the constrained component, 5 of which were revised. In addition, 4 hips were revised for aseptic loosening of the acetabular component, 4 hips were revised for aseptic femoral loosening, and 1 hip was revised for acetabular osteolysis. Considering the complexity of the cases, this component has provided durable fixation and hip stability at this intermediate-term follow-up. PMID:14560423

Bremner, Barron R B; Goetz, Devon D; Callaghan, John J; Capello, William N; Johnston, Richard C

2003-10-01

193

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

International Nuclear Information System (INIS)

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

2008-10-01

194

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.

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

195

Hip Replacement  

Science.gov (United States)

... for more information The most common reason for hip replacement is osteoarthritis. Osteoarthritis occurs when the cartilage covering the ends of the bones where they meet to form joints breaks down. This causes the ... hip damage include injuries, fractures, bone tumors, rheumatoid arthritis, ...

196

Early results of treatment of hip impingement syndrome in slipped capital femoral epiphysis and pistol grip deformity of the femoral head-neck junction using the surgical dislocation technique.  

Science.gov (United States)

Pistol grip deformity of the femoral head-neck junction and slipped capital femoral epiphysis can cause anterior impingement leading to pain, cartilage damage and eventual osteoarthritis. Osteoplasty of this metaphyseal prominence, with or without concomitant intertrochanteric osteotomy, using a surgical dislocation approach, can effectively treat this problem. Clinical and radiographic outcomes were assessed in 19 patients who underwent osteoplasty or osteoplasty/intertrochanteric osteotomy via Ganz-type surgical dislocation with average 12-month follow-up. Preoperative and postoperative Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaires and radiographs were obtained and evaluated. In the osteoplasty group, 7 patients improved, 4 were unchanged, and 2 worsened. In the osteoplasty/osteotomy group, 5 of 6 patients improved. Patients with chondral flaps had less improvement. No avascular necrosis was noted postoperatively, and all trochanteric osteotomies healed. The surgical dislocation approach, combined with osteoplasty and/or bony realignment, is a safe efficacious treatment option for symptomatic pistol grip deformity. Outcomes are worse if there is preexisting cartilage damage. PMID:16670535

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

2006-01-01

197

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

198

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

2012-08-21

199

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

200

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

Directory of Open Access Journals (Sweden)

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

Ioana Mihaela Tomulescu

2003-01-01

 
 
 
 
201

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 tog...

Paji? Miloš; Vukašinovi? Zoran

2007-01-01

202

Vertical atlantoaxial dislocation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

An unusual case of vertical atlantoaxial dislocation without medulla oblongata or spinal cord injury is reported. The pathogenic process suggested occipito-axial dislocation. The case was treated surgically with excellent results on mobility and pain.

Ramare?, S.; Lazennec, J. Y.; Camelot, C.; Saillant, G.; Hansen, S.; Trabelsi, R.

1999-01-01

203

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2009-01-01

204

Hip Replacement  

Medline Plus

Full Text Available ... pain may interfere with normal work and activities. Walking may become very difficult. Alternative Treatments Patients may ... of a cane or walker may help for walking. Injections of steroids in the hip joint may ...

205

Hip Revision  

Medline Plus

Full Text Available ... go to the next radiograph, unfortunately, three years down the line, this patient was developing increasing hip ... protein. And we -- on everybody -- send tissue back down for frozen. We just got that back showing ...

206

Hip Replacement  

Medline Plus

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

207

Hip Revision  

Medline Plus

Full Text Available ... that time. Here's Scott's initial preoperative x-ray, where we see a hybrid hip arthroplasty with a ... that's a good thing -- especially in these cases where there's a fair bit of bone loss. So ...

208

Hip Replacement  

Medline Plus

Full Text Available ... any of these symptoms occur. Getting out of bed shortly after surgery may help decrease the risk ... legs, bend your hip, or sit up in bed. Your orthopedic surgeon will tell you about the ...

209

Hip Replacement  

Medline Plus

Full Text Available ... causes the surfaces to become rough. This can result in severe pain and may even lead to the inability to walk. Hip arthritis can result from chronic inflammation of the joint or may ...

210

Hip ultrasound.  

Science.gov (United States)

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

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

2012-12-01

211

Hip Revision  

Medline Plus

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

212

Low-dose 3D computed tomography of the pediatric hip  

International Nuclear Information System (INIS)

The purpose of this article was to determine the dependence of three-dimensional computed tomography (3D CT) images on absorbed dose in pediatric patients. While plain radiographs are often used as part of the initial evaluation of patients with congenital hip dislocation, it is well known that the performance of 3D CT may be necessary for a more complete evaluation. Because of special anatomical views, lateral views of the hip joints, which can be evaluated at 3D CT, cannot be seen on plain radiography. But absorbed dose of the reproductive organs of 3D CT is high compared with one of plain radiography. Typical manufactures preprogrammed protocols for 3D CT examinations were designed to produce images with low image noise and with high absorbed dose of organs. The low-dose technique that made use of lower milliampare second in the same incremental manner, could produce 3D CT image that was diagnostically acceptable but that slightly decreased in volume. This low dose technique could make 3D CT images of pediatric pelvis with maintained diagnostic quality at 60% reduction in absorbed dose. (author)

1994-10-01

213

A polytrauma patient with an unusual posterior fracture-dislocation of the femoral head: a case report  

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We report a case of a 27-year-old man who was involved in a high-speed car accident. He sustained multiple organ damage including multiple brain petechiae suggesting diffuse axonal damage, aortic dissection, retroperitoneal haematoma and a fracture-dislocation of the right hip with a femoral head fracture and an ipsilateral intertrochanteric fracture. Due to the general condition of the patient, physiological stabilisation was prioritized, and at 2 weeks the fracture-dislocation of the hip w...

Rodriguez-martin, Juan; Pretell-mazzini, Juan; Porras-moreno, Miguel Angel; Hernanz-gonzalez, Yolanda; Resines-erasun, Carlos

2010-01-01

214

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

International Nuclear Information System (INIS)

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

2001-10-01

215

Congenital epulis.  

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

1993-01-01

216

Congenital epulis.  

Directory of Open Access Journals (Sweden)

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

Subramaniam R

1993-01-01

217

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

1988-01-01

218

Vascular injuries during total hip revision  

International Nuclear Information System (INIS)

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

1989-12-01

219

Cyclic deformation dislocation microstructures  

Energy Technology Data Exchange (ETDEWEB)

Single crystals of aluminum and copper were cyclically deformed, in single slip, to presaturation at 77 and 298 K, respectively. The dislocation substructures were carefully analyzed using conventional BF and DF TEM with particular attention directed towards the dislocation dipole spacing. It was found that, in both metals, the dipole spacing was independent of the location in the heterogeneous substructure, which consisted of dense dipole bundles (or veins), and the relatively low dislocation-density channels. Furthermore, the stress to separate the largest spacing dipoles was nearly equal to the applied stress. The stress necessary to pass dislocations through the dense veins was also about equal to the applied stress. The observations and calculations suggest a uniform state of stress throughout the heterogeneous dislocation substructure, without the presence of significant internal stresses. Convergent beam electron diffraction (CBED) experiments were also undertaken. These results will be discussed in terms of dislocation dynamics and their consistency with the absence of long-range internal stresses.

Kassner, M.E.; Perez-Prado, T.; Vecchio, K.S.

1999-07-01

220

A modified direct lateral approach in total hip arthroplasty.  

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Full Text Available A modified lateral approach of Hardinge allows adequate access for orientation of the implant was described. Although this approach is more difficult than the posterior approach, there is a learning curve, when mastered, it ll definitely reduce the incidence of dislocation. In the Author s opinion, this approach should be used routinely for total hip arthroplasty for fractured neck of femur where the incidence of dislocation is unacceptably high using the posterior approach.

Pai VS

2002-06-01

 
 
 
 
221

Primary traumatic patellar dislocation  

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

Tsai Chun-Hao

2012-06-01

222

Primary traumatic patellar dislocation  

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

Tsai Chun-Hao; Hsu Chin-Jung; Hung Chih-Hung; Hsu Horng-Chaung

2012-01-01

223

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

224

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

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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

225

Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty  

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

Shu-Tai Shih

2007-02-01

226

Hip reconstruction osteotomy by Ilizarov method as a salvage option for abnormal hip joints.  

Science.gov (United States)

Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required) for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg's gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD). PMID:24895616

Umer, Masood; Rashid, Haroon; Umer, Hafiz Muhammad; Raza, Hasnain

2014-01-01

227

Open surgical dislocation versus arthroscopic treatment of femoroacetabular impingement.  

Science.gov (United States)

It is unclear if open surgical dislocation or arthroscopy of the hip is superior for the treatment of femoroacetabular impingement (FAI). We prospectively compared the clinical results of these 2 surgical methods performed by a single surgeon. Five patients met the inclusion criteria for the open surgical dislocation group and 18 for the arthroscopic group. Patient-reported scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS) and Hip Outcome Score-Activities of Daily Living (HOS-ADL) were used preoperatively, and at 3 months, 6 months, and 1 year postoperatively to compare the 2 groups. Average follow-up was 14.7 months (range, 12 to 25 months); both groups showed significant improvement in their postoperative scores compared with preoperative scores (P FAI. The arthroscopic group demonstrated a trend toward faster recovery and quicker return to sports, but larger and longer-term studies are needed. PMID:24839626

Botser, Itamar B; Jackson, Timothy J; Smith, Thomas W; Leonard, James P; Stake, Christine E; Domb, Benjamin G

2014-05-01

228

Hip Replacement  

Science.gov (United States)

... uncemented. Cemented parts are fastened to existing, healthy bone with a special glue or cement. Hip replacement using these parts is referred to as a “cemented” procedure. Uncemented parts rely on a process called biologic ... surface that allows your own bone to grow into the pores and hold the ...

229

An injury risk curve for the hip for use in frontal impact crash testing.  

Science.gov (United States)

To facilitate the assessment of hip injury risk in frontal motor-vehicle crashes, an injury risk curve that relates peak force transmitted to the hip to the probability of hip fracture was developed by using survival analysis to fit a lognormal distribution to a recently published dataset of hip fracture forces. This distribution was parameterized to account for the effect of subject stature, which was the only subject characteristic found to significantly affect hip fracture force (X(2)(1)=6.03, p=0.014). The distribution was further parameterized to account for the effects of hip flexion and abduction from a standard driving posture on hip fracture force using relationships between mean hip fracture force and hip flexion/abduction reported in the literature. The resulting parametric distribution was used to define relationships between force applied to the hip and the risk of hip fracture for the statures associated with the small female, midsize male, and large male crash-test dummies, thus allowing these dummies to assess hip fracture/dislocation risk in frontal crashes, provided that such dummies are sufficiently biofidelic. For the midsize male crash test dummy, a 50% risk of hip fracture was associated with a force of 6.00kN. For the small female and large male dummies, a 50% risk of hip fracture was associated with forces of 4.46 and 6.73kN, respectively. PMID:19875117

Rupp, Jonathan D; Flannagan, Carol A C; Kuppa, Shashi M

2010-02-10

230

Dislocations and radiation damage  

International Nuclear Information System (INIS)

The influence of dislocations on the response of crystalline materials to irradiation is reviewed. Those dislocation properties that are essential to our understanding of the evolution of the microstructure during irradiation are identified and it is shown how the rate theory model can thereby describe the collective behaviour of the microstructure. (author)

1985-05-01

231

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 ... The developing baby can become infected with toxoplasmosis if the ... spread to the developing baby during the pregnancy itself, or ...

