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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 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

  12. 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.

  13. 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.

  14. 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.

  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. 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.

  10. 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

  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. 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.

  19. 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

  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 ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  5. 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, ...

  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 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 ...

  15. 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.

  16. 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.

  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 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

  2. 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 ...

  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 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.

  15. 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)

  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. 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...

  6. 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

  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.

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

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

    2014-01-01

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

  12. Congenital Anomalies in Infant with Congenital Hypothyroidism

    Zahra Razavi; Alireza Yavarikia; Saadat Torabian

    2012-01-01

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

  13. Hip replacement

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

  14. Radiological diagnosis of hip joint abnormalities in children

    Михаил Михайлович Камоско

    2015-06-01

    Full Text Available Abnormalities of the hip joint in children covers a wide range of diseases, including both congenital and acquired ones. Hip dysplasia, Legg-Calve-Perthes disease and juvenile slipped capital femoral epiphysis account for up to 25 % of all diseases of the musculoskeletal system in pediatric patients. Early diagnosis of these disorders and timely treatment are of paramount importance in the prevention of childhood disability.

  15. Radiological diagnosis of hip joint abnormalities in children

    Mikhail Mikhailovich Kamosko; Mahmoud Stanislavovich Poznovich

    2015-01-01

    Abnormalities of the hip joint in children covers a wide range of diseases, including both congenital and acquired ones. Hip dysplasia, Legg-Calve-Perthes disease and juvenile slipped capital femoral epiphysis account for up to 25 % of all diseases of the musculoskeletal system in pediatric patients. Early diagnosis of these disorders and timely treatment are of paramount importance in the prevention of childhood disability.

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

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

    2012-01-01

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

  17. Initial Stability of Subtrochanteric Oblique Osteotomy in Uncemented Total Hip Arthroplasty: A Preliminary Finite Element Study

    Li, Liangtao; Yu, Mingyang; Ma, Renshi; Zhu, Dong; Gu, Guishan

    2015-01-01

    Background Subtrochanteric oblique osteotomy (SOO) has been widely used to reconstruct highly dislocated hips in uncemented total hip arthroplasty. The occurrence of complications can be attributed to the instability of the osteotomy region. The aim of this study was to evaluate the initial stability of SOO in uncemented total hip arthroplasty. Material/Methods A 3-dimensional finite element femur-stem model was created, and a virtual SOO was performed at 4 oblique angles: 30°, 45°, 60°, and ...

  18. Congenital diplopodia

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

    2003-11-01

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

  19. Bursitis of the Hip

    MENU Return to Web version Bursitis of the Hip Overview What is bursitis? Bursitis (say: “burse-eye- ... bursitis is swelling affecting the bursae of the hip. Bursitis does not only happen in the hip. ...

  20. Hip fracture surgery

    ... repair; Femoral neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... top of the bone) you may have a hip pinning procedure. During this surgery: You lie on ...

  1. Hip fracture - discharge

    ... 2012:chap 55. Read More Broken bone Hip fracture surgery Hip pain Leg MRI scan Osteoporosis - overview Patient Instructions Getting your home ready - knee or hip surgery Osteomyelitis - discharge Update Date 11/ ...

  2. Characteristics of children with hip displacement in cerebral palsy

    Wagner Philippe

    2007-10-01

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

  3. Luxatio erecta: Inferior glenohumeral dislocation

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

    2007-01-01

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

  4. Luxatio erecta: Inferior glenohumeral dislocation

    Baba Asif

    2007-01-01

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

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

    Jacobsen, Steffen

    2006-01-01

    Osteoarthritis (OA) presupposes the interaction of systemic and/or local factors. In hip joint OA, congenital or developmental malformation is believed to constitute an individual risk factor for premature degeneration. Hip dysplasia (HD) is such a malformation. The radiological and epidemiological...... to be a significant risk factor for hip OA in men. However, only obesity was found to determine an event of hip replacement surgery. In a longitudinal study of 81 subjects and with mild or moderate hip dysplasia followed for a decade we did not document a tendency for radiological degeneration compared to 136 control...... studies. To develop a comprehensible and reproducible radiographic discriminator of hip OA with as close an association to self reported hip pain as possible. To identify prevalences of hip OA and HD in a Caucasian, urban background population and investigate the influence of sex, age, physical...

  6. GPU accelerated dislocation dynamics

    Ferroni, Francesco; Tarleton, Edmund; Fitzgerald, Steven

    2014-09-01

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

  7. Congenital syphilis

    Lee, Sang Wook; Kim, Kyung Soo; Hur, Don [Chosun University College of Medicine, Kwangju (Korea, Republic of)

    1983-12-15

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

  8. Congenital syphilis

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

  9. Radiographic observation of congenital diaphragmatic hernia

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

  10. Acute traumatic patellar dislocation.

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

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

    Davies, A.M. [Royal Orthopaedic Hospital, Birmingham (United Kingdom). MRI Centre; Johnson, K.J. [Princess of Wales Birmingham Children' s Hospital (United Kingdom); Whitehouse, R.W. (eds.) [Manchester Royal Infirmary (United Kingdom). Dept. of Clinical Radiology

    2006-07-01

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

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

    Tribe, H; Malek, S.; Stammers, J; Ranawat, V; Skinner, JA

    2013-01-01

    Oxinium™ (Smith & Nephew, Memphis, TN, US) has been used in hip arthroplasty since 2003. The surface coating is hard and provides low wear rates but if this surface coating is damaged, the soft metal core is at risk of accelerated wear. Previous reports have described accelerated wear following intra and postoperative hip dislocation. We report a case of advanced wear of an in situ Oxinium™ femoral head implant following a cracked acetabular liner. The liner had disengaged from the titanium s...

  13. Ultrasound: Infant Hip

    ... ultrasound when they suspect a problem called developmental dysplasia of the hip (DDH) . DDH is a hip deformity that can ... THIS TOPIC X-Ray Exam: Leg Length Developmental Dysplasia of the Hip X-Ray Exam: Hip Contact Us Print Resources ...

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

    Fernando Farcetta Junior

    2010-01-01

    Full Text Available OBJETIVO: Mostrar o planejamento pré-operatório, e os resultados do tratamento cirúrgico da luxação paralítica do quadril em pacientes com paralisia cerebral. A técnica utilizada foi a osteotomia derrotatória e varizante do fêmur proximal, associada à osteotomia do ilíaco tipo Dega, sem abertura da cápsula articular. MÉTODOS: Realizamos um estudo retrospectivo de 10 quadris em oito pacientes com paralisia cerebral tipo tetraparesia espástico, submetidos a tratamento cirúrgico entre 2003 e 2005 com a mesma técnica cirúrgica. Foram avaliados parâmetros clínicos e radiográficos pré e pós-operatórios, bem como o planejamento pré-operatório com uso do intensificador de imagem. Os parâmetros clínicos analisados foram: dor, dificuldade de higiene e dificuldade de posicionamento. Os parâmetros radiológicos foram os índices de Reimers, índice acetabular e ângulo cervicodiafisário. Estes resultados foram submetidos a análise estatística. RESULTADOS: Obtivemos bons resultados com esta técnica. Com um seguimento médio de três anos, todos os quadris estavam reduzidos na última consulta, com alto grau de satisfação dos familiares, em relação ao tratamento. Além disso, mostramos que o planejamento pré-operatório com uso do intensificador de imagem nos permite a redução e estabilização desses quadris sem a necessidade de capsuloplastia. CONCLUSÃO: Os autores concluíram que no tratamento da luxação do quadril dos pacientes com paralisia cerebral tetraparéticos espásticos com o planejamento pré-operatório, não é necessária a capsuloplastia para estabilização da articulação coxofemoral.OBJECTIVES: To show the preoperative planning and the results of surgical treatment for paralytic hip dislocation in children with cerebral palsy. The techniques used were proximal femoral varus derotation osteotomy and Dega osteotomy without opening of the joint capsule. METHODS: We performed a retrospective review of

  15. Statistical characterization of dislocation ensembles

    El-Azab, A; Deng, J; Tang, M

    2006-05-17

    We outline a method to study the spatial and orientation statistics of dynamical dislocation systems by modeling the dislocations as a stochastic fiber process. Statistical measures have been introduced for the density, velocity, and flux of dislocations, and the connection between these measures and the dislocation state and plastic distortion rate in the crystal is explained. A dislocation dynamics simulation model has been used to extract numerical data to study the evolution of these statistical measures numerically in a body-centered cubic crystal under deformation. The orientation distribution of the dislocation density, velocity and dislocation flux, as well as the dislocation correlations have been computed. The importance of the statistical measures introduced here in building continuum models of dislocation systems is highlighted.

  16. Patellar dislocation with genu valgum treated by DFO.

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

    2013-06-01

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

  17. Actis Total Hip System 2 Year Follow-up

    2016-08-09

    Osteoarthritis; Traumatic Arthritis; Rheumatoid Arthritis; Congenital Hip Dysplasia; Avascular Necrosis of the Femoral Head; Acute Traumatic Fracture of the Femoral Head or Neck; Certain Cases of Ankylosis; Non-union of Femoral Neck Fractures; Certain High Sub-Capital and Femoral Neck Fractures in the Elderly

  18. Dislocation Dynamics During Plastic Deformation

    Messerschmidt, Ulrich

    2010-01-01

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

  19. Congenital hypothyroidism

    Pankaj Agrawal

    2015-01-01

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

  20. 不同应对方式与发育性髋关节脱位患儿家长心理反应的相关性研究%Correlation research in different coping styles and psychological reaction of parents whose children with developmental dislocation of the hip

    康玉闻; 韩月明

    2011-01-01

    Objective To understand the relevance of different coping styles and psychological reaction of the parents whose children with developmental dislocation of the hip (ODH). Methods To use symptom checklist (SCL-90) and simple coping style questionnaire, 96 parents of DDH children were questionnaired of the coping styles and psychological symptoms, and compared with the national norm, derived from the rating scale and the relationship between coping styles. Results Psychological symptom score of parents of DDH children was higher than the national norm, the psychological symptoms was objective, compared with the national norm, interpersonal sensitivity, depression, anxiety were statistically significant; interpersonal sensitivity, depression, anxiety was positively correlated with coping actively, somatization was positively correlated with the negative. Conclusions Parents of DDH children should be given more psychological counseling and psychological care,it may reduce the incidence of psychological symptoms,make them to take the right way to deal with.%目的 了解不同应对方式与发育性髋关节脱位(DDH)患儿家长心理反应的相关性.方法 采用症状自评量表(SCL-90)和简易应对方式问卷,对96例DDH家长进行简易应对方式问卷和心理症状的调查,并与国内常模进行比较,得出自评量表各因子与应对方式之间的关系.结果 DDH患儿家长心理症状总分高于国内常模;其心理症状客观存在,结果与国内常模比较,人际关系敏感、抑郁、焦虑均有差异;人际关系敏感、抑郁、焦虑与积极应对呈显著负相关,躯体化与消极呈正相关.结论 DDH患儿家长应给予更多的心理疏导和心理护理,可能会减少心理症状的发生,使其采取正确的应对方式.

  1. Ultrasound screening for developmental dysplasia of the hip and its socioeconomic impact: Experience of tertiary care health level

    Khaled Aly Matrawy

    2014-03-01

    Conclusion: Screening ultrasound is a useful tool for detection of hip dislocation and dysplasia especially among the population of infants at increased risk of developmental dysplasia of the hip. Limitation of screening ultrasound programs for those at risk only reduces the financial burden with better outcome in choosing candidates for further workup especially surgical intervention.

  2. Complications after total hip replacement

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

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

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

    2005-04-01

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

  4. Dislocation-dislocation and dislocation-twin reactions in nanocrystalline Al by molecular-dynamics simulation.

    Yamakov, V.; Wolf, D.; Phillpot, S. R.; Gleiter, H.; Materials Science Division; Forschungszentrum Karlsruhe

    2003-08-15

    We use massively parallel molecular dynamics simulations of polycrystal plasticity to elucidate the intricate dislocation dynamics that evolves during the process of deformation of columnar nanocrystalline Al microstructures of grain size between 30 and 100 nm. We analyze in detail the mechanisms of dislocation-dislocation and dislocation-twin boundary reactions that take place under sufficiently high stress. These reactions are shown to lead to the formation of complex twin networks, i.e. structures of coherent twin boundaries connected by stair-rod dislocations. Consistent with recent experimental observations, these twin networks may cause dislocation pile-ups and thus give rise to strain hardening.

  5. Supersonic Dislocation Bursts in Silicon

    Hahn, E. N.; Zhao, S.; Bringa, E. M.; Meyers, M. A.

