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Sample records for hip dislocation congenital

  1. Hip dysplasia and congenital hip dislocation

    Lingg, G.; Nebel, G.; von Torklus, D.

    1981-11-01

    In human genetics and orthopedics quite different answers have been given to the question of hereditary transmission and frequency of hip dysplasia in families of children with congenital hip dislocation. We therefore have made roentgenometric measurements of 110 parents of children with congenital hip dislocation. In 25% we found abnormal flat acetabulae, whereas 12% had pathologic deep hips. This may propose a new concept of morphology of congenital hip dysplasia.

  2. Screening for congenital dislocation of the hip

    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

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

    Pranita viveki; R. G. Viveki

    2014-01-01

    Congenital Dislocation of Hip (CDH), is one of the most common congenital diseases in the orthopedic field. It is also known as Developmental Dysplasia of Hip. The condition can be diagnosed by clinical, ultrasonographic and radiological examination. Here we are reporting two days old male baby with congenital dislocation of right hip joint. The goal of treatment is to obtain a reduction to provide an optimal environment for femoral head and acetabular development. Early diagnosis is the mo...

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

    Pranita viveki

    2014-11-01

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

  5. Pemberton technique in congenital hip dislocation

    Cakmak, Mehmet; Cabuk, Mustafa K.; Karamehmetoglu, Mahmut; Taser, Omer; Domanic, Unsal; Hamzaoglu, Azmi

    2004-01-01

    63 hips of 55 cases on when Pemberton osteotomy was performed because of acetabular dysplasia have been examined at the termination of a period of at least 6 months and at most 26 months, with an average of 8 months of following in the Department of Orthopaedics and Traumatology of the Istanbul Medical School. It has been concluded that with Pemberton osteotomy the acetabular index which was found to be 39.5 prior to surgery was reduced to 20.3, and that in 82.5% of cases good results in 12.6...

  6. Total Hip Prosthesis in Coxarthrosis due to Congenital Dislocation or Subluxation of the Hip

    Aritamur, Ayhan; Cakmak, Mehmet; Taser, Omer

    2004-01-01

    At our clinic, total hip prostheses were adapted in 4 cases with coxarthrosis accompanied by severe acetabular insufficiency due to congenital hip dislocation or Subluxation. For the reconstruction of acetabuler insufficiency, femoral head was employed as graft in compliance with the Harris technique. This technique was realized on the patient in between two stages with the purpose of avoding femoral resection, yet temporary neurologic symptoms appeared posfoperatively in this case of ours. O...

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

    Mukesh Tiwari

    2013-04-01

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

  8. Pathogeny and natural history of congenital dislocation of the hip.

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

    2014-02-01

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

  9. Modular noncemented total hip arthroplasty for congenital dislocation of the hip. Case report and design rationale.

    Gorski, J M

    1988-03-01

    The highest rate of failure and the greatest technical difficulty in total hip arthroplasty occurs with congenital dislocation of the hip (CDH). Predisposing factors are failure to secure special femoral components to fit an extremely narrow and straight medullary cavity with space for only a very thin mantle of cement. The acetabulum is usually atrophic, and bone grafts are commonly required to support a small-diameter cup. The young age of the average patient and high levels of activity contribute to cement failure. A new modular cementless prosthesis provides excellent immediate skeletal fixation and pain relief in CDH patients. Five modular components are screwed or press-fit into bone. The modular approach facilitates implantation, reduces inventory, and is adaptable to unforeseen problems. These advantages are ordinarily absent with standard or custom cemented components. Modular components may also permit easier revision. The prosthesis is made of titanium alloy for its superalloy strength, elastic modulus, and bioinertness. By omitting the cement mantle, press-fit is obtained with the largest possible implant. The large size minimizes stem breakage in these young, small bones. Excellent short-term results suggest that modular cementless implants are indicated in some patients with CDH. PMID:3342552

  10. Automatic measurement system for congenital hip dislocation using a computed radiography

    Acetabular angle which is a diagnostic parameter of congenital hip dislocation has been measured manually in conventional X-ray film system. Using digital image directly provided from a computed radiography, an automatic measurement system was developed for this parameter. The process of the measurement was completed within a reasonable time, and accurate enough. The system was combined with an image database, so that it would be a measurement tool of PACS

  11. Salter%u2019s Innominate Osteotomy in the Treatment of Congenital Hip Dislocation

    Eyup Cagatay Zengin

    2014-03-01

    Full Text Available Aim: Developmental displazy of hip is much seenillness which interest orthopaedic surgery in Turkey and around the world. In early times of illness conservative treatment is succesful but late times of illness surgery is necessary. Salter’s innominate osteotomy, since its initial description in 1961, has become a well-established surgical procedure in the treatment of congenital dislocation of the hip.Material and Method: We reviewed 59 patients with 74 congenitally dislocated hips, all managed by open reduction and Salter’s innominate osteotomy. Mean follow-up period was 4,2 years (range, 2 to 7 years; %82,4 of the hips had a excellent clinical result, and %75,7 were excellent radiologically. The patients who underwent Salter’s innominate osteotomy before the age of 3 had beter clinical and radiological results (%90,4 and %82,5, respectively. The radiographs of the unilateral normal hips were compared to the surgically treated hips according to their acetabular index angles, center-edge angles of Wiberg and femoral neck-shaft angles. No statistical differences were found between these two groups. The Kalamchi-McEwen classification of avascular necrosis. The late radiographic signs of types 2, 3 and 4 avasculer necrosis were seen in %10,8 of this series. Discussion: The results show that Salter’s innominate osteotomy provides good lateral coverage of the femoral head. The results are beter if the operation is performed between the ages 18 months and 3 years.

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

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

  13. [Clinical and ultrasonic diagnosis of congenital hip dislocation (dynamics of changes in early therapy)].

    Poul, J; Procházka, J; Klimsová, J; Janovec, M; Bajerová, J; Jíra, I; Straka, M; Sommernitz, M

    1990-08-01

    The authors present part of their prospective epidemiological study of congenital dysplasia of hip joints within which newborns were examined by ultrasonogram prior to the beginning of the therapy. Apart from the standard examination in the frontal plane after Graf they examined on principle also the ultrasonographic stability by the dynamic test after Schuler as well as by the application of the probe anteriorly with the simultaneous provocation according to Palmén. The authors have processed pathological ultrasonographic findings in 53 newborns (64 hip joints). The technique of the examination by ultrasound from the anterior approach is explained in detail. The comparison of both dynamic tests has shown that the examination from the anterior approach is considerably more sensitive than Schuler's dynamic test and also fully correlates with the clinical finding. It is a fact that the shift of the head in the flexion dorsally represents the most important component of the movement in unstable hip joint during provocation, it is far more noticeable than the lateralization of the head or the shift in the cranial direction. After achieving ultrasonographic stability the classical Graf method is sufficient for the registration of residual changes on the acetabular rim. The follow-up of patients until their complete healing has shown a surprisingly rapid remodellation of hip joints. The whole complex of clinically unstable hip joints has been divided into subgroups according to Graf classification. In type IIc or IId on the basis of ultrasonographic examination from the anterior approach the stable joints from the ultrasonographic viewpoint have been distinguished from unstable ones. The follow-up carried out in short intervals has shown that of longest duration is the remodellation of total dislocation and, on the contrary, of shortest duration is the healing of joints in the IIc or IId type. An absolute majority of affected hip joints have become normal until 3rd

  14. A modified method of traction for young children with congenital dislocation of the hip as a preliminary to reduction.

    Pan, K L; Rasit, H

    2004-12-01

    Many authors agree that preliminary traction prior to closed or open reduction for congenital dislocation of the hip is helpful. Different ways of traction have been used and each of them has its own advantages and disadvantages. One of the problems in the very young child is the difficulty in maintaining a suitable traction that is biomechanically effective. We found that using a rocker bed made the traction more "user friendly" for the child, the parent and the doctors. PMID:15941161

  15. The evaluation of concomitant open reduction and innominate osteotomy in the treatment of congenital dislocation of the hip

    Bilgen, Omer F.; Durak, Kemal; Kejanlioglu, Sinan; Ayan, Mahir; Ozdemir, Recai

    2004-01-01

    Forty eight hips of 34 patients who underwent concomitant open reduction and innominate osteotomy for the treatment of congenital dislocation of the hip were evaluated radiologically and clinically. The study group consisted of 31 (91.1%) girls and 3 (8.9%) boys. The mean age was 24 (17-56) months and the average follow-up period was 4.3 (2.9-7) years. The rate of excellent and good results radiologically and clinically were 83.3% and 87.3% respectively. We established avascular necrosis of 4...

  16. Do normal hips dislocate?

    Alshameeri, Zeiad; Rehm, Andreas

    2014-11-01

    There have been a small number of case reports describing late normal-hip dislocations in children who were later diagnosed with developmental dysplasia of the hip. Here, we contest the assumption that normal hips can dislocate. We argue that (as in our case) the ultrasound scans in all published case reports on late dislocated normal hips did not show results that were entirely normal and therefore, so far, there has been no convincing evidence of a dislocation of a normal hip. We also want to highlight the importance of meticulous ultrasound and clinical assessments of high-risk children by an experienced orthopaedic surgeon. PMID:25144883

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

    Niethard, F U

    1987-01-01

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

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

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

    1983-12-01

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

  19. Congenital thoracic ectopic kidney with eventration of the diaphragm bilateral pes equinovarus and developmental dislocation of the hip: A case report Case Report

    Sezgin, Betül; Büyük, Sema; Yiğit, Özgül; Demircili, Oyhan; Sander, Serdar

    2007-01-01

    Congenital thoracic ectopic kidney is a very rare developmental anomaly It is usually asymptomatic and discovered incidentally on a routine chest radiography We report a left thoracic ectopic kidney in a 2 months 22 days old girl with eventration of the diaphragm bilateral pes equinovarus and developmental dislocation of the hip Turk Arch Ped 2007; 42: 125 8 Key words: Congenital diaphragm eventration thoracic ectopic kidney

  20. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    Iulian ICLEANU; Mariana CORDUN

    2015-01-01

    Congenital hip luxation is a disorder which evolves in time. Teratological hip dislocation is a distinct form of hip luxation, which usually appears with other disorders. These hips are dislocated before birth. In this thesis we will try to elaborate a recovery program, through physical exercises, which will help us realize our treatment objectives: diminishing articular stiffness, increasing articular mobility, increasing muscle strength, recalibration of agonist and antagonist balances and ...

  1. [Congenital hip dysplasia, screening and therapy].

    Kolb, A; Windhager, R; Chiari, C

    2015-11-01

    Congenital hip dysplasia and hip dislocation are relatively common pathological conditions of the musculoskeletal system in infants. An early and certain diagnosis can now be achieved by sonographic hip screening within the framework of screening examination programs. This early diagnostic procedure in infants is essential particularly for a conservative treatment strategy. Therefore, apart from possessing in-depth knowledge, training of the examiner in specialist courses is of central importance. This article presents an overview of the entity of congenital hip dysplasia and hip dislocation, the diagnostics and treatment with special emphasis on recent developments. PMID:26489825

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

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

  3. Anesthesia in Operations for Congenital Hip Dislocation in Children%小儿髋脱位手术的麻醉

    鲁纯新; 金鸣苍

    1984-01-01

    This paper discusses the anesthetic management in 122 operations for congenital dislocation of the hip in children. Comparison was made between continuous epidural (46),ether(60)and ketamin(16)anesthesias. Observation of the elevation of blood pressure during the operation showed that BP was the highest in ketamin group and when compared with the other two methods, P <0.05.The ether group had markedly increased pulse rate with p<0.01.Duzing the operation the epidural group showed little change in BP and pulse and respiration was also stable whether during or after the operation. With ether anesthesia, the induction phase was prolonged and endotracheal intubation was often required. In addition, it brought on marked acceleration in respiration and pulse during the operation and delayed recovery of consciousness. While BP was elevated in the ketamin group, respiration and pulse were more stable than in ether group and consciousness recovered earlier. Besides, its medication was simple and there was no need for intubation. To sum up, epidural anesthesin should be rated as first of the three. But ketamin is recommendable for general anesthesia.%@@ 先天性髋脱位为常见的小儿骨科疾病,除了较小婴儿可用闭合复位蛙式石膏固定方法外,多需手术治疗.现将有关此种手术的麻醉方法选择和术中失血量的测定的几点体会介绍如下: 临床资料 121例,男32例,女89例,其中1例先后施行二次手术,共122次麻醉.

  4. [An abduction applicance for congenital dislocation of the hip (author's transl)].

    Lang, G; Kehr, P; Paternotte, H; Aebi, J; Pintu, J

    1980-06-21

    The appliance described consists of a shoulder belt from which an abduction bar is hanging. Two adjustable rings enclosing the thigh and the leg of the child are attached to the shoulder-belt and to the bar. The lower limb is not immobilized but kept flexes and abducted. The appliance is primarliy used for those children with minor dysplasis of the hip who do not require complete immobilization but cannot be left without any treatment. It is also useful after prolonged orthopaedic or surgical immobilization. PMID:7402893

  5. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    Iulian ICLEANU

    2015-11-01

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

  6. Traumatic hip dislocations in children

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  7. Congenital Dislocation and Developmental Dysplasia of Hip%先天性髋关节脱位和髋关节发育不良

    贺明礼; 余春善

    2002-01-01

    @@ 先天性髋脱位(congenital dislocation of hip,CDH)是婴儿出生时就患有的髋关节疾患.但是,并不是所有的病儿在刚出生时即可诊断本病[1~3],而是在出生后逐渐演变而成.因此,有作者[4]认为完全有理由将本病称为发育性髋关节发育不良(developmental displasia of hip,DDH).有许多病例在新生儿早期表现正常,随着日龄、月龄或年龄的增长逐渐出现半脱位(subluxatable hip),此时若不及时治疗即发展为完全脱位(dislocation)[5].后者的命名更能反映本病的发生和发展过程.所以DDH这个名称越来越被广泛接受.

  8. Limitations of cost-benefit evaluation of non-systematic radiological screening of congenital dislocatable or dislocated hip in Germany

    Cost-benefit analyses in the field of screening procedures not only comprise economic aspects, but they also require a thorough analysis of possible health risks, which are imminent in these examinations. Many publications on this topic during the past years have proven that even in such a well investigated problem, like the dislocated or dislocatable hip, this can lead to difficulties. We encountered in Germany these questions connected to hip joint screening, when we tried to analyse the data from the German General Screening Program (GGSP). It ws found that 10 times as many children were treated than one would have expected from epidemiological data. In addition a similarly large number of tentative diagnoses was found, which in summary caused great concern amongst the interested social pediatricians. It was to be expected, that the special examinations and treatments resulting from the screening of children had caused considerable and partially useless costs and unnecessary x-ray exposures. Considerable concern was stirred by information from orthopedic clinics, which reported that still cases of hip luxations and hip dysplasias are seen past the half year margin

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

    .org Developmental Dislocation (Dysplasia) of the Hip (DDH) Page ( 1 ) The hip is a “ball-and-socket” joint. In a normal hip, the ball at the ... American Academy of Orthopaedic Surgeons. .org Developmental Dislocation (Dysplasia) of the Hip cont. • Family history of DDH (parents or siblings) • ...

  10. 高频超声在先天性髋关节脱位早期诊断中的应用价值%Application of high frequency ultrasonographic diagnosis in congenital dislocation of the hip

    姚树新

    2012-01-01

    Objective: To study the ultrasonic image features of Congenital dislocation of the Hip and the value of high frequency ultrasonography in diagnosing Developmental Dysplasia of The Hip. Methods: 125 patients with Congenital dislocation of the Hip were enrolled , another 50 healthy cases were selected as normal control. With high frequency ultrasonographic we checked the hip. Compared the difference of the hip in two groups. Results; In 125 cases , 105 cases were confirmed, 15 cases were missed and 5 cases were misdiagnosed. Conclusion: High Frequency Ultrasonography can invasively show lesions of Congenital dislocation of the Hip. It is a very useful method to demonstrate Congenital dislocation of the Hip.%目的 探讨先天性髋关节脱位的超声表现及高频超声技术在诊断先天性髋关节脱位中的应用价值.方法 选择我院就诊的先天性髋关节脱位患儿125例,同期随机选取正常儿50例,应用高频超声检查髋关节,包括髋臼窝外形、髋臼骨性缘、软骨纤维肾唇及α,β角,分析这些指标在先天性髋关节脱位组与正常对照组间的差异.结果 125例先天性髋关节脱位患儿的超声检查正确诊断105例,漏诊15例,误诊5例.结论 高频超声能较好地显示先天性髋关节脱位的形态学表现,可为临床提供较可靠地诊断依据,其无创、价廉及可重复性操作为先天性髋关节脱位的诊断及预后判断提供一种好的途径,值得推广.