232

Congenital syphilis  

Science.gov (United States)

Congenital lues; Fetal syphilis ... which is passed from mother to child during fetal development or at birth. Nearly half of all ... problem of the lower leg) Scarring of the skin around the mouth, genitals, and anus

233

CONGENITAL MYOPATHIES  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital myopathies are a heterogeneous group of disorders characterized by muscle weakness and typical histopathological changes at muscle biopsy. In spite of recent advances on molecular genetics, their classification is still based on morphological criteria. Phenotypical and genetic heterogeneicity are common findings. The clinical symptoms usually appear in infancy, but adult-onset cases have been described. In this review, we focus on the current knowledges on congenital myopathies and we report our experience on adult-onset cases.

MT. Dotti

2009-11-01

234

Hip joint-preserving surgery: beyond the classic osteotomy.  

Science.gov (United States)

It has been postulated that hip osteoarthritis is often caused by developmental anatomic deformities. Recent studies have demonstrated that relatively subtle anatomic abnormalities such as acetabular retroversion, acetabular overcoverage, and decreased offset of the femoral head-neck junction also may lead to pain and osteoarthritis. Advances in surgical techniques such as the periacetabular osteotomy, safe surgical dislocation of the hip, and hip arthroscopy have provided the surgeon with effective and safe tools to correct these anatomic problems. Clinical and radiographic techniques are used to identify these anatomic abnormalities. PMID:16958447

Kim, Young-Jo; Ganz, Reinhold; Murphy, Stephen B; Buly, Robert L; Millis, Michael B

2006-01-01

235

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)

2013-04-01

236

Dual mobility canine total hip prosthesis: implant characteristics and surgical procedure.  

Science.gov (United States)

Prosthetic dislocation is one of the most common complications after canine hip replacement. The use of dual mobility acetabular components has been shown to reduce the rate of dislocation in first intent hip replacement in human patients who are at high risk for dislocation. In such implants, a mobile polyethylene liner articulates on one side with a metallic acetabular component and on the other side with a metallic prosthetic head. A dual mobility cemented acetabular component has been designed for use in dogs, and is available for use in association with a previously designed modular femoral component. This report describes the characteristics and the procedure for implantation of this implant combination. PMID:23111812

Guillaumot, P; Autefage, A; Palierne, S; Dembour, T; Chancrin, J-L

2012-11-14

237

Is patient selection important for hip resurfacing?  

Science.gov (United States)

The optimal implant option for hip arthroplasty in the young, active patient remains controversial. There has been renewed interest for metal-on-metal hip resurfacing due to improved design and manufacturing of implants, better materials, enhanced implant fixation, theoretical advantages over conventional total hip arthroplasty, and recent Food and Drug Administration approval of two devices. Recent studies indicate satisfactory short- and midterm clinical results (1- to 10-year followup) with low complication rates, but there is a learning curve associated with this procedure, a more extensive surgical approach is necessary, and long-term results have yet to be determined. Proper patient selection may help avoid complications and improve patient outcomes. Patient selection criteria in the literature appear based predominantly on theoretical considerations without any consensus on stratifying patient risk. The most commonly reported complications encountered with hip resurfacing include femoral neck fracture, acetabular component loosening, metal hypersensitivity, dislocation, and nerve injury. At the time of clinical evaluation, patient age; gender; diagnosis; bone density, quality, and morphology; activity level; leg lengths; renal function; and metal hypersensitivity are important factors when considering a patient for hip resurfacing. Based on our review, we believe the best candidates for hip resurfacing are men under age 65 with osteoarthritis and relatively normal bony morphology. Level of Evidence: Level V, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18941859

Nunley, Ryan M; Della Valle, Craig J; Barrack, Robert L

2009-01-01

238

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

Science.gov (United States)

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

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

2014-05-01

239

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

Directory of Open Access Journals (Sweden)

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

Robertsson Otto

2010-08-01

240

Hip Replacement - Physical Therapy  

Medline Plus

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

 
 
 
 
241

Hip Implant Systems  

Science.gov (United States)

... Provide Treatment to Patients with a Metal-on-Metal Hip Implant Information for Patients FDA Activities Recalls Other Resources Report a Problem Hip Implants Hip implants are medical devices intended ...

242

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... patient needs to recognize the limitations of a new hip. This reference summary reviews necessary steps that ... order to get the most out of a new hip. Anatomy The hip joint joins the pelvis ...

243

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

Science.gov (United States)

Developmental Dysplasia of the Hip (DDH) is a common congenital malformation. Avascular necrosis of femoral head is the major complication of both close and open reduction of the dislocated joint. Aim of this study was to determine the incidence and influencing factors in different types of a vascular necrosis of femoral head, following surgical treatment of developmental dysplasia of hip in 1-7 years patients. In this study, 120 patients aged from 1 to 7 years old with DDH who had been undergone open surgery, entered to the study. All of these patients followed up for at least 1 year. Surgery procedures divided to 4 groups: open reduction, open reduction+salter osteotomy, open reduction+femur shortening and open reduction+salter osteotomy+femur shortening. The presence of Avascular Necrosis (AVN) had been appraised. 27.5% of surgeries performed on male and 72.5 on female patients. 35.0% of DDH cases were unilateral and remaining was bilateral. 36 patients (30%) shows radiologic findings of AVN, although all of them placed at group I of Bucholz-Ogden classification. 40% of group A patients, 25% of group B, 14.3% of group C and 36.4% of group D patients developed this findings. Open reduction of DDH in older children is effective in the management of DDH and if all of the contrivance considered in the surgery, the rate of AVN would be low and mild (at least in short term follow ups). PMID:24199469

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

2012-04-15

244

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

Directory of Open Access Journals (Sweden)

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

O.A. Aghdam

2012-01-01

245

Quantitative assessment of bone scintigraphy in the hip joint disease  

International Nuclear Information System (INIS)

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

1985-01-01

246

Unconstrained tripolar hip implants: effect on hip stability.  

Science.gov (United States)

Tripolar implants were developed to treat unstable total hip arthroplasties. However, there is limited confirmation that they achieve this purpose despite their increasing use. Because they have a larger effective head size, these implants are expected to increase range of motion to impingement and improve stability in situations at risk for impingement compared with conventional implants. We assessed the range of motion to impingement using a tripolar implant mounted to an automated hip simulator using 22.2-mm and 28-mm femoral head sizes. The 22 and 28-mm tripolar implants provided increases of 30.5 degrees in flexion, 15.4 degrees in adduction, and 22.4 degrees in external rotation compared with the conventional 22.2-mm femoral head diameter implant. At the critical position of 90 degrees hip flexion, there was an increase of 45.2 degrees in internal rotation. At 0 degrees and 30 degrees external rotation, extension increases were 18.8 degrees and 7.8 degrees, respectively. Bony impingement was the limiting factor. Tripolar implants increased the arc of motion before impingement in positions at risk for dislocation and are expected to provide greater stability. PMID:17279045

Guyen, Olivier; Chen, Qing Shan; Bejui-Hugues, Jacques; Berry, Daniel J; An, Kai-Nan

2007-02-01

247

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.

2014-01-01

248

Pediatric Transepiphyseal Seperation and Dislocation of the Femoral Head  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Pediatric hip fractures and dislocations are rare in practice and are related to high-energy trauma. The incidence of postoperative avascular necrosis is increasing, especially in the case of transepiphyseal fractures. Surgery is the most common form of treatment, and its timing is important for prognosis of the fracture. Patients and their families should be informed about the possibility of avascular necrosis and further complications related to the fracture.

2013-01-01

249

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

International Nuclear Information System (INIS)

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

1988-01-01

250

Dislocation climb in two-dimensional discrete dislocation dynamics:  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In this paper, dislocation climb is incorporated in a two-dimensional discrete dislocation dynamics model. Calculations are carried out for polycrystalline thin films, passivated on one or both surfaces. Climb allows dislocations to escape from dislocation pile-ups and reduces the strain-hardening rate, especially for fully passivated films. Within the framework of this model, climb modifies the dislocation structures that develop during plastic deformation and results in the formation of pil...

Davoudi, K. M.; Nicola, L.; Vlassak, J. J.

2012-01-01

251

Luxatio erecta: Inferior glenohumeral dislocation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Baba Asif; Bhat Javid; Paljor S; Mir Naseer; Majid Suhail

2007-01-01

252

Luxatio erecta: Inferior glenohumeral dislocation  

Directory of Open Access Journals (Sweden)

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

Baba Asif

2007-01-01

253

Metal-on-Metal Total Hip Resurfacing Arthroplasty  

Science.gov (United States)

Executive Summary Objective The objective of this review was to assess the safety and effectiveness of metal on metal (MOM) hip resurfacing arthroplasty for young patients compared with that of total hip replacement (THR) in the same population. Clinical Need Total hip replacement has proved to be very effective for late middle-aged and elderly patients with severe degenerative diseases of the hips. As indications for THR began to include younger patients and those with a more active life style, the longevity of the implant became a concern. Evidence suggests that these patients experience relatively higher rates of early implant failure and the need for revision. The Swedish hip registry, for example, has demonstrated a survival rate in excess of 80% at 20 years for those aged over 65 years, whereas this figure was 33% by 16 years in those aged under 55 years. Hip resurfacing arthroplasty is a bone-conserving alternative to THR that restores normal joint biomechanics and load transfer. The technique has been used around the world for more than 10 years, specifically in the United Kingdom and other European countries. The Technology Metal-on-metal hip resurfacing arthroplasty is an alternative procedure to conventional THR in younger patients. Hip resurfacing arthroplasty is less invasive than THR and addresses the problem of preserving femoral bone stock at the initial operation. This means that future hip revisions are possible with THR if the initial MOM arthroplasty becomes less effective with time in these younger patients. The procedure involves the removal and replacement of the surface of the femoral head with a hollow metal hemisphere, which fits into a metal acetabular cup. Hip resurfacing arthroplasty is a technically more demanding procedure than is conventional THR. In hip resurfacing, the femoral head is retained, which makes it much more difficult to access the acetabular cup. However, hip resurfacing arthroplasty has several advantages over a conventional THR with a small (28 mm) ball. First, the large femoral head reduces the chance of dislocation, so that rates of dislocation are less than those with conventional THR. Second, the range of motion with hip resurfacing arthroplasty is higher than that achieved with conventional THR. A variety of MOM hip resurfacing implants are used in clinical practice. Six MOM hip resurfacing implants have been issued licences in Canada. Review Strategy A search of electronic bibliographies (OVID Medline, Medline In-Process and Other Non-Indexed Citations, Embase, Cochrane CENTRAL and DSR, INAHTA) was undertaken to identify evidence published from Jan 1, 1997 to October 27, 2005. The search was limited to English-language articles and human studies. The literature search yielded 245 citations. Of these, 11 met inclusion criteria (9 for effectiveness, 2 for safety). The result of the only reported randomized controlled trial on MOM hip resurfacing arthroplasty could not be included in this assessment, because it used a cemented acetabular component, whereas in the new generation of implants, a cementless acetabular component is used. After omitting this publication, only case series remained. Summary of Findings   Health Outcomes The Harris hip score and SF-12 are 2 measures commonly used to report health outcomes in MOM hip resurfacing arthroplasty studies. Other scales used are the Oxford hip score and the University of California Los Angeles hip score. The case series showed that the mean revision rate of MOM hip resurfacing arthroplasty is 1.5% and the incidence of femoral neck fracture is 0.67%. Across all studies, 2 cases of osteonecrosis were reported. Four studies reported improvement in Harris hip scores. However, only 1 study reported a statistically significant improvement. Three studies reported improvement in SF-12 scores, of which 2 reported a significant improvement. One study reported significant improvement in UCLA hip score. Two studies reported postoperative Oxford hip scores, but no preoperative values were reported. None of the reviewed studies r