    2016-06-01

    Dislocations are the primary agents of permanent deformation in crystalline solids. Since the theoretical prediction of supersonic dislocations over half a century ago, there is a dearth of experimental evidence supporting their existence. Here we use non-equilibrium molecular dynamics simulations of shocked silicon to reveal transient supersonic partial dislocation motion at approximately 15 km/s, faster than any previous in-silico observation. Homogeneous dislocation nucleation occurs near the shock front and supersonic dislocation motion lasts just fractions of picoseconds before the dislocations catch the shock front and decelerate back to the elastic wave speed. Applying a modified analytical equation for dislocation evolution we successfully predict a dislocation density of 1.5 × 1012 cm‑2 within the shocked volume, in agreement with the present simulations and realistic in regards to prior and on-going recovery experiments in silicon.

  6. The Knowledge of Pediatricians About Developmental Hip Dysplasia in a Training Hospital

    Nihan Uygur Külcü

    2015-08-01

    Full Text Available Introduction: Developmental dysplasia of the hip (DDH is the most common hip pathology which can be prevented with early diagnosis and treatment. Prevention, early diagnosis and treatment can be achieved if health professionals are endowed with adequate knowledge. Here, we aimed to evaluate the knowledge level of pediatric trainees and specialists in an education and training hospital and to review the up-to-date information about DDH. Materials and Methods: A multiple choice questionnaire about etiopathogenesis, risk factors, diagnosis and treatment of DDH was answered by the pediatric trainees and specialists in Zeynep Kamil Maternity and Children Education and Training Hospital, İstanbul. NCSS 2007®, USA Software Program is used for statistical analysis.Results: Thirty-nine pediatric residents and twenty-one pediatric specialists were enrolled to the study. Person with DDH in the family, swaddling, breech presentation, female gender, oligohydroamnios were risk factors known with rate ≥70%. Metatarsus adductus, Larsen syndrome, congenital knee dislocation were the least known risk factors (≤10%. The recognition rates of residents and specialist about torticollis, multiple gestation, first born baby and metatarsus adductus as risk factors were statistically different (p<0.05. For the diagnosis of DDH, specialist tended to use conventional methods like physical examination and direct radiographs while residents chose computerized tomography and magnetic resonance imagining. Pediatric residents thought cigarette smoking (48.7% and factors other than mechanic pressure of femoral head for the acetabular development (30.7% as most responsible factors (p<0.05. There was no relationship between duration of residency, duration of being specialists, bearing children and knowledge about DDH. Conclusions: The actual knowledge of pediatricians about DDH should be improved and updated for the success of prevention, diagnosis and treatment of DDH

  7. Congenital hypothyroidism

    LaFranchi Stephen H

    2010-06-01

    Full Text Available Abstract Congenital hypothyroidism (CH occurs in approximately 1:2,000 to 1:4,000 newborns. The clinical manifestations are often subtle or not present at birth. This likely is due to trans-placental passage of some maternal thyroid hormone, while many infants have some thyroid production of their own. Common symptoms include decreased activity and increased sleep, feeding difficulty, constipation, and prolonged jaundice. On examination, common signs include myxedematous facies, large fontanels, macroglossia, a distended abdomen with umbilical hernia, and hypotonia. CH is classified into permanent and transient forms, which in turn can be divided into primary, secondary, or peripheral etiologies. Thyroid dysgenesis accounts for 85% of permanent, primary CH, while inborn errors of thyroid hormone biosynthesis (dyshormonogeneses account for 10-15% of cases. Secondary or central CH may occur with isolated TSH deficiency, but more commonly it is associated with congenital hypopitiutarism. Transient CH most commonly occurs in preterm infants born in areas of endemic iodine deficiency. In countries with newborn screening programs in place, infants with CH are diagnosed after detection by screening tests. The diagnosis should be confirmed by finding an elevated serum TSH and low T4 or free T4 level. Other diagnostic tests, such as thyroid radionuclide uptake and scan, thyroid sonography, or serum thyroglobulin determination may help pinpoint the underlying etiology, although treatment may be started without these tests. Levothyroxine is the treatment of choice; the recommended starting dose is 10 to 15 mcg/kg/day. The immediate goals of treatment are to rapidly raise the serum T4 above 130 nmol/L (10 ug/dL and normalize serum TSH levels. Frequent laboratory monitoring in infancy is essential to ensure optimal neurocognitive outcome. Serum TSH and free T4 should be measured every 1-2 months in the first 6 months of life and every 3-4 months thereafter

  8. Finite strain discrete dislocation plasticity

    Deshpande, VS; Needleman, A; Van der Giessen, E

    2003-01-01

    A framework for carrying out finite deformation discrete dislocation plasticity calculations is presented. The discrete dislocations are presumed to be adequately represented by the singular linear elastic fields so that the large deformations near dislocation cores are not modeled. The finite defor

  9. Behavior of dislocations in silicon

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

    1995-08-01

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

  10. Phonon-dislocation interaction

    Thermal conductivity measurements on LiF crystals in the temperature range 0.04 to 30 K have demonstrated that, throughout this range, thermal phonons interact with dislocations via a dynamic or resonant process which is highly frequency- and phonon-mode dependent. The results of earlier work are consistent with this interpretation

  11. Genetics Home Reference: congenital hypothyroidism

    ... Help Me Understand Genetics Home Health Conditions congenital hypothyroidism congenital hypothyroidism Enable Javascript to view the expand/collapse ... Genetic Testing Registry: Congenital hypothyroidism Genetic Testing Registry: Hypothyroidism, ... Encyclopedia: Congenital Hypothyroidism These resources ...

  12. Hip replacement - precautions

    ... Barker KL, Dewey ME, Sackley CM. Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic ... to ask your doctor Hip replacement - discharge Preventing falls - what to ask your doctor Update Date 11/ ...

  13. Taper Hip Prosthesis

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

  14. Taper Hip Prosthesis

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

  15. Study on a new synchronous screening model for congenital heart disease and developmental dysplasia of the hip during the period of the newborn infants visit in Beijing%新生儿访视期先天性心脏病和发育性髋关节发育不良同步筛查模式研究

    张晚霞; 袁雪; 陈雪辉

    2011-01-01

    [目的]建立北京市新生儿访视期开展先天性心脏病(congenital heart disease,CHD)和发育性髋关节发育不良(developmental dysplasia of hip,DDH)同步筛查模式,使CHD和DDH可疑患儿早确诊,早康复,提高生存质量.[方法]由社区儿保人员在新生儿访视期间采用经过专项培训的筛查方法开展CHD和DDH同步筛查,采集2009年北京市9区县18社区新生儿访视期间1799名筛查数据资料进行描述性统计分析.[结果]2009年6-8月期间1799名访视新生儿中,筛出CHD可疑患儿42例(23.35‰),确诊17例(9.45%);同时筛出DDH可疑患儿24例(13.34‰),确诊2例(1.11‰).[结论]新生儿访视期开展CHD和DDH同步筛查模式的特点突出表现为开始时间早,覆盖面广,筛查技术简单有效,普及性强,有利于CHD和DDH患儿把握最佳的康复时间.%[Objective] To establish a new synchronous screening model for congenital heart disease(CHD) and developmental dysplasia of the hip(DDH) during the period of the newborn infants visit in Beijing, in order that suspicious CHD or DDH cases can be diagnosed and restored to health earlier and their life quality can be increased. [Method] Professional trained medical staff in child health services used standard methods to screen the suspicious CHD and DDH cases,then 1 799 cases were collected were screening data from June to August in 2010 and analysed it. [ Results] In total 1 799 cases, 42 suspicious CHD cases were discovered and 17 CHD cases were diagnosed finally. Meanwhile, 24 suspicious DDH cases were discovered and 2 DDH cases were diagnosed. [Conclusions] The new synchronous screening model for CHD and DDH during the period of the newborn infants visit in Beijing has outstanding features such as the earlier screening time, wide screening coverage, simple and effective screening skill and stronger universal applicability. The model will be beneficial to the suspicious CHD and DDH cases to win best recovery time.

  16. Congenital pachygyria

    Jing-xia HU

    2016-02-01

    Full Text Available Objective To investigate the imaging and clinicopathological features of pachygyria limited in the right temporo-parieto-occipital lobe and the key points of its diagnosis and treatment, in order to improve the recognition of this disease.  Methods and Results A 2-year-old boy was admitted to hospital because of paroxysmal loss of consciousness and convulsion for 18 months with progressive aggravation. MRI showed malformations of cortical development in the right temporo-parieto-occipital lobe. Epileptic foci resection on the right temporo-parieto-occipital lobe was made. Histological examination after operation showed uneven thickening of gray matter, shrinking of white matter and disappearing cortical stratification, while a lot of dysmorphic neurons, balloon cells and scattered balloon cells in white matter appeared. Immunohistochemical staining revealed that dysmorphic neurons were positive for non-phosphorylated neurofilament protein SMI-32, microtubule-associated protein-2 (MAP-2 and vimentin (Vim or neurofilament protein (NF. Both dysmorphic neurons and balloon cells expressed phosphorylated ribosomal S6 protein (RPS6, while the former was stronger than the latter. Balloon cells were not positive for MAP-2 or Vim. No disturbance of consciousness or limb twitches occurred in this patient during one-year follow-up.  Conclusions Congenital pachygyria was cortical dysplasia caused by the early proliferation and migration disorder of brain, and should be distinguished with focal cortical dysplasia (FCD type Ⅱ b and tuberous sclerosis complex (TSC. Clinical history, imaging and histological features should be included in the diagnosis. DOI: 10.3969/j.issn.1672-6731.2016.02.005

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

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

    2013-11-01

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

  18. Hip Injuries and Disorders

    Your hip is the joint where your thigh bone meets your pelvis bone. Hips are called ball-and-socket joints because the ... a cup-like space in your pelvis. Your hips are very stable. When they are healthy, it ...

  19. Hip supporting device

    2011-01-01

    The present invention relates to a device for limiting movements in one or more anatomical joints, such as a device for limiting movement in the human hip joint after hip replacement surgery. This is provided by a device for limiting movement in the human hip joint, said device comprising: at least...

  20. Correlation between nucleotide polymorphism of growth differentiate factor 5 and congenital dysplasia of the hip%生长分化因子5的基因多态性与先天性髋关节发育不良的相关性研究

    戴进; 诸蓬生; 朱伦庆; 秦江辉; 王珂杰; 诸洪涛; 赵宝成; 史冬泉; 蒋青

    2009-01-01

    目的 探讨生长分化因子5(growth differentiate factor 5,GDF5)的基因多态性与先天性髋关节发育不良(congenital dysplasia of the hip,CDH)的相关性.方法 用TaqMan探针法对CDH患儿及正常对照人群进行单核苷酸基因多态性(single nucleotide polymorphism,SNP)位点基因分型.CDH患儿338例,女291例,男47例;年龄2~72个月,平均(21.6±12.4)个月,单侧或双侧受累,均排除系统性疾病.正常对照组622例,女316例,男306例;年龄39~94岁,平均(58.1±11.0)岁,均无CDH病史及症状.结果 SNP位点与CDH有显著相关性(P=0.0037,0R=1.40,95%CI:1.11~1.75).对性别进行分层后,女性患儿中的SNP位点与CDH有显著相关性;对严重程度进行分层后,SNP位点与髋关节全脱位有显著相关性.结论 GDF5在CDH的病原学中起重要作用.

  1. Congenital Heart Information Network

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

  2. Adult congenital heart disease

    Morphet, John AM

    2006-01-01

    One million people over the age of 20 suffer from congenital heart disease in the United States. These adult patients can slip through the cracks of our medical system; many are too old to be cared for in most pediatric institutions by pediatric cardiologists and, unfortunately, most adult cardiologists are not trained in congenital heart disease. Therefore, it is important to identify the common lesions in adult congenital heart disease and how they should be managed. Acyanotic congenital he...

  3. Hip arthroscopy in the setting of hip dysplasia

    Yeung, M.; Kowalczuk, M.; Simunovic, N.; Ayeni, O. R.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to Ju...

  4. Congenital sternoclavicular dermoid sinus.

    Willaert, Annelore; Bruninx, Liesje; Hens, Greet; Hauben, Esther; Devriendt, Koen; Vander Poorten, Vincent

    2016-02-01

    We report a case series of 8 patients, presenting with a congenital sinus in the region of the sternoclavicular joint. This rare malformation has only been reported in the Japanese dermatological literature under the name of "congenital dermoid fistula of the anterior chest region". It has to be distinguished from other congenital anomalies and requires complete excision. PMID:26810293

  5. Interaction of dislocation loops with dislocations studied by dislocation dynamics in α-iron

    Shi, X. J.; Dupuy, L.; Devincre, B.; Terentyev, D.; Vincent, L.