  11. 超声在先天性髋关节脱位中的早期诊断准确率分析%Analysis of the accuracy of ultrasond in the early diagnosis of congenital dislocation of the hip

    徐永通; 孙建东; 郭瑞; 冯涛; 黄楠

    2014-01-01

    Objective To investigate the early diagnostic methods of B-mode ultrasonography in neonatal hip anatomy and congenital dislocation of the hip. Methods The results of B-mode ultrasonog-raphy of bilateral hip joints of 1083 cases neonatus were analyzed retrospectively. Results There was 1 case of congenital subluxation of hip unilateral. The α,β angle,acetabular index and morin ratio of the neonatal hip on the hip joint coronal plane sonogram echogram were measured,and the normal values were:65. 10° ± 5. 10°,40. 27° ± 6. 14°,24. 75° ± 4. 29°,(64. 66 ± 5. 63)% . Conclusions The B-mode ultrasound can discover the congenital dislocation and dysplasia of the hip early,it is simple,econ-omy,painless and has no radioactive damage.%目的:探讨新生儿髋关节的超声解剖和先天性髋关节脱位的 B 超早期诊断方法。方法回顾性分析1083例新生儿两侧髋关节 B 超检查结果。结果发现先天性髋关节半脱位1例,在髋关节冠状面声像图上分别测量新生儿髋关节的α角、β角、髋臼指数和股骨头骨性髋臼覆盖率,其正常值分别为:65.10°±5.10°、40.27°±6.14°、24.75°±4.29°、(64.66±5.63)%。结论 B 超能早期发现先天性髋关节脱位及发育不良,操作简单、经济、无痛、无放射性损害。

  12. A Bilateral Traumatic Hip Obturator Dislocation

    Karaarslan, Ahmet Adnan; Acar, Nihat; Karci, Tolga; Sesli, Erhan

    2016-01-01

    A case of a bilateral simultaneous traumatic obturator dislocation of both hip joints in an 18-year-old young man following a traffic accident is presented. We reduced the dislocated femoral heads immediately under general anesthesia followed by passive and active exercises and early full-weight bearing mobilization. After 5 years, the result was excellent. PMID:26977327

  13. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    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...

  14. Surgical hip dislocation for treatment of cam femoroacetabular impingement

    Milind M Chaudhary

    2015-01-01

    Conclusion: Cam femoroacetabular Impingement causing pain and limitation of hip movements was treated by open osteochondroplasty after surgical hip dislocation. This reduced pain, improved hip motion and gave good to excellent results in the short term.

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

    Galbraith, John G

    2011-01-01

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

  16. [Dislocation of the hip in a patient with von Recklinghausen disease].

    Del Bosque-Herrero, A; Ezquerra-Herrando, L; Albareda-Albareda, J

    2014-01-01

    Neurofibromatosis type 1 (NF-1) is one of the most common autosomal dominant disorders affecting humans. Patients with NF-1 may present with characteristic orthopaedic manifestations such as scoliosis, congenital pseudoarthrosis and limb hyperttrophy. Dislocation of the hip associated with NF-1 is a rare occurrence. There is a relative paucity of reported cases of pathological hip dislocation in patients with NF-1, with 13 documented cases found in the published literature. Seven dislocations occurred following trivial trauma and 6 cases were deemed atraumatic. We report a case of hip dislocation in a 26 years old male with NF-1 and scoliosis, that was treated successfully by closed reduction and skin traction. PMID:24094733

  17. Limited Immcblilization in the Treatment of Congenital Dislocation of Hip in Young Children%幼儿期先天性髋脱位的有限制动治疗

    梁栋; 史颖奇; 郑允直; 范丁安; 张荣英; 王承武; 范源

    1986-01-01

    @@ 先天性髋脱位的治疗近年来在切开复位手术方法上有许多新的发展并取得较前改善的治疗效果,但术后仍有种种不尽满意的结果,如关节活动受限甚至僵硬、半脱位或再脱位、以及股骨头骺缺血性坏死等,虽可再行补救治疗但效果仍不满意.故至今国内外对早期采用闭合复位治疗先天性髋脱位的方法仍极重视.%The traditional method of immobilization following close reduction of the congenital di-slocation of hip is keeping the hip strictly immobilized with the trunk and both lowerli-mbs in a plaster as Lorenz's frog-leg cast or Lange's hip spica. It would make the patient feel dull and would hinder the development of the affected hip. As the development of the hip joint depends on the active movement of the femoral head in the socket, active move-ment after the reduction should be stared ea-rlier. In our series, 171 hips in 124 cases were treated by limited immobilization mehtod after close reduction with good results. It has the advantages as follows: 1. While it keeps the reduction stable as the conventional strict immobilization does, it allows, to a certain extent, the patient to sit up, lie down, standing up, and even crawl around with the plaster on. 2. As in this method, it lea-ves the hip outside the plaster, the femoral head will be better palpable and a clearer x-ray film can be obtained for check-up. In ad-dition, there is less chance of spoiling the cast due to urine soiling and little possibility of developing pressure sores in the lumbo-sacral region. No special orthopedic table is required for the application of this kind of plaster cast. Soft tissue contracture due to strict immobilization can also be avoided. On all but a few cases, the procedures were performed in the out-patient clinic. The operation time is rem-arkably shortened and the plaster used is much less, so that this operation would be more effective. Correction of the shortness and co

  18. CONSERVATIVE TREATMENT OF HIP DYSPLASIA

    Mikhail Mikhailovich Kamosko; Mahmoud Stanislavovich Poznovich

    2014-01-01

    Hip dysplasia in children is the subject of careful study by specialists both in our country and abroad. There are three basic variants of hip dysplasia: congenital acetabular dysplasia, congenital subluxation of the hip and congenital dislocation of the hip. However, treatment of congenital dislocation of the hip, which is the most severe form of hip dysplasia in children, currently remains one of the topical problems of children’s orthopedics, despite the significant achievements of modern ...

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

    Jørgensen, Christoffer C; Kjaersgaard-Andersen, Per; Solgaard, Søren; Kehlet, Henrik; Hansen, Torben Bæk

    2014-01-01

    STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors. METHODS: Prospective data on preoperative patient......-track total hip arthroplasty. Further studies including detailed information on patient and prosthesis characteristics, and activity restrictions are needed to reduce the risk of dislocation....

  20. [Juvenile hip dislocation and the Vojta neuro-physiotherapy].

    Schütt, B

    1981-09-17

    Partial dislocation of the hip in case of cerebral palsy is a result of the disturbance of the neuromuscular system. Immobilization cannot improve the inadequate function the hip. A case of a girl is reported; stabilization of the hip after 3 years of neurophysio-therapy after Vojta could be achieved. PMID:7274945

  1. Traumatic inferior hip dislocation: a rare adult case with ipsilateral bifocal hip fracture

    El Hajj Moussa, Majd; Tawk, Charbel; Hoyek, Fadi; Lahoud, Jean-Claude

    2016-01-01

    Inferior dislocation is a rare type of hip dislocation, especially in adults. Few cases have been reported; most of them were isolated. This is the case of a traumatic adult hip dislocation after a road traffic accident. Reduction was made under general anaesthesia; a CT-Scan after the reduction showed a bifocal non-displaced hip fracture. In this article, we present a small review of the literature and we discuss the possible mechanism of hip dislocation. We found through our case study that this condition is not exclusive to children and CT-Scan is mandatory after the reduction of hip dislocation to eliminate any associated injury. To our knowledge, a bifocal hip fracture has not previously been documented, in the English language literature. PMID:27141043

  2. CT findings of traumatic posterior hip dislocation after reduction

    Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Jin Wook

    2008-06-15

    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.

  3. Traumatic hip dislocation with associated femoral head fracture

    Dortaj, H; Emamifar, A

    2015-01-01

    Dislocation of the hip is a critical injury that results from high-energy trauma. This paper describes a case of posterior dislocation of the right hip in a 35-year-old woman with associated ipsilateral femoral head fracture. Initial treatment included reduction of the right hip through posterior...... approach and fixation of the femoral head fracture with three absorbable screws. After 15-month follow-up, a full range of motion has been achieved and there are no signs of avascular necrosis, hip instability, or limping. The authors describe their method of surgery....

  4. Congenital dislocation of the patella – clinical case☆

    Miguel Sá, Pedro; Raposo, Filipa; Santos Carvalho, Manuel; Alegrete, Nuno; Coutinho, Jorge; Costa, Gilberto

    2015-01-01

    Congenital patellar dislocation is a rare condition in which the patella is permanently dislocated and cannot be reduced manually. The patella develops normally as a sesamoid bone of the femur. This congenital dislocation results from failure of the internal rotation of the myotome that forms the femur, quadriceps muscle and extensor apparatus. It usually manifests immediately after birth, although in some rare cases, the diagnosis may be delayed until adolescence or adulthood. Early diagnosis is important, thereby allowing surgical correction and avoiding late sequelae, including early degenerative changes in the knee. A case of permanent dislocation of the patella is presented here, in a female child aged seven years. PMID:26962496

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

    Čobeljić Goran

    2009-01-01

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

  6. Bilateral inferior dislocation of the hip-a case report

    Bhagwat Kishan R

    2012-04-01

    Full Text Available 【Abstract】Inferior dislocation of the hip is the ra-rest type in hip dislocation. Very few cases have been re-ported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30-year-old patient with a bilateral inferior hip dislocation. He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction. The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 110 (right degrees and 100 (left degrees respectively away from the axis. Closed reduction under sedation was successfully performed. Skin traction for a period of 6 weeks was advised and the follow-up re-vealed an excellent result. We present the details of this case, the first of its kind along with a review of the literature, discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip. Key words: Hip dislocation; Joints; Femur

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

    Harty James A

    2011-03-01

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

  8. The value on high frequency ultrasound in the diagnosing of congenital dislocation and dysplasia of the hip joint of infant%高频超声在婴幼儿先天性髋关节脱位和发育不良中的诊断价值

    李志威

    2011-01-01

    Objective: To explore the clinical value on high frequency ultrasound in the diagnosing of congenital dislocation and dysplasia of the hip joint of infants to offer help for clinical diagnosis and treatment. Methods: 421 infants (842 hips) who were under the age seven months were examined by Graf method of ultrasound examination in hip joint. The hip joint was classified with Graf method by observing the skeletal dysplasia, skeletal dysplasia boundary, soft skeletal dysplasia morphology, angels a and p. Results: Among 421 infants (842 hips) who were under the age of seven months, and there were 370 cases (740 hips) to be normal, there were 14 cases (28 hips) suffered from congenital subluxation of hip, 8 cases (16 hips) suffered from congenital dislocation of hip, 29 cases (58 hips) suffered from contracted congenital dysplasia of hip. Conclusion: Ultrasonic has the advantages of non-invasive and no radiation, what's more, it's convenient to use for checking, and with no contraindication, and it can be applied repeatedly. It is the first choice as screening for the infants, and it can help observing the effect of the clinical therapy.%目的:探索高频超声在婴幼儿先天性髋关节脱位和发育不良诊断中的临床价值,为临床的诊断治疗提供帮助.方法:对421例7个月以内的婴幼儿(842个髋关节)行Graf法髋关节超声检查,通过观察骨性髋臼、骨性髋臼外侧缘、软骨性髋臼形态及测量α、β角,对髋关节进行Graf分型,探讨高频超声作为新生儿髋关节发育不良筛查的诊断工具对临床治疗效果进行动态观察的价值.结果:检查7个月以下婴幼儿421例(842个髋关节),其中,正常髋关节370例(740个髋关节),婴幼儿先天性髋关节半脱位14例(28个髋关节),全脱位8例(16个髋关节),发育不良29例(58个髋关节).结论:超声波具有无创、无射线的特性,且检查方便,无禁忌证,可以重复应用,可作为对新生儿进行筛查工作的首

  9. An Unexpected Complication of Hip Arthroplasty: Knee Dislocation

    Serdar Yilmaz

    2015-01-01

    Full Text Available An increasing number of patients with hip fracture have been seen with osteoporosis associated with osteoarthritis. Although knee dislocation is related to high-energy trauma, low-grade injuries can also lead to knee dislocation which is defined as “ultra-low velocity dislocation.” The case reported here is of an 82-year-old patient who presented with a left intertrochanteric hip fracture. Partial arthroplasty was planned because of osteoporosis. In the course of surgery, degenerative arthritic knee was dislocated during the hip reduction maneuver with the application of long traction. The neurovascular examination was intact, but the knee was grossly unstable and was dislocated even in a brace; thus a hinged knee prosthesis was applied nine days after surgery. The patient was mobilized with crutches after the knee prosthesis but exercise tolerance was diminished. In conclusion, it should be emphasized that overtraction must be avoided during the hip reduction maneuver in patients with advanced osteoarthritic knee.

  10. Differentiating subluxation from developmental dislocation of the hip

    Joao O. Tavares

    2012-02-01

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

  11. Voluntary habitual dislocation of the hip in children

    The clinical and radiologic findings in a child with habitual voluntary dislocation of the hip are reported. Observations made in this case and in 6 others on record suggest that this rare condition is a specific pediatric entity with a good prognosis. (Auth.)

  12. Dislocations

    Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. You can dislocate your ankles, knees, shoulders, hips, elbows and jaw. You can also dislocate your finger and toe joints. Dislocated joints often ...

  13. CONSERVATIVE TREATMENT OF HIP DYSPLASIA

    Михаил Михайлович Камоско

    2014-12-01

    Full Text Available Hip dysplasia in children is the subject of careful study by specialists both in our country and abroad. There are three basic variants of hip dysplasia: congenital acetabular dysplasia, congenital subluxation of the hip and congenital dislocation of the hip. However, treatment of congenital dislocation of the hip, which is the most severe form of hip dysplasia in children, currently remains one of the topical problems of children’s orthopedics, despite the significant achievements of modern medicine. In spite of the large amount of research in this field, treatment principles of hip dysplasia are still under discussion.

  14. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

    Deepak

    2015-06-01

    Full Text Available High velocity road traffic accidents leads to complicated lower limb injuries. Such injuries demand highly experienced surgeon and are associated with high morbidity and mortality. Hip or knee dislocations are two different orthopaedic emergencies. Concomitant fracture dislocation of the hip and knee is rare and very few cases have been reported in the literature. A 45 year old man with history of fall from motorcycle came to the casualty. He had ipsilateral hip and knee dislocation. Immediately patient was shifted to operation theatre and closed reduction was performed under general anaesthesia. Reduction was confirmed under fluoroscopy and post-operative x-rays were taken. The functional results were excellent. After 2 months patient made an uncomplicated recovery and had satisfactory functional outcome with right hip having 110⁰ flexion and right knee flexes to 120⁰.There was no neurological deficit. The urgency, that the treating surgeon shows in managing these injuries, significantly affects the prognosis and outcome finally achieved by these patients (golden period in reducing the hip joint has been described to be 6 hours.

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

    Zafer Dogan

    2014-06-01

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

  16. Total hip arthroplasty in paralytic dislocation from poliomyelitis.

    Laguna, Rafael; Barrientos, Jesús

    2008-02-01

    This article presents a case of a patient with degenerative hip disease in paralytic dislocation by poliomyelitis. Poliomyelitis is an acute infection disease caused by a group of neurotrophic viruses, which has a special affinity by the anterior horns cells of the spinal cord and for certain motor nuclei of the brain stem. Paralysis is a flaccid type and characteristically paralysis is asymmetrical. It is said that the joints of the affected limb by poliomyelitis are protected from the development of osteoarthritis. Hip dislocation in poliomyelitis is an acquired deformity caused by flaccid paralysis and the resulting muscular imbalance. In young children, when the gluteus maximus and medius muscles are paralyzed and the hip flexors and adductors are of normal strength, eventual luxation of the hip is almost inevitable. Hip osteoarthritis in a limb with poliomyelitis is an unusual entity because these limbs do not support excessive loads. In patients who present with the residual effects of poliomyelitis including degenerative disease and hip dysplastic, surgery is one of the most difficult challenges faced by reconstructive surgeons. In such cases, surgeons should attempt to optimize the component position and choice, surgical approach, and soft tissue tensioning because stability of the prosthesis can be problematic. PMID:19292189

  17. Asymmetric traumatic bilateral dislocation of hip. Case report

    Pedro Gonzalo González González

    2009-05-01

    Full Text Available 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.