2006-01-01

254

Imaging of the hip and bony pelvis. Techniques and applications  

International Nuclear Information System (INIS)

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

2006-01-01

255

Dislocations in graphene  

Energy Technology Data Exchange (ETDEWEB)

We study the stability and evolution of various elastic defects in a flat graphene sheet and the electronic properties of the most stable configurations. Two types of dislocations are found to be stable: 'glide' dislocations consisting of heptagon-pentagon pairs, and 'shuffle' dislocations, an octagon with a dangling bond. Unlike the most studied case of carbon nanotubes, Stone Wales defects seem to be dynamically unstable in the planar graphene sheet. Similar defects in which one of the pentagon-heptagon pairs is displaced vertically with respect to the other one are found to be dynamically stable. Shuffle dislocations will give rise to local magnetic moments that can provide an alternative route to magnetism in graphene.

Carpio, Ana [Departamento de Matematica Aplicada, Universidad Complutense de Madrid, 28040 Madrid (Spain); Bonilla, Luis L [G Millan Institute for Fluid Dynamics, Nanoscience and Industrial Mathematics, Universidad Carlos III de Madrid, 28911 Leganes (Spain); Juan, Fernando de; Vozmediano, MarIa A H [Unidad Asociada ICMM-UC3M, Instituto de Ciencia de Materiales de Madrid, CSIC, Cantoblanco, 28049 Madrid (Spain)], E-mail: bonilla@ing.uc3m.es

2008-05-15

256

Dislocations in graphene  

International Nuclear Information System (INIS)

We study the stability and evolution of various elastic defects in a flat graphene sheet and the electronic properties of the most stable configurations. Two types of dislocations are found to be stable: 'glide' dislocations consisting of heptagon-pentagon pairs, and 'shuffle' dislocations, an octagon with a dangling bond. Unlike the most studied case of carbon nanotubes, Stone Wales defects seem to be dynamically unstable in the planar graphene sheet. Similar defects in which one of the pentagon-heptagon pairs is displaced vertically with respect to the other one are found to be dynamically stable. Shuffle dislocations will give rise to local magnetic moments that can provide an alternative route to magnetism in graphene

2008-05-01

257

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

258

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

259

Hip disease in the young, active patient: evaluation and nonarthroplasty surgical options.  

Science.gov (United States)

As a distinct entity, femoroacetabular impingement has been suggested to be a preosteoarthritic mechanism. The condition occurs when the proximal femur repeatedly comes into contact with the native acetabular rim during normal hip range of motion. Early diagnosis and surgical management are imperative to delay degenerative changes associated with these conditions. Femoroacetabular impingement is most prevalent in young, active patients. Physical examination should include evaluation of gait and foot progression angle, as well as leg length measurement, hip range of motion, and abductor strength. Imaging studies, including plain radiographs and magnetic resonance arthrography, aid in accurate diagnosis. Surgical treatment options include surgical hip dislocation, periacetabular osteotomy, and hip arthroscopy. PMID:19056918

Sierra, Rafael J; Trousdale, Robert T; Ganz, Reinhold; Leunig, Michael

2008-12-01

260

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

Directory of Open Access Journals (Sweden)

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

Scott Yang

2012-01-01

 
 
 
 
261

Proximal tibiofibular dislocation.  

Science.gov (United States)

Proximal tibiofibular joint dislocation is an uncommon injury, which may be easily missed on plain radiography. If recognised, it can be treated in the emergency department, avoiding surgery and long term problems. The case is presented of a 22 year old male rugby player who was tackled from the left hand side while turning to the left. He heard a "pop" from his knee as he fell to the ground. Clinical examination revealed a prominence in the area of the fibular head. There was no evidence of peroneal nerve injury. Plain x rays confirmed a clinical suspicion for anterior dislocation of the proximal tibiofibular joint. Proximal tibiofibular joint dislocation typically occurs when the knee is slightly flexed and the foot is rotated and plantar flexed. Antero lateral dislocation is the most common pattern. Diagnosis is largely clinical, but the findings may be subtle. Plain films may not show any abnormality and computed tomography is the investigation of choice if there is clinical suspicion for the injury. The dislocation should be reduced in the emergency department, but controversy exists whether early mobilisation or casting is the most appropriate course of action. PMID:16627827

Horan, J; Quin, G

2006-05-01

262

Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy.  

Science.gov (United States)

Osteoarthritis (OA) secondary to dislocation and dysplasia is a common problem in patients with cerebral palsy. The purpose of this study was to evaluate the results of total hip replacement (THR) in ambulatory patients with cerebral palsy. Eighteen total hip arthroplasties were performed in 16 ambulatory patients with cerebral palsy. The patient's mean age at surgery was 42 +/- 8 years (range 32-58 years), and the mean follow-up was 10 +/- 6 years (range 2-18 years). Data were obtained by a standardised telephone interview. There was a significant postoperative reduction in pain on the NAS (narrative analogue scale) from 8.4 preoperatively to 1.1 postoperatively (p = 0.002). At follow-up no stem had been revised. Three cups were revised for aseptic loosening at two and six years, and one cup was revised for recurrent dislocation of the hip. One hip was revised for infection 12 years after the index surgery. One hip dislocated (three months postoperatively) and was treated by closed reduction. In ambulatory patients with cerebral palsy and secondary osteoarthritis of the hip THR can provide long-term pain relief and improved function. The rate of long term complications was moderate in this series; however, the dislocation rate was higher than in standard OA cases. PMID:19387644

Schroeder, Kerstin; Hauck, Christian; Wiedenhöfer, Bernd; Braatz, Frank; Aldinger, Peter R

2010-03-01

263

Proximal interphalangeal joint fracture dislocations.  

Science.gov (United States)

Proximal interphalangeal joint fracture dislocations are complex, potentially disabling injuries for any patient, especially the competitive athlete. Dorsal fracture dislocations are fairly common and volar fracture dislocations are rare. Stable injuries often heal with minimal functional deficit, whereas unstable injuries can result in limitation in range of motion, joint incongruity, and degenerative joint disease. A number of surgical procedures have been described to treat the unstable dorsal fracture dislocation, including ORIF, extension block pinning, external fixation, dynamic traction, and volar plate arthroplasty. Volar fracture dislocations are usually amenable to closed or open reduction and internal fixation. The results of treatment of both volar and dorsal fracture dislocations can be unpredictable. PMID:10955207

Glickel, S Z; Barron, O A

2000-08-01

264

Dislocations jam at any density.  

Science.gov (United States)

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 flows. We use dislocation dynamics and scaling arguments in two dimensions to show that the critical stress grows with the square root of the dislocation density. Consequently, dislocations jam at any density, in contrast with granular materials, which only jam below a critical density. PMID:21469802

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

2011-03-11

265

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

266

Primary metal-on-metal total hip arthroplasty with large-diameter femoral heads: a clinical trial of 59 hips.  

Science.gov (United States)

Large-diameter femoral heads with nearly anatomical sizes became available for metal-on-metal total hip arthroplasty after recent advances in metal-on-metal technology. We retrospectively studied the clinical and radiological results in 59 hips of 54 patients (32 women and 22 men, mean age 54.4 years) who underwent cementless metal-on-metal total hip arthroplasty with large-diameter heads. Patients were followed for a mean of 48.6 months. Range of motion improved significantly after surgery (p = 0.001). Harris hip scores improved from 38.5 points to 903 points at latest follow-up. We found no gender-related differences in Harris hip scores, whereas there was a correlation between age and Harris hip scores (p squeaking within their hips, which however disappeared in a short time. We did not observe any dislocation, deep infection or loosening. Grade 1 heterotopic ossification was detected in one hip. Although the inherent stability and the functional results of large anatomical heads are encouraging, longer follow-up data and larger series are essential to evaluate the real advantages of this type of prosthesis over conventional femoral heads. PMID:21302573

Cicek, Hakan; Kilicarslan, Kasim; Yalcin, Nadir; Arslan, Erhan; Dogramaci, Yunus; Yildirim, Hasan

2010-12-01

267

Dislocations in graphene  

Science.gov (United States)

We study the stability and evolution of various elastic defects in a flat graphene sheet using a periodized discrete elasticity model. Two types of dislocations are found to be stable: ``glide'' dislocations consisting of heptagon-pentagon pairs, and ``shuffle'' dislocations, an octagon with a dangling bond. Unlike the most studied case of carbon nanotubes, Stone Wales defects are dynamically unstable in the planar graphene sheet and they annihilate when the dynamics is overdamped. Similar defects in which one of the pentagon-heptagon pairs is displaced vertically with respect to the other one are found to be dynamically stable. Effects of curvature of the graphene sheet are also introduced and do not change the previous results. A discussion of the origin of damping is provided.

Bonilla, Luis L.; Carpio, Ana

2010-03-01

268

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

1973-12-01

269

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 ...

270

Congenital hypothyroidism  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

2010-01-01

271

Congenital hypothyroidism  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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, la...

2010-01-01

272

Effective dislocation lines in continuously dislocated crystals. III. Kinematics  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A class of congruences of principal Volterra-type effective dislocation lines associated with a dislocation density tensor is distinguished in order to investigate the kinematics of continuized defective crystals in terms of their dislocation densities (tensorial as well as scalar). Moreover, it shown, basing oneself on a formula defining the mean curvature of glide surfaces for principal edge effective dislocation lines, that the considered kinematics of continuized defecti...

Trzesowski, Andrzej

2007-01-01

273

Total hip arthroplasty for arthrodesed hips.  