    2015-05-01

    Interstitial dislocation loops with Burgers vector of type are formed in α-iron under neutron or heavy ion irradiation. As the density and size of these loops increase with radiation dose and temperature, these defects are thought to play a key role in hardening and subsequent embrittlement of iron-based steels. The aim of the present work is to study the pinning strength of the loops on mobile dislocations. Prior to run massive Dislocation Dynamics (DD) simulations involving experimentally representative array of radiation defects and dislocations, the DD code and its parameterization are validated by comparing the individual loop-dislocation reactions with those obtained from direct atomistic Molecular Dynamics (MD) simulations. Several loop-dislocation reaction mechanisms are successfully reproduced as well as the values of the unpinning stress to detach mobile dislocations from the defects.

  6. Results of hip resurfacing for developmental dysplasia of the hip of Crowe type Ⅰ and Ⅱ

    XU Wei-dong; LI Jia; ZHOU Zhen-hua; WU Yue-song; LI Ming

    2008-01-01

    Background Recently, the new generation of metal-on-metal total hip resurfacing arthroplasty is well known for preserving the proximal femoral bone stock, minimizing the risk of postoperative dislocation using large femoral heads, and expecting low wear of metal-on-metal articulation for longer prosthesis survival. It also has the advantage in biomechanical loading in the proximal femur. The osteoarthritis secondary to developmental dysplasia of the hip (DDH) has been the most common reason for total hip arthroplasty. Most of the patients are young and active, who require improved range of motion of the hip besides relief of the pain, even expect to resume the ability to run and jump after the joint arthroplasty, thus to be allowed an active lifestyle. The objective of the current study was to evaluate the early outcome of resurfacing arthroplasty for the mild DDH cases (Crowe type Ⅰ and Ⅱ).Methods Between September 2005 and May 2007, twenty-one consecutive patients (twenty-six hips) with the diagnosis of osteoarthritis secondary to DDH underwent metal-on-metal resurfacing arthroplasty. The average age at the time of surgery was 46.5 years (range, 37-59 years). Six patients (28.6%) were male and fifteen (71.4%) were female. Clinical and radiographic results were observed. The follow-up was performed at 6 weeks, 3, 6, 9 months and then yearly.Results All patients were followed for a mean of 18 months (9-29 months). During the follow-up period no complications, such as dislocation of hip joints, infection or femoral neck fracture occurred. The clinical outcomes, as rated with the Harris hip score, improved significantly compared with the preoperative ratings. The mean postoperative Harris hip score was 90.7, compared to 35.5 preoperatively. The radiographic analysis showed that all prostheses were fixed with no radiolucencies. All of the patients who had equal limb lengths preoperatively had equal lengths postoperatively. Of the nine patients with preoperative

  7. 发育性髋关节发育不良%Developmental dysplasia of the hip

    李卫平; 王华明

    2011-01-01

    背景:发育性髋关节发育不良这一术语已经取代先天性髋关节脱位,因为它更能准确地反映导致未成熟髋部畸形形成所有范畴.目的:就发育性髋关节发育不良特性、危险因素以及治疗手段的研究进展进行综述.方法:由第一作者应用计算机检索PubMed数据库及中国期刊网全文数据库2006-01/2011-09有关发育性髋关节发育不良诊断、临床筛查、体格检查、物理检查及治疗等方面的文章,英文检索词为"developmental dysplasia of the hip,examination,treatment",中文检索词为"发育性髋关节发育不良,检查,治疗".排除重复性研究,共保留27篇文献进行综述.结果与结论:发育性髋关节发育不良判断危险因素包括臀先露和家族史,本病诊断是建立在医生体格检查的基础上.髋关节的不稳定、双下肢不等长及大腿皮肤皱褶不对称均可出现在新生儿发育性髋关节脱位的病例中;然而步态不稳及髋关节外展活动受限在大龄儿童更为常见.超声波扫描技术检查存在着一定的争议,然而一旦诊断确立后通常可以用来验证和评估髋关节的发育情况.支具相对于6个月以下的儿童而言是最重要的治疗手段;手术适应于超过6个月的患儿保守治疗失败.早期诊断髋关节发育不良对于改善治疗结果非常重要,同时降低了并发症发生的风险.%BACKGROUND: Developmental dysplasia of the hip (DDH) has replaced the term congenital dislocation of the hip, because theDDH can more accurately reflect all category of leading to immature hip deformity.OBJECTIVE: To review research progress of characteristics, risk factors and research methods of the DDH.METHODS: The articles related to diagnosis, clinical screening, medical examination, physical examination and treatment ofDDH from PubMed and Chinese journal full-text databases between January 2006 and September 2011 were retrieved by thecomputer with the key words of

  8. Thermodynamically consistent continuum dislocation dynamics

    Hochrainer, Thomas

    2016-03-01

    Dislocation based modeling of plasticity is one of the central challenges at the crossover of materials science and continuum mechanics. Developing a continuum theory of dislocations requires the solution of two long standing problems: (i) to represent dislocation kinematics in terms of a reasonable number of variables and (ii) to derive averaged descriptions of the dislocation dynamics (i.e. material laws) in terms of these variables. The kinematic problem (i) was recently solved through the introduction of continuum dislocation dynamics (CDD), which provides kinematically consistent evolution equations of dislocation alignment tensors, presuming a given average dislocation velocity (Hochrainer, T., 2015, Multipole expansion of continuum dislocations dynamics in terms of alignment tensors. Philos. Mag. 95 (12), 1321-1367). In the current paper we demonstrate how a free energy formulation may be used to solve the dynamic closure problem (ii) in CDD. We do so exemplarily for the lowest order CDD variant for curved dislocations in a single slip situation. In this case, a thermodynamically consistent average dislocation velocity is found to comprise five mesoscopic shear stress contributions. For a postulated free energy expression we identify among these stress contributions a back-stress term and a line-tension term, both of which have already been postulated for CDD. A new stress contribution occurs which is missing in earlier CDD models including the statistical continuum theory of straight parallel edge dislocations (Groma, I., Csikor, F.F., Zaiser, M., 2003. Spatial correlations and higher-order gradient terms in a continuum description of dislocation dynamics. Acta Mater. 51, 1271-1281). Furthermore, two entirely new stress contributions arise from the curvature of dislocations.

  9. Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement?

    Mikkelsen, Lone Ramer; Petersen, Annemette Krintel; Søballe, Kjeld;

    2014-01-01

    . DESIGN: Non-randomized, controlled study. SETTING: Inpatient. POPULATION: 365 consecutively included THR patients. METHODS: Patients included the 3 initial month of the study underwent rehabilitation with restrictions in hip movement and a standard package of assistive devices (restricted group). This...... IMPACT: It is possible to reduce movement restrictions and use of assistive devices considerably. More research on safety issues is needed to elucidate the effect of unrestricted rehabilitation on hip dislocation....

  10. Frequency of Developmental Hip Dysplasia in a Training Hospital

    Emrah Can

    2010-09-01

    Full Text Available Aim: We aimed to determine the frequency of cases with developmental hip dysplasia during the neonatal period and the associated risk factors. Methods: Hip ultrasound images of 258 full-term newborns aged one month were evaluated prospectively in conjunction with physical examination for developmental hip dysplasia in GATA well baby outpatient clinic. Results: The incidence of developmental hip dysplasia was 0.3% in one-month-old, healthy, full-term babies included in the study. 44% of them were male and 56% were female. The mean birth weight was 3311.8±511.4 g. 48% of all births were spontaneous vaginal deliveries and 52% cesarean deliveries. A history of oligohydramniosis was present in 8% of cases, 1% had breech presentation, 7% had a family history of developmental dysplasia and 7% had been swaddled. Additional congenital anomaly and torticollis were not detected at the physical examination of the babies. The risk factors were determined to be twin birth and female gender in the only baby who had developmental hip dysplasia (Type 2a. Conclusion: Developmental hip displasia is a significant public health concern in developing countries. Physical examination performed in conjunction with hip ultrasonography routinely in the neonatal period may contribute to the early diagnosis and treatment. (The Medical Bulletin of Haseki 2010; 48: 99-102

  11. Osteotomy template to correct hip dysplasia in children designed by reverse engineering technique%应用逆向工程技术设计儿童髋关节畸形矫正截骨模板的研究

    佟矿; 余斌; 张晟; 王博炜

    2013-01-01

    目的 探讨利用三维重建与逆向工程技术为儿童先天性髋关节脱位Steel三相截骨矫正术设计截骨模板,以期为临床提供一种相对精确的截骨方案.方法 选取1例需行Steel三相截骨的先天性髋关节脱位患儿,男性,6岁.采用连续螺旋CT对患者骨盆行连续断层扫描,将扫描所得.dicom格式图像导入Mimics Innovation Suite 14.1软件,采用表面遮盖显示法进行双侧髋关节三维表面重建,建立患者髋关节模型,以.stl格式保存并导入Imageware 12.0软件,通过镜像还原患髋矫形后位置,模拟Steel三相截骨,提取患髋截骨区域,通过旋转、移动截骨区域,设计截骨模板. 结果 通过三维重建得到的髋关节三维模型可以直观显示患髋的解剖形态.通过重建患侧髋关节并模拟截骨,实现了截骨模板设计,生成的截骨模板可以通过快速成型技术生成实体模板. 结论 通过三维重建与逆向工程技术构建的截骨模板可以应用于Steel三相截骨矫正术,且截骨精确.%Objective To design a digital navigational template using three dimensional (3D) reconstruction and reverse engineering technique for Steel's triple pelvic osteotomy to correct developmental dysplasia of the hip in children.Methods A 6-year-old boy with congenital hip dislocation was recruited in the present study who required Steel' s triple pelvic osteotomy.Spiral CT scanning of the boy' s pelvis was performed to obtain image data which were imported in.dicom format into a computer workstation.A 3D model of the affected hip was reconstructed using software Materialise Mimics Innovation Suite 14.1 and saved in.stl format.Then the 3D model was imported into software Imageware 12.0.The Steel's triple pelvic osteotomy was simulated in the 3D model until an anatomically stable hip was achieved as a result of correcting dislocation of the hip in the boy.The osteotomy navigational template was designed according to the anatomic features

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

    Won Yong Shon

    2014-01-01

    CONCLUSION: The sagittal position of pelvis is a key factor in impingement and dislocation after total hip arthroplasty. Pelvic tilting affects the position of acetabular component in the sagittal plane of the body as compared with its anatomic position in the pelvis. We suggest a preoperative lateral view of spine-pelvis, in upright and supine position for evaluation of a corrective adaptation of the acetabular cup accordingly with pelvic balance.

  13. The other hip in unilateral hip dysplasia

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2006-01-01

    We reviewed transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. A center-edge angle of 20 degrees or less was considered the upper normal value. Four groups were identified: 69 patients...... with apparently unilateral right developmental dysplasia (left hip center-edge angles greater than 20 degrees), 26 patients with apparently unilateral left developmental dysplasia (right hip center-edge angles greater than 20 degrees), 68 patients with bilateral developmental dysplasia, and 34 patients...... with bilateral borderline developmental dysplasia (bilateral center-edge angles less than or equal to 25 degrees). The pelvic computed tomography scans were compared with computed tomography scans of 41 control subjects with healthy hips. The joint anatomy of patients with developmental dysplasia differed from...

  14. Les dislocations: textes et contextes

    Leonarduzzi, Laetitia; Herry, Nadine

    2005-01-01

    In this paper we analyse the contexts in which left and right dislocations appear. Our corpus is based on written as well as oral discourse, with texts ranging from the year 1884 to 2005. After trying to define both types of dislocation, and seeing how far the definitions can be extended, we notice that the dislocated NP is most of the time definite (90% of our examples). This phenomenon may be explained by the notions of anaphora, deixis and thematisation. Dislocations appear both in oral an...