  18. Treatment for Congenital Dislocation of Hip in School ager by metal Shelf Acetabuloplasty%金属顶盖在学龄期儿童先天性髋脱位中的应用

    房论光; 马承宣; 王雅琴; 许瑞江

    1989-01-01

    In 1978-1986,40 school-agars (64 hips) aged 10.5 years on average with CDH were treated with metal shelf acetabuloplasty.An 1-8 years (average 4.5 yrs) follow-up showed 80% cases obtained satisfactory results The overall rate of femoral head necrosis was 20%.The metal shelf acetabuloplasty indicated,the patient's age must be over 6 years,acetabular dysplasia with an index over 38 and the level of the dislocated head 4 cm higher than normal.This procedure has such.advantages as:1.protecting and promoting.the growth of the acetabular cartilage;2.stabilizing the femoral head in the aeetabulum;3.aiding early training of the activity of the hip and avoiding necrosis of the femoral head.%本文报告采用髋臼成形、金属顶盖、股骨上端斜形截骨术治疗学龄期儿童髋关节脱位、半脱位、髋臼发育不良及股骨头增大50例(64个髋关节).术后随诊平均4年6个月,优良率80%.金属顶盖的作用在于增加股骨头复位后的稳定性,促进髋臼上缘软骨发育,恢复髋臼与股骨头同心圆关系.

  19. 高频超声在先天性髋关节发育不良和脱位诊断中的临床价值%Clinical Value of High-frequency Ultrasound in Diagnosis of Congenital Hip Dysplasia and Dislocation

    尹海霞

    2015-01-01

    目的:探讨高频超声应用于先天性髋关节发育不良和脱位临床诊断的价值。方法整群选用2014年1月—2014年12月,该院接受髋筛超声检查的6月龄内婴幼儿1359例,采用Graf法进行高频超声髋关节检查,观察髋关节发育性异常(DDH)发生情况。结果 1359例(2716个髋关节)婴幼儿中,88例(6.48%)共130个(4.79%)髋关节为DDH;超声Graf诊断分型结果为1271例(2586个关节)Ⅰ型(正常),73例(113髋)Ⅱ型(髋关节发育欠成熟),13例(14髋)Ⅲ型(半脱位),2例(3髋)Ⅳ型(全脱位)。 DDH阳性与临床诊断及X线检查结果完全一致,诊断符合率为100%。结论高频超声操作简便、无创伤且无放射性损伤、重复性好,对于DDH的早期筛查、诊断及干预治疗具有重要意义。%Objective To investigate the value of high-frequency ultrasound in the clinical diagnosis of congenital hip dysplasia and dislocation. Methods 1359 cases of infants within 6 months of age who received high frequency ultrasound diagnosis in our hospital between January 2014 and December 2014 were collected, and all received high-frequency ultrasound examination of the hip by Graf method, and occurrence of dysplasia of the hip (DDH) was observed. Results In 1359 cases (2716 hip) infants, total 130 (4.79%) hip of 88 cases (6.48%) were DDH; graf ultrasound diagnostic genotyping result was 1271 cases (2586 hips) Ⅰ type (normal),73 patients (113 hips) Ⅱ type (hip dysplasia less mature),13 patients (14 hips) Ⅲ type (subluxation),2 cases (three hips)Ⅳ type (full dislocation). DDH positive was entirely consistent with the clinical diagnosis and X-ray findings, and the diagnosis rate was 100%. Conclusion High-frequency ultrasound is easy to operate, non-invasive and without radiation damage and with good repeatability. Therefore it is important for early screening, diagnosis and intervention of DDH.

  20. Imaging of traumatic dislocation of the hip in childhood

    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

    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.)

  1. Imaging of traumatic dislocation of the hip in childhood

    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.)

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

    Erdil Mehmet

    2012-07-01

    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

  3. 先天性髋关节脱位术后康复训练38例体会%Experience of postoperative rehabilitation training on 38 cases of congenital dislocation of hip joint

    闫庆荣; 丁新友

    2003-01-01

    @@ BACKGROUND: Postoperative long-tern immobilization ofdislocation of hip joint may lead to degradation of ligament structure, decreasing of intensity and decline of stress ability. Besides tissue proliferation, organization and adhesion in the course of repairing will lead to dysfunction of hip jolt even stiffness. So planned rehabilitation training on hip joint is very necessary.

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

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

  5. Dislocation

    ... Alternative Names Joint dislocation Images Radial head injury Dislocation of the hip Shoulder joint References Boss SE, Mehta A, Maddow C, ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also ... Browse the Encyclopedia A.D.A.M., Inc. ...

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

    Brennan, Stephen A

    2012-09-01

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

  7. BILATERAL ASYMMETRIC TRAUMATIC HIP DISLOCATION IN AN ADULT - A CASE REPORT

    Venkateswarlu

    2015-11-01

    Full Text Available Bilateral asymmetric traumatic hip dislocation without an associated fracture of the pelvis or femur occurring in an young adult with no previous history of hip abnormality or ligamentous laxity is a rarity. There were only 58 such cases reported in literature till date. Here is a 28 year old male patient presented to our Department of Orthopaedics and Traumatology, Rangaraya Medical College, Kakinada, Andhrapradesh, India with a history of fall from mango tree with bilateral asymmetric traumatic hip dislocation. The mode if injury is fall from a height. The dislocations were promptly reduced by closed method. Serial follow-up revealed no complications.

  8. Leg lengthening of more than 5 cm is a risk factor for sciatic nerve injury after total hip arthroplasty for adult hip dislocation

    Higuchi, Yoshitoshi; Hasegawa, Yukiharu; Ishiguro, Naoki

    2015-01-01

    ABSTRACT Total hip arthroplasty (THA) in patients with high hip dislocation is challenging and technically demanding. Nerve injury is a problem associated with leg lengthening after THA. The purpose of this study was to identify the risk factors for sciatic nerve injury after THA in patients with high hip dislocation. Thirty-seven patients (41 THAs) with Crowe type IV hips were consecutively treated. The average leg lengthening (LL) was 3.2 cm. The average Harris hip score was improved from 5...

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

    Amin Foroughi

    2009-01-01

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

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

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

    2015-01-01

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

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

    Forde, James C

    2012-02-01

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

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

    Venkatachalam Santosh

    2009-12-01

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

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

    Venkatachalam, Santosh; Heidari, Nima; Greer, Tony

    2009-01-01

    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. PMID:20003496

  14. Late results of recestion angulation osteotomy in pathologic dislocation of the hip due to septic arthritis

    Taser, Omer; Aritamur, Ayhan; Cakmak, Mehmet; Karamehmetoglu, M.; Alturfan, Aziz; Berkman, Mahmut

    2004-01-01

    Resection angulation osteotomy were applied on 5 cases with an average age of 18.8 which had pathologic dislocation of the hip due to septic arthritis between 1970-1980. The results of these cases of ours which were followed on an average 4.7 years have been presented. Attempts have been made to discuss under the light of literature, the precedures that might be applied on the pathological dislocation of the hip which referred to in advanced ages.

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

    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.)

  16. Inferior dislocation of the hip: a case series and literature review

    Aggarwal Sameer

    2012-11-01

    Full Text Available 【Abstract】 Inferior hip dislocation is the rarest type among all hip dislocations. Very few cases have been re-ported in the English literature. Most of the earlier reported cases involves the pediatric age group. No single case series could be found in the English literature. We came across 4 cases of inferior hip dislocation with a varied age profile (range 10 to 56 years, mean 33.8 years. Patients with this disease usually complained of pain and kept the thigh flexed and abducted. The diagnosis can be confirmed by radiographs which reveal that the long axis of the femur varies in alignment with respect to the spine from parallel to an angle almost 90° away from the axis. In our series, closed reduction was successful in all patients, either under seda-tion or general anaesthesia. Skin traction for a period of 6 weeks was applied in all of them and follow-up revealed pain-free, stable and mobile hips. In this study we present the details of these cases along with a review of literature discussing the various modes and mechanisms that pro-duce inferior hip dislocation. Key words: Hip dislocation; Therapeutics; Traction; Weight-bearing

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

    Lidder Surjit

    2009-08-01

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

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

    Wang Chen-Ti

    2008-02-01

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

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

    Plate Johannes F

    2012-10-01

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

  20. Traumatic posterior hip dislocation in a 16-month-old child: a case report and review of literature

    Meena Sanjay

    2012-12-01

    Full Text Available 【Abstract】 Traumatic posterior hip dislocation is an uncommon injury in children, constituting less than 5% of paediatric dislocations. In a younger child (<5 years, minor trauma such as a slip or fall from a low height may cause a hip dislocation, whereas in an adolescent a dislocation is usually caused by a major trauma such as motor vehicle accident. In this case report we present a rare case of trau-matic hip dislocation in a 16-month-old girl. Early detection and closed reduction ensured good outcome in our case. A high index of suspicion is necessary to achieve satisfactory reduction within six hours of dislocation because reduction after this period will greatly increase the risk of complications. Key words: Hip dislocation; Child; Accidents; Wounds and injuries

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

    Mladenović Marko

    2015-01-01

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

  2. Chronic Lymphedema of the Lower Limb: A Rare Cause of Dislocation of Total Hip Arthroplasty.

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-01-01

    Total hip arthroplasty (THA) in a patient with chronic lymphedema of both lower limbs is rarely reported in the literature. Chronic lymphedema is a challenging condition associated with various complications especially in a patient with THA. However, dislocation of the total hip prosthesis due to acute exacerbation of lower limb swelling in the postoperative period is an extremely rare complication. The cause that led to the dislocation of the prosthesis is intricate and difficult to assess, as this has not been discussed in the literature yet. We believe that the excessive weight of the limb due to chronic lymphedema had a deleterious effect on the biomechanics of total hip prosthesis, thereby increasing the tendency for dislocation. This case illustrates that chronic lymphedema of the lower limb should be dealt with aggressively using various modalities like intermittent pneumatic compression pumps and compression stockings after THA in such patients. PMID:27226940

  3. Proximal femoral resection arthroplasty for patients with cerebral palsy and dislocated hips

    Knaus, Andreas; Terjesen, Terje

    2009-01-01

    Background and purpose Chronic hip dislocation in non-ambulatory individuals with cerebral palsy (CP) can lead to severe problems, of which pain is often the most severe. We studied the outcome of proximal femoral resection, especially regarding pain, sitting balance, perineal care, and patient satisfaction. Patients and methods During the period 1998–2005, we operated 20 non-ambulatory patients with spastic quadriplegic CP (8 females and 12 males). 13 patients had unilateral dislocation and ...

  4. Inferior dislocation of the hip: a case series and literature review

    Sameer Aggarwal; Vishal Kumar; Kishan Ramachandra Bhagwat; Vokkaleri Shankaranarayana Shashikanth; Holalu Shankaralingegowda Ravikumar

    2012-01-01

    Inferior hip dislocation is the rarest type among all hip dislocations.Very few cases have been reported in the English literature.Most of the earlier reported cases involves the pediatric age group.No single case series could be found in the English literature.We came across 4 cases of inferior hip dislocation with a varied age profile (range 10 to 56 years,mean 33.8 years).Patients with this disease usually complained of pain and kept the thigh flexed and abducted.The diagnosis can be confirmed by radiographs which reveal that the long axis of the femur varies in alignment with respect to the spine from parallel to an angle almost 90° away from the axis.In our series,closed reduction was successful in all patients,either under sedation or general anaesthesia.Skin traction for a period of 6 weeks was applied in all of them and follow-up revealed pain-free,stable and mobile hips.In this study we present the details of these cases along with a review of literature discussing the various modes and mechanisms that produce inferior hip dislocation.

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

    Gavaskar Ashok S

    2012-12-01

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

  6. Computed tomography in abnormalities of the hip

    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.)

  7. Computed tomography in abnormalities of the hip

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

    1982-06-26

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

  8. IPSILATERAL TRAUMATIC POSTERIOR DISLOCATION OF THE HIP ACCOMPANIED BY PRETROCHANTERC FRACTURE

    Taser, Omer; Cakmak, Mehmet; Cubuk, Mustafa Kemal; Domanic, Unsal; Karamehmetoglu, M.

    2004-01-01

    Attempts have been made to present a case with ipsilateral traumatic posterior dislocation of the hip and fracture of the trachanteric region without any acetabular fracture. In this unique case with no second in the literature, treatment of choice has been discussed and late results obtained from this case reported.

  9. A clinical comparative study of anatomic parameters before and after total hip replacement on congenital dysplasia.

    Huang, Ziqiang; Zhou, Yonggang; Chai, Wei; Ji, Weiping; Cui, Guopeng; Ma, Miaoqun; Zhu, Yin

    2016-07-01

    [Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I-III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I-III). PMID:27512242

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

    Navin

    2015-03-01

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

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

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

    2013-01-01

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

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

    Sutsungkokla Imchen

    2013-01-01

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

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

    Koutsostathis Stefanos D; Tsakotos George A; Macheras George A

    2010-01-01

    Abstract Introduction We present a rare case of two concomitant morbidities treated in one operation. To our knowledge, this is the first report of its kind in the literature. Case presentation A 57-year-old Greek woman was admitted to the emergency department having sustained a spiral mid-shaft femoral fracture. She also suffered from an ipsilateral hip congenital dysplasia with ankylosed hip joint due to severe arthritis. She was treated with a total hip arthroplasty using a long stem perfo...

  14. Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

    Bolder, S.B.T.; Melenhorst, J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2001-01-01

    We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up o

  15. Indications of open reduction in non-fradured traumatic posterior dislocation of the hip

    Domanic, Unsal; Ozturk, Irfan; Cakmak, Mehmet; Hamzaoglu, Azmi; Taser, Omer

    2004-01-01

    Non-fractured traumatic posterior dislocotion of the hip either can not always be reduced by closed reduction of can not be concentrically reduced. In 4 out of 19 cases with non-fractured traumatic posterior dislocation of the hip who applied to the Department of Orthopaedics and Traumatology of the Medical School of the İstanbul University during the years 1970-1983, it was obligatory to perform open reduction. The reason why open reduction was effected is that attempts failed to maintoin re...

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

    Vasileios Sakellariou; Michael Christodoulou; Gregory Sasalos; George Babis

    2014-01-01

    Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4...

  17. Concomitant Posterior Hip Dislocation, Ipsilateral Intertrochanteric- and Proximal Tibial- Fractures with Popliteal Artery Injury: A Challenging Trauma Mélange

    Chotai, Pranit N.; Ebraheim, Nabil A.; Ryan Hart; Andrew Wassef

    2015-01-01

    Constellation of ipsilateral posterior hip dislocation, intertrochanteric- and proximal tibial fracture with popliteal artery injury is rare. Management of this presentation is challenging. A motor vehicle accident victim presented with these injuries, but without any initial signs of vascular compromise. Popliteal artery injury was diagnosed intra-operatively and repaired. This was followed by external fixation of tibial fracture, open reduction of dislocated hip and internal fixation of int...

  18. Bilateral congenital absence of anterior cruciate ligaments associated with the scoliosis and hip dysplasia: a case report and review of the literature

    HU Jun; DU Shi-xin; HUANG Zhong-lian; XIA Xue

    2010-01-01

    @@ Congenital absence of the cruciate ligaments is an extremely rare condition with a prevalence of 0.017 per 1000 live births.~1 Niebauer and King~2 first reported this disease in 1960, and after that, similar cases have been reported. These cases are usually associated with other deformities of the knee joint, such as the joint dislocation, absence of the tibial intercondylar eminence, deformity of the meniscus, dysplasia of the distal femur, etc.~3 However, its association with multiple congenital abnormalities in other areas of the body has been rarely reported. Here, we report a patient with congenital deficiency of bilateral anterior cruciate ligaments associated with scoliosis and hip dysplasia, together with the result of four years follow-up along with a literature review.