Directory of Open Access Journals (Sweden)

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

Howard MB

2002-06-01

274

Congenital CMV Infection  

Science.gov (United States)

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

275

Ceramic-on-Ceramic Total Hip Arthroplasty: Minimum of Six-Year Follow-up Study  

Science.gov (United States)

Background This study examines the clinical and radiologic results of ceramic-on-ceramic total hip arthroplasties with regard to wear, osteolysis, and fracture of the ceramic after a minimum follow-up of six years. Methods We evaluated the results of a consecutive series of 148 primary ceramic-on-ceramic total hip arthroplasties that had been performed between May 2001 and October 2005 in 142 patients. The mean age was 57.2 years (range, 23 to 81 years). The mean follow-up period was 7.8 years (range, 6.1 to 10.1 years). Preoperative diagnosis was avascular necrosis in 77 hips (52%), degenerative arthritis in 36 hips (24.3%), femur neck fracture in 18 hips (12.2%), rheumatoid arthritis in 15 hips (10.1%), and septic hip sequelae in 2 hips (1.4%). Clinical results were evaluated with the Harris hip score, and the presence of postoperative groin or thigh pain. Radiologic analysis was done with special attention in terms of wear, periprosthetic osteolysis, and ceramic failures. Results The mean Harris hip score improved from 58.3 (range, 10 to 73) to 92.5 (range, 79 to 100) on the latest follow-up evaluation. At final follow-up, groin pain was found in 4 hips (2.7%), and thigh pain was found in 6 hips (4.1%). Radiologically, all femoral stems demonstrated stable fixations without loosening. Radiolucent lines were observed around the stem in 25 hips (16.9%), and around the cup in 4 hips (2.7%). Endosteal new bone formation was observed around the stem in 95 hips (64.2%) and around the cup in 88 hips (59.5%). No osteolysis was observed around the stem and cup. There were 2 hips (1.4%) of inclination changes of acetabular cup, 2 hips (1.4%) of hip dislocation, 1 hip (0.7%) of ceramic head fracture, and 1 hip (0.7%) of squeaking. The Kaplan-Meier survival rate of the prostheses was 98.1% at postoperative 7.8 years. Conclusions The ceramic-on-ceramic total hip arthroplasty produced excellent clinical results and implant survival rates with no detectable osteolysis on a minimum six-year follow-up study. The ceramic-on-ceramic couplings could be a reasonable option of primary total hip arthroplasty for variable indications.

Choy, Won-Sik; Lee, Sang Ki; Bae, Kyoung Wan; Hwang, Yoon Sub; Park, Chang Kyu

2013-01-01

276

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

Science.gov (United States)

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

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

2013-11-01

277

Neglected irreducible posterolateral knee dislocation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Saini Raghav; Mootha Aditya; Goni Vijay; Dhillon Mandeep

2010-01-01

278

Behavior of dislocations in silicon  

Energy Technology Data Exchange (ETDEWEB)

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

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

1995-08-01

279

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... It allows the leg to go up and down, in and out, and also allows the leg ... the hip include: • walking • running • going up and down stairs Socket Anchor • sitting down Artificial Hips Artificial ...

280

Hip Revision Surgery  

Medline Plus

Full Text Available ... very high hip center. This is the teardrop down here, so she's had a very high hip ... would be to try to bring the socket down and perhaps use a trabecular metal augment above ...

 
 
 
 
281

Hip Replacement - Physical Therapy  

Medline Plus

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

282

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... socket device. Artificial hips allow a very wide range of motion, even though it is a little ... physical therapy, strengthen your leg and improve the range of motion in your new hip. The surgeon, ...

283

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... knee joint, the hip joint moves in many directions. It allows the leg to go up and ... Artificial hips allow a very wide range of motion, even though it is a little less than ...

284

Hip Replacement - Physical Therapy  

Medline Plus

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

285

Hip Revision Surgery  

Medline Plus

Full Text Available ... see how it's changed positions? Yes. That hopefully means it's loose. Excellent. And we see a textbook ... near that on a revision hip -- or I mean on a primary hip. So, those kinds of ...

286

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 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%)

1983-12-01

287

Congenital epulis  

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

2010-01-01

288

Hip Revision Surgery  

Medline Plus

Full Text Available ... commonly on revisions because of the higher dislocation rate. But, with the advent of highly crosslinked poly, ... better offset on our femoral components, our dislocation rate is, you know, it's still higher than primaries, ...

289

Intermediate- to long-term results after hybrid total hip arthroplasty in patients with rheumatoid arthritis.  

Science.gov (United States)

There have been few reports describing intermediate- to long-term results after hybrid total hip arthroplasty in patients with rheumatoid arthritis. We followed up 52 hips in 44 patients aged 5 men and 39 women, with a mean of 11.5 years (range, 5-23.5 years). Revisions had been performed in 6 hips in 6 patients: 1 both acetabular and femoral components for infection, 1 acetabular component for aseptic loosening, 3 acetabular components for recurrent dislocation, and 1 acetabular component for dislodgement of the polyethylene liner from the metal shell. None of other acetabular or femoral components were revised or found to be loose at the final follow-up. Although postoperative dislocation remains a concern, hybrid total hip arthroplasty had an acceptable result in patients with rheumatoid arthritis. PMID:22854346

Ito, Hiroshi; Tanino, Hiromasa; Yamanaka, Yasuhiro; Minami, Akio; Matsuno, Takeo

2013-02-01

290

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... it moves in the hip socket. Unlike the knee joint, the hip joint moves in many directions. It allows the leg to go up and down, in and out, and also allows the leg to rotate. Hip Socket Femur Ligaments protect the head of the femur from coming ...

291

Total hip arthroplasty in healed tuberculous hip.  

Directory of Open Access Journals (Sweden)

Full Text Available Total hip arthroplasty was performed in a patient who had tuberculous hip, quiescent for the last 15 years, without pre or postoperative anti-tuberculous chemotherapy. At a 27 month follow up, there has been no evidence of reactivation. A brief review of relevant literature is also presented.

Dogra A

1995-10-01

292

Prevention of hip fracture with hip protectors.  

Science.gov (United States)

The prevention of fractures amongst older people consists of (i) prevention and treatment of osteoporosis, (ii) prevention of falling and (iii) prevention of fractures using injury-site protection. As the great majority of hip fractures are caused by a sideways fall with direct impact on the greater trochanter of the proximal femur, one approach to prevention is the use of an adequately configured padded, firm-shield external hip protector. With this type of two-part design, the impacting force and energy are, at the time of the fall-impact, first weakened by the padding part of the protector and then diverted away from the greater trochanter by the shield part of the same. Following this line, a series of consecutive studies by the Accident & Trauma Research Center at the UKK Institute, Tampere, Finland, found that a padded, strong-shield hip protector was effective in preventing hip fractures. In the context of the wider literature on hip protectors, these more encouraging results suggest the need for a more rigorous regulation of protector design and characteristics. Alongside inadequacies of design, the other most frequent general problem with hip protectors is compliance. Not all elderly people with a high risk of hip fracture will agree to use hip protectors and in those who do, long-term adherence may decrease. Caregiver motivation and involvement appear therefore to be crucial. PMID:16926206

Kannus, Pekka; Parkkari, Jari

2006-09-01

293

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  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 degre...

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

2012-01-01

294

Radiographic assessment of biomechanical parameters following hip resurfacing and cemented total hip arthroplasty.  

Science.gov (United States)

Resurfacing hip arthroplasty and total hip replacement both aim to restore anatomical parameters.Leg length and offset discrepancy can result in altered joint reaction forces, and are associated with increased wear, dislocation, and decreased patient satisfaction. This study assesses the accuracy of leg length and offset restoration after either a Birmingham Hip Resurfacing (BHR) or a cemented total hip replacement (THR).Standardised antero-posterior radiography was performed on two groups of 30 patients with unilateral primary osteoarthritis undergoing either a cemented total hip or resurfacing. The normal contra-lateral hip was used as the control. Leg length and offset were measured pre-operatively with no significant difference between the two groups.Cup offset, femoral offset, total offset and leg length of the prosthesis and normal side were measured by two observers and mean measurements were analysed by a paired t test.Leg lengths in each group did not differ significantly from the normal side, THR 0.53 mm (95% CI -2.4 to 3.4 mm) but BHR implantation did result in mean leg shortening of -1.9 mm (95% CI -4.5 mm to 0.6mm). Cup offset differed significantly from normal anatomy in both groups, as did femoral and total offset for the total hip replacement group. However, femoral offset was restored in the Birmingham resurfacing group. When the THR group was compared against the BHR group we found no difference between restoration of leg lengths (p = 0.21) and cup offset (p = 0.30) but femoral (p = 0.0063) and total offset (p = 0.03) were restored more accurately with a BHR. PMID:19891051

Robb, Curtis; Harris, Richard; O'Dwyer, Kevin; Aslam, Nadim

2009-01-01

295

Are abductor muscle quality and previous revision surgery predictors of constrained liner failure in hip arthroplasty?  

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Dislocation is one of the most common complications of total hip arthroplasty. The use of constrained liners is an option for the management of chronic hip instability, typically used after other methods have failed. The purposes of this study were to evaluate the overall clinical outcomes and failure rates of a tripolar constrained liner design, to assess the radiographic outcomes of its use, and to examine whether various factors such as abductor mechanism quality and history of previous re...

Zywiel, Michael G.; Mustafa, Loi’y H.; Bonutti, Peter M.; Mont, Michael A.

2011-01-01

296

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

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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. C...

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

2011-01-01

297

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

298

Arthrography of the hip in children  

International Nuclear Information System (INIS)

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

1980-01-01

299

Congenital dysfibrinogenemia.  

Science.gov (United States)

Fibrinogen abnormalities can be classified as congenital or acquired. Each class manifests quantitative or qualitative alterations; the latter are known as dysfibrinogenemias. In dysfibrinogenemias, structural defects cause alterations in the conversion of fibrinogen to fibrin. Approximately 300 abnormal fibrinogens have been reported, and about 83 structural defects have been identified. The most common structural defect involve the fibrinopeptides and their cleavage sites, and the second most common involves the gamma-chain polymerization region. Approximately half of the mutants are clinically silent, whereas hemorrhage and thrombosis occur in almost equal numbers of cases. Study of the abnormal fibrinogens has provided insight into fibrinogen structure and fibrin formation and dissolution. Some of the structural abnormalities exhibit defective assembly and activation of components of the fibrinolytic system on the abnormal fibrin, resulting in impaired dissolution of fibrin, clinically associated with thrombosis. PMID:9288470

Martinez, J

1997-09-01

300

Congenital dacryocystocele.  

Science.gov (United States)

Four cases of congenital lacrimal sac distention were managed in an initially conservative manner to further elucidate the natural history of the condition and to formulate a more systematic approach to its treatment. In three cases, the abnormality resolved without nasolacrimal duct probing, with no adverse sequelae. In one case, dacryocystitis caused by Serratia marcescens, corneal astigmatism, and severe canthal distortion prompted surgical intervention. The management of individual cases of dacryocystocele should be influenced by the presence of inflammation, the virulence of any infecting organisms, the induction of astigmatism and anisometropia, and the degree of canthal distortion. Dacryocystocele appears to be a more specific term for lacrimal sac distention than either amniotocele or mucocele, and is not restricted to only one source of its fluid contents. PMID:7138344

Harris, G J; DiClementi, D

1982-11-01

 
 
 
 
301

Are abductor muscle quality and previous revision surgery predictors of constrained liner failure in hip arthroplasty?  