  15. Multiligamentous injuries and knee dislocations.

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

    2015-11-01

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

  16. Design rules for dislocation filters

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

  17. Design rules for dislocation filters

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

    2014-08-14

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

  18. Dislocation dynamics in nanocrystalline nickel.

    Shan, Z W; Wiezorek, J M K; Stach, E A; Follstaedt, D M; Knapp, J A; Mao, S X

    2007-03-01

    It is believed that the dynamics of dislocation processes during the deformation of nanocrystalline materials can only be visualized by computational simulations. Here we demonstrate that observations of dislocation processes during the deformation of nanocrystalline Ni with grain sizes as small as 10 nm can be achieved by using a combination of in situ tensile straining and high-resolution transmission electron microscopy. Trapped unit lattice dislocations are observed in strained grains as small as 5 nm, but subsequent relaxation leads to dislocation recombination. PMID:17359167

  19. Application of uncemented Zweymüller hip prosthesis in adult patients with hip osteoarthritis secondary to developmental dysplasia

    XU Yong-sheng; WANG Yan; LU Long; WEI Bao-gang

    2012-01-01

    Background Developmental dysplasia encompasses a wide spectrum of hip pathology ranging from a shallow acetabulum to a completely dislocated ‘high-riding' hip.It is a common cause of secondary osteoarthritis in young adults and is the underlying diagnosis in up to 48% of patients requiring total hip arthroplasty (THA) for coxarthrosis.The aim of this study was to evaluate efficiency and safety of THA using Zweymüller hip implant in the treatment of severe osteoarthritis secondary to developmental dysplasia of the hip (DDH) in adults.Methods From January 2000 to February 2008,35 patients (40 hips) with developmental dysplasia of the hip were included.Five were male and 30 were female,with ages ranging from 26 to 65 years and an average age of 45 years.According to Hartofilakidis classification,there were type Ⅰ in 5 hips,type Ⅱ in 20 hips,type Ⅲ in 15 hips.All the patients were performed the THA using the Zweymüller hip implant.The preoperative average Harris score was 44.The bilateral arthroplasty was performed in 5 patients and the unilateral arthroplasty in 30 patients.The patients mainly suffered from pain and claudication.Clinical and radiological results were analyzed.The Harris score was used for outcome measurement.Results Thirty five patients (40 hips) were followed and the mean follow-up period was 46 months (ranged from 24 months to 96 months).The latest follow-up average Harris score was 88.9 (97.1% of good rate).All the patients were pain-free and there was no sign of infection,aseptic loosening and subsidence.Conclusions In summary,THA using Zweymüller hip implant is a good treatment method for severe osteoarthritis secondary to DDH in adults.The key techniques for the total hip replacement are as follows:good preoperative plan,firmly placing the acetabular component in the true acetabulum,proper preparation of proximal femur,suitable femoral component choosing and improving the techniques of the bone graft.

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

    Liliana SAVIN

    2012-07-01

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

  1. Anesthesia for an achondroplastic individual with coexisting atlantoaxial dislocation.

    Kaushal, Ashutosh; Haldar, Rudrashish; Ambesh, Paurush

    2015-01-01

    Achondroplasia is a congenital, disfiguring condition which is the most common form of short-limbed dwarfism. Defective cartilage formation is the hallmark of this condition, which results in a wide spectrum of skeletal abnormalities including spinal defects. Various other systems such as cardiac, pulmonary, and neurological can be simultaneously affected adversely including airway defects. Anesthetic management of such individuals is complicated because of their multisystem affliction. Concomitant atlantoaxial dislocation can further amplify the difficulty during the administration of anesthesia in such patients. We report the successful anesthetic conduct of such a patient with the positive outcome. PMID:26712995

  2. Painful Hip Prosthesis: Definition

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

    2010-01-01

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

  3. Annealing of dislocation loops in dislocation dynamics simulations

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

  4. Annealing of dislocation loops in dislocation dynamics simulations

    Mordehai, Dan; Clouet, Emmanuel [SRMP, CEA-Saclay, 91191 Gif-sur-Yvette Cedex (France); Fivel, Marc; Verdier, Marc, E-mail: danmord@tx.technion.ac.il [CNRS/SIMAP, INPG, BP 75, 38402 St Martin d' Heres (France)

    2009-07-15

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

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

    2014-01-01

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

  6. Hip fracture - discharge

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge

  7. Hip Fractures among Older Adults

    ... online training for health care providers. Learn More Hip Fractures Among Older Adults Recommend on Facebook Tweet ... get older. What You Can Do to Prevent Hip Fractures You can prevent hip fractures by taking ...

  8. An Insight into Methods and Practices in Hip Arthroplasty in Patients with Rheumatoid Arthritis

    Mohammad Saeed Mosleh-shirazi

    2015-01-01

    Full Text Available Total hip arthroplasty (THA has improved the quality of life of patients with hip arthritis. Orthopedic community is striving for excellence to improve surgical techniques and postoperative care. Despite these efforts, patients continue facing postoperative complications. In particular, patients with rheumatoid arthritis display a higher risk of certain complications such as dislocation, periprosthetic infection, and shorter prosthesis durability. In this review we present the current knowledge of hip arthroplasty in patients with rheumatoid arthritis with more insight into common practices and interventions directed at enhancing recovery of these patients and current shortfalls.

  9. Effect analysis of Early screening manipulation reposition splint in treatment of neonatal congenital hip dyspla-sia%早期筛查手法复位夹板对新生儿先天性髋关节发育不良的效果分析

    郑毅勇

    2014-01-01

    Objective To probe into the early screening,technique massage assisted by breaststroke splint treatment of neonatal congen-ital dysplasia of the hip( DDH ) with the traditional infant breaststroke splint compare effectiveness for the treatment of DDH. Method screening of total of 21 cases of children with DDH in neonatal,and Cannot be discover within 1 month of DDH outpatient infant children of 17 cases with auxiliary breaststroke splint treatment effect comparison of reference of the hip function criteria( Harris score)to evaluate the therapeutic effect. Results 21 cases of the experimental groupand 71 cases of the contrast group were treated and long-term follow-up. Experimental Harris score,excellent in 9 cases,as good in 10 cases,fine rate was 90. 48%(19/21);Control group Har-ris scoring,excellent 3 cases,good 5 cases,fine rate was 72. 73%(8/11). Two groups of children with excellent and had significant differ-ence(P<0. 05). Conclusion Early screening,auxiliary massage breaststroke splint treatment of neonatal DDH,has simple operation,small trauma,fewer complications,curative effect is reliable.%目的:探讨早期筛查,手法复位辅助蛙式夹板治疗新生儿先天性髋关节发育不良( DDH)与传统婴幼儿单纯用蛙式夹板治疗DDH的疗效比较。方法:选择在新生儿中筛选出的患有DDH的患儿共21例,与未能在出生1月内发现DDH的门诊婴幼儿患儿17例以手法按摩辅助蛙式夹板进行治疗对其效果比较。参考髋关节功能评分标准( Harris评分)对疗效进行评价[3]。结果:试验组21例及对照组17例均接受治疗及长期随访。试验组Harris评分,其中优9例,良10例,优良率为90.48%(19/21);对照组Harris评分,其中优3例,良5例,优良率为72.73%(8/11)。两组患儿优良率差异有统计学意义(0.01

  10. Nature of Dislocations in Silicon

    Hansen, Lars Bruno; Stokbro, Kurt; Lundqvist, Bengt;

    1995-01-01

    Interaction between two partial 90 degrees edge dislocations is studied with atomic-scale simulations using the effective-medium tight-binding method. A large separation between the two dislocations (up to 30 Angstrom), comparable to experimental values, is achieved with a solution of the tight-b...

  11. Genetics of congenital hypothyroidism

    Park, S.; Chatterjee, V

    2005-01-01

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

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

    Mantu Jain

    2013-10-01

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

  13. Impact of Congenital Heart Defects

    ... High Blood Pressure Tools & Resources Stroke More The Impact of Congenital Heart Defects Updated:Oct 21,2015 ... is an important part of successful coping. The Impact of Congenital Heart Defects • Home • About Congenital Heart ...

  14. Taper Hip Prosthesis

    Full Text Available Zimmer M/L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome to this "OR Live" Webcast presentation ... an "OR Live" Webcast on the Kinectiv Total Hip System. At this time, let’s join Dr. Maltry ...

  15. TREATMENT OF HIP DYSPLASIA

    Iulian ICLEANU

    2015-11-01

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

  16. Hip joint injection

    ... cause of the pain. For some, it can last weeks or months. Alternative Names Cortisone shot - hip; Hip injection; Intra-articular steroid ... writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ... Institutes of Health Page last updated: 23 August 2016

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

    Pajić Miloš

    2007-01-01

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

  18. Formed HIP Can Processing

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

    2015-07-27

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

  19. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    Alberto Nicodemo

    2014-01-01

    Full Text Available Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

  20. Late-presenting developmental dysplasia of the hip in Jordanian males

    Samarah, Omar Q.; Hadidi, Fadi A. Al; Hamdan, Mohammad Q.; Hantouly, Ashraf T.

    2016-01-01

    Objectives: To describe the pattern of developmental dysplasia of the hip (DDH) in late presenting Jordanian male patients and identify the risk factors and associated findings. Methods: This is a retrospective study of 1145 male patients who attended the Pediatric Orthopedic Clinic for a DDH check up. This study was carried out in the Orthopedic Section, Special Surgery Department, Faculty of Medicine, The University of Jordan, Amman, Jordan between March 2011 and October 2014. Data was collected from medical records, and x-ray measurements were evaluated. Results: Of the 1145 male patients, 43 (3.75%) with 70 involved hips were diagnosed with late- presenting DDH. Being a first-born baby resulted in 41.9% increased risk for DDH. Cesarian delivery was significantly associated with an increased risk of hip dislocation (p=0.004) while normal delivery was significantly associated with acetabular dysplasia (p=0.004). No predictable risk factors were found in 44.2% patients with DDH. Bilateral cases were more common than unilateral cases: (26 [60.5%] versus 17 [39.5%]). Limited abduction was a constant finding in all dislocated hips (pcongenital muscular torticollis were not observed. Conclusion: Cesarian section is a significant risk for dislocated hips while normal delivery is significantly associated with acetabular dysplasia. Bilateral DDH is more common than the unilateral. Club foot and torticollis were not observed in this series. PMID:26837397

  1. Congenital Hepatic Fibrosis

    MH Antikchi

    2010-09-01

    Full Text Available Congenital hepatic fibrosis (CHF is a rare disease that primarily involves hepatobiliary and renal systems. It is characterized by hepatic fibrosis, portal hypertension and renal cystic disease. We present a 22 years old man with fever, abdominal pain, icterus and hematemesis. On complete work up of the patient and liver with kidney biopsy, the diagnosis was congenital hepatic fibrosis.

  2. Congenital symmastia revisited

    Sillesen, Nanna H; Hölmich, Lisbeth R; Siersen, Hans Erik;

    2012-01-01

    Symmastia is defined as medial confluence of the breast. The term 'symmastia' is modified from Greek (syn meaning 'together', and mastos meaning 'breast') and was first presented by Spence et al. in 1983. Two forms of symmastia exist: an iatrogenic and a congenital version. Congenital symmastia i...

  3. Total Hip Arthroplasty for the Paralytic and Non-paralytic Side in Patient with Residual Poliomyelitis

    Sonohata, Motoki; Kitajima, Masaru; Kawano, Shunsuke; Mawatari, Masaaki

    2016-01-01

    Background: Total hip arthroplasty (THA) for poliomyelitis is a problematic procedure due to difficulty in positioning the cup of the prosthesis in the true acetabulum and the risk of dislocation after THA due to the low muscle tone. Methods: We herein present a case of bilateral hip pain with a history of poliomyelitis. Radiograph showed bilateral hip osteoarthritis caused by hip dysplasia due to residual poliomyelitis in right hip joint or developing dysplasia of the hip joint in left hip joint. THA was performed to bilateral hip joints. Results: Six years after bilateral THA, bilateral hip pain significantly improved. Additionally, the muscle strength on the paralyzed right side partially improved. However, the muscle strength on the non-paralyzed left side did not significantly improve. No complications related to the surgery were observed. Conclusion: Promising early results were obtained for THA in our patient with residual poliomyelitis. However, surgeons should pay attention to the potential development of complications concerning THA that may arise due to the residual poliomyelitis. PMID:27347238

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

    Issack Paul S

    2012-06-01

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

  5. Moving Dislocations in Disordered Alloys.

    Marian, J; Caro, A

    2006-11-18

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

  6. Patellar Dislocations and Reduction Procedure.

    Ramponi, Denise

    2016-01-01

    Acute patellar dislocations are a common injury occurring in adolescents involved in sports and dancing activities. This injury usually occurs when the knee is in full extension and sustains a valgus stress on the knee. The medial patellofemoral ligament is the medial restraint that assists in stabilizing the patella from lateral dislocations. The patella usually dislocates laterally and is usually not difficult to reduce after patient evaluation and prereduction radiographs. After postreduction radiographs confirm proper position of the patella postreduction and the absence of fractures, the patient is usually treated conservatively with initial immobilization, orthopedic referral, and physical therapy. PMID:27139130

  7. Doğuştan kalça çıkığı ve displazisinde total kalça artroplastisi

    Akman, Senol; Sen, Cengiz; Sener, Nadir; Tozun, I. Remzi

    2004-01-01

    Objectives: We evaluated our methods and short-term results of total hip arthroplasty in the treatment of neglected congenital dislocation or dysplasia of the hip. Methods: We performed total hip arthroplasty in 13 hips of 11 female patients (mean age 47.9 years; range 36-65 years) with osteoarthritis secondary to congenital dislocation or dysplasia. Patients with severe acetabular dysplasia required augmentation with bone grafts. In high-riding hips, femoral shortening osteotomy was perfo...