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

    Hamid Honarpisheh

    2015-07-01

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

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

    Honarpisheh, Hamid; Ghazavi, Mohammad Taghi

    2015-07-01

    The natural history of an untreated case of a Developmental Dysplasia (Dislocation) of the Hip (DDH) associated with multiple congenital abnormalities is reported in a 55-years-old man. The patient's complaints and the varieties of the typical manifestations emerged in other parts of the body throughout the life are reviewed and discussed as comorbidities of a dysplastic condition. Two-stage bilateral total hip replacement (THR) operations were performed at the age of 55. In addition, to relieve the pain, the walking disabilities were overcome, hence gaining normal walking in swing and stances. The leg length discrepancy was corrected by anatomically positioned prostheses, examined by the knee bending test and characterized and evidenced by radiological features and indices. PMID:26170527

  1. Dislocation of a dual mobility total hip replacement following fracture of the polyethylene liner.

    Vedrine, Bertrand; Guillaumot, Pierre; Chancrin, Jean-Luc

    2016-05-18

    An eight-year-old male English Setter was referred for management of a dislocation of a cemented dual mobility canine total hip prosthesis that occurred four months after the initial surgery. Revision surgery showed that the dislocation was associated with fracture of the ultra-high molecular weight polyethylene liner. The dislocation was successfully reduced after replacing the liner. A dual mobility acetabular component is composed of a mobile polyethylene liner inside a metallic cemented cup. Chronic wear of the components of a canine dual mobility total hip replacement has not been described previously. The use of this type of implant is fairly recent and limited long term follow-up of the implanted cases may be the explanation. Acute rupture of a polyethylene liner has never been described in humans, the only case of rupture of a polyethylene liner occurred 10 years after implantation. The case presented here of rupture of the polyethylene liner of a dual mobility total hip replacement is a hitherto unreported failure mode in this model of acetabular cup in the dog. PMID:26991949

  2. Position of the prosthesis and the incidence of dislocation following total hip replacement

    HE Rong-xin; YAN Shi-gui; WU Li-dong; WANG Xiang-hua; DAI Xue-song

    2007-01-01

    Background Dislocation is the second most common complication of hip replacement surgery, and impact of the prosthesis is believed to be the fundamental reason. The present study employed Solidworks 2003 and MSC-Nastran software to analyze the three dimensional variables in order to investigate how to prevent dislocation following hip replacement surgery.Methods Computed tomography (CT) imaging was used to collect femoral outline data and Solidworks 2003 software was used to construct the cup model with variabilities. Nastran software was used to evaluate dislocation at different prosthesis positions and different geometrical shapes. Three dimensional movement and results from finite element method were analyzed and the values of dislocation resistance index (DRI), range of motion to impingement (ROM-I),range of motion to dislocation (ROM-D) and peak resisting moment (PRM) were determined. Computer simulation was used to evaluate the range of motion of the hip joint at different prosthesis positions.Results Finite element analysis showed: (1) Increasing the ratio of head/neck increased the ROM-I values and moderately increased ROM-D and PRM values. Increasing the head size significantly increased PRM and to some extent ROM-I and ROM-D values, which suggested that there would be a greater likelihood of dislocation. (2) Increasing the anteversion angle increased the ROM-I, ROM-D, PRM, energy required for dislocation (ENERGY-D) and DRI values,which would increase the stability of the joint. (3) As the chamber angle was increased, ROM-I, ROM-D, PRM, Energy-D and DRI values were increased, resulting in improved joint stability. Chamber angles exceeding 55(°-) resulted in increases in ROM-I and ROM-D values, but decreases in PRM, Energy-D, and DRI values, which, in turn, increased the likelihood of dislocation. (4) The cup, which was reduced posteriorly, reduced ROM-I values (2.1-5.3(°-)) and increased the DRI value (0.073). This suggested that the posterior high side

  3. Irreducible traumatic posterior hip dislocation with entrapment and a buttonhole effect

    Uzel Andre Pierre

    2012-02-01

    Full Text Available 【Abstract】The authors reported the case of a 27-year-old man who sustained an irreducible postero-lateral traumatic dislocation of the hip with capsular and labral entrapment. Initial X-rays showed only a small acetabular fragment. After two attempts to reduce the hip with muscle paralysis under general anaesthesia failed, the patient was treated by immediate open reduction through a postero-lateral approach. Surgical exploration of the hip revealed a small osteochondral fragment attached to a large piece of labrum and capsule, clogging the acetabulum. The femoral head crossed over the torn capsule with a buttonhole effect. These elements were relieved, the bone fragment was fixed with a 2 mm screw and the capsule was repaired. At the 10-year follow-up, the functional outcome was excellent with a Harris score of 100 points and no signs of necrosis or osteoarthritis. The authors propose a literature review of this uncommon lesion. Key words: Hip dislocation; Tears; Acetabulum; Necrosis

  4. Hip Dislocation and Physis Separation Related to the Delayed Diagnosis of Septic Arthritis - Case Re

    Mehmet Gokalp

    2013-10-01

    Full Text Available If the diagnosis of the hip septic arthritis is delayed, serious complications such as the arthrosis in joint, the separation of epiphyseal, osteomyelitis and sepsis can develop. The presence of the accompanying infectious diseases contributes to the delay of the diagnosis. In order to get rid of the late period sequelaes of septic arthritis, the required tests should be asked for the differential diagnosis of this disease in each patient presenting with hip pain. In this paper we presented 13 years old pediatric patient who was treated with the diagnosis of pneumonia developed joint dislocation together with the physis separation of the femoral head because of delayed diagnosis of accompanying hip septic arthritis.

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

    Koutsostathis Stefanos D

    2010-07-01

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

  6. The value of ultrasonography as a screening procedure for congenital dysplasia of the hip in newborn

    R.M. Castelein

    1989-01-01

    textabstractIn the present investigation the additional value of ultrasound screening of newborns for congenital dysplasia of the hip, over routine clinical examination was studied. The main question that has led to this prospective study was, whether neonatal ultrasonography could detect cases of h

  7. TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE IV CONGENITAL DYSPLASIA OF HIP WITH DISLOCATION IN ADULTS%人工全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节发育不良伴脱位

    李文波; 张文明; 白国昌; 黄子达; 沈荣凯

    2013-01-01

    目的 探讨人工全髋关节置换术(total hip arthroplasty,THA)治疗成人CroweⅣ型先天性髋关节发育不良伴脱位的髋臼假体选择及疗效. 方法 2008年6月— 2012年5月,收治8例8髋CroweⅣ型先天性髋关节发育不良伴脱位女性患者;年龄20~35岁,平均25岁.左髋5例,右髋3例.患髋Harris评分为(53.9士6.6)分.患肢较健侧短缩4~6cm,平均4.8 cm.X线片示患髋均完全高位脱位.术中采用42~44mm小号髋臼假体、S-ROM股骨假体并转子下截骨行THA. 结果 患者切口均Ⅰ期愈合,无髋关节脱位、坐骨神经损伤发生.术后2d1例发生股神经损伤,术后7d2例出现无症状下肢肌间静脉血栓形成,均经对症处理后治愈.8例均获随访,随访时间1~5年,平均3年.患者术前跛行步态均明显改善,均恢复日常工作.术后6个月测量患肢长度与健侧相差-1.0~0.6 cm,平均0.4 cm.髋关节Harris评分达(87.6士0.3)分,与术前比较差异有统计学意义(t=1.77,P=0.00).X线片复查示,股骨截骨处均在术后3~6个月愈合;髋臼假体-骨界面稳固,无松动.随访期间无假体翻修. 结论 使用小号髋臼假体并转子下截骨行THA是治疗成人Crowe Ⅳ型先天性髋关节发育不良伴脱位的有效方法之一,近期疗效较满意,但假体远期生存率仍需进一步观察.

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

    Jäger M

    2011-05-01

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

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

    Behari S

    2000-04-01

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

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

    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)

  11. Femoral Varus Osteotomy for Hip Instability after Traumatic Fracture Dislocations of the Hip Associated with Femoral Head Fractures: A Report of Two Cases

    Nakamura, Junichi; Takahashi, Kazuhisa

    2016-01-01

    Fracture of the femoral head and the acetabulum with traumatic dislocation of the hip is a severe injury representing various types and unfavorable outcome. We showed a 45-year-old man with Pipkin type-IV fracture and coxa valga. An immediate closed reduction was achieved followed by open reduction and internal fixation via a posterior approach 6 days later. However, dislocation occurred three times without traumatic events after three weeks. CT demonstrated no displacement of posterior fragments or implant failure. Femoral intertrochanteric varus osteotomy was performed to gain concentric stability and successfully resolved recurrent dislocation. Another 45-year-old woman with Pipkin type-IV fracture and coxa valga also underwent closed reduction initially and then continued conservative treatment. After eight weeks, when she started gait training, progressive pain became symptomatic. Persistent hip pain at weight bearing was not improved in spite of arthroscopic synovectomy and osteochondroplasty. Two years after injury, femoral intertrochanteric varus osteotomy was indicated and her refractory pain was resolved gradually. We suggest that femoral varus osteotomy should be considered for superolateral subluxation associated fracture dislocation of the hip in Pipkin type-IV and coxa valga. PMID:27293934

  12. Dislocations

    Representations of main geometrical properties of dislocations, their interaction between each other and with a free surface are given. Mechanisms of dislocation formation and movements in different crystal lattices and their role in material strain hardening are considered. Grain boundaries and twin ones are described as dislocation rows imposed on each other

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

    Stojković-Jovanović Tatjana

    2013-01-01

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

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

    Periasamy Kumar

    2008-02-01

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

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

    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

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

    Paragjyoti Gogoi

    2014-01-01

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

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

    Sen Ramesh Kumar

    2011-06-01

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

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

    Chatley Anooj

    2008-01-01

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

  19. The utility of ultrasonography for the diagnosis of developmental dysplasia of hip joint in congenital muscular torticollis

    Park, H.K.; Kang, E.Y.; Lee, Shermin; Kim, K.M.; Jung, A.Y.; Nam, D.H.

    2013-01-01

    OBJECTIVE: To determine whether a routine ultrasonography (US) is necessary for diagnosis of developmental dysplasia of hip (DDH), presenting with congenital muscular torticollis (CMT). METHODS: Cases of 133 patients (81 males, 52 females) diagnosed as CMT were reviewed, retrospectively. We reviewed

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

    Vasileios Sakellariou

    2014-09-01

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

  1. Seasonality of congenital anomalies in Europe

    Luteijn, Johannes Michiel; Dolk, Helen; Addor, Marie-Claude;

    2014-01-01

    with influenza. RESULTS: We detected statistically significant seasonality in prevalence of anomalies previously associated with influenza, but the conception peak was in June (2.4% excess). We also detected seasonality in congenital cataract (April conceptions, 27%), hip dislocation and/or dysplasia (April, 12......%), congenital hydronephrosis (July, 12%), urinary defects (July, 5%), and situs inversus (December, 36%), but not for nonchromosomal anomalies combined, chromosomal anomalies combined, or other anomalies analyzed. CONCLUSION: We have confirmed previously described seasonality for congenital cataract and hip...... dislocation and/or dysplasia, and found seasonality for congenital hydronephrosis and situs inversus which have not previously been studied. We did not find evidence of seasonality for several anomalies which had previously been found to be seasonal. Influenza does not appear to be an important factor...

  2. Neurofibromatosis induced hip arthritis. An unusual presentation

    Alrumaih, Husam; Ilyas, Imran; Kashif, Syed

    2014-01-01

    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 bef...

  3. Association of a single nucleotide polymorphism in growth differentiate factor 5 with congenital dysplasia of the hip: a case-control study

    Dai, Jin; Shi, Dongquan; Zhu, Pengsheng; Qin, Jianghui; Ni, Haijian; XU, YONG; Yao, Chen; Zhu, Lunqing; Zhu, Hongtao; Zhao, Baocheng; Wei, Jia; Liu, Baorui; Ikegawa, Shiro; Jiang, Qing; Ding, Yitao

    2008-01-01

    Introduction Congenital dysplasia of the hip is an abnormal seating of the femoral head in the acetabulum, mainly caused by shallow acetabulum and lax joint capsule. Genetic factors play a considerable role in the pathogenesis of congenital dysplasia of the hip. The gene growth differentiate factor 5 (GDF5) has been implicated in skeletal development and joint morphogenesis in humans and mice. A functional single nucleotide polymorphism (SNP) in the 5'-untranslated region of GDF5 (rs143383) w...

  4. Hip Ultrasound

    ... Infant ultrasound can be used to check the hips for developmental dysplasia of the hip (DDH), which in infants can range from a shallow cup (bony acetabular dysplasia), to complete dislocation with the ball of the ...

  5. MRI在儿童发育性髋关节发育不良中的应用及进展%The application and progress of MRI in developmental dislocation of the hip

    周颖; 楼跃

    2014-01-01

    发育性髋关节发育不良(DDH)是儿童最常见的先天四肢畸形之一,是指于出生前及出生后股骨头和髋臼在发育和(或)解剖关系中出现异常的一系列髋关节病症。早期诊断及治疗对该病预后影响很大,MRI在其辅助诊断及治疗方案制订中起到了显著的作用。本文重点阐述MRI在发育性髋关节发育不良病例中的应用价值及进展。%Developmental dysplasia of the hip (DDH) is a common congenital childhood disorder of the limbs. It refers to a series of the hip joint disease in development and/or abnormal anatomical relationships of femoral head and acetabulum before and after the birth. Early diagnosis and treatment have a great influence on the prognosis of the disease, and MRI has played an important role. This contribution summarizes the application and progress of MRI in developmental dislocation of the hip.

  6. 发育性髋关节脱位与雌激素相关研究进展%Impact of Estrogen on the Developmental Dislocation of the Hip

    齐秀玉(综述); 李志奇(审校)

    2016-01-01

    发育性髋关节脱位的确切病因尚不明确,其与内分泌性因素关系密切。髋关节脱位的发病率存在显著性别差异;雌激素对原代软骨细胞的作用亦有性别差异。动物实验研究和临床研究观察到雌激素与髋关节脱位相关。髋关节脱位的患儿的雌激素受体的存在酶切位点多态性。雌激素通过作用于髋关节的软骨,韧带和胶原等结构导致发育性髋关节脱位。%Although the exact etiology remains unknown , developmental dysplasia of the hip has been related to hormonal factors.There is gender-related difference in the response of primary chondrocytes to estrogen.Results in clinical and basic research revealed that congenital dislocation of the hip was closely related to abnormal estrogen and estrogen receptor polymorphisms.It has been reported that estrogen could influence the development of the hip joint and associated structures such as cartilage,ligament and collagen.

  7. Hip Dislocation and Physis Separation Related to the Delayed Diagnosis of Septic Arthritis - Case Re

    Mehmet Gokalp

    2013-01-01

    If the diagnosis of the hip septic arthritis is delayed, serious complications such as the arthrosis in joint, the separation of epiphyseal, osteomyelitis and sepsis can develop. The presence of the accompanying infectious diseases contributes to the delay of the diagnosis. In order to get rid of the late period sequelaes of septic arthritis, the required tests should be asked for the differential diagnosis of this disease in each patient presenting with hip pain. In this paper we presented 1...

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

    Tetsunaga,Tomonori

    2009-06-01

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

  9. Walking pattern in adults with congenital hip dysplasia: 14 women examined by inverse dynamics

    Pedersen, Eva Natalia G.; Simonsen, Erik B; Alkjaer, T;

    2004-01-01

    Knowledge of the gait dynamics in patients with hip dysplasia may help to understand the consequences of the mechanical changes in the hip.......Knowledge of the gait dynamics in patients with hip dysplasia may help to understand the consequences of the mechanical changes in the hip....

  10. Radiographic outcomes and evaluation of developmental dysplasia of the hip in children

    Ventura, Sandra Rua; Monteiro, Altino

    2010-01-01

    The Developmental Dysplasia of the Hip (DDH), also know as Congenital Dislocation of the Hip, is common in infants and children and may persist into adulthood. The radiographic interpretation is highly conditioned by appropriate patient positioning and image quality criteria. The main goal of this study is to demonstrate the value of radiographic evaluation of DDH. Through the retrospective analysis of 65 radiographs of the hips, only 2 (3.1%) female patients with 1-2 years of age prese...

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

    Ramesh Kumar Sen; Sujit Kumar Tripathy; Vibhu Krishnan; Tarun Goyal; Vanyambadi Jagadeesh

    2011-01-01

    This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture.A 32-year-old man presented with ipsilateral fracturedislocations of the left hip (Pipkin's type Ⅳ) and knee (Moore Ⅱ)joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints.Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.

  12. Developmental Dislocation of the Hip (DDH) after Rehabilitation Guidance%发育性髋关节脱位(DDH)术后康复指导

    谢喜波

    2015-01-01

    Objective To investigate the developmental dysplasia of the hip in older children of rehabilitation nursing of dislocation after improved Pembertonsa operation in patients with. Methods 9 cases of this group of older developmental dislocation of the hip in children treated by modified Pemberton operation, psychological nursing after operation and the rehabilitation training plan, phased, step by step. Results In this group, 9 cases (13 hips) postoperative joint function:excel ent in 8 hips, good in 4 hips, 1 hips, the reduction rate of 100%. Conclusion Rehabilitation nursing is very important to the older developmental dislocation of the hip after operation, close reduction and rehabilitation nursing, nursing, medicine, only the parents and children in close cooperation, in order to obtain satisfactory curative ef ect.%目的探讨大龄儿童发育性髋脱位行改良Pembertonsa术后的康复护理要点。方法对本组9例大龄儿童发育性髋关节脱位行改良Pemberton手术,术后进行心理护理及采用有计划、分阶段、循序渐进的康复训练。结果本组9例(13髋)术后关节功能:优8髋,良4髋,可1髋,复位成功率100%。结论大龄儿童发育性髋关节脱位术后康复护理至关重要,复位效果与康复护理密不可分,只有医、护、家长和患儿密切合作,才能获得满意疗效。

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

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

    2006-06-15

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

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

    Ezhov I.Y.