Science.gov (United States)

Dislocation is one of the most common complications of total hip arthroplasty. The use of constrained liners is an option for the management of chronic hip instability, typically used after other methods have failed. The purposes of this study were to evaluate the overall clinical outcomes and failure rates of a tripolar constrained liner design, to assess the radiographic outcomes of its use, and to examine whether various factors such as abductor mechanism quality and history of previous revision surgeries were associated with an increased risk of failure. Forty-three hips in 39 patients who had a mean follow-up of 51 months (range, 24-110 months) were reviewed. Ninety-one percent of the hips (39 of 43 hips) did not need any revisions over the study period. A new liner was implanted in all four failed hips with concurrent revision of the acetabular cup in three cases. No further dislocations occurred in this group. The mean hip score for surviving hips was 82 points (range, 38-100 points) at final follow-up. Radiographic evaluation revealed stable, well-fixed acetabular components in all surviving hips without progressive radiolucencies. No association was found between abductor muscle quality and the incidence of failure, but patients who experienced a constrained liner failure were more likely to have undergone at least one previous hip revision operation. Tripolar constrained acetabular liners can provide successful outcomes in patients with hip instability, although it is important not to rely on the use of a constrained liner alone in an attempt to compensate for other correctable factors such as component positioning. PMID:20174798

Zywiel, Michael G; Mustafa, Loi'y H; Bonutti, Peter M; Mont, Michael A

2011-06-01

302

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

303

Common finger fractures and dislocations.  

Science.gov (United States)

Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of finger fractures and dislocations. Dorsal dislocation of the proximal interphalangeal joint is the most common type of finger dislocation. Finger dislocations should be reduced as quickly as possible and concurrent soft tissue injuries treated appropriately. Referral to a hand specialist is needed if a dislocation cannot be reduced; is unstable following reduction; or involves significant ligament, tendon, or soft tissue injury. Some common finger fractures can be treated conservatively with appropriate reduction and immobilization. Referral to a hand specialist is required if a fracture is unstable, involves a large portion (greater than 30 percent) of the intra-articular surface, or has significant rotation. PMID:22534390

Borchers, James R; Best, Thomas M

2012-04-15

304

COMPUTER SIMULATION OF DISLOCATION PATTERNING  

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The dislocation structures formed in metals during monotonic or cyclic plastic straining usually build up characteristic bi- or tridimensional patterns : walls, veins, cells... Long range elastic interactions between dislocations are responsible for the occurrence of such non-uniform and organized structures. Two competing factors control these collective effects : when recovery (by cross-slip and/or climb) is effective, dense dislocation arrays tend to form stable structures which minimize t...

Le?pinoux, J.; Kubin, L.

1989-01-01

305

Irradiation induced dislocation climb sources  

International Nuclear Information System (INIS)

The formation of dislocation loops at apparently random positions during electron irradiation has been observed many times in a variety of materials. In Cu-Ni alloys loops may form at random, but under certain conditions loops are continually nucleated at specific points, i.e. at dislocation climb sources. In situ observations of the operation of these dislocation climb sources and the loops emitted during electron irradiation in a high voltage electron microscope are reported

1975-09-01

306

Grain Orientation and Dislocation Patterns  

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Abstract Dislocation patterns have been characterized by transmission electron microscopy and Kikuchi line analysis in pure, polycrystalline aluminium deformed in tension at room temperature in the strain range 0.05-0.34. The angular strain relationship of the dislocation boundaries, their scaling behaviour and the occurrence of similitude shows that two dislocation patterns coexist in all grains, however, with very different characteristics dependent on the grain orientation. An a...

2006-01-01

307

Mobile Dislocations, Electrons, and Chaos*  

Science.gov (United States)

We show that the electron drag force on a dislocation moving in a magnetic field, H, introduces a sharp maximum in the drag stress when H is parallel to the dislocation line (tilt-effect**). The angular width of this maximum, given by the radius of the effective electron-dislocation interaction is, in the linear approximation, of the order of w/RGumen, J. Galligan, Phil. Mag. A, 77, 497 (1998).

Galligan, James; McKrell, Thomas; Krokhin, Arkady; Vigueras, Enrique

2000-03-01

308

[Chronic dislocations of the shoulder].  

Science.gov (United States)

Diagnosis and management of chronic dislocations of the glenohumeral joint remain challenging. These dislocations usually occur in debilitated patients with a poor bone quality and they often have a decreased rehabilitation potential. Treatment can only be successful with early recognition of the condition, careful patient selection, and implementation of appropriate surgical techniques. This article reviews current information on clinical evaluation, preoperative radiologic investigations, and treatment strategies in patients with chronic dislocations of the glenohumeral joint and associated articular surface defects. PMID:15925923

Bezer, Murat; Güven, Osman; Karahan, Mustafa

2005-01-01

309

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

Science.gov (United States)

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

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

2013-01-01

310

Nature of Dislocations in Silicon  

DEFF Research Database (Denmark)

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

Hansen, Lars Bruno; Stokbro, Kurt

1995-01-01

311

Congenital vocal cord paralysis.  

Science.gov (United States)

Congenital stridor is rare. The most common presentation for congenital stridor is chronic loud breathing since birth. It is noticed in patients by the first 4 to 6 weeks of life. There are many causes of congenital stridor. Laryngomalacia is the most common cause of congenital stridor. Congenital vocal cord paralysis is the second most common cause of congenital stridor. Vocal cord paralysis in infants and children can be either congenital or acquired and either unilateral or bilateral. Although most commonly the paralysis is idiopathic, there are many causes of acquired vocal cord paralysis. Arnold-Chiari malformation is the most common congenital central nervous system abnormality resulting in vocal cord paralysis, and central nervous system abnormalities usually may cause bilateral vocal cord paralysis. In this article, we report 2 patients with idiopathic congenital vocal cord paralysis. One of them has the unilateral vocal cord paralysis, and the other, bilateral. PMID:20098198

Ada, Mehmet; Isildak, Huseyin; Saritzali, Gkioukxel

2010-01-01

312

Hip resurfacings revised for inflammatory pseudotumour have a poor outcome.  

Science.gov (United States)

Inflammatory pseudotumours occasionally occur after metal-on-metal hip resurfacing and often lead to revision. Our aim was to determine the severity of this complication by assessing the outcome of revision in these circumstances and by comparing this with the outcome of other metal-on-metal hip resurfacing revisions as well as that of matched primary total hip replacements. We identified 53 hips which had undergone metal-on-metal hip resurfacing and required revision at a mean of 1.59 years (0.01 to 6.69) after operation. Of these, 16 were revised for pseudotumours, 21 for fracture and 16 for other reasons. These were matched by age, gender and diagnosis with 103 patients undergoing primary total hip replacement with the Exeter implant. At a mean follow-up of three years (0.8 to 7.2) the outcome of metal-on-metal hip resurfacing revision for pseudotumour was poor with a mean Oxford hip score of 20.9 (sd 9.3) and was significantly worse (p < 0.001) than the outcome for fracture with a mean Oxford hip score of 40.2 (sd 9.2) or that for other causes with a mean Oxford hip score of 37.8 (sd 9.4). The clinical outcome of revision for pseudotumour was also significantly worse (p < 0.001) than the outcome of matched primary total hip replacements. By contrast, the outcome for fracture and other causes was not significantly different from that of matched primary total hip replacements (p = 0.065). After revision for pseudotumour there were three cases of recurrent dislocation, three of palsy of the femoral nerve, one of stenosis of the femoral artery and two of loosening of the component. Five hips required further revision. In three of these there was evidence of recurrent pseudotumour, and one is currently awaiting further revision. The incidence of major complications after revision for pseudotumour (50%) was significantly higher (p = 0.018) than that after revision for other causes (14%). The outcome of revision for pseudotumour is poor and consideration should be given to early revision to limit the extent of the soft-tissue destruction. The outcome of resurfacing revision for other causes is good. PMID:19651827

Grammatopolous, G; Pandit, H; Kwon, Y-M; Gundle, R; McLardy-Smith, P; Beard, D J; Murray, D W; Gill, H S

2009-08-01

313

Proximal tibiofibular dislocation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

2006-01-01

314

Disassociation at the head-trunnion interface: an unseen complication of modular hip hemiarthroplasty.  

Science.gov (United States)

A woman in her mid-90s underwent a left uncemented bipolar hemiarthroplasty for an intracapsular femoral neck fracture. Postoperative radiographs at 48h showed a disassociation of the left femoral prosthesis at the head-trunnion interface, with the bipolar head remaining in the acetabulum. There was no preceding trauma and the patient had mobilised postoperatively. The hip was revised to a monopolar head, and the patient's hip was protected postoperatively in a brace limiting flexion and external rotation. At 30 days following revision she was mobilising pain-free with a stable hip. Disassociation at the head-trunnion interface has never been reported in hip hemiarthroplasty, and is only described in relation to primary or revision total hip replacements (THR) following dislocation or trauma to the THR. This demonstrates a potential complication of modular prostheses for trauma. PMID:24092606

Moores, Thomas Steven; Blackwell, John R; Chatterton, Benjamin Dougal; Eisenstein, Neil

2013-01-01

315

The evolution and concepts of joint-preserving surgery of the hip.  

Science.gov (United States)

The use of joint-preserving surgery of the hip has been largely abandoned since the introduction of total hip replacement. However, with the modification of such techniques as pelvic osteotomy, and the introduction of intracapsular procedures such as surgical hip dislocation and arthroscopy, previously unexpected options for the surgical treatment of sequelae of childhood conditions, including developmental dysplasia of the hip, slipped upper femoral epiphysis and Perthes' disease, have become available. Moreover, femoroacetabular impingement has been identified as a significant aetiological factor in the development of osteoarthritis in many hips previously considered to suffer from primary osteoarthritis. As mechanical causes of degenerative joint disease are now recognised earlier in the disease process, these techniques may be used to decelerate or even prevent progression to osteoarthritis. We review the recent development of these concepts and the associated surgical techniques. PMID:24395304

Leunig, M; Ganz, R

2014-01-01

316

Hip Arthroscopy for Challenging Deformities: Global Pincer Femoroacetabular Impingement  

Science.gov (United States)

Pincer femoroacetabular impingement occurs in focal or global forms, the latter having more generalized and typically more extreme acetabular overcoverage. Severe global deformities are often treated with open surgical dislocation of the hip. Arthroscopic technical challenges relate to difficulties with hip distraction; central-compartment access; and instrument navigation, acetabuloplasty, and chondrolabral surgery of the posterior acetabulum. Techniques addressing these challenges are introduced permitting dual-portal hip arthroscopy with central-compartment access, subtotal acetabuloplasty, and circumferential chondrolabral surgery. The modified midanterior portal in combination with a zone-specific sequence of acetabular rim reduction monitored with fluoroscopic templating enables precision subtotal acetabuloplasty. Guidelines for acetabular rim reduction include the following suggested radiographic endpoints: postoperative center-edge angle of 35°, a neutral posterior wall sign, and an anterior margin ratio of 0.5. Arthroscopic zone-specific chondrophobic rim preparation and circumferential labral reparative and reconstructive techniques and tools permit the arthroscopic treatment of these challenging deformities.