  8. MR findings of congenital anorectal malformation

    Kim, Yoo Kyung; Kim, Hyae Young; Kwag, Hyon Joo; Chung, Eun Chul; Lee, Jung Sik; Suh, Jeong Soo [Ewha Womens University, medical College, Seoul (Korea, Republic of)

    1995-05-15

    To assess the usefulness of MRI in preoperative diagnosis of congenital anorectal malformation. MR findings of 11 cases with surgically proved anorectal malformations were retrospectively reviewed and compared with operative findings, according to the level of atresia, the development of sphincter muscle, fistula and associated anomalies of other organs. Four of 11 cases were low type of anorectal atresia, 3 cases were intermediate type, and 3 cases were high type. There was one case of Currarino triad with low type of anorectal stenosis. MRI demonstrated the levels of atresia correctly in all cases and revealed fistulas in all high type of anomalies. Degrees of the development of the sphincter muscles were good in all cases of low types and fair in a case of intermediate type and an anorectal stenosis, whereas the development was poor in 2 cases of intermediate type and all 4 cases of high type. The associated anomalies in anorectal malformation were renal agenesis, congenital hip dysplasia and sacral defect with presacral teratoma in Currarino triad. MRI was a simple and useful study to confirm the level of atresia, fistula and associated anomalies in the diagnosis of the congenital anorectal malformation.

  9. Evolution of the term and definition of dysplasia of the hip - a review of the literature.

    Musielak, Bartosz; Idzior, Maciej; Jóźwiak, Marek

    2015-10-12

    There is no consensus on the definition of dysplasia of the hip (DH). Past and present concepts used to describe DH do not form a complete view of the pathology. Moreover, some authors still present the disease as congenital, not developmental. This prompted authors to analyze the evolution of the definition of DH. Based on the biomedical databases 500 articles and books in the field of hip dysplasia were found and analyzed. Fifteen definitions of hip dysplasia met inclusion criteria, subsequently were analyzed and presented in chronological order. The analysis revealed that currently there is no single, universal definition of hip dysplasia in the aspect of morphological, clinical, and radiological studies. Despite the widely-used term of DH, it is described imprecisely and in different ways. Therefore, it is necessary to develop a multidisciplinary definition of this pathology covering all aspects of hip disorders considered valid in modern orthopaedics. PMID:26528350

  10. Two Different Total Hip Arthroplasties for Hartofilakidis Type C1 Developmental Dysplasia of Hip in Adults

    Ya-Ming Chu; Yi-Xin Zhou; Na Han; De-Jin Yang

    2016-01-01

    Background: Total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH) is more complex than the normal hip, with large replacement risks and many complications.Although nonosteotomy THA is convenient to perform, femoral osteotomy shortening can avoid blood vessel and nerve traction injuries.This study aimed to compare osteotomy THA with nonosteotomy to determine reasonable options for operative management of DDH.Methods: Data on 48 DDH patients who underwent THA were analyzed retrospectively.The patients were divided into two groups: Group A 29 cases (nonosteotomy), and group B 19 cases (osteotomy).Harris and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, limb length discrepancy (LLD), radiological data on the hip, and claudication were evaluated.Data were analyzed by using paired-sample Student's t-test, independent-sample Student's t-test, and Pearson's Chi-square test;the test level was α =0.05.Results: Postoperative Harris (90.7 ± 5.1) and WOMAC scores (88.0 ± 10.6) were significantly improved compared with preoperative Harris (44.8 ± 5.7) and WOMAC scores (42.0 ± 5.3) in group A (P < 0.05).Postoperative Harris (90.4 ± 2.8) and WOMAC scores (88.2 ± 5.9) were significantly improved compared with preoperative Harris (44.4 ± 4.2) and WOMAC scores (43.2 ± 4.3) in group B (P < 0.05).One case of dislocation occurred in group A;after closed reduction, dislocation did not recur.In group A, 2 patients developed cutaneous branch injury of the femoral nerve, which spontaneously recovered without treatment.Postoperative LLD >2 cm was seen in one case in group A and five cases in group B.Postoperative claudication showed no significant difference between the two groups (P > 0.05).No patients developed infection;postoperative X-rays showed that the location of the prosthesis was satisfactory, and the surrounding bone was not dissolved.Conclusions: THA is effective and safe for DDH.For unilateral high dislocation

  11. UK survey of occupational therapist’s and physiotherapist’s experiences and attitudes towards hip replacement precautions and equipment

    Smith, T.O.; Sackley, C. M.

    2016-01-01

    Background: Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). Historically, people following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. The purpose of this study was to determine current practices in the provision of these interventions in the UK for people following primary THR. Methods: A 27-question, self-adminis...

  12. Simultaneous shoulder and elbow dislocation

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; KARATAŞ, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to...

  13. Congenital anomalies associated with hypothyroidism.

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

    1986-01-01

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

  14. Hip arthroscopy in the setting of hip dysplasia

    Yeung, M.; Kowalczuk, M.; Simunovic, N.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. Results The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. Conclusion The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies. Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225–231. DOI: 10.1302/2046-3758.56.2000533. PMID:27313136

  15. Magnetic resonance imaging of labral cysts of the hip

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

    1996-11-01

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

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

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

    2011-03-15

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

  17. Current Trends in Management of Atlantoaxial Dislocation.

    Yin, Qing-shui; Wang, Jian-hua

    2015-08-01

    Atlantoaxial dislocation (AAD), often caused by trauma, tumors or congenital malformations, is a challenging disorder of the craniocervical junction. Because of its deep location and intricate anatomic structure, the craniocervical junction is always a difficult region for spine surgery. With recent developments in medical science, great progress has been made in the diagnosis and treatment of AAD such that more instructive clinical classifications and efficacious treatment strategies, various novel operation techniques including innovative posterior or transoral anterior reduction, and novel fixation instruments are now widely used in clinical practice for managing AAD. However, surgeons continue to face more special characteristics and difficulty in carrying out upper cervical surgery than they encounter in other regions of the spine. Consequently, this high risk surgery should only be performed by extremely skilled and experienced surgeons and only when stringent indications have been met. Therefore, the aim of this course is to assist surgeons who are dealing with AAD by providing comprehensive information about AAD, including related anatomy, classification, clinical manifestations and diagnosis, imaging examinations and surgical techniques, thus decreasing the occurrence of complications and improving the level of diagnosis and treatment. PMID:26311092

  18. Congenital myasthenia gravis.

    Nizamani, Noor Bakht; Talpur, Khalid Iqbal; Memon, Mariya Nazish

    2013-07-01

    Congenital myasthenia gravis is caused by genetic mutations affecting neuromuscular transmission, characterized by muscle weakness usually starting in childhood. A two and a half years old male child presented with bilateral ptosis and hoarseness of voice. The symptoms progressed giving the clinical impression of congenital myasthenia gravis. A series of tests were done including Ice Pack Test, acetylcholine receptor antibody test, trial of steroids and finally neostigmine test which confirmed the diagnosis. This case illustrates the challenges in diagnosing congenital myasthenia gravis and highlights the potential benefits of neostigmine test in its diagnosis. PMID:23823963

  19. Taper Hip Prosthesis

    Full Text Available ... L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome ... hopefully you will see the benefits and the advantages of the new Zimmer Kinectiv System. Thank you. ...

  20. Taper Hip Prosthesis

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

  1. Imaging of hip arthroplasty

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

  2. Treatment of hip dysplasia.

    Anderson, A

    2011-04-01

    Hip dysplasia is a common orthopaedic developmental disorder of dogs. This paper reviews the treatment options available for management of the condition in the skeletally immature and adult dog. PMID:21906059

  3. Taper Hip Prosthesis

    Full Text Available Zimmer M/L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome to this "OR Live" Webcast presentation brought to you by Zimmer. During ...

  4. Hip flexor strain - aftercare

    ... such as sprinting, kicking, and changing direction while running or moving, can stretch and tear the hip flexors. Runners, people who do martial arts, and football, soccer, and hockey players are more likely to have ...

  5. HIP osteoarthritis and work.

    Harris, E Clare; Coggon, David

    2015-06-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on the capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242

  6. Arthroscopic hip labral repair.

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

    2013-05-01

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

  7. HIP osteoarthritis and work

    Harris, E C; Coggon, D.

    2015-01-01

    Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by the elimination or redesign of processes and the use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where...

  8. Management of dislocated intraocular implants.

    Chan, C K; Agarwal, A; Agarwal, S; Agarwal, A

    2001-12-01

    Implant dislocation may occur in the absence of appropriate capsular or zonular support (PCIOL) (11,35,53) or following traumatic injury to anterior ocular tissues (ACIOL). (11,19,20) Other factors (e.g., advanced patient age, high myopia, previous vitrectomy, pseudoexfoliation syndrome, and certain connective tissue disorders) also may predispose implant dislocation. (9,52) Although reported for all types of IOLs, implant dislocation is becoming more manageable because of the advancement of surgical techniques. A dislocated ACIOL or PCIOL may be explanted, exchanged, or repositioned. (11,48,71) Repositioning the dislocated PCIOL in the ciliary sulcus with modern vitreoretinal techniques provides an optimal environment for visual recovery. (11,71) Implant repositioning techniques generally may be categorized into the external or the internal approaches. (8,11) The former involves external suturing methods for a primary or secondary implant in the absence of adequate capsular or zonular support (15,16,31,42,56,60,61,64,66,73,76) and the latter is achieved through modern pars plana techniques. 8,11,62,69) Recently, several implant repositioning methods gaining increasing acceptance include the scleral loop fixation, (45) the snare approach, (43) the use of the 25-gauge implant forceps, (13) temporary haptic externalization, (8,11,36,71) and the use of perfluorocarbon liquids. (1,28,40,41,44) The temporary haptic externalization method combines the best features of the external and the internal approaches, avoids complex intraocular maneuvers, and allows precise scleral fixation of the dislocated IOL on a consistent basis. (8,11,71) Endoscopy provides the surgeon with optimal viewing of the anterior retropupillary anatomy that is often difficult to appreciate (e.g., capsular-zonular complex, ciliary sulcus, anterior retina, and vitreous base). (6,11) As a result, precise haptic placement is possible during the repositioning process. (6,11) However, a three

  9. Dislocations in Monolayers and Semiconductors.

    Ren, Qiang

    1995-01-01

    Four different aspects of the properties of dislocations in monolayer and semiconductors have been investigated: (i) Using atomic relaxation techniques, dislocation dipoles of various sizes and orientations have been studied for monolayers with the Lennard-Jones potential (LJP) and the nearest-neighbour piecewise linear force (PLF) interactions. In the WP system the lower energy vacancy dipoles have over a wide range of angles an energy which is mainly a function of the vacancy content of the dipole. There is a competition between the elastic forces and the topological constraints which favour a five-fold coordinate vacancy (FCV) at the centre of each core. For the short range PLF system the lattice usually compresses upon the introduction of a dislocation, a consequence of the soft core of the interaction potential, and interstitial dipoles are lower in energy. For the long range LJP system the dislocations are mobile whereas for the PLF system they are pinned. The relevance of these results to existing theories of melting are discussed. (ii) Using generalized stacking-fault (GSF) energies obtained from first-principles density-functional calculations, a zero-temperature model for dislocations in silicon is constructed within the framework of a Peierls-Nabarro (PN) model. Core widths, core energies, PN pinning energies, and stresses are calculated for various possible perfect and imperfect dislocations. Both shuffle and glide sets are considered. 90^circ partials are shown to have a lower Peierls stress (PS) than 30 ^circ partials in accord with experiment. (iii) We have also studied by atomic relaxation techniques the properties of dislocations in silicon, modelled by the empirical potential of Stillinger and Weber. In order to compare with the preceding calculation no reconstruction is allowed. We find no evidence of dissociation in the shuffle dislocations. Within this model shuffle dislocations glide along their slipping planes. On the other hand, glide sets