    2013-06-01

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

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

    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

    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.

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

    Posterior hip dislocation in children and adolescents may involve the non-ossified posterior acetabular wall. Plain radiographs and computed tomography (CT) have been shown to underestimate injury to the unossified acetabulum as well as associated soft-tissue structures. The purpose of this study was to describe findings on radiographs, CT and magnetic resonance imaging (MRI) after posterior hip dislocation in a series of adolescents and to report the intraoperative findings, which are considered the gold standard. Measurements of the posterior wall length using MRI and CT scans were also performed. After institutional review board approval, 40 patients who sustained a traumatic posterior dislocation of the hip between September 2007 and April 2014 were identified. Inclusion criteria were (1) age younger than 16 years old and (2) availability of MRI obtained following closed reduction of the hip. Eight male patients and one female patient with an average age of 13.2 years (range: 10.1-16.2 years) underwent hip MRI following posterior dislocation. Seven of the nine patients also underwent evaluation by CT. Plain radiographs, CT scans and MRI were evaluated in all patients by a single pediatric radiologist blinded to surgical findings for joint space asymmetry, posterior wall fracture, femoral head fracture, labrum tear, complete or partial ligamentum teres rupture and presence of intra-articular fragments. Six patients underwent surgical treatment and the intraoperative findings were compared with the imaging findings. CT identified all bone injuries but underestimated the involvement of posterior wall fractures. Assessment of the posterior wall size and fracture displacement was possible with MRI. All surgically confirmed soft-tissue injuries, including avulsion of the posterior labrum, were identified preoperatively on MRI. The measurement of posterior wall length was not statistically different using CT and MRI. Intraoperative pathological findings at the time of

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

    Mayer, Stephanie W.; Kestel, Lauryn; Novais, Eduardo N. [Children' s Hospital Colorado and University of Colorado School of Medicine, Department of Orthopaedic Surgery, Aurora, CO (United States); Stewart, Jaime R.; Fadell, Michael F. [Children' s Hospital Colorado, University of Colorado School of Medicine, Department of Radiology, Aurora, CO (United States)

    2015-08-15

    Posterior hip dislocation in children and adolescents may involve the non-ossified posterior acetabular wall. Plain radiographs and computed tomography (CT) have been shown to underestimate injury to the unossified acetabulum as well as associated soft-tissue structures. The purpose of this study was to describe findings on radiographs, CT and magnetic resonance imaging (MRI) after posterior hip dislocation in a series of adolescents and to report the intraoperative findings, which are considered the gold standard. Measurements of the posterior wall length using MRI and CT scans were also performed. After institutional review board approval, 40 patients who sustained a traumatic posterior dislocation of the hip between September 2007 and April 2014 were identified. Inclusion criteria were (1) age younger than 16 years old and (2) availability of MRI obtained following closed reduction of the hip. Eight male patients and one female patient with an average age of 13.2 years (range: 10.1-16.2 years) underwent hip MRI following posterior dislocation. Seven of the nine patients also underwent evaluation by CT. Plain radiographs, CT scans and MRI were evaluated in all patients by a single pediatric radiologist blinded to surgical findings for joint space asymmetry, posterior wall fracture, femoral head fracture, labrum tear, complete or partial ligamentum teres rupture and presence of intra-articular fragments. Six patients underwent surgical treatment and the intraoperative findings were compared with the imaging findings. CT identified all bone injuries but underestimated the involvement of posterior wall fractures. Assessment of the posterior wall size and fracture displacement was possible with MRI. All surgically confirmed soft-tissue injuries, including avulsion of the posterior labrum, were identified preoperatively on MRI. The measurement of posterior wall length was not statistically different using CT and MRI. Intraoperative pathological findings at the time of

  18. 先天性髋关节发育不良全髋置换术偏心距重建前后对比研究%Comparative analysis of preoperative and postoperative femoral offset in congenital hip dysplasia treated with total hip replacement

    黄自强; 朱颖; 麻妙群; 季卫平; 柴伟; 崔国鹏; 周勇刚

    2015-01-01

    Objective To explore the preoperative and postoperative hip circumference data of the various types of congenital hip dysplasia treat-ed with total hip replacement. Methods There were 78 cases congenital hip dysplasia patients (TypeⅠ-Ⅲ) included in this study. The preoperative and postoperative femoral offset were measured. Statistical analysis was performed by SPSS 17.0 software. Results Preoperative femoral offset was 33.27± 8.36 mm. Postoperative femoral offset was 39.09 ± 7.10 mm. Conclusion Postoperative hip had no significantly statistical differences compared with normal data parameters. The description of postoperative hip returned to near normal physiological anatomy of each model (TypeⅠ-Ⅲ). The data indicated that the more dislocation, the greater the postoperative hip offset. They have proportional relationship.%目的:探讨各种类型的先天髋关节发育不良全髋置换术前、术后偏心距数据变化的对比研究。方法对国人78例先髋患者(Ⅰ~Ⅲ型)术前、术后股骨偏心距的测量,比照前后数据,对所测数据用SPSS软件进行处理。结果78例患者全部纳入研究结果分析。术前偏心距:(33.27±8.36)mm、术后偏心距数据:(39.09±7.10)mm;测量结果存在正相关,P<0.001。结论术后偏心距与正常人相比无明显统计学差异,说明术后髋周恢复了接近正常的生理解剖。各型先髋(Ⅰ~Ⅲ型)数据统计显示脱位数据越多,术后恢复的偏心距数值越大,成正比关系。

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

    Brockmann, W.P.; Wilmsdorf, H.v.; Weh, L.; Korn, U.

    1984-05-01

    Twenty-four infants and children aged five days to three years had their hips examined by ultrasound, and in 17 the findings were compared with the radiographic appearances. Real-time sonography, because of its flexibility, is a suitable screening method for the early diagnosis of hip dysplasia. It has the typical characteristics of a screening method: so far there have been no false negative findings. False positive results are rare, but cannot be completely excluded. The patients examined so far were mostly abnormal, and a final assessment of false positive findings will have to await larger clinical material, including normals. 6 figs.

  20. Impaction Grafting for Acetabular Deficiency in Total Hip Arthroplasty for Congenital Hip Dysplasia: A Surgical Technique%加压植骨技术在先天性髋关节发育不良患者全髋置换术中修复髋臼缺损的应用

    毛新展; 赵耀超; Sujoy Roychowdhury; Ross W Crawford

    2013-01-01

    目的 介绍加压植骨技术在先天性髋关节发育不良(congenital hip dysplasia,CDH)全髋关节置换术中修复髋臼缺损的应用,并对其临床早期效果进行评估. 方法 2012年8月~2013年5月我院对15例(15髋)CDH患者施行该术式.对患者手术前后X线结果进行分析,应用Harris评分评价手术前后髋关节功能. 结果 本组患者术前患髋Harris评分平均为(45.2±10.6)分,术后3月随访提高到(81.1±16.5)分,术后未出现感染、脱位等早期并发症. 结论 通过联合应用加压植骨、钛网固定及骨水泥加压技术,患者髋臼形态得以重建,术后恢复良好.多种技术的联合应用在CDH患者全髋置换术中具有重要意义.%Objective To introduce a surgical technique incorporating the impaction bone graft,mesh and cemented technique to reconstruct hip center for congenital hip dysplasia (CHD) patients and reveal some tips of the technique for the severe deficiency of the acetabulum.Methods All 15 CHD patients were performed total hip arthroplasty(THA) combining the impaction bone graft,mesh and cemented technique.The detail of the surgery was compared by the X-ray results of the pre-and post-operation.Then the hip functions were assessed according to Harris score.Results The Harris scores of the patients were increased from average 45.2 ± 10.6 to average 81.1 ± 16.5.No early complications such as infection or dislocation were found after the surgery.Conclusion The technique incorporating the impaction bone graft,mesh and cemented technique should be regarded as a valuable alternative in THA for CHD.

  1. [Congenital multiple arthrogryposis].

    Parsch, Klaus; Pietrzak, Szymon

    2007-03-01

    From 1975 to 2004 a total of 38 children handicapped by congenital multiple arthrogryposis were cared for. The congenital joint contractures demand a major effort in terms of surgical reconstruction. In the case of distal arthrogryposis the chances that patients will be able to walk without help are good, while those with amyoplasia are likely to be dependent on mobility aids throughout their lives. The ultimate goal of treatment for patients is to develop into self-confident adults who can cope with life despite their handicaps. The hip in arthrogryposis shows variable forms of pathology, ranging from the almost normal hip to hip contractures with dislocation. Its treatment has some limited advantages, but hardly improves mobility. The knee contractures are actively treated to allow patients to sit, stand and walk better. The club foot and the rocker-bottom foot need sophisticated conservative and operative treatments. If conservative manipulation of bilateral extension contractures of the elbow fails operative treatment is carried out on the dominant side. For shoulder, hand and finger contractures conservative manipulation brings about little improvement, and surgical approaches help hardly at all. PMID:17323063

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

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

    2015-01-01

    -track patients with a suspected dislocation (with no radiographic verification) were moved directly to the post-anesthesia care unit and then straight to the operating room. Dislocation was confirmed under fluoroscopy with reduction under general anesthesia. Surgical delay (in hours), LOS (in hours......), perioperative complications, and complications during the hospital stay were recorded. Dislocation status for fast-track patients (confirmed or unconfirmed by fluoroscopy) was also recorded. RESULTS: Both surgical delay (2.5 h vs. 4.1 h; p < 0.001) and LOS (26 h vs. 31 h; p < 0.05) were less in patients...

  3. Atlantoaxial dislocation

    Vijendra K Jain

    2012-01-01

    Full Text Available Atlanto-axial dislocations (AADs may be classified into four varieties depending upon the direction and plane of the dislocation i.e. anteroposterior, rotatory, central, and mixed dislocations. However, from the surgical point of view these are divided into two categories i.e. reducible (RAADs and irreducible (IAADs. Posterior fusion is the treatment of choice for RAAD. Transarticular screw fixation with sub-laminar wiring is the most stable& method of posterior fusion. Often, IAAD is due to inadequate extension in dynamic X-ray study which may also be due to spasm of muscles. If the anatomy at the occipito-atlanto-axial region {O-C1-C2; O: occiput, C1: atlas, C2: axis} is normal on X-ray, the dislocation should be reducible. In case congenital anomalies at O-C1-C2 and IAAD are seen on flexion/extension studies of the cervical spine, the C1-C2 joints should be seen in computerized tomography scan (CT. If the C1-C2 joint facet surfaces are normal, the AAD should be reducible by cervical traction or during surgery by mobilizing the joints. The entity termed "dolichoodontoid" does not exist. It is invariably C2-C3 (C3- third cervical vertebra fusion which gives an appearance of dolichoodontoid on plain X-ray or on mid-saggital section of magnetic resonance imaging (MRI or CT scan. The central dislocation and axial invagination should not be confused with basilar invagination. Transoral odontoidectomy alone is never sufficient in cases of congenital IAAD, adequate generous three-dimensional decompression while protecting the underlying neural structures should be achieved. Chronic post-traumatic IAAD are usually Type II odontoid fractures which get malunited or nonunited with pseudoarthrosis in dislocated position. All these dislocations can be reduced by transoral removal of the offending bone, callous and fibrous tissue.

  4. [Spasm of the adductor muscles, pre-dislocations and dislocations of the hip joints in children and adolescents with cerebral palsy. Clinical observations on aetiology, pathogenesis, therapy and rehabilitation. Part II. The importance of the iliopsoas tendon, its tenotomy, of the coxa valga antetorta, and correction through osteotomy turning the hip into varus (author's transl)].

    Fettweis, E

    1979-02-01

    The following factors besides spasm and contraction of the adductor muscles contribute to the occurrence of dislocations of the hip in spastic paralysis: Spasm and contraction of the iliopsoas muscle and enhanced valgus position and antetorsion. The author holds the opinion that in case of malformation of the proximal end of the femur, it is not only the indirect action of the spastic musculature via the proximal femur-epiphyseal cartilage which is responsible for this phenomen in accordance with the law on functional adaption through longitudinal growth (Pauwels), but also the direct traction of the iliopsoas tendon. A clue in this direction is the often very pronounced elongation or enlargement of the trochanter minor. The author demonstrates the pathogenetic importance of iliopsoas contracture and malpositioning of the neck of the femur by means of analyses of the course in two patients. The following principles of treatment are postulated for spastic dislocation of the hip: Elimination of the pathogenetic factors through myotenotomy of the adductor muscles and complete resection of the obturator nerve, with observation of strict aftertreatment criteria, tenotomy of the iliopsoas, repositioning and osteotomy with turning into varus. Osteotomy without previous elimination of the pathogenetically acting muscular forces does not appear useful. Likewise, permanent re-positioning by means of muscle-relaxing operation cannot be sufficiently safe-guarded without additional osteotomy once the dislocation has taken place. In twelve patients with spastic dislocation of the hip, treated in accordance with these guidelines (two without osteotomy) aged 6 6/12 and 19 5/12 years, a roentgenologically good result was obtained in half of the cases, whereas the functional result was satisfactory not only with these patients but also with part of the other patients. If surgical treatment is instituted early enough, and if the experiences described here are taken into consideration

  5. Congenital and acquired orthopedic abnormalities in patients with myelomeningocele.

    Westcott, M A; Dynes, M C; Remer, E M; Donaldson, J S; Dias, L S

    1992-11-01

    This article presents a radiologic review of the spectrum of acquired and congenital orthopedic abnormalities found in patients with myelomeningocele. These abnormalities are caused predominantly by muscle imbalance, paralysis, and decreased sensation in the lower extremity. Iatrogenic injury, such as a postoperative tethered cord, may also cause bone abnormalities. Selected images were obtained from more than 800 children. Important entities presented include spinal curvatures such as kyphosis, scoliosis, and lordosis; subluxation and dislocation of the hip, coxa valga, contractures of the hip, and femoral torsion; knee deformities; rotational abnormalities of the lower extremity and external and internal torsion; ankle and foot abnormalities such as ankle valgus, calcaneus foot, congenital vertical talus (rocker-bottom deformity), and talipes equinovarus; and metaphyseal, diaphyseal, and physeal fractures. Familiarity with congenital abnormalities and an understanding of the pathogenesis of acquired disorders in patients with myelomeningocele are essential for proper radiologic interpretation and timely therapy. PMID:1439018

  6. 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

    Luis Eduardo Munhoz da Rocha

    2010-01-01

    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.