Matsuda, Dean K.; Gupta, Nikhil; Hanami, Dylan

2014-01-01

317

Hip Arthroscopy Update  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Kelly, Bryan T.; Buly, Robert L.

2005-01-01

318

Painful hip arthroplasty: definition  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Total hip arthroplasty (THA) has been indicated as the surgical intervention with greatest improvement in pain and physical function. However some patients continue to experience hip pain after elective surgery. We investigate prognostic factors that negatively affect treatment effectiveness and the patient outcome. The “hip region” constitutes the groin, buttock, upper lateral thigh, greater trochanteric area, and the iliac crest. Pain originating from various sources and not directly li...

Ferrata, Paolo; Carta, Serafino; Fortina, Mattia; Scipio, Daniele; Riva, Alberto; Di Giacinto, Salvatore

2011-01-01

319

Painful Hip Prosthesis: Definition  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Pain is the main reason inducing patients to undergo surgery and persistence of pain after the operation is a major concern, both for the patient and the surgeon. Up to 10% of patients report pain five years after hip arthroplasty. An analysis of the literature reveals numerous causes of pain localised to the replacement hip. In assessing a painful hip it is fundamental to arrive at a definite diagnosis before starting any treatment. Intrinsic causes can be identified, such as unrecognised as...

Ferrata, P.; Carta, S.; Fortina, M.; Scipio, D.; Riva, A.; Di Giacinto, S.

2010-01-01

320

Congenital distal humeral dysplasia: a case report  

International Nuclear Information System (INIS)

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

2003-01-01

 
 
 
 
321

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

Directory of Open Access Journals (Sweden)

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

Issack Paul S

2012-06-01

322

Congenital Heart Information Network  

Science.gov (United States)

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

323

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

324

Arthrography of the hip in children. Technique, normal anatomy and findings in unstable hip joints.  

Science.gov (United States)

A method by which bilateral hip arthrography was performed under general anaesthesia in 130 infants and children 1 month to 7 years of age is described. Significant contractures of the adductor muscles had been corrected before the examination. Most of the children were girls with unilateral congenital idiopathic hip instability detected before the age of one year. From films exposed in standardized projections valuable information was obtained about the configuration of the joint cavity and the size and shape of the femoral head. Criteria for normal appearance in infants of ages 2 to 12 months are presented. More reliable details on the relation between the articular surfaces, the radiographic anatomy of the acetabulum and the distribution of the contrast medium were yielded by stereoradiography. Closed reduction was usually accomplished successfully during the arthrography, which made beginning of definitive treatment under the same anaesthesia possible. PMID:7415855

Lönnerholm, T

1980-01-01

325

Congenital hyperinsulinism.  

Science.gov (United States)

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

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

2010-05-01

326

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. Maltry ... need to accommodate the total anteversion of a total hip replacement, because you're using the connective, you ...

327

Perilunate Injuries, Not Dislocated (PLIND).  

Science.gov (United States)

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

Herzberg, Guillaume

2013-11-01

328

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

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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 ...

2011-01-01

329

The other hip in unilateral hip dysplasia  

DEFF Research Database (Denmark)

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

Jacobsen, Steffen; Rømer, L

2006-01-01

330

Reversal Of Hip Arthrodesis With Birmingham Hip Resurfacing  

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The reversal of hip arthrodesis with a Total Hip Arthroplasty has been well documented. We describe the case of a reversal of an ankylosed hip in a 69-year-old man using a Birmingham Hip Resurfacing device. No surgical complication occurred. Six months following surgery, the patient exhibited good clinical function and remained satisfied with the outcome. We conclude that metal-on-metal resurfacing arthroplasty represents a viable alternative for the reversal of hip arthrodesis. To our k...

2007-01-01

331

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

332

Phase Field Methods and Dislocations  

CERN Document Server

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

Rodney, D

2001-01-01

333

DYNAMIC DISLOCATION DAMPING IN METALS  

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The simultaneous measurements of the amplitude independent damping and modulus defect in the copper and lead single crystals are performed within the temperature range from 4,2 K to 300 K (Cu) and from 4,2 K to 10 K (Pb) at 5+15 MHz. It is found that the dislocation internal friction in copper is determined by the superposition of two energy loss contributions : dynamic loss caused by the viscous dislocation drag and the relaxation one caused by thermoactivated dislocation motion. The dynamic...

Al Shits, V.; Kobelev, N.; Soifer, Ya

1981-01-01

334

Moving Dislocations in Disordered Alloys.  

Energy Technology Data Exchange (ETDEWEB)

Using atomistic simulations of dislocation motion in Ni and Ni-Au alloys we report a detailed study of the mobility function as a function of stress, temperature and alloy composition. We analyze the results in terms of analytic models of phonon radiation and their selection rules for phonon excitation. We find a remarkable agreement between the location of the cusps in the {sigma}-v relation and the velocity of waves propagating in the direction of dislocation motion. We identify and characterize three regimes of dissipation whose boundaries are essentially determined by the direction of motion of the dislocation, rather than by its screw or edge character.

Marian, J; Caro, A

2006-11-18

335

Is Congenital Syphilis Really Congenital Syphilis?  

Directory of Open Access Journals (Sweden)

Full Text Available Detroit has recently been distinguished as having the highest congenital syphilis rate in the United States (250.3 cases per 100 000 live births in Detroit versus 10.3 in the US. However, depending on each health department's followup and CDC reporting, these data may not accurately reflect the true congenital syphilis rate. This study examines the reported cases over a three-year time period with focus on the criteria used for diagnosis. All local health department congenital syphilis CDC collection forms (form 73.126 were reviewed for the years in question. The reported congenital syphilis cases in the year 2002–2004 in Detroit were reviewed. No cases met confirmed case criteria and few probable cases were based on neonatal evaluations. The majority of “congenital syphilis” cases were established based on incomplete maternal data such as missing followup serologic titers in the absence of complete neonatal information. In conclusion, although the reported congenital syphilis rate in Detroit is alarmingly high, the true occurrence of congenital syphilis is likely to have been overstated. A health department reporting program that includes more diligent neonatal followup would allow for a more accurate representation of this public health concern.

Bernard Gonik

2006-12-01

336

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

337

Magnetic resonance imaging of labral cysts of the hip  

Energy Technology Data Exchange (ETDEWEB)

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

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

1996-11-01

338

Magnetic resonance imaging of labral cysts of the hip  

International Nuclear Information System (INIS)

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

1996-11-01

339

Kinetic Monte Carlo simulation of dislocation dynamics  

Energy Technology Data Exchange (ETDEWEB)

A kinetic Monte Carlo simulation of dislocation motion is introduced. The dislocations are assumed to be composed of pure edge and screw segments only, and are assumed to be confined to a fixed lattice. The stress and temperature dependence of the dislocation velocity is studied. It is also noted that the simulated dislocations display kinetic roughening.

Lin, K.; Chrzan, D.C.

1999-07-01

340

Transient osteoporosis of the hip.  

Directory of Open Access Journals (Sweden)

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

McWalter Patricia

2009-01-01

 
 
 
 
341

Aberrometry changes and IOL dislocation  

Directory of Open Access Journals (Sweden)

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

A.B. Kachanov

2013-02-01

342

Total hip arthroplasty  

Directory of Open Access Journals (Sweden)

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

Slavkovi? Nemanja

2012-01-01

343

Bipolar dislocation of the clavicle  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

344

Proximal carpal row dislocation: a case report  

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Carpal dislocations commonly occur as the result of high-energy axial loading of the forearm with the wrist extended. There exists several variants of carpal dislocations with the most commonly observed being those about the lunate. Perilunate dislocations and fracture dislocations were first characterized by Mayfield in 1980 and represent a spectrum of traumatic carpal dislocation beginning radial and progressing to the ulnar side of the wrist (Mayfield et al. J Hand Surg [Am] 5:226–241, 1...

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

2010-01-01

345

Continuum theory of evolving dislocation fields  

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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...

2007-01-01

346

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

347

Anterior muscle sparing approach for total hip arthroplasty  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of this review is to examine the validity of positive claims regarding the direct anterior approach (DAA with a fracture table for total hip arthroplasty. Recent literature regarding the DAA was searched and specific claims investigated including improved early outcomes, speed of recovery, component placement, dislocation rates, and complication rates. Recent literature is positive regarding the effects of total hip arthroplasty with the anterior approach. While the data is not definitive at present, patients receiving the anterior approach for total hip arthroplasty tend to recover more quickly and have improved early outcomes. Component placement with the anterior approach is more often in the “safe zone” than with other approaches. Dislocation rates tend to be less than 1% with the anterior approach. Complication rates vary widely in the published literature. A possible explanation is that the variance is due to surgeon and institutional experience with the anterior approach procedure. Concerns remain regarding the “learning curve” for both surgeons and institutions. In conclusion, it is not a matter of should this approach be used, but how should it be implemented.

Joseph T Moskal

2013-01-01

348

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... muscles around the hip joint must be strengthened after surgery and the patient needs to recognize the limitations ... the highest during the first 6-8 weeks after surgery. If your surgeon has performed the surgery using ...

349

Hip Revision Surgery  

Medline Plus

Full Text Available ... of that rim there, probably some of the effects of the in vivo oxidation. Yeah, you can ... for you with regard to what type of effect, adverse or not, would a high hip center ...

350

Hip Revision Surgery  

Medline Plus

Full Text Available ... that Dr. Pearson may turn to. As you recall from the preoperative xray, the hip center is ... them on protected weigh-bearing for a longer period of time, or does that not matter in ...

351

Imaging of hip arthroplasty  

International Nuclear Information System (INIS)

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

2002-06-01

352

Hip Replacement - Physical Therapy  

Medline Plus

Full Text Available ... does. Common activities that use the hip include: • walking • running • going up and down stairs Socket Anchor • ... your physical therapist. Examples of such goals include: • walking 100 yards • going up or down the stairs • ...

353

Hip Revision Surgery  

Medline Plus

Full Text Available ... So now, we've got a 40 millimeter internal diameter liner for this socket. And certainly, even ... really, really stable hip. Yeah, a lot of internal rotation there. Yeah, so I would be very, ...

354

Hip Revision Surgery  

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Full Text Available ... underwent a primary hip replacement. She then developed problems with that, the details of which I'm ... graft. The ability to avoid the graft eliminates problems with fabrication, potential infectious transmission, concerns about the ...

355

Hip Revision Surgery  

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Full Text Available ... a year or two later, she underwent a primary hip replacement. She then developed problems with that, ... why we're planning on revising that. Her primary source of pain, for the past several years ...

356

Hip Revision Surgery  

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Full Text Available ... because we're taking it in a weird direction. But maybe not. Okay, you're in. That's ... of this hip with really great range of motion and the extremes of extension and flexion. So ...