  10. Microinstability of the Hip and the Splits Radiograph.

    Harris, Joshua D; Gerrie, Brayden J; Lintner, David M; Varner, Kevin E; McCulloch, Patrick C

    2016-01-01

    A normal hip has a natural tendency toward stability because of both osseous and soft tissue structures. Hip motion is primarily rotational around a center of rotation. When the femoral head and its center of rotation translate, with or without rotation, the inherent stability of the femoroacetabular articulation may be lost. The spectrum of hip instability ranges from subtle microinstability to traumatic dislocation. Microinstability may be the cause or the effect of several other hip pathologies. Soft tissue contributions to stability include the static capsule, dynamic musculotendinous units, and underlying generalized connective tissue (eg, Ehlers-Danlos). Osseous contributions include multiple femoral and acetabular radiographic coverage parameters. Iatrogenic contributions include an unrepaired capsulotomy, overresection of the acetabular rim (iatrogenic dysplasia), overresection of cam osteochondroplasty, iliopsoas tenotomy, labral debridement, and ligamentum teres debridement. Patients with hip microinstability often have deep groin pain, exhibited by a C sign. These patients frequently participate in flexibility sports and activities, such as ballet, gymnastics, figure skating, and martial arts. On physical examination, generalized hypermobility syndromes should be assessed, as should loss of log-roll external rotation recoil, excessive abduction, trochanteric-pelvic impingement, and abductor fatigue. Standard imaging, including plain radiographs, magnetic resonance imaging, and computed tomography, should be analyzed for all causes of hip pain. A new plain radiograph, the splits radiograph is introduced here, consistently showing lateral femoral head translation and creation of a vacuum sign, showing hip microinstability. The splits radiograph is illustrated in a 22-year-old female dancer who presented with bilateral deep anterolateral groin pain. PMID:26730687

  11. Causes of Congenital Malformations

    J Gordon Millichap

    2002-01-01

    The genetic epidemiology of congenital malformations (CMs) and interaction with environmental causes are reviewed from the Arkansas Center for Birth Defects, Arkansas Children’s Hospital, Little Rock, AS.

  12. Congenital Ocular Motor Apraxia

    J Gordon Millichap

    2007-06-01

    Full Text Available The clinical and neuroradiological findings, and long-term intellectual prognosis in 10 patients (4 boys and 6 girls with congenital ocular motor apraxia (COMA are reviewed by researchers at Tottori University, Yonago, Japan.

  13. Congenital orbital teratoma

    Shereen Aiyub

    2013-01-01

    Full Text Available We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.

  14. Leber Congenital Amaurosis

    ... Congenital Amaurosis Macular Degeneration Retinitis Pigmentosa Stargardt Disease Usher Syndrome Other Retinal Diseases Glossary News & Research News & ... affected by retinitis pigmentosa, age-related macular degeneration, Usher syndrome and the entire spectrum of retinal diseases. ...

  15. Congenital Ocular Motor Apraxia

    J Gordon Millichap

    2007-01-01

    The clinical and neuroradiological findings, and long-term intellectual prognosis in 10 patients (4 boys and 6 girls) with congenital ocular motor apraxia (COMA) are reviewed by researchers at Tottori University, Yonago, Japan.

  16. Identification of congenital deafblindness

    Dammeyer, Jesper Herup

    2012-01-01

    For many reasons an accurate and straightforward identification of congenital deafblindness can be difficult. This article reports on the assessment procedures and experience in Denmark where medical examinations were combined with functional assessments performed through direct observation. The ...

  17. Congenital nephrotic syndrome

    The disorder often leads to infection, malnutrition, and kidney failure. It can lead to death by age 5, and many children die within the first year. Congenital nephrotic syndrome may be controlled in some cases with early ...

  18. Congenital histiocytosis X

    Congenital histiocytosis X involving multiple organs is a rare disease that causes rapid mortality in intrauterine and neanatal life. The diagnosis of histiocytosis X (Litterer-Siwe disease should be considered in a neonate with vesiculated crusting skin lesions. We present clinical, radiographic and histopathological findings in a neonate with congenital histiocytosis who died of respiratory failure due to diffuse infilteration of lungs with histiocytic cells. Congenital histiocytosis X is a rare form of Langerhans cell histiocytosis. We report on an infant with congenital histiocytosis X who died within 10 days of birth due to diffuse infiltration of multiple organ systems with Langerhans histiocytic cells. To our knowledge, this is the first case of the radiographic illustration of progressive lung involvement in an infant with histiocytosis X. (orig.)

  19. Congenital laryngeal anomalies,

    Rutter, Michael J.

    2014-01-01

    Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the ma...

  20. Congenital Cystic Lung Diseases

    Aditi Jain

    2013-01-01

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

  1. Congenital chylous ascites

    Romańska-Kita, Justyna; Borszewska-Kornacka, Maria Katarzyna; Dobrzańska, Anna; Rudzińska, Iwona; Czech-Kowalska, Justyna; Wawrzoniak, Tomasz

    2011-01-01

    Summary Congenital chylous ascites is a rare entity, conditioned by numerous factors and with changing dynamics of the disease. Because of the lack of therapeutic and diagnostic standards, this disease constitutes to be a medical challenge. This article presents current knowledge on pathogenesis, diagnostics and management of this disease, as well as a case of a newborn with primary congenital chylous ascites in the abdominal cavity.

  2. Congenital distal humeral dysplasia: a case report

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

    2003-01-01

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

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

    van Raaij Jos JAM

    2008-10-01

    Full Text Available Abstract Background Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, but can increase systemic cobalt and chromium ion concentrations. The objective of this study is to compare two cementless total hip arthroplasties: a conventional 28 mm metal-on-polyethylene articulation and a large head metal-on-metal articulation. We hypothesize that the latter arthroplasties show less bone density loss and higher serum metal ion concentrations. We expect equal functional scores, greater range of motion, fewer dislocations, fewer periprosthetic radiolucencies and increased prosthetic survival with the metal-on-metal articulation. Methods A randomized controlled trial will be conducted. Patients to be included suffer from non-inflammatory degenerative joint disease of the hip, are aged between 18 and 80 and are admitted for primary cementless unilateral total hip arthroplasty. Patients in the metal-on-metal group will receive a cementless titanium alloy acetabular component with a cobalt-chromium liner and a cobalt-chromium femoral head varying from 38 to 60 mm. Patients in the metal-on-polyethylene group will receive a cementless titanium alloy acetabular component with a polyethylene liner and a 28 mm cobalt-chromium femoral head. We will assess acetabular bone mineral density by dual energy x-ray absorptiometry (DEXA, serum ion concentrations of cobalt, chromium and titanium, self reported functional status (Oxford hip score, physician reported functional status and range of motion (Harris hip score, number of dislocations and prosthetic survival. Measurements will take place preoperatively, perioperatively, and postoperatively (6 weeks, 1 year, 5 years and 10 years. Discussion

  4. Editorial Commentary: Risk Factors for Chondral Lesions in the Hip-There Is More to It Than Cam and Pincer.

    Hohmann, Erik

    2016-08-01

    Age has been cited in a recent article as the largest predictor of both chondral and labral lesions in patients with hip dysplasia. But it was not surprising that there is also a direct relation between a small lateral center-edge angle, acetabular head index, and cartilage degeneration and an increased acetabular index and labral tears in patients with hip dysplasia. The severity of the congenital disease determines the severity of the intra-articular lesions. PMID:27495863

  5. Dislocations and other topological oddities

    Pieranski, Pawel

    2016-03-01

    We will show that the book Dislocations by Jacques Friedel, published half a century ago, can still be recommended, in agreement with the author's intention, as a textbook "for research students at University and for students at engineering schools as well as for research engineers". Indeed, today dislocations are known to occur not only in solid crystals but also in many other systems discovered more recently such as colloidal crystals or liquid crystals having periodic structures. Moreover, the concept of dislocations is an excellent starting point for lectures on topological defects occurring in systems equipped with order parameters resulting from broken symmetries: disclinations in nematic or hexatic liquid crystals, dispirations in chiral smectics or disorientations in lyotropic liquid crystals. The discussion of dislocations in Blue Phases will give us an opportunity to call on mind Sir Charles Frank, friend of Jacques Friedel since his Bristol years, who called these ephemeral mesophases "topological oddities". Being made of networks of disclinations, Blue Phases are similar to Twist Grain Boundary (TGB) smectic phases, which are made of networks of screw dislocations and whose existence was predicted by de Gennes in 1972 on the basis of the analogy between smectics and superconductors. We will stress that the book by Jacques Friedel contains seeds of this analogy.

  6. MR imaging in congenital lower limb deformities

    Laor, T. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Jaramillo, D. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Hoffer, F.A. [Dept. of Radiology, Children`s Hospital and Harvard Medical School, Boston, MA (United States); Kasser, J.R. [Dept. of Orthopedics, Children`s Hospital and Harvard Medical School, Boston, MA (United States)

    1996-06-01

    Treatment for children with cogenital deformities of the lower extremities may vary, depending on the state of the unossified skeletal structures and surrounding soft tissues. The purpose of our study was to demonstrate the spectrum of the osteochondral and extrasosseous abnormalities as depicted with MR imaging. We retrospectively reviewed MR examinations of 13 limbs of ten children (aged 1 month-9 years, mean 2.1 years) with longitudinal and transverse deformities of the lower extremities. The lesions imaged were fibular hemimelia (n=5), tibial hemimelia (n=5), and congenital constriction bands (n=3). Each examination was assessed for abnormalities in the osteocartilaginous and extraosseous (articular or periarticular components such as ligaments, tendons, and menisci; the muscles and the arteries) structures. Abnormalities were seen in all patients. Osteocartilaginous abnormalities in the patients with longitudinal deformities included abnormal distal femoral epiphyses, abnormal proximal tribial physes, hypertrophied and dislocated proximal fibular epiphyses, unsuspected fibular and tibial remnants, and absence or coalition of the tarsal bones. No osteocartilaginous abnormalities were seen in the patients with congential constriction bands. Articular abormalities in patients with either form of hemimelia included absent cruciate ligaments and menisci, dislocated or absent cartilaginous patellae, absent patellar tendons, and abnormal collateral ligaments. All but one limb imaged had absent or attenuated muscle groups. Of the nine MR arteriograms performed at the level of the knee, eight were abnormal. The normal popliteal trifurcation was absent or in an abnormal location. We conclude that MR imaging of children with congenital lower extremity deformities shows many osteochondral and extraosseous abnormalities that are not depicted by conventional radiogrpahy. This information can help to plan early surgical intervention and prosthetic rehabilitation. (orig.)

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

    Hartig-Andreasen, Charlotte; Stilling, Maiken; Søballe, Kjeld;

    2014-01-01

    After periacetabular osteotomy (PAO), some patients develop osteoarthritis with need of a total hip arthroplasty (THA). We evaluated the outcome of THA following PAO and explored factors associated with inferior cup position and increased polyethylene wear. Follow-up were performed 4 to 10years...... after THA in 34 patients (38 hips) with previous PAO. Computer analysis evaluated cup position and wear rates. No patient had dislocations or revision surgery. Median scores were: Harris hip 96, Oxford hip 38 and WOMAC 78. Mean cup anteversion and abduction angles were 22(o) (range 7°-43°) and 45......° (range 28°-65°). Outliers of cup abduction were associated with persisting dysplasia (CE...