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

    Rupant K Das

    2007-01-01

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

  8. Surgical hip dislocation in the treatment of various hip surgeries%髋关节外科脱位技术在髋关节手术中的应用

    李军; 梅玉峰; 王海鹏; 陈祝峰; 胡运生; 周程沛; 王波

    2016-01-01

    Objective To analyze the clinical and radiographic results of surgical hip dislocation ( SHD ) in the treatment of various hip surgeries, and to evaluate the influence factors of the clinical outcomes. Methods From February 2008 to August 2013, 29 SHD surgeries were performed. Nineteen patients were followed up with the average of 28 months ( range: 11 - 46 months ). Primary diagnoses of the hip abnormalities: femoracetabular impingement ( FAI ) in 8 cases, FAI and avascular necrosis of the hip ( AVN ) in 3 cases, hip benign tumors in 5 cases, Perth’s disease in 3 cases. All patients had the symptoms of the hip pain and the dysfunction of the hip. Radiographs indicated the deformity. The mean age was 31.2 years ( range: 16 - 55 years ). In the latest follow-up, the hip X-ray was applied to evaluated the femur head avascular necrosis and Non-Arthritic Young Hip Scores ( YHS ) was applied to evaluate the hip functions. Results preoperatively and postoperatively were compared and analyzed by statistics. Results The average time of the SHD was 32.6 min and the bleeding volume was 353.43 ml. All patients had some degree of the pain relief and increased range of motion. The mean YHS improved from ( 49.42 ± 7.73 ) to ( 83.52 ± 10.19 ) points. The modified YHS satisfactory scores showed excellent in 5 cases ( 26.3% ), good in 12 cases ( 63.2% ) , fair in 1 case ( 5.3% ) and poor in 1 case ( 5.3% ). There were no non-unions of the trochanteric osteotomy sites, any signs of AVN, or inter-trochanteric fractures. Conclusions SHD can be used to treat a variety of hip joint abnormalities with good view of the hip joint, and no disturbance of the blood supply for the femoral head.%目的:观察髋关节外科脱位( surgical hip dislocation,SHD )技术在髋关节手术中的应用效果,探讨与临床意义有关的影响因素。方法回顾分析2008年2月至2013年8月,29例患者应用 SHD 技术进行手术,得到全程随访19例,随访时间11~46

  9. Large femoral head in ceramic-on-ceramic total hip prosthesis for congenital dysplasia of hip in adults%大头陶瓷-陶瓷人工全髋关节置换术治疗成人先天性髋关节发育不良

    黄文泽; 彭昊; 方洪松; 郑慧锋; 周建林; 谭俊峰

    2013-01-01

    目的 探讨大头陶瓷-陶瓷人工全髋关节置换术治疗成人先天性髋关节发育不良的临床疗效.方法 对51例先天性髋关节发育不良患者(62髋)行大头陶瓷-陶瓷人工全髋关节置换术,术后皮牵引固定,对疗效进行评价.结果 51例均获随访,时间20 ~63 (35.1 ±6.2)个月.患者切口均一期愈合.2例术后出现股神经麻痹症状,3个月后恢复正常;1例出现轻度跛行.未出现脱位、感染、下肢深静脉血栓等并发症.术后患侧肢体较术前延长2 ~5 cm.术后5个月,患者均可下床活动且恢复日常生活及工作.根据Harris评分标准:疼痛评分术前为15 ~25(18.5±3.5)分,术后为33 ~42(38.1±2.6)分,差异有统计学意义(P<0.05).髋关节功能评分由术前的9~18(15.4±2.3)分增加到末次随访时的37~45(40.3±1.8)分,差异有统计学意义(P<0.05);屈髋活动度术前为65°~120°(81.5°±10.1°),术后为92°~135°(118.5°±7.6°),差异有统计学意义(P<0.05).结论 大头陶瓷-陶瓷人工全髋关节置换术治疗成人先天性髋关节发育不良临床疗效满意.%Objective To discuss the clinical efficacy of congenital dysplasia of hip in adults treated with large femoral head in ceramic-on-ceramic total hip prosthesis. Methods 51 patients (62 hips) of congenital dysplasia of hip were treated with large femoral head in ceramic-on-ceramic total hip prosthesis. All patients were treated with skin traction after operation. The efficacy of the operation was evaluated. Results 51 cases were followed up for 20~63 (35. 1 ± 6. 2) months. Healing of incision by first intention was achieved in all patients. There were 2 cases of femoral nerve palsy and recovered in 3 months. There was 1 case of claudication. The other patients with no dislocation, infection, and deep venous thrombosis of lower limbs occurred. The mean amount of postoperation leg lengthening was 2~5 cm. All patients could walk independently and return to

  10. Traumatic hip dislocation in children: clinical characteristics and management%儿童创伤性髋关节脱位的临床特点与治疗

    闫桂森; 杨征; 张骥; 朱振华

    2010-01-01

    Objective To investigate the characteristics, therapeutic effects, and prognosis of cases with traumatic dislocations of the hip in children. Methods From January 1990 to December 2006, 27 pa-tients with traumatic hip dislocations were entered in the study, including 19 males and 8 females with an average age of 10.2 years (range, 2.5-14.4 years). Sixteen cases were caused by high-energy trauma, and 11 occurred during daily activities. 25 patients were diagnosed to have a posterior dislocation, and direction of the dislocation was not clear in 2 cases for spontaneous reduction. The diagnosis in one case was initially missed, possibly due to a combination of femur shaft fracture. The duration between injury and reduction was 1-9 h in 24 cases and over 24 h in the other 3. Twenty-one cases were treated by closed reduction, and 6 by open reduction. Of 6 cases with open reduction, 3 cases had osteoehondral fragments, 2 glenoid labrum tear and incarceration, 1 intra-articular incarceration. All the cases were immobilized with spica cast after reduc-tion for 4-6 weeks, and avoided weight-bearing for 3 months. Results The ratio of boys to girls was 2.4:1, and 48 percent of the patients aged under ten. There was significant difference between the age of high- and low-energy trauma. All patients were followed up for an average of 3.6 years (range, 2.4-8.3 years). Accord-ing to Thompson and Epstein's criterion, clinical results were excellent in 24, good in 2, fair in 1. At final follow-up four had femoral head necrosis and three developed residual coxa magna, all of them were high-en-ergy trauma. There was high risk of femoral head necrosis in the group which reduction was delayed over 24 h. Conclusion The trauma energy caused hip dislocation is lower in childhood, the combined injury was few. Closed reduction was usually easy to achieve with few complications. If central reduction was failed, open reduction should be performed. The results were satisfactory of which

  11. Hip fracture surgeries

    ... nih.gov/pubmed/20837683 . Weinlein JC. Fractures and dislocations of the hip. In: Canale ST, Beaty JH, eds. Campbell's Operative ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  12. Hip joint replacement

    ... may have problems with infection, loosening, or even dislocation of the new hip joint. Over time the artificial ... Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  13. Congenital Anomalies in Infant with Congenital Hypothyroidism

    Zahra Razavi

    2012-09-01

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

  14. Roentgenography of hip-joint using tubus in infants

    Roentgenography of hip-joint using tubus was discussed. This technique has been made at St. Marianna University, School of Medicine, in order to reduce the exposure dose in x-ray examination of congenital dislocation of hip-joint. The tubus is designed to butterfly-shaped. Only the site which is necessary for roentgenography of hip-joint is exposed, and the sexual gland is outside exposure. The exposure dose of the sexual gland using tubus is 1/10 in female infants and 1/30 in male infants of those without tubus (6.7 mR in male infants, 2.0 mR in female infants). There are some advantages in the tubus: it is clinically used for both sexes as well as reducing exposure doses, and it can be used widely from neonates to infants. (Serizawa, K.)

  15. Hip Problems in Infants

    ... problems that can lead to dislocation of the hip bones. This is also called dysplasia (say: "diss-play-see-uh"). This means that ... problems later in life? Source Screening for Developmental Dysplasia of the Hip by LM French, M.D., and FR Dietz, ...

  16. Imaging of hip arthroplasty

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

    2012-12-15

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

  17. 'Hip' pain.

    Zacher, Josef; Gursche, Angelika

    2003-02-01

    'Hip' pain is usually located in the groin, upper thigh or buttock and is a common complaint. Slipped capital femoral epiphysis, avascular femoral head necrosis and apophyseal avulsion are the most common diagnoses in childhood and adolescents. Strains and fractures are common in sport-active adults. Osteoarthritis occurs in middle-aged and older adults. Trauma may result in femoral head fracture or typical muscle and tendon sprains and bursitis. Septic or inflammatory arthritis can occur at every age. Septic arthritis, fractures and acute epiphyseal slipping are real emergency cases. Congenital dysplasia of the hip joint may lead to labral tears and early osteoarthritis. The most important hip problems in children, adolescents, adult and older people are discussed; these problems originate from intra-articular disorders and the surrounding extra-articular soft tissues. Medical history, clinical examination and additional tests, including imaging, will be demonstrated. Principles of treatment are given for specific disorders. PMID:12659822

  18. 人工全髋关节置换术后脱位的原因及其防治%Cause and control measures of postoperetive dislocation af ter tto al hip arthroplasty

    段军; 李锋生

    2015-01-01

    目的:探讨人工全髋关节置换术后假体脱位的原因及其防治措施。方法:收集2004年1月~2014年1月在我院行全髋关节置换的病人资料,总共408人4,48髋,男211人,234髋,女197人,214髋。其中脱位15例,男7例,女8例。对其进行回顾性分析,探讨脱位的影响因素及其治疗原则。结果:全髋关节置换术后脱位15例,脱位率3.3%;其中前脱位5例,后脱位10例;全髋关节置换术后翻修25例,脱位3例,脱位率12%;1例病人有精神病史,4例病人既往有髋部手术史,6例病人假体位置不佳或髋臼周围骨赘较多,4例病人术后有深蹲或翘二郎腿动作。15例患者脱位后均予以麻醉下手法复位,卧床皮肤牵引6周,其中10例复位成功,1例半年后再次脱位。5例予以手术切开复位或者调整假体位置,术后患者功能均恢复良好。结论:人工髋关节术后假体脱位有多种影响因素,大致可以从3方面考虑:(1)病人的状态;(2)医生的因素;(3)假体的设计。当然,有时这几方面是可以同时存在的。因此,只有全面了解病人脱位的原因,有针对性的治疗时,才能取得较好的效果。%Objective:To analyze and prevent postoperative dislocation after total hip arthroplasty.Methods:408 patients (448hips) were collected from Jan 2004 to Jan 2014,which involved males 211(234 hips),female 197 (214 hips).There were 15 patients developed into dislocation.The influence and therapeutic principle of the dislocation were discussed through retrospective investigation.Results:There were 15 cases had dislocation,the rate was 3.3%,5 cases were anterior dislocation ,10 cases were posterior dislocation.25 patients were revision cases, among them 3 cases developed into dislocation, the rate was 12%.One case had mental disease;Four patients once had hip surgery;Six cases the position of prosthesis were not beautifull or some

  19. Total Hip Arthroplasty for Hip Fractures

    Monzón, Daniel Godoy; Iserson, Kenneth V.; Jauregui, José; Musso, Carlos; Piccaluga, Francisco; Buttaro, Martin

    2014-01-01

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

  20. 成人先天性髋关节发育不良的围手术期护理%Nursing Care of Perioperative Period in Adult Congenital Hip Dysplasia

    刘倩; 周莉; 何晓凤

    2011-01-01

    Adult congenital hip dysplasia(ACHD) is a congenital defect of acetabular disease. It may develop subluxation or luxation of hip after a long term, and osteonecrosis of the femeral head may occur at last. Now the patients with ACHD at early stage are treated with the operation of rotational osteotomy of the acetabulum, but in later period it can only be treated with the operation of total hip replacement. No matter which method is selected, nursing care of perioperative period plays a very important role in recoveries of the patients.%成人先天性髋关节发育不良是一种髋臼先天性发育缺陷的疾病,长期发展会形成髋关节半脱位、脱位,最终甚至可能出现股骨头坏死等严重合并症.对于早期患者目前主要采用髋臼旋转截骨手术治疗,而晚期出现股骨头脱位及坏死则只能通过全髋关节置换进行治疗.不论哪种手术方式,围手术期的护理时于患者的健康恢复都有着非常重要的意义.

  1. Postoperative observation and nursing of hip developmental dislocation in infants with Ferguson operation%Ferguson 手术治疗婴幼儿发育性髋脱位的术后护理

    王楠; 覃倩; 叶蕾

    2013-01-01

    Objective To explore the clinical nursing of hip developmental dislocation in infants with Ferguson operation.Method The nursing strategy was performed including observation of the surgical incision,skin care,care of cast and instructions to their parents. Result No pressure sores occurred in all the 34 cases of hip developmental dislocation.1 case had delayed allergy reaction because of use of contrast media during operation,1 cast syndrome,and 19 edema of perineum of different degrees including 6 severe edemata,which were cured using wet compress with Adlerika.Conclusion It is of great importance for the reduced incurrence of operation complications and promising operative effect to observe the conditions and treat timely problems in postoperative nursing.%  目的探讨 Ferguson 手术治疗婴幼儿发育性髋脱位的术后护理方法。方法对34例发育性髋脱位患儿Ferguson 术后做好伤口渗血的观察和处理,皮肤护理,人类位石膏的护理以及家属的指导。结果34例患儿无1例发生再脱位和压疮。1例发生造影剂过敏,1例发生石膏综合征,6例会阴部水肿,经治疗症状好转。结论严密的病情观察可及时发现术后护理问题,同时采取积极和针对性的护理措施,对于降低患儿术后并发症,保证手术成功具有重要意义。

  2. Hip and Spine in Cerebral Palsy

    Persson-Bunke, Måns

    2015-01-01

    Abstract Background: Children with cerebral palsy (CP) have an increased risk of scoliosis, contractures including windswept hip deformity (WS), and hip dislocation. In 1994, a follow-up program and registry for children and adolescents with CP (CPUP) was initiated in Sweden to allow the early detection and prevention of hip dislocations and other musculoskeletal deformities. Purpose: To analyze the prevalence of scoliosis and WS in children with CP and to study the effect of CPUP. To e...

  3. Techniques and results for open hip preservation

    David eLevy

    2015-12-01

    Full Text Available While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve ́-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/ or acetabulum. Chronic slipped capital femoral epiphysis (SCFE may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy.

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

    Rupant K Das; Sanjay Behari; Namit Singhal; Awadesh K Jaiswal; Mahapatra, Ashok K.

    2007-01-01

    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. Ca...

  5. THE USE OF ROBOTIC MOTOR REHABILITATION IN COMPLEX TREATMENT OF SUBLUXATION AND DISLOCATION OF THE HIP IN CHILDREN WITH SEQUELAE OF SPINA BIFIDA

    Stanislav Vyacheslavovich Ivanov

    2014-12-01

    Full Text Available The article presents the results of rehabilitation in children with sequelae of spina bifida using the robotic complex “Pediatric Lokomat” produced by «Hocoma» company (Switzerland. In such patients, one of the most significant orthopedic problems in frequency and clinical relevance is the instability of the hip joint. The approach to rehabilitation treatment in children after reconstructive surgery of the hip involves the principle “early motion - late weight bearing”. Conventional methods of rehabilitation treatment are performed in supine position, and don’t allow to combine this principle with training the skills of vertical posture, which leads to the development of osteoporosis and the risk of pathological fractures. Robotic mechanotherapy enables to cope with this problem by working in isokinetic mode with no load on the supporting surface.

  6. The Short-term Clinical Outcome of the Total Hip Arthroplasty for Adult CroweⅣType of Congenital Hip Dyspla- sia%全髋关节置换术治疗成人严重先天性髋关节发育不良的近期疗效观察

    罗毅; 丁晓川; 侯伟光; 刘煊文; 张强

    2015-01-01

    Objective To investigate the short-term clinical outcome of the total hip arthroplasty for adult Crowe Ⅳ type of congenital hip dysplasia. Methods From 2008 February to 2011 February, 6 patients(6 hip)with adult CroweⅣtype of con-genital hip dysplasia were treat with total hip arthroplasty, including 1 male and 5 females with an average age of 30 years( range, 25~45 years) , the clinical follow-up time was 3~5 years. Results 6 patients were all obtained follow-up, the mean follow-up time was 38 months. The hip function of all patients was normal, the pain was disappeared. The average Harris score was 82 points, 1 patient suffered postoperative sciatic stretch symptoms and recovered subsequently, acetabularⅠ,Ⅱzone of 1 patient ap-peared <1mm bright line, femoral and acetabular prosthesis were no looseness, acetabulum of 1 patient appeared heterotopic ossi-fication of BrookerⅠ, but no effect on the function of hip. Conclusion The total hip arthroplasty for Crowe type IV congenital dysplasia of the hip operation is one of the effective methods, and has good recent therapeutic effect.%目的:探讨全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节发育不良的近期疗效。方法2008年2月至2011年2月,对6例6髋成人Crowe Ⅳ型先天性髋关节发育不良进行了全髋关节置换术,其中男1例,女5例;年龄25~45岁,平均年龄30岁,并进行了3~5年的临床随访。结果6例患者均完全获得随访,平均随访时间为38个月。所有患者患髋功能基本正常,疼痛基本消失。平均Harris评分82分,1例患者术后出现坐骨神经牵拉症状,并随后恢复,1例患者在髋臼Ⅰ、Ⅱ区出现<1mm的透亮线,股骨假体及髋臼假体未见松动,1例患者出现BrookerI型异位骨化,但对功能无影响。结论全髋关节置换术治疗Crowe Ⅳ型先天性髋关节发育不良的有效手术方法之一,且近期疗效满意。

  7. THEEMPIRICAL STUDY TO THE PATHOLOGICAL CHANGES OF ACETABULAR CHONDROCYTE IN THE DEVELOPMENTAL DISLOCATION OF THE HIP%发育性髋脱位髋臼软骨细胞病理学改变的实验研究

    韦宜山; 刘万林; 丁良甲; 王炳海; 白锐; 李岱鹤; 赵振群

    2012-01-01

    Objective: To investigate the pathological changes of acetabular chondrocyte in the developmental dislocation of the hip( DDH). Methods: 20 rabbits of 4-week-old which female and male were not restricted had been made for the models. The back limb that the hip was flexured and the knee was extened then fixed with a plaster cast was made for DDH model group and the right side without fixationas the control group. Pelvis anteroposterior X-rays had been made on the models before the fixation and after8 - weeks fixation. The femoral head dislocation or not by shenton ' s line was discontinuity or by the femoral head was at the extabottom or extraupper quadrant of the Perkin squarse. Observing the changes of general shape of bilateral acetabular and the changes of chondrocyte, then observing the apoptosis of acetabular chondrocyte in 12 successful models. Results: Success rate of DDH models were60% ( 12/20). Hip X-ray of experimental side shown that the femoral head was dislocation toward the extabottom or extraupper quadrant of the Perkin squarse, the acetabular angle of the experimental was significantly increased than the control side(P<0. 05). The experimental side was found that the acetabulum became narrowing and fiied with soft tissue and the color of cartilage changed into dark,the chondrocytes were sparse and in a mess. Transmission electron microscopy results shown that the chromatin of acetabular chondrocytes were margination and condensation, the nuclear shape was irregular, the cytoplasmic vacuoles were present. Apoptosis rate of acetabular chondrocytes in experimental side was higher than the control side(P<0. 05). Conclusion; Excessive apoptosis of acetabular chondroctes may take part in the regulation of acetabular cartilage dysplasia in DDH.%目的:探讨发育性髋脱位(DDH)髋关节结构内髋臼软骨细胞的病理学变化.方法:选取出生4W的新西兰大耳白兔20只,雌雄兼用,采用兔后肢屈髋伸膝位管型石膏固定制作DDH

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

    Gilberto Francisco Brandão

    2010-01-01

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

  9. Infant hip sonography: current concepts.

    Harcke, H T; Grissom, L E

    1994-08-01

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

  10. Subtalar dislocation

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

  11. Subtalar dislocation

    El-Khoury, G.Y.; Yousefzadeh, D.K.; Mulligan, G.M.; Moore, T.E.