357

Hip Revision Surgery  

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Full Text Available ... chosen not to and dealt with this socket where is and probably cemented a liner in. However, ... very high hip center. And we'll see where we reconstruct this, there are a couple of ...

358

Hip Revision Surgery  

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Full Text Available ... fixed, and has really simplified and increased the margin of safety in some of the very demanding ... done or watched a lot of them. The margin of error for revision hip surgery is right. ...

359

Taper Hip Prosthesis  

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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 ...

360

Taper Hip Prosthesis  

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

 
 
 
 
361

Taper Hip Prosthesis  

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Full Text Available ... Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome to this " ... size 6. My final templated size is a 12 -- 12.5. Therefore, we'll skip one rasp ...

362

Hip Revision Surgery  

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Full Text Available ... And I think you can see in your mind's eye -- Dan, clean that off, it's little blurry -- ... hip center reconstruction, it's something to keep in mind as a potential extra-articular source of impingement. ...

363

Taper Hip Prosthesis  

Medline Plus

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

364

The use of constrained components in total hip arthroplasty.  

Science.gov (United States)

The use of a constrained component may be appropriate for the surgical treatment of recurrent dislocation due to soft-tissue insufficiency following a total hip arthroplasty. Constrained components usually include a locking mechanism incorporated into the polyethylene acetabular liner to keep the prosthetic femoral head in place. Two different prosthetic designs are available and have been approved by the U.S. Food and Drug Administration. The S-ROM constrained component uses additional polyethylene in the rim, which deforms to more fully capture the femoral head and then is held in place by a metal locking ring. The Howmedica Osteonics constrained component is a tripolar device; its bipolar component articulates with another polyethylene liner. These constrained components transfer hip forces that would otherwise lead to dislocation to the locking mechanism, the liner-shell interface, or the bone-prosthesis interface. These forces may eventually contribute to failure of the component due to loosening, dissociation, breakage, or recurrent dislocation. Studies of these components show a failure rate of 4% to 29% at relatively short-term follow-up. PMID:15089072

Lachiewicz, Paul F; Kelley, Scott S

2002-01-01

365

Dislocations in Monolayers and Semiconductors.  

Science.gov (United States)

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

Ren, Qiang

1995-01-01

366

Genetics of congenital hypothyroidism  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

367

Hip Revision Surgery  

Medline Plus

Full Text Available ... really helped us. In addition to having better offset on our femoral components, our dislocation rate is, ... the highly crosslinked liners, you do increase the offset 2 or 3 millimeters compared to a 32 ...

368

Osteoarthritis of the hip  

International Nuclear Information System (INIS)

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

1993-07-01

369

Revision total hip arthroplasty using an interlocking stem with an allograft-prosthesis composite.  

Science.gov (United States)

We report the clinical and radiographic outcomes and complications of revision surgery using a cementless interlocking stem with an allograft-prosthesis composite (APC). This study included 11 patients with an average follow-up of 73 years. Of the 11 revisions, 1 was aseptic, 7 were septic, and 3 were periprosthetic femoral fractures. The mean Harris hip score improved from 25.6 points before surgery to 74.8 points at final follow-up. Osseous union at the proximal allograft-host bone junction occurred in 10 hips (90.9%) ; the greater trochanter did not unite in 4 of 7 hips (57.1%). Moderate and severe allograft resorption occurred in one hip each. Postoperative complications included 1 deep infection, 2 heterotopic ossifications, and 1 dislocation. Using an interlocking stem with an allograft-prosthesis composite in revision surgery provided acceptable results in the presence of circumferential massive bone deficiency of the proximal femur. PMID:24205769

Uchiyama, Katsufumi; Moriya, Mitsutoshi; Yamamoto, Takeaki; Fukushima, Kensuke; Takahira, Naonobu; Itoman, Moritoshi

2013-08-01

370

Trabecular metal used for major bone loss in acetabular hip revision.  

Science.gov (United States)

The purpose of this study was to evaluate the outcome of trabecular metal (TM) acetabular components used in revision hip arthroplasty with major bone deficiency. We retrospectively reviewed the records of 46 patients undergoing revision hip arthroplasty with severe acetabular bone loss. Clinical outcomes were assessed using Harris Hip Score, Western Ontario and McMaster Universities, and Short-Form 12. Mean follow-up was 50 months. All patients had Paprosky type IIc or III acetabular bone deficiency. Major complications included 1 infection, 2 dislocations, and 1 arterial bleeding. Average Harris Hip Score was 78.2. Short-Form 12 scores were within population-based age-matched averages. Western Ontario and McMaster Universities scores were mainly in the 2 lowest disability categories. Porous tantalum shows promising results in revision arthroplasty with severe acetabular bone loss. PMID:21481564

Davies, Jonah Hebert; Laflamme, G Yves; Delisle, Josee; Fernandes, Julio

2011-12-01

371

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

372

[Osteochondrosis dissecans of the hip in adults--differential diagnosis of free joint bodies--case report].  

Science.gov (United States)

The causes of hip pain in adults can vary greatly. We present the case of a 44-year-old woman with recurrent hip pain over a period of years. Medical history and clinical examination did not provide any decisive information. The X-rays revealed a loose body in the cavity of the hip joint. The MRI scan made the following differential diagnosis plausible: osteochondrosis dissecans coxae, osteochondroma and chondromatosis. The final diagnosis of osteochondrosis dissecans coxae was confirmed by surgical dislocation of the hip as modified by Ganz and histological examination of the loose body. This case supports the importance of including rare lesions in the differential diagnostic work-up of joint pain. The advantages of the offset operation as modified by Ganz versus arthroscopy of the hip are outlined. PMID:16821182

Hagemann, L; Berger, S; Philipps, B; Ostertag, H; Siebert, C H

2006-01-01

373

Subtrochanteric valgus osteotomy with monolateral external fixator in hips for patients with severe cerebral palsy.  

Science.gov (United States)

Subtrochanteric valgus osteotomy has been used for painful hip joint dislocation in patients with severe cerebral palsy. The goal of this study was to evaluate 11 patients (17 hips) with severe cerebral palsy who had chronically dislocated and painful hips treated with subtrochanteric valgus osteotomy using a monolateral external fixator. A retrospective review was performed of 11 patients (average age, 17.8 years) with severe quadriplegic cerebral palsy with flexion-adduction contractures due to chronically dislocated and painful hips. A subtrochanteric valgus osteotomy with a monolateral fixator was performed in all patients. Patients were analyzed clinicoradiologically, and caregivers were asked about ease of handling, transfers, and perineal care. At an average follow-up of 37 months (range, 14-72 months), all caregivers were satisfied with the surgery and felt that their child was more comfortable and could sit with support for a longer time period and that perineal care, wheelchair mobilization, and transfers were much easier. A total of 11 complications in 7 patients were observed, including pin-tract infections, delayed consolidation, abduction deformity, and hypostatic pneumonia. The complication rate of subtrochanteric valgus osteotomy was comparable with other methods, and this method had the advantage of shorter surgical time, ease of application, no internal implant with lesser chance of infection or heterotopic calcification, and less intraoperative blood loss with less morbidity. PMID:23379924

Agashe, Mandar; Song, Sang-Heon; Tong, Xue-Bo; Hong, Jin-Ho; Song, Hae-Ryong

2013-02-01

374

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

Science.gov (United States)

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

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

2014-01-01

375

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

International Nuclear Information System (INIS)

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

2003-05-01

376

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)

1980-06-27

377

Non-singular dislocation fields  

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-07-15

378

Noncemented total hip replacement in various disorders of the hip  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Noncemented total hip arthroplasty has emerged as effective option in various disorders of hip in young patients and those with good bone stock. Method: Between 1992 and 2002, 34 patients underwent 47 uncemented total hip replacements. Preoperative and postoperative Harris hip scores were compared. Patients were followed up for a minimum period of 2 years and maximum of 10 years. Result: Mean Harris hip score improved from preoperative mean of 36.6 to 89 after average follow up of 5.7 years. Forty one hips had excellent or good result and one had poor result. There was no case of femoral stem failure and one case of acetabular component failure. Conclusion: Noncemented total hip arthroplasty gives excellent results in disabling disorders of the hip.

Dhaon B

2005-01-01

379

Virtual reality computer animation of the effect of component position and design on stability after total hip arthroplasty.  

Science.gov (United States)

Virtual reality technology was utilized to assess the effect of component orientation and component design on the range of motion prior to impingement following total hip arthroplasty. Components were digitized, oriented in the pelvis, and computer animations were performed to assess the likelihood of dislocation with different combinations of component orientation. PMID:11689370

Barrack, R L; Lavernia, C; Ries, M; Thornberry, R; Tozakoglou, E

2001-10-01

380

Congenital patellar syndrome.  

Science.gov (United States)

Congenital patellar syndrome is bilateral isolated absence of patella. Congenital patellar aplasia or hypoplasia associated with genetic disorders belongs to a clinically diverse and genetically heterogeneous group of lower limb malformations. Absence of patella as an isolated anomaly is extremely rare and we discuss such a case in a 9-year-old boy. PMID:19434325

Jerome, J Terrence Jose; Varghese, M; Sankaran, B

2009-01-01

 
 
 
 
381

Relaxation strain measurements in cellular dislocation structures  

International Nuclear Information System (INIS)

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

1984-01-01

382

Fracture After Total Hip Replacement  

Science.gov (United States)

... American Academy of Orthopaedic Surgeons. Fracture A er Total Hip Replacement A periprosthetic fracture is a broken bone ... occurs around the components or implants of a total hip replacement. It is a serious complication that most ...

383

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 ...

384

Congenital muscular dystrophies.  

Science.gov (United States)

The congenital muscular dystrophies are a heterogeneous group of disorders in which weakness and dystrophic pattern on muscle biopsy are present at birth or during the first months of life. This chapter reviews the most common forms of congenital muscular dystrophies, including laminin ?-2 (merosin) deficiency, Ullrich congenital muscular dystrophy, fukutin-related proteinopathy, rigid spine syndrome, and glycosylation disorders of ?-dystroglycan. The latter group is often associated with neuronal migration defects including lissencephaly, pachygyria, cerebellar and brainstem abnormalities, and variable ocular anomalies. Typical clinical findings and underlying genetic defects are discussed to assist in the differential diagnosis and diagnostic work-up of patients with congenital muscular dystrophies. There are still no curative treatment options for patients with congenital muscular dystrophies but regular follow-up and symptomatic care by a multidisciplinary team considering the peculiarities of each disorder are important to maintain or improve patients' quality of life. PMID:23622361

Kirschner, Janbernd

2013-01-01

385

Modified complete synovectomy prevents recurrence in synovial chondromatosis of the hip.  