  8. Hip injuries in children and adolescents.

    Craig, C L

    1980-10-01

    Hip injuries in children present a wide spectrum of problems. Frequently because of the severity of the trauma involved, other injuries may take precedence and may require modification of the usual approaches to treatment. However, certain precepts are essential to the successful treatment of these injuries and should be kept in mind regardless of the milieu in which they are found. In the child with a hip dislocation, the potential presence of an acetabular, femoral head, femoral shaft, patellar or tibial plateau fracture must always be considered. Specialized x-ray views are necessary for this evaluation. Laminography and arthrography may also be required. The essential feature of successful subsequent treatment is a gentle closed reduction performed within 24 hours of injury. Treatment of displaced fractures of the femoral neck remains an unresolved issue. Accurate reduction held with adequate internal fixation would appear to offer the best chance for a successful result. The possible complications of avascular necrosis, delayed union and non-union, coxa vara, premature closure of the epiphyseal plate, and shortening should be appreciated. Early institution of appropriate treatment may mitigate the ultimate effect of these potentially devastating problems. PMID:7454245

  9. Vojta method in the treatment of developmental hip dysplasia – a case report

    Kiebzak, Wojciech; Żurawski, Arkadiusz; Dwornik, Michał

    2016-01-01

    Background Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and structural disorders. Such cases particularly demand optimizing therapeutic effects and maximally reducing the duration of therapy. Purpose The aim of this case report is to present the therapeutic process in a child with developmental hip dysplasia. Case report This is a case report of a female child with a birth weight of 2,800 g and an Apgar score of 9 points born to a gravida 3 para 3 mother at 37 weeks. The child was delivered by cesarean section, and the pregnancy was complicated by oligohydramnios. Subluxation of the left hip joint was diagnosed by an orthopedist in the third month of life. The treatment followed was the Vojta method (the first phase of reflex turning and reflex crawling). Results During the 6 weeks of the Vojta treatment, the left half of the femoral head was centralized, and the process of formation of the hip joint acetabulum was influenced effectively enough to change the acetabulum’s Graff type from the baseline D to IIb after 41 days of treatment. Conclusion The diagnostic work-up of congenital hip joint dysplasia should involve a physiotherapist who will investigate the child’s neuromuscular coordination, in addition to a neonatologist and a pediatrician. The therapy for a disorder of hip joint development of neuromotor origin should involve the application of global patterns according to Vojta. Children with congenital dysplasia of the hip joint should commence rehabilitation as early as possible. PMID:27578980

  10. Bipolar dislocation of the clavicle

    Wei Jiang

    2012-01-01

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

  11. Bipolar dislocation of the clavicle.

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

    2012-11-01

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

  12. A comparison of outcomes and dislocation rates using dual articulation cups and THA for intracapsular femoral neck fractures.

    Tarasevicius, Sarunas; Robertsson, Otto; Dobozinskas, Paulius; Wingstrand, Hans

    2013-01-01

    Total hip arthroplasty for intracapsular femoral neck fractures (FNF) is associated with a greater risk of dislocation. Dual articulation systems in this group of patients may provide better implant stability and a reduced dislocation rate. The aim of our study was to investigate FNF patients treated with dual articulation cups (DAC) and conventional THA and compare their clinical results at four months and one year after surgery. Our study compared femoral neck fracture patients treated with either DAC or conventional THA during two different time periods. Before surgery and during follow-up, the patients answered questions regarding their mobility, pain and usage of walking aids. Additionally at four-month and one-year follow-ups EQ-5D and HOOS questionnaires were applied for those patients qualifying for functional and quality of life analysis. Out of 125 femoral neck fracture patients 58 were treated with DAC and 67 with conventional THA. At four months and one year follow-up the HOOS and EQ-5D results did not differ significantly between DAC and conventional THA. Five hips in the THA group were revised for recurrent dislocation and two had a single dislocation. One year after surgery, the functional result of DAC and conventional THA are comparable but DAC have a lower risk of dislocation. PMID:23397197

  13. Light scattering from dislocations in silicon

    Monier, Vanessa; Capello, Luciana; Kononchuk, Oleg; Pichaud, Bernard

    2010-11-01

    Nondecorated glide dislocations in Czochralski grown silicon have been studied by laser scattering tomography technique. Dependence of intensity of scattered light on polarization of the incident light has been measured for different orientations of the dislocation line and Burgers vector. Detailed theory of light scattering by dislocation in silicon crystals is presented. It is shown that by combination of polarization and tomography measurements it is possible to determine slip system of nondecorated mixed dislocation in Si.

  14. Intermittent dislocation flow in viscoplastic deformation

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

    2001-01-01

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

  15. Drift of dislocation tripoles under ultrasound influence.

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

    2016-01-01

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

  16. Bilateral fracture dislocation of the shoulder (Presentation of a Case)

    Kuzgun, Unal; Baskir, Orhan; Temelli, Yener; Yazicioglu, Onder; Temocin, Bahattin O.; Kokino, Misel

    2004-01-01

    The largest portion of the dislocations encountered in the adults comprises shoulder dislocations and 2.16% of these dislocations constitute posterior dislocations. It is possible to detect that a dislocation develops secondary to convulsions due to immediate loss of consciousness in the history of most of the posterior dislocations of the shoulder. Approximately 20 cases have been so far reported in literature regurding bilateral dislocations of the shoulder. Bilateral dislocation associated...

  17. CT to delineate hip pathology in cerebral palsy

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

  18. X-Ray Exam: Hip

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth X-Ray Exam: Hip KidsHealth > For Parents > X-Ray Exam: Hip Print A A A Text Size ... español Radiografía: cadera What It Is A hip X-ray is a safe and painless test that uses ...

  19. Traumatic Knee Dislocation with Acute Artery Injury

    Hüseyin Şahin1; Mustafa Uzkeser2; Ayhan Aköz; et al.

    2014-01-01

    Traumatic knee dislocation is very rare injury in patients presenting to the emergency room. The complications associated with knee dislocation such as amputation of extremities and die is required emergency response. We discussed a case, that he has only knee dislocation and popliteal artery injury and mortal as soon as possible.

  20. Congenital cataract screening

    Zhale Rajavi

    2016-01-01

    Full Text Available Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender.

  1. Scattering of phonons by dislocations

    By 1950, an explicit effort had been launched to use lattice thermal conductivity measurements in the investigation of defect structures in solids. This technique has been highly successful, especially when combined with the measurements of other properties such as optical absorption. One exception has been the study of dislocations. Although dislocations have a profound effect on the phonon thermal conductivity, the mechanisms of the phonon-dislocation interaction are poorly understood. The most basic questions are still debated in the literature. It therefore is pointless to attempt a quantitative comparison between an extensive accumulation of experimental data on the one hand, and the numerous theoretical models on the other. Instead, this chapter will attempt to glean a few qualitative conclusions from the existing experimental data. These results will then be compared with two general models which incorporate, in a qualitative manner, most of the proposed theories of the phonon-dislocation interaction. Until very recently, measurement of thermal conductivity was the only means available to probe the interaction between phonons and defects at phonon frequencies above the standard ultrasonic range of approx. = 109 Hz. The introductory paragraphs provide a brief review of the thermal-conductivity technique and the problems which are encountered in practice. There is also a brief presentation of the theoretical models and the complications that may occur in more realistic situations

  2. Metal working and dislocation structures

    Hansen, Niels

    2007-01-01

    Microstructural observations are presented for different metals deformed from low to high strain by both traditional and new metal working processes. It is shown that deformation induced dislocation structures can be interpreted and analyzed within a common framework of grain subdivision on a finer...... metals with structures on the scale from about 10 nm to 1 mu m....

  3. Congenital laryngeal anomalies,

    Michael J. Rutter

    2014-12-01

    Full Text Available Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the main aspects concerning airway management of infants will be analyzed. Conclusions: It is critical for clinicians to understand issues relevant to the airway management of infants.

  4. Congenital midline nasofrontal masses.

    Saettele, Megan; Alexander, Alan; Markovich, Brian; Morelli, John; Lowe, Lisa H

    2012-09-01

    Congenital midline nasal masses are uncommon anomalies including nasal dermoids/epidermoids, nasal glial heterotopias and encephaloceles. These lesions can occur at the nasal bridge, extend intranasally and have intracranial extension with communication to the subarachnoid space. Therefore, accurate diagnosis of these lesions is critically important for presurgical planning and prevention of potentially fatal complications. Neuroimaging is essential in the evaluation of congenital midline nasal masses to identify the specific type of lesion, evaluate for the presence of intracranial extension and allow for appropriate presurgical planning. PMID:22648391

  5. Congenital heart disease

    1995-01-01

    950283 Surgical treatment of congenital coronaryartery fistula.CAO Qingheng(曹庆亨),et al.DeptCardiovasc Surg,Shanghai Chest Hosp,Shanghai,200030.Shanghai Med J 1995;18(1):10-12.From October 1957 through December 1990,twenty-five patients with congenital coronary artery fistula(CCAF),including 3 cases complicated with giantcoronary artery aneurysms,underwent surgical repair.The ages ranged from 4 to 47 years (mean 19.8years).CCAF originated from the right coronaryartery in 17 cases (68.0%) and terminated into RA,RV,pulmonary artery (PA) or LV,in 8 cases (32.

  6. Congenital spinal malformations

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

  7. Ullrich Congenital Muscular Dystrophy

    Goknur Haliloglu

    2011-06-01

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

  8. Congenital pancreatic cysts

    Seddighy A

    1998-07-01

    Full Text Available Congenital cyst of the pancreas is an uncommon problem in the pediatric patient. The common symptoms at the time of diagnosis have been abdominal mass and pain or fullness, nausea and vomiting. Despite of various paraclinic methods for diagnosis, ultrasound is now recognized as the most effective and best noninvasive method for diagnosis of pancreatic cyts. Surgical intervention is the best mode of therapy. Upper abdominal cystic mass are seen in the fetus and newborn infants. In Amirkabir Hospital, during 12 years from 1981 to 1993, 8 pancreatic cysts have been operated on and only in this case it was congenital.

  9. Congenital Pulmonary Alveolar Proteinosis

    Saber Hammami

    2013-01-01

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

  10. CONGENITAL HYPERINSULINISM (HYPERAMMONEMIA HYPERINSULINISM

    Garuda Rama

    2015-02-01

    Full Text Available BACKGROUND: Congenital hyperinsulinism causing hypoglycemia. CASE CHARACTERISTICS : 1yr child with hypoglycemic convulsion. OBSERVATION: High insulin levels on fasting, hyperammonemia, diffuse hyperplasia of pancreas on PET dopa scan. OUTCOME: Good response to frequent glucose feeds and diazoxide. MESSAGE: Any child presenting with convulsion needs blood sugar estimation and hypoglycemia if any, should be thoroughly investigated. Congenital hyperinsulinism comprises a group of different genetic disorders with the common finding of recurrent episodes of hyperinsulinemic hypoglycemia due to inappropria te secretion of insulin by pancreatic β - islet cells. Hyperammonemia hyperinsulinism is due to type - 3 diffuse hyperinsulinism transmitted as autosomal dominant due to mutation in glutamate dehydrogenase gain of function mutation

  11. Medial subtalar dislocation: Case report

    Manojlović Radovan

    2010-01-01

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

  12. Congenital syphilis in the newborn.

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

    1988-01-01

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

  13. A 61-year-old woman develops polyuria after hip revision

    Shaheen, Aisha; Dobish, Mark; Gleason, Vanessa; Setren, Adam; Stem, Jonathan; Kohl, Benjamin A.

    2016-01-01

    A 61-year-old previously healthy woman developed progressive hearing and visual loss over a period of 2–3 months prior to admission. Her medical/surgical history was remarkable for a left hip arthroplasty 11 years ago requiring revision approximately 6 months prior to admission. After dislocating the revised hip, she re-presented to her surgeon and underwent a closed reduction. Several weeks following the reduction, the patient began having polyuria and symptoms of hearing and vision loss along with numbness in her extremities and abdominal region. PMID:27170702

  14. Hip Arthroscopy: A Brief History.

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day. PMID:27343387

  15. The painful hip: new concepts

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

    2006-06-15

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

  16. The athlete's hip and groin.

    Tammareddi, Kumar; Morelli, Vincent; Reyes, Miguel

    2013-06-01

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

  17. Hip Abnormities in Patients with Spinal Cord Injury (review)%脊髓损伤后髋关节异常

    王雪菲; 张军卫

    2014-01-01

    脊髓损伤后患者并发症较多,其中包括髋关节异常。到目前为止,关于脊髓损伤并发髋脱位的报道较少,可能与发病率较低,临床不易发现有关。本文从脊髓损伤后髋脱位的流行病学、发病原因、诊断、预防及治疗方面进行阐述。%Patients with spinal cord injury would suffer many complications including hip abnormities. Few reports on spinal cord inju-ry with hip dislocation had been published because of a lower incidence and difficulty to be found in clinical practice. This paper reviewed epidemiology, etiology, diagnosis, prevention and treatment of hip dislocation after spinal cord injury.

  18. Taper Hip Prosthesis

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

  19. Atomistic simulations of dislocation processes in copper

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

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

  20. Slip systems, lattice rotations and dislocation boundaries

    Winther, Grethe

    of dislocation structure formed, in particular the crystallographic alignment of dislocation boundaries, and the slip pattern are demonstrated. These relations are applied to polycrystals deformed in tension and rolling, producing good agreement with experiment for rolling but less good agreement for......Plastic deformation by slip induces rotations of the crystallographic lattice and evolution of dislocation structures. Both lattice rotations and dislocation structures exhibit a dependence on the grain orientation, which reflects underlying relations to the slip pattern. Relations between the type...... these discrepancies is discussed. Finally, the implications of the relations between slip and dislocation structures for the modelling of mechanical properties are discussed....