    1982-05-01

    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.

  12. Congenital Absence of Posterior Elements of C2 Vertebra with Atlanto-Axial Dislocation and Basilar Invagination: A Case Report and Review of Literature.

    Srivastava, Sudhir Kumar; Nemade, Pradip Sharad; Aggarwal, Rishi Anil; Bhoale, Sunil Krishna

    2016-02-01

    Developmental anomalies of the axis are commonly encountered, especially anomalies involving the odontoid process. Anomalies of the posterior elements are uncommon. We describe a unique case of agenesis of posterior elements of C2 with basilar invagination and atlanto-axial dislocation. An obese 8-year-old boy presented with symptoms of cervical myelopathy. Radiological workup revealed a craniovertebral junction anomaly with occipitalised atlas, absent posterior elements of axis, and hypertrophied C3 spinous process. Atlanto-axial instability and basilar invagination was present. Magnetic resonance angiography revealed hypoplastic left vertebral artery. Traction with cervical tongs failed to improve the alignment and symptoms. Anterior trans-oral release, followed by posterior decompression and custom-made instrumentation, was done. The patient recovered completely and was asymptomatic at the end of two years. X-ray and computed tomography scan demonstrated reduction of basilar invagination and maintenance of alignment. This is the first case to be reported of agenesis of posterior elements of axis associated with basilar invagination. One should look for this condition in patients with hypertrophied spinous process of C3. Utilization of hypoplastic pedicle of axis serves as an additional fixation point to increase the stability of the construct. PMID:26949474

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

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

    2013-01-01

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

  14. 先天性肌性斜颈伴发育性髋关节异常儿童的康复治疗%Rehabilitation management of congenital muscular torticollis coexisted with developmental dysplasia of the hip in children

    杜青; 赵黎; 王惠芳; 周璇; 李海; 沈品泉; 陈珽; 陈楠; 张树新

    2010-01-01

    Objective Congenital muscular torticollis (CMT) and developmental dysplasia of the hip (DDH) are common congenital problems in infants. Association between CMT and DDH has been reported in literatures. The aim of this study was to assess coexistence of DDH in infants with CMT and curative effects of its rehabilitative therapy. Methods In total, 187 infants less than two months old with CMT were recruited in the study. DDH was diagnosed and graded by Graf's bilateral hip type B ultrasonography and pelvic X-ray films. Massage manipulation, magnetic strapping, postural orthosis at home and heat compress were instituted for CMT and frog spica device and hip-flexion abduction plaster immobilization were instituted for DDH. Their early rehabilitative effects were evaluated. Results DDH was coexisted in 24 of 187 infants with CMT, with incidence of 12. 8%. The hips of 22 infants were graded as type Ⅱ b (91.7%) and two as type Ⅲ a (8.3%), and eight at the left side and seven at the right side.Comorbid hips completely recovered normal with early frog spica device and hip-flexion abduction therapy in 24 infants. Conclusions Coexistence of CMT and DDH are relatively common in infants. Type B ultrasonography can be used as a measure for screening DDH in neonates with CMT. Early rehabilitative therapy is effective for those coexisted with DDH and CMT at the same time.%目的 了解先天性肌性斜颈(CMT)伴发育性髋关节异常(DDH)发生情况及其康复治疗的效果.方法 对187例月龄<2个月的CMT患儿,应用Graf方法行双侧髋关节B超、骨盆X线摄片检查以明确诊断,筛查DDH并对其髋关节类型进行分类.CMT采用手法推拿、磁贴、家庭体位矫治、热敷治疗,DDH采用屈髋外展支架、外展位石膏治疗,观察早期康复治疗的效果.结果 187例CMT患儿中,24例(12.8%)合并DDH;髋关节类型:Ⅱb型22例(91.7%),Ⅲa型2例(8.3%).24例患儿通过早期康复和屈髋外展支具治疗,共存疾

  15. Pathologic ligamentous constraint of the hip.

    Crowninshield, R D; Johnston, R C; Brand, R A; Pedersen, D R

    1983-12-01

    A mathematic model of the hip capsule and lower extremity musculature was utilized to predict the forces present in the hip ligaments during locomotion. The results demonstrate principles and trends (rather than absolute results) in hip mechanics, the details of which are affected by the associated modeling assumptions. The active stretching of a hip joint capsule tightened by scarring or surgical transfer may appreciably increase the hip contact force. Capsular elements that prevent hip flexion and adduction play a major role in hip contact force exaggeration during common activities. The positive effect of maintaining the hip capsule to reduce total hip component dislocation contrasts with the potential negative effects of restricting joint motion and increasing the joint contact force. Increased joint loading due to capsular restriction may contribute to prosthetic component loosening. PMID:6641064

  16. Hip sonography in the newborn

    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

  17. 发育性髋脱位髋臼软骨细胞凋亡的实验研究%The empirical study to acetabular chondrocyte apoptosis in the developmental dislocation of the hip.

    韦宜山; 刘万林; 丁良甲; 王炳海; 白锐; 李岱鹤; 赵振群

    2012-01-01

    Objective To investigate the correlation of the apoptosis of acetabular chondrocyte and expression of Bcl-2 in the developmental dislocation of the hip ( DDH). Method 20 rabbits of 4-week-old which female and male were not restricted had been made for the models. The back limb that the hip was flex-ured and the knee was extened then fixed with a plaster cast was made for DDH model group and the right side without fixation as the control group. Pelvis anteroposterior X-rays had been made on the models before the fixation and after 8-weeks fixation. The femoral head dislocation or not by shenton' s line was discontinuity or by the femoral head was at the extabottom or extraupper quadrant of the Perkin squarse. 12 successful models were sacrificed at once. Observing the changes of general shape of bilateral acetabular and the changes of chondrocyte , then observing the apoptosis and expression of Bel - 2 of acetabular chondrocyte. Results Success rate of DDH models were 60% (12/20). Hip X-ray of experimental side shown that the superior margin of acetabu-lum was blunting, the femoral head was dislocation toward the extabottom or extraupper quadrant of the Perkin squarse, the acetabular angle of the experimental was significantly increased than the control side ( P < 0. 05 ) . The experimental side was found that the acetabulum became narrowing and fiied with soft tissue and the color of cartilage changed into dark, the chondrocytes were sparse and in a mess . Transmission electron microscopy results shown that the chromatin of acetabular chondrocytes were margination and condensation , the nuclear shape was irregular, the cytoplasmic vacuoles were present. Apoptosis rate of acetabular chondrocytes in experimental side was higher than the control side ( P < 0. 05 ) . The expression of Bcl-2 of acetabular chondrocytes in experimental side was lower than the control side ( P < 0. 05 ) , apoptosis and Bcl-2 expression of acetabular chondroctes were positive correlation in

  18. Hip Replacement

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

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

    2016-08-03

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

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

    2011-09-01

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

  1. Bipolar hip arthroplasty.

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

    2011-12-01

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

  2. Finite Element Analysis of CroweⅣ Development Dislocation of the Hip%CroweⅣ型髋关节脱位儿童髋臼有限元生物力学分析

    巴晶晶; 雷伟; 颉强; 山世鹏; 严亚波; 马义善

    2013-01-01

    目的:建立CroweW型发育性髋关节脱位儿童骨盆三维有限元模型,对发育性髋关节脱位儿童真性髋臼及假性髋臼的生物力学进行初步分析.方法:采用单侧发育性髋关节脱位儿童骨盆CT扫描DICOM数据,通过Mimics10.0对图像DICOM数据进行重建,经Geomagic Proe5.0进行网格优化,在Hepermesh 10.0中进行有限元网格划分后输入ANSYS12.0中,在ANSYS中根据解剖部位建立骨盆主要韧带,行单腿站立载荷加载,计算该加载方式下骨盆的应力及位移分布情况.结果:模拟患者单腿(患侧)站立状态下身体重心通过假关节的中心,骨盆极度倾斜约45°,给予生理载荷,应力主要集中在假髋臼和骶髂关节面之间,耻骨上肢内侧是应力集中区但是应力小于骶髂关节周围部分;患侧骨盆位移以髂骨翼前侧向后侧逐渐减弱.结论:建立的有限元模型在静载荷下特征部位的应力及位移能够反映CroweⅣ型髋关节脱位儿童骨盆的力学结构特性,模型的准确性高,可以成为CroweⅣ型髋关节脱位儿童骨生物力学研究的工具,满足临床研究需要.%Objective:To construct a three-dimensional (3D) finite element pelvic model of child with Crowe Ⅳ developmental dislocation of the hip (DDH),and to investigate the stress around pseudo-acetabular and acetabular of DDH.Methods:One ten-year-old girl with DDH was scanned by multi-slices computerized tomography (MSCT) and the images of every cross-section were obtained.The three-dimensional images of the DDH child pelvis were reconstructed with the software Mimics 10.0.The three-dimensional model of the pelvis was imported into the ANSYS12.0 by the Geomagic Proe 5.0 and the Hempermesh 10.0.Digital three-dimensional structures of the DDH child pelvis,such as ligament,were added to the three-dimensional model with powerful pre-processing modular of ANSYS.Finally,the integrated three-dimensional finite elemental model of the DDH child pelvis was

  3. The hip in cerebral palsy.

    Bleck, E E

    1980-01-01

    Orthopedic surgery can alleviate the hip flexion, adduction, and medial rotation deformities of the hip and improve the function and appearance of gait. To accomplish this, however, careful examination and prudence in the operative procedure to avoid overdoing and overcorrecting are important. Orthopedic surgery can prevent subluxation and dislocation of the hip before the age of seven years, and consequently repetitive radiographic examinations of the hip in children who have spastic paralysis of the hip musculature should be a routine procedure. Subluxation and dislocation of the hip, when established, can be successfully treated with orthopedic surgical procedures. Physicians must keep in mind that the spastic paralysis of cerebral palsy originates in the brain, and therefore the spasticity cannot be eliminated. The best that can be done is to weaken or remove some muscles as deforming forces and to achieve compromises for continued function. The goal should be optimal independence for the child and adolescent during development, and freedom from pain with deteriorating function due to degenerative arthritis in the adult. PMID:7360505

  4. Magnetic resonance imaging of hip joint cartilage and labrum

    Christoph Zilkens

    2011-09-01

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

  5. Arthroscopic management of an intraarticular osteochondroma of the hip

    Brian T. Feeley

    2009-04-01

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

  6. Hip instability.

    Smith, Matthew V; Sekiya, Jon K

    2010-06-01

    Hip instability is becoming a more commonly recognized source of pain and disability in patients. Traumatic causes of hip instability are often clear. Appropriate treatment includes immediate reduction, early surgery for acetabular rim fractures greater than 25% or incarcerated fragments in the joint, and close follow-up to monitor for avascular necrosis. Late surgical intervention may be necessary for residual symptomatic hip instability. Atraumatic causes of hip instability include repetitive external rotation with axial loading, generalized ligamentous laxity, and collagen disorders like Ehlers-Danlos. Symptoms caused by atraumatic hip instability often have an insidious onset. Patients may have a wide array of hip symptoms while demonstrating only subtle findings suggestive of capsular laxity. Traction views of the affected hip can be helpful in diagnosing hip instability. Open and arthroscopic techniques can be used to treat capsular laxity. We describe an arthroscopic anterior hip capsular plication using a suture technique. PMID:20473129

  7. Bilateral anterior shoulder dislocation

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  8. Ultrasonic screening of congenital developmental dysplasia of hip%超声筛查先天性髋关节发育不良情况分析

    尚永玲; 梁倩; 刘玮; 刘冠金

    2013-01-01

    目的 利用超声筛查婴儿的髋关节发育不良及异常情况.方法 采用Graf超声检查方法 对6 170例婴儿进行髋关节发育不良筛查,根据分型及诊断标准判定可疑髋关节发育不良、髋关节发育异常及脱位情况.结果 检出可疑髋关节发育不良107例,阳性率为1.73%;髋关节发育异常或脱位17例,阳性率为0.28%.本地和外地籍可疑髋关节发育不良或异常婴儿阳性率比较差异无统计学意义(P>0.05).男婴和女婴可疑先天性髋关节发育不良或不稳定关节、髋关节发育异常或脱位的阳性率比较差异均有统计学意义(χ2值分别为82.127、18.789,均P 0. 05 ). There were significant differences in positive rate of suspicious DDH or unstable joint , anomalies or dislocation between boys and girls (χ2 value was 82. 127 and 18. 789, respectively, both P < 0. 05). Conclusion Ultrasonic screening of DDH in infants creates condition for early treatment , and it plays an important role in the follow-up observation, curative effect tracking and treatment adjustment.

  9. Bilateral inferior dislocation of the hip——a case report

    Kishan R Bhagwat; Bhavuk Garg; Sameer Aggarwal; Mandeep S Dhillon

    2012-01-01

    Inferior dislocation of the hip is the rarest type in hip dislocation.Very few cases have been reported in the anglophonic literature,most of which involved the pediatric age group.Surprisingly,we came across a 30-year-old patient with a bilateral inferior hip dislocation.He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction.The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 110 (fight) degrees and 100 (left) degrees respectively away from the axis.Closed reduction under sedation was successfully performed.Skin traction for a period of 6 weeks was advised and the follow-up revealed an excellent result.We present the details of this case,the first of its kind along with a review of the literature,discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip.

  10. Hip Revision

    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. ...

  11. Hip Revision

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

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

    Nepple, Jeffrey J; Smith, Matthew V

    2015-12-01

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

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

    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)

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

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

    2009-02-01

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

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

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

    1997-11-01

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

  16. Congenital contractural arachnodactyly (Beals syndrome).

    Viljoen, D

    1994-01-01

    Congenital contractural arachnodactyly (CCA) is an autosomal dominant disorder akin to, but usually less severe than, Marfan syndrome. The clinical features are marfanoid habitus, arachnodactyly, crumpled ears, camptodactyly of the fingers and adducted thumbs, mild contractures of the elbows, knees, and hips, and mild muscle hypoplasia especially of the calf muscles. Many patients have kyphoscoliosis and mitral valve prolapse and, very occasionally, aortic root dilatation and ectopia lentis h...

  17. To Observe the Clinical Effect of Pelvic Osteotomy in the Treatment of Congenital Dysplasia of the Hip%骨盆截骨术治疗小儿先天性髋关节发育不良的临床疗效观察

    曹思鼎; 卞凌云

    2015-01-01

    目的:探讨骨盆截骨术治疗小儿先天性髋关节发育不良的临床疗效。方法选自2010年1月至2014年12月我院收治的小儿先天性髋关节发育不良患儿43例,对这43例患儿采用骨盆截骨术进行治疗。结果术前患儿的平均髋臼指数为(47.21±1.39)°,术后患儿平均髋臼指数为(16.38±1.45)°,43例患儿术后髋关节良好率为95.3%。结论骨盆截骨术治疗小儿先天性髋关节发育不良效果显著,手术成功率高,患儿髋臼指数改善明显,该种手术方式值得在临床上推广。%ObjectiveTo investigate the clinical effect of pelvic osteotomy in the treatment of congenital dysplasia of the hip.MethodsChildren with congenital hip joint from January 2010 to December 2014 in our hospital, 43 cases of dysplasia patients, the 43 cases were treated with pelvic osteotomy for treatment.ResultsThe average preoperative acetabular index in children was (47.21±1.39) degrees, the averagepostoperative acetabular index was (16.38 ±1.45) degrees, 43 cases of postoperative hip good rate was 95.3%.ConclusionPelvic osteotomy for the treatment of children with congenital dysplasia of the hip joint operation effect, high success rate, with a cetabular index improved signiifcantly, the operation method is worthy of clinical promotion.