Science.gov (United States)

Synovial chondromatosis of the hip is a rare disorder with few published reports regarding treatment and outcomes, and therefore, selecting the optimal surgical treatment is difficult. We reviewed eight patients with monoarticular synovial chondromatosis of the hip who had joint débridement and a modified total synovectomy performed through a surgical hip dislocation with a trochanteric flip osteotomy. Patients were evaluated for recurrence of disease, progression of osteoarthritis, clinical outcomes, and subsequent reoperations. The minimum followup was 4 years (mean, 6.5 years). At final review, no patient had recurrence of disease. Two patients had progression of osteoarthritis requiring total hip arthroplasties at 5 and 10 years after the initial surgical intervention. These patients did not show recurrent disease on histologic examination of the synovial membrane at the time of the arthroplasty. The six patients with preserved joints were followed up for a mean of 6.2 years. The mean Merle d'Aubigné and Postel score in this group was 16.5 points (range, 15-18 points) at the latest followup. There were no major or minor complications related to this treatment. Our midterm results suggest that open débridement with modified total synovectomy is an effective treatment that prevents recurrence of disease and provides substantial pain relief. Surgical hip dislocation allows safe and complete access to the joint for débridement and synovectomy with no added morbidity. PMID:16760824

Schoeniger, Ralf; Naudie, Douglas D R; Siebenrock, Klaus A; Trousdale, Robert T; Ganz, Reinhold

2006-10-01

386

Hip resurfacing: a technology reborn  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Cutts, Steven; Carter, Paul B.

2006-01-01

387

Transient Osteoporosis of the Hip  

Digital Repository Infrastructure Vision for European Research (DRIVER)

  "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 syndrom...

Farideh Shahandeh

2009-01-01

388

Extra-articular hip endoscopy  

Science.gov (United States)

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

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

2012-01-01

389

Pseudotumours associated with metal-on-metal hip resurfacings.  

Science.gov (United States)

We report 17 patients (20 hips) in whom metal-on-metal resurfacing had been performed and who presented with various symptoms and a soft-tissue mass which we termed a pseudotumour. Each patient underwent plain radiography and in some, CT, MRI and ultrasonography were also performed. In addition, histological examination of available samples was undertaken. All the patients were women and their presentation was variable. The most common symptom was discomfort in the region of the hip. Other symptoms included spontaneous dislocation, nerve palsy, a noticeable mass or a rash. The common histological features were extensive necrosis and lymphocytic infiltration. To date, 13 of the 20 hips have required revision to a conventional hip replacement. Two are awaiting revision. We estimate that approximately 1% of patients who have a metal-on-metal resurfacing develop a pseudotumour within five years. The cause is unknown and is probably multifactorial. There may be a toxic reaction to an excess of particulate metal wear debris or a hypersensitivity reaction to a normal amount of metal debris. We are concerned that with time the incidence of these pseudotumours may increase. Further investigation is required to define their cause. PMID:18591590

Pandit, H; Glyn-Jones, S; McLardy-Smith, P; Gundle, R; Whitwell, D; Gibbons, C L M; Ostlere, S; Athanasou, N; Gill, H S; Murray, D W

2008-07-01

390

CT to delineate hip pathology in cerebral palsy  

International Nuclear Information System (INIS)

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

1987-12-04

391

Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Osteoarthritis (OA) secondary to dislocation and dysplasia is a common problem in patients with cerebral palsy. The purpose of this study was to evaluate the results of total hip replacement (THR) in ambulatory patients with cerebral palsy. Eighteen total hip arthroplasties were performed in 16 ambulatory patients with cerebral palsy. The patient's mean age at surgery was 42?±?8 years (range 32–58 years), and the mean follow-up was 10?±?6 years (range 2–18 years). Data were o...

Schroeder, Kerstin; Hauck, Christian; Wiedenho?fer, Bernd; Braatz, Frank; Aldinger, Peter R.

2010-01-01

392

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

DEFF Research Database (Denmark)

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

Penny, Jeannette Ã?stergaard; Ovesen, Ole

2013-01-01

393

Bilateral Pathological Subluxation of Hips Secondary to Tuberculosis in an Adult: A Rare Presentation  

Science.gov (United States)

Clinical descriptions of tuberculosis date back to antiquity. Extra-pulmonary involvement is noted in approximately 14% of patients, with 1% to 8% having osseous disease. In literature, some cases of bilateral traumatic dislocations have been described, but reports on bilateral pathological subluxations or dislocations of hip joints, that too in adults, are extremely rare. Tuberculosis can present in myriad ways and it can mimic any disease. The sole purpose of writing this article was to report one of the extremely rare presentations of skeletal tuberculosis.

Hegde, Atmananda; Babu, Rajan; Shetty, Abhishek

2014-01-01

394

Atomistically informed dislocation dynamics in fcc crystals  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We develop a nodal dislocation dynamics (DD) model to simulate plastic processes in fcc crystals. The model explicitly accounts for all slip systems and Burgers vectors observed in fcc systems, including stacking faults and partial dislocations. We derive simple conservation rules that describe all partial dislocation interactions rigorously and allow us to model and quantify cross-slip processes, the structure and strength of dislocation junctions, and the formation of fcc-specific structure...

Marti?nez Sa?ez, Enrique; Marian, Jaime; Arsenlis, A.; Victoria, Maximo Pedro; Perlado Martin, Jose Manuel

2008-01-01

395

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,

396

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. = 10"9 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

1979-01-01

397

Congenital anomalies associated with hypothyroidism.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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.

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

1986-01-01

398

Boundary dislocation structure of crystalline composites  

Energy Technology Data Exchange (ETDEWEB)

The authors perform the first studies of the dislocation structure of intergrowth boundaries and the adjoining regions in the example of crystalline composites of lithium flouride single crystals. It has been established that the intergrowth boundary of a crystalline composite consists of two dislocation networks: a network of immobile dislocations and the usual subboundary that may shift from its original position.

Regel' , V.A.; Stepantsov, E.A.; Tovmasyan, A.B.

1986-01-01

399

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

Directory of Open Access Journals (Sweden)

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

Julio Nazer H

2001-01-01

400

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.

 
 
 
 
401

Hemovac drainage after hip arthroplasty.  

Science.gov (United States)

The authors have reviewed the pattern of drainage of Hemovac devices in 107 arthroplasties of the hip. Drainage ceased in 55 hips (51%) within 18 hours and 93 hips (89%) within 24 hours. The mean drainage volume was 303 cc in femoral head replacement, 498 cc in simple total hip replacement, and 663 cc in extensive total hip replacement. Ninety nine per cent of the total drainage had been achieved within 24 hours, indicating that drainage devices can be removed then rather than between 24 and 72 hours as had been previously recommended. This early removal will help reduce the possibility of retrograde infection, and promote more comfortable rehabilitation after operation. PMID:8407041

Rowe, S M; Yoon, T R; Kim, Y S; Lee, G H

1993-01-01

402

The painful hip: new concepts  

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

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

2006-06-15

403

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.)

2006-06-01

404

Inferior dislocation of the proximal tibiofibular joint: a new type of dislocation with poor prognosis.  

Science.gov (United States)

Dislocation of the proximal tibiofibular joint is an unusual injury. We report a patient, who developed inferior proximal tibiofibular dislocation after a severe motorcycle accident. The dislocation was associated with avulsion of the leg, fractures of the fibula and the ankle and neurovascular lesions. The patient was surgically treated and had a good final outcome. Classifications of proximal tibiofibular dislocations did not include inferior dislocation. This type is always associated with avulsion mechanism and has the poorest prognosis. PMID:17922281

Nikolaides, A P; Anagnostidis, K S; Kirkos, J M; Kapetanos, G A

2007-12-01

405

Pipe diffusion at dislocations in UO2  

Science.gov (United States)

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

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

2014-04-01

406

Dislocations and mechanical properties of icosahedral quasicrystals  

Science.gov (United States)

In this article we interpret the mechanical properties of icosahedral quasicrystals with the dislocation theory. After having defined the concept of dislocation in a periodic crystal, we extend this notion to quasicrystals in the 6-dimensional space. We show that perfect dislocations and imperfect dislocations trailing a phason fault can be defined and observed in transmission electron microscopy (TEM). In-situ straining TEM experiments at high temperature show that dislocations move solely by climb, a non-conservative motion-requiring diffusion. This behavior at variance with that of crystals which deform mainly by glide is explained by the atypical nature of the atomic structure of icosahedral quasicrystals.

Mompiou, Frédéric; Caillard, Daniel

2014-01-01

407

Experimental verification of Foreman dislocation model  

International Nuclear Information System (INIS)

We present a strain analysis of an edge dislocation core, and a detailed discussion of the Foreman dislocation model. In order to examine the model, the quantitative measurement of strain field around an edge dislocation in aluminum is performed, and high-resolution transmission electron microscopy and geometric phase analysis are employed to map the strain field of the edge dislocation core in aluminum. The strain measurements are compared with the Foreman dislocation model, showing that they are in good agreement with each other when 0.7 < a < 1.5

2009-06-01

408

Congenital distal humeral dysplasia: a case report  

Energy Technology Data Exchange (ETDEWEB)

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

Joseph, Benjamin; Varghese, Renjit A. [Department of Orthopaedics, Kasturba Medical College, Manipal 576119, Karnataka State (India)

2003-01-01

409

A Rare Dislocation: Isolated Proximal Tibiofibular Joint Dislocation  

Directory of Open Access Journals (Sweden)

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

ibrahim Arziman

2011-09-01

410

A Rare Dislocation: Isolated Proximal Tibiofibular Joint Dislocation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Isolated dislocation of proximal tibiofibular joint is one of the rarely encountered and easily overlooked traumas in ER departments. Injury mechanism can not be elucidated entirely; however it occurs commonly by sudden inversion of foot, concurrently knee is at flexion and foot is at plantar flexion. Diagnosis can be made by determining swelling and sensitivity increase at proximal tibia with comparing healthy side and radiological imaging techniques. Treatment is still a challenging and con...

2011-01-01

411

Hip Replacement - Physical Therapy  

Medline Plus

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

412

Hip Replacement - Physical Therapy  

Science.gov (United States)

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

413

Hip Osteotomy Arthroplasty  

Science.gov (United States)

We previously reported the initial success of combined osteotomy and arthroplasty of the hip for arthritis with femoral deformity. This technique has gained acceptance. We now report, for the first time, the ten year clinical and radiographic results with histology of 2 specimen. The osteotomies healed and the proximal femoral segment remained viable. One of three patients is symptom free without subsequent operative treatment. One of three patients had revision for acetabular loosening at eight years and biopsy of the proximal femur showed the proximal femoral segment to be viable. One of three patients had loosening of a macrofit bipolar prosthesis which required revision to total hip replacement at five years. Histology revealed viability of the proximal femur. All three patients are doing well at ten year follow-up. Based on the results of this study and current knowledge, the technique of osteotomy and arthroplasty for hip arthritis associated with femoral deformity is effective when combined with current techniques of ingrowth femoral component of total hip arthroplasty.

DeCoster, Thomas A; Incavo, Steven J; Swenson, Darren; Frymoyer, John W

1999-01-01

414

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 ...

415

Hip Revision Surgery  

Medline Plus

Full Text Available ... the anatomic site first and then find a plastic trial that best fits the defect. These plastic trials replicate the size and dimension of the ... routinely use a big head on most revision surgeries. And that's really helped ... hip center reconstructions, as Dr. Pearson pointed out, the potenti