  18. Congenital Zika syndrome with arthrogryposis: retrospective case series study

    Filho, Epitacio Leite Rolim; Lins, Otavio Gomes; Aragão, Maria de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Cruz, Danielle Di Cavalcanti Sousa; Rocha, Maria Angela Wanderley; Sobral da Silva, Paula Fabiana; Carvalho, Maria Durce Costa Gomes; do Amaral, Fernando José; Gomes, Joelma Arruda; Ribeiro de Medeiros, Igor Colaço; Ventura, Camila V; Ramos, Regina Coeli

    2016-01-01

    Objective To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. Design Retrospective case series study. Setting Association for Assistance of Disabled Children, Pernambuco state, Brazil. Participants Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. Results The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. Conclusions Congenital Zika syndrome should be added to the differential diagnosis of congenital

  19. Neonatal hip dysplasia: Differental diagnosis

    Vukašinović Zoran

    2010-01-01

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

  20. Management of hip posture in cerebral palsy.

    Clarke, A M; Redden, J. F.

    1992-01-01

    Seating arrangements for cerebral palsy children with total body involvement are often unsatisfactory and can pose considerable problems for the multi-disciplinary team. Hip joints at risk of dislocation must be kept in an abducted position in order to minimize pain. A new wheelchair with a barrel-shaped cylindrical seat has been developed which improves the femoral head location and alleviates pain.

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

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

    2008-10-15

    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.)

  2. Hip Revision

    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 ...

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

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

    2015-01-01

    Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of...

  4. Dislocated shoulder - aftercare

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... You most likely dislocated your shoulder from a sports injury or accident, such as a fall. You have likely injured (stretched or torn) some of the muscles, ...

  5. Dislocated shoulder - aftercare

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  6. 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

    2016-05-09

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

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

    2016-07-01

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

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

    2016-08-12

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

  9. 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

    2014-04-29

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

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

    2016-08-15

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

  11. A Randomised Single Centre Study to Compare the Long-Term Wear Characteristics of Marathon™ and Enduron™ Polyethylene Cup Liners in Primary Total Hip Replacement

    2009-04-07

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

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

    2014-08-13

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

  13. Traumatic Elbow Dislocations

    Iordens, Gijs

    2014-01-01

    markdownabstractThe elbow is the second most common major joint to dislocate after the shoulder in the adult population. Its stability is highly dependent on a complex interaction between bony articulations, capsuloligamentous structures and dynamic muscle restraints. Dislocations are traditionally classified by the presence (complex dislocations) or absence (simple dislocations) of associated fractures and by the direction of the displacement of the forearm relative to the humerus. The gener...

  14. Hip arthroscopy

    Henrique Antônio Berwanger de Amorim Cabrita

    2015-06-01

    Full Text Available Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff, although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve.

  15. Hip Revision

    Full Text Available ... radiograph, unfortunately, three years down the line, this patient was developing increasing hip pain. And you can ... you on the x-rays, this was a patient that had an infection; and we treated this ...

  16. Hip ultrasound

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

    2012-12-15

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

  17. Hip ultrasound.

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

    2012-12-01

    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

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

    Sharifi Reza

    2008-11-01

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

  19. Osteochondritis Dissecans of the Hip

    Linden, B. [Hoeglands Hospital, Eksjoe (Sweden). Dept. of Orthopedic Surgery; Jonsson, K. [Univ. Hospital, Lund (Sweden). Center for Medical Imaging and Physiology; Redlund-Johnell, I. [Univ. Hospital, Malmoe (Sweden). Dept. of Diagnostic Radiology

    2003-03-01

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

  20. Osteochondritis Dissecans of the Hip

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

  1. Congenital toxoplasmosis

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

  2. [Congenital thrombophilia].

    Kojima, Tetsuhito

    2016-03-01

    Congenital thrombophilia is a thrombotic diathesis caused by a variety of genetic abnormalities in blood coagulation factors or their inhibitory factors associated with physiological thrombus formation. Patients with congenital thrombophilia often present with unusual clinical episodes of venous thrombosis (occasionally combined with pulmonary embolism, known as venous thromboembolism) at a young age and recurrence in atypical vessels, such as the mesenteric vein and superior sagittal sinus, often with a family history of this condition. Studies in Japan as well as in western countries have shown congenital thrombophilia to be caused by a wide variety of genetic abnormalities in natural anticoagulant proteins, such as antithrombin, protein C, and protein S. However, there may still be many unknown causes of hereditary thrombosis. We recently reported a case of hereditary thrombosis induced by a novel mechanism of antithrombin resistance, that is, congenital thrombophilia caused by a gain-of-function mutation in the gene encoding the coagulation factor prothrombin. PMID:27076244

  3. Congenital syphilis

    Congenital syphilis is caused by the bacteria Treponema pallidum , which is passed from mother to child during fetal development or at birth. Nearly half of all children infected with syphilis while they ...

  4. Congenital dislocation of the hip with displasia of acetabulum%先天性髋关节脱位闭合复位后表现的髋臼发育不良

    张德文; 刘正全; 刘传康; 李明; 唐盛平

    2000-01-01

    目的探讨先天性髋关节脱位伴髋臼发育不良的治疗效果.方法本院1970~1990年间,闭合复位治疗小儿先天性髋关节脱位469例,成功421例.经过1~15年平均9年的随访,发现33例髋臼发育不良.结果 33例均作了及时补救手术治疗,获得满意效果.结论先天性髋关节脱位患儿治疗后需长期定时随访,至少要随访至小儿骨骼发育成熟期,一旦发现髋臼发育不良,需及时处理.

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

    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.)

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

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

    2001-10-01

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

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

    Hirotake Yo

    2012-01-01

    Full Text Available We report the case of a 72-year-old woman whose pseudoaneurysm was difficult to diagnose and treat. The patient had a history of congenital dislocated hip and was undergoing anticoagulation therapy with warfarin due to the mitral valve replacement. Her chief complaint was pain and enlargement of the left buttock, and the laboratory tests revealed severe anemia. However, her elderly depression confused her chief complaint, and she was transferred to a psychiatric hospital. Two months after the onset of the symptoms, she was finally diagnosed with a pseudoaneurysm by contrast-enhanced CT and angiography. IDC coils were used for embolization. A plain CT showed hemostasis as well as a reduced hematoma at 2 months after the embolization. The possible contributing factors for the pseudoaneurysm included bleeding due to warfarin combined with an intramuscular hematoma accompanied by Crowe type IV developmental dysplasia of the hip that led to an arterial rupture by impingement between pelvis and femoral head. Since the warfarin treatment could not be halted due to the valve replacement, embolization was chosen for her treatment, and the treatment outcome was favorable.

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

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

    2010-07-05

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

  9. 髋关节发育不良和脱位:早期发现并分型选择治疗%Developmental dislocation or dysplasia of hip: diagnosing early and performing the operation correctly according to the classification

    李子荣

    2008-01-01

    1992年北美小儿矫形外科学会将先天性髋关节脱位[congenital dislocation(dysplasia)of hip,CDH]修正为发育性髋关节脱位[developmental dislocation(dysplasia)of hip,DDH]。此概念的变更使骨科医师重视后天因素对髋关节发育不良的作用,也使他们在预防DDH进展到严重畸形上能有所作为。本期集中刊登数篇关于DDH诊治经验的论著及综述,对成年DDH患者的治疗进行了总结,无疑会使外科医师有所借鉴。

  10. Radiology of total hip replacement

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

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

  11. 自体骨植骨在成人先天性髋臼发育不良全髋关节置换术中的疗效分析%Autogenous bone grafting in total hip arthroplasty for congenital acetabular dysplasia

    周垂宝; 李明; 张元凯

    2012-01-01

    To discuss the effect of the femoral-head autograft in uncemented total hip arthroplasty for congenital acetabular dysplasia. Methods 21 patients(24 hips) with acetabular dysplasia (Crowe type Ⅱ orⅢ ) from August 2007 to May 2010 received femoral head autograft in cementless total hip arthroplasty for acetabular dysplasia to reconstruct acetabula. Classified Harris Hip Score (CHHS) and imaging examination were used in the follow-up visit. Results There was a significant difference between the pre and post operation according to CHHS (P <0.05). At an average follow-up of 27 months,all the patients had excellent clinical results. Neither acetabular autograft resorption nor non-union was observed. Conclusion Using femoral-head autograft was an effect method in uncemented total hip arthroplasty for the acetabular dysplasia.%目的 分析成人先天性髋臼发育不良全髋关节置换术中使用自体骨结构性移植重建髋臼的疗效.方法 2007年8月至2010年5月手术治疗先天性髋臼发育不良CroweⅡ、Ⅲ型患者21例(24髋),男3例(3髋),女18例(21髋),行非骨水泥型全髋关节置换术,应用自体股骨头植骨重建髋臼,随访指标为Harris评分和影像学检查.结果 Harris评分统计分析显示,术前与术后差异有统计学意义(P<0.05),移植骨愈合,无移植骨的吸收.结论 自体骨结构性植骨在非骨水泥型全髋关节置换治疗先天性髋臼发育不良中有良好疗效.

  12. Hip Instability: Current Concepts and Treatment Options.

    Dumont, Guillaume D

    2016-07-01

    Instability of the hip can manifest in a wide range of settings, with presenting symptoms including subtle discomfort at end range of motion or more dramatic dislocation of the joint. It can result from traumatic injury with dislocation or subluxation; atraumatic capsular laxity; structural bony abnormality, such as acetabular dysplasia; and iatrogenic injury. Initial treatment of the concentrically reduced joint often begins with physical therapy to strengthen dynamic stabilizers and to allow time for resolution of acute symptoms. Surgical treatment is aimed at repairing injured soft tissue structures, including static stabilizers, and addressing underlying bony structural deficiencies. PMID:27343395

  13. UNCEMENTED PRIMARY TOTAL HIP ARTHROPLASTY FOR OSTEONECROSIS OF HIP WITH SECONDARY OSTEOARTHRITIS IN YOUNG ADULTS

    Chatla

    2016-03-01

    Full Text Available BACKGROUND Osteonecrosis of the femoral head is a progressive disease that generally affects patients in the third through fifth decade of life, if left untreated. Currently, 18% of all Total Hip Arthroplasty performed in USA are done for Osteonecrosis.(1 The aetiology for the Osteonecrosis varies from idiopathic, alcohol intoxication, steroid abuse or due to childhood hip disorders and hip trauma. We have selected 40 patients suffering from advanced femoral head osteonecrosis with subchondral collapse leading to Osteoarthritis of hip in young adults, treated by uncemented primary total hip replacement. This study is aimed to suggest that uncemented total hip arthroplasty can be applied predictably to this younger, potentially more active patient population. MATERIAL AND METHODS We have done 54 uncemented primary hips in 40 cases with mean follow-up of 5.5 years. The average age of the patient at the time of surgery was 43 years. All the hips are clinically and radiologically examined both pre- and post-operatively. All the cases are operated through postero-lateral approach and have used the fully Hydroxyapatite coated femoral straight stem designed for press fit insertion and hemispherical HA-coated cup inserted with press fit and in few cases we used an HA-coated screw. The patients are under regular follow-up. RESULTS All the patients are reviewed at 6 weeks, 3 months, 6 months and yearly thereafter. The clinical and functional status was recorded using the Harris Hip Score and WOMAC Hip Score. The mean Harris score has improved from an average of 44 points to an average of 93 points postoperatively; 94% showed good-to-excellent results, 2% of cases had shortening, one case developed hip dislocation after two weeks due to unguarded physiotherapy. CONCLUSION The short-term results of cementless total hip arthroplasty in patients with Osteonecrosis of the femoral head were encouraging. We await further follow-up to see if these promising

  14. Dislocation-dynamics method

    Dislocation-Dynamics (DD) technique is identified as the method able to model the evolution of material plastic properties as a function of the microstructural transformation predicted at the atomic scale. Indeed, it is the only simulation method capable of taking into account the collective behaviour of a large number of dislocations inside a realistic microstructure. DD simulations are based on the elastic dislocation theory following rules inherent to the dislocation core structure often call 'local rules'. All the data necessary to establish the local rules for DD have to come directly from experiment or alternatively from simulations carried out at the atomic scale such as molecular dynamics or ab initio calculations. However, no precise information on the interaction between two dislocations or between dislocations and defects induced by irradiation are available for nuclear fuels. Therefore, in this article the DD technique will be presented and some examples are given of what can be achieved with it. (author)

  15. Dislocation Formation in Alloys

    Minami, Akihiko; Onuki, Akira

    2006-05-01

    An interaction between dislocations and phase transitions is studied by a phase field model both in two and three dimensional systems. Our theory is a simple extension of the traditional linear elastic theory, and the elastic energy is a periodic function of local strains which is reflecting the periodicity of crystals. We find that the dislocations are spontaneously formed by quenching. Dislocations are formed from the interface of binary alloys, and slips are preferentially gliding into the soft metals. In three dimensional systems, formation of dislocations under applied strain is studied in two phase state. We find that the dislocation loops are created from the surface of hard metals. We also studied the phase separation above the coexisting temperature which is called as the Cottrell atmosphere. Clouds of metals cannot catch up with the motion of dislocations at highly strained state.

  16. Vascular injuries during total hip revision

    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

  17. Congenital Leukemia

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

    2013-01-01

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

  18. Collective behavior of dislocations

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

  19. Primary traumatic patellar dislocation

    Tsai Chun-Hao

    2012-06-01

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

  20. Homogenization of dislocation dynamics

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

  1. Homogenization of dislocation dynamics

    El Hajj, Ahmad; Ibrahim, Hassan; Monneau, Regis, E-mail: elhajj@cermics.enpc.fr, E-mail: ibrahim@cermics.enpc.fr, E-mail: monneau@cermics.enpc.fr [CERMICS, ENPC, 6 and 8 avenue Blaise Pascal, Cite Descartes, Champs sur Marne, 77455 Marne-la-Valle Cedex 2 (France)

    2009-07-15

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

  2. Hip Revision

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

  3. Sonographic guidance for infant hip reduction under anesthesia

    An initial attempt to reduce a hip dislocation in a 15-month-old by palpation under general anesthesia led to the subsequent discovery of a posterior subluxation by CT. During the second attempt, sonographic guidance in the operating room was used to show concentric reduction both before and after the application of a spica cast. Successful reduction was later confirmed by CT. Imaging by real-time sonography can be useful in monitoring infant hip reduction. (orig.)

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

    Yang Nan-Ping

    2011-11-01

    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.

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

    Poorter, Jolanda de

    2010-01-01

    Approximately one million total hip replacement operations are performed worldwide annually, mostly for osteoarthritis and rheumatoid arthritis. A major complication in total hip arthroplasties is loosening of the prosthesis leading to pain and walking difficulties and a higher risk for dislocations

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

    Penny, Jeannette Østergaard; Ovesen, Ole; Varmarken, Jens-Erik;

    2013-01-01

    BACKGROUND AND PURPOSE: 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) c...

  7. Traumatic Elbow Dislocations

    G.I.T. Iordens (Gijs)

    2014-01-01

    markdownabstractThe elbow is the second most common major joint to dislocate after the shoulder in the adult population. Its stability is highly dependent on a complex interaction between bony articulations, capsuloligamentous structures and dynamic muscle restraints. Dislocations are traditionally

  8. Dislocations in yttrium orthovanadate

    Eakins, D. E.; LeBret, J. B.; Norton, M. G.; Bahr, D. F.

    2004-06-01

    Dislocation structures in single crystals of yttrium orthovanadate have been identified by transmission electron microscopy. Electron diffraction was used to predict possible Burgers vectors for the dislocations. Results suggest vectors of the type {1}/{2}[1 1 1] or {1}/{4}[0 2 1] . Arguments for the likelihood of each possible vector have been presented.

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

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

  10. Hip Reconstruction Osteotomy by Ilizarov Method as a Salvage Option for Abnormal Hip Joints

    Masood Umer

    2014-01-01

    Full Text Available 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.