  1. Kinetic Monte Carlo simulation of dislocation dynamics

    A kinetic Monte Carlo simulation of dislocation motion is introduced. The dislocations are assumed to be composed of pure edge and screw segments confined to a fixed lattice. The stress and temperature dependence of the dislocation velocity is studied, and finite-size effects are discussed. It is argued that surfaces and boundaries may play a significant role in the velocity of dislocations. The simulated dislocations are shown to display kinetic roughening according to the exponents predicted by the Kardar-Parisi-Zhang equation. copyright 1999 The American Physical Society

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

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

    2015-11-01

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

  3. Congenital angular deformities of the leg : congenital pseudoarthrosis and congenital posteromedial angulation of the tibia

    Güner, Dr. Güntekin; Elmalı, Dr. Nurzat; Ayan, Dr. İrfan; Ataşlı, Dr. Nusret

    1996-01-01

    Congenital angular deformities of the leg are rare. Congenital anterolateral angulation of the tibia is a complex deformity which needs close observation because, fracture and pseudoarthrosis are always potential risk. Here we report 4 cases in which two had congenital pseudoarthrosis of the tibia and the other two had congenital posteromedial angulation of the tibia which were managed between 1994-1996 and the related literature were reviewed. [Journal of Turgut Ozal Medical Center 1996;3(4)...

  4. 髋关节强直人工关节置换术治疗分析%Experience of hip artificial joint replacement in the treatment of ankylosis of hip joint

    冯国英; 王心宽; 张辉; 刘铁军

    2014-01-01

    Objective To investigate the clinical curative effect and the technique of hip artificial joint replacement in the treatment of ankylosis of hip joint.Methods A retrospective data of 19 patients with hip joint ankylosis operated by artificial joint replacement was reviewed between July 2010 and June 2013 in our hospital.The hipfusion due to ankylosing spondylitis was in 15 cases; congenital acetabular dysplasia and osteoarthritis were in 3 cases; ischemic necrosis of femoral head was in 1 case.The history of all the cases was 5-40 years in which 15 cases of hip joint was complete rigidity and no activity with hip 10 °-45 ° of adduction and flexion.The preoperative,intraoperative and postoperative data were summarized.Results Totally 19 cases were all followed up and the follow-up time was 0.5-3.5 years.All the patients had no complications after operation,such as nerve,vascular injury,acute pulmonary embolism,acute renal and heart failure,pulmonary infection and deep vein thrombosis.During the follow-up period,all the patients had no dislocation,loosening prosthesis and delayed infection.The postoperative activity of hip joint was significantly improved after operation.There were 3 cases (15.8%) of heterotopic ossification.Conclusions Artificial joint replacement is an ideal method in the treatment of hip joint ankylosis,which can significantly improve the joint function and the quality of life.Intraoperative technology directly affects the effect after operation.The lateral approach of hip joint has a lot of advantages and can effectively prevent the dislocation after artificial joint replacement.%目的 探讨髋关节强直人工关节置换手术的临床疗效和技术要点.方法 回顾性分析自2010年7月至2013年6月在北京市通州区中西医结合医院住院的19例髋关节强直患者经过人工关节置换手术后的临床资料.其中强直性脊柱炎髋关节融合15例,先天性髋臼发育不良伴骨性关节炎3

  5. Solute drag on perfect and extended dislocations

    Sills, R. B.; Cai, W.

    2016-04-01

    The drag force exerted on a moving dislocation by a field of mobile solutes is studied in the steady state. The drag force is numerically calculated as a function of the dislocation velocity for both perfect and extended dislocations. The sensitivity of the non-dimensionalized force-velocity curve to the various controlling parameters is assessed, and an approximate analytical force-velocity expression is given. A non-dimensional parameter S characterizing the strength of the solute-dislocation interaction, the background solute fraction ?, and the dislocation character angle ?, are found to have the strongest influence on the force-velocity curve. Within the model considered here, a perfect screw dislocation experiences no solute drag, but an extended screw dislocation experiences a non-zero drag force that is about 10 to 30% of the drag on an extended edge dislocation. The solutes can change the spacing between the Shockley partials in both stationary and moving extended dislocations, even when the stacking fault energy remains unaltered. Under certain conditions, the solutes destabilize an extended dislocation by either collapsing it into a perfect dislocation or causing the partials to separate unboundedly. It is proposed that the latter instability may lead to the formation of large faulted areas and deformation twins in low stacking fault energy materials containing solutes, consistent with experimental observations of copper and stainless steel containing hydrogen.

  6. Discrete dislocation dynamics simulations in a cylinder

    Li, Maosheng; Gao, Chan; Xu, Jianing

    2015-02-01

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

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

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

    2013-01-01

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

  8. Evolution of geometrically necessary dislocation density from computational dislocation dynamics

    This paper presents a method for calculating GND densities in dislocation dynamics simulations. Evolution of suitably defined averages of GND density as well as maps showing the spatial nonuniform distribution of GNDs are analyzed under uniaxial loading. Focus is laid on the resolution dependence of the very notion of GND density, its dependence upon physical dimensions of plastically deformed specimens and its sensitivity to initial conditions. Acknowledgments Support from the National Science Foundation (CMMI-0748187) is gratefully acknowledged.

  9. Evolution of geometrically necessary dislocation density from computational dislocation dynamics

    Guruprasad, P J; Benzerga, A A, E-mail: pjguru@tamu.edu, E-mail: benzerga@aero.tamu.edu [Department of Aerospace Engineering, Texas A and M University, College Station, TX 77843-3141 (United States)

    2009-07-15

    This paper presents a method for calculating GND densities in dislocation dynamics simulations. Evolution of suitably defined averages of GND density as well as maps showing the spatial nonuniform distribution of GNDs are analyzed under uniaxial loading. Focus is laid on the resolution dependence of the very notion of GND density, its dependence upon physical dimensions of plastically deformed specimens and its sensitivity to initial conditions. Acknowledgments Support from the National Science Foundation (CMMI-0748187) is gratefully acknowledged.

  10. Congenital CMV Infection

    ... infect the baby. This can happen when a pregnant woman experiences a first-time infection, a reinfection with a different CMV strain (variety), ... passed their newborn hearing test. Diagnosis Congenital CMV ... newborn baby’s saliva, urine, or blood. Such specimens must be collected for ...

  11. Congenital heart disease

    1997-01-01

    970296 Evaluating the degree of pulmonary vascularlesions in congenital heart disease with selective pul-monary angiography. PAN Shiwei(潘世伟), et al.Fuwai Hosp, CAMS & PUMC, Beijing, 100037. Chin JCardiol 1997; 25(1): 39-41. Objective: To evaluate the degree of pulmonary vas-

  12. CONGENITAL PATELLA LUXATION

    Cakmak, Mehmet; Taser, Omer; Domanic, Unsal; Temelli, Yener; Karamehmetoglu, Mahmut

    2004-01-01

    Five cases of congenital patella luxation which is rarely seen, have been presented. The diagnosis and treatment problems of this disease have been discussed in our cases with literature on the subject. It was concluded the method of the plastic of Williams-Picat quadriceps performed in the unification with the method of Krogius is the most appropriate form of treatment.

  13. Congenital Lumbar Hernia

    Sanjay Sharma; Gagan Bali; Satish Parihar; Neeraj Koul

    2008-01-01

    Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

  14. Congenital Lumbar Hernia

    Sanjay Sharma

    2008-01-01

    Full Text Available Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

  15. Congenital Absence of Tibia

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

    2002-10-01

    Full Text Available Congenital absence of tibia is a rare anomaly. We repol1 a case who presented at the age of 3 years withabsence of tibia right side with associated anomolies and was managed by reconstruction of the kneeand ankle joints b transfer of fibula

  16. Severe congenital neutropenia

    Borregaard, Niels

    2014-01-01

    In this issue of Blood, Tidwell et al1 demonstrate that mutations in the start codon (protein synthesis is initiated at the codon ATG) of neutrophil elastase (ELANE) result in the production of N-terminally truncated elastase, which mislocates to the nucleus and results in severe congenital neutr...... neutropenia (SCN)....

  17. Bilateral Congenital Diaphragmatic Hernia

    Dhua, Anjan K; Aggarwal, Satish K; NB Mathur; GR Sethi

    2012-01-01

    Bilateral congenital diaphragmatic hernia (CDH) is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension.

  18. Congenital temporal triangular alopecia.

    Bargman, H

    1984-01-01

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

  19. DEVELOPMENTAL DYSPLASIA OF THE HIP AT SEVEN YEARS OF AGE TREATED WITH OPEN REDUCTION AND FEMORAL DEROTATION OSTEOTOMY AND PEMBERTON ACETABULOPLASTY: A CASE REPORT

    Somashekar

    2014-03-01

    Full Text Available DDH includes a spectrum of disorders affecting a developing hip joint, varying from an occult dysplasia to frank dislocation. Since the hip joint at birth is purely cartilaginous the chances of missing this condition is very high. High degree of suspicion is essential to make sure that cases are detected early. Difficulty in changing the diapers may be any early indicator of occult dysplasia.

  20. The Modified Steel Pelvis Three- point Osteotomy and Subtrochanteric Rotary Osteotomy for Treating the Congenital Dislocations of Hip Joint in Old Children%改良Steel骨盆三点截骨及股骨粗隆下旋转截骨术治疗大龄先髋脱位

    许屾; 刘祥清; 李洪恩; 张印峰; 李国建; 李伟元; 高伟; 徐昌建

    2006-01-01

    目的:探讨大龄先天性髋关节脱位手术治疗的有效方法.方法:应用改良Steel骨盆三点截骨及股骨粗隆下旋转短缩截骨治疗大龄先天性髋关节脱位38例46髋.结果:38例46髋中,32例40髋随访15~144个月,平均36个月.参照Mckay评定标准,优良率达90%.结论:改良Steel骨盆三点截骨及股骨粗隆下旋转截骨术,是一种治疗大龄先髋脱位简单有效的方法.

  1. 新生儿及婴儿早期髋脱位及髋发育不良的X线诊断应用研究%Early X-ray Diagnosis of Congenital Dislocation and Developmental Dysplasia of the Hip in Newborn and Infant

    贺明礼; 赖华; 王苏民; 喻少聪; 张冠楠; 周艳

    2007-01-01

    目的 探讨婴儿髋关节脱位(CDH)及髋关节发育不良(DDH)的早期X线诊断方法.方法 经临床随访证实的26例CDH及DDH婴儿47个患髋和30例正常婴儿60个正常髋关节用X线对照的方法寻求婴儿早期CDH及DDH诊断方法,统计学卡方检验.结果 (1)婴儿早期正常髋臼形态为清晰的"一"字形,模糊"一"字形或形态不清应视为异常,敏感度为100%,特异度为91.59%,准确度为85%.统计学比较显示P<0.05;(2)3个月以内婴儿正常髋臼指数应<30°;(3)研究组的47个患髋中闭孔线阳性18髋(其中10髋为CDH),阴性29髋,对照组30例60个正常髋闭孔线阳性2髋,阴性58髋,敏感度为38.3%,特异度为96.7%,准确度为71.1%.统计学比较显示P<0.05;(4)研究组26例47个患髋股骨颈轴线阳性10髋(后均证实为CDH),可疑17髋(后证实13髋为DDH),阴性20髋,对照组30例60个正常髋股骨颈轴线阳性1髋,可疑0髋,阴性59髋,敏感度为57.45%,特异度为98.33%,准确度为80.37%.统计学比较显示P<0.001.结论 闭孔线结合股骨颈轴线可诊断新生儿及婴儿早期CDH;髋臼形态异常可提示DDH.

  2. 96例先天性髋关节脱位和髋关节发育不良的早期超声诊断%Early Diagnosis of Congenital Dislocation and Dysplasia of the Hip by Ultrasonography in 96 Cases

    全学模; 梁猷惠; 陈文龙; 胡汶竹; 刘正全; 张德文

    1991-01-01

    本文对正常小儿613例(1 226个髋关节)行超声观察分析,提出先天性髋关节脱位的诊断标准和分型方法.作者检查患儿107例,发现96例(140个髋关节)为先天性髋关节脱位或髋关节发育不良,结果与同期X片检查相符,超声优于X片,能早期观察股骨头和髋臼软骨发育状况.

  3. Preoperative planning and postoperative evaluation of total hip arthroplasty that takes combined anteversion.

    Imai, Hiroshi; Miyawaki, Joji; Kamada, Tomomi; Takeba, Jun; Mashima, Naohiko; Miura, Hiromasa

    2016-07-01

    The purpose of this study was to investigate whether postoperative combined anteversion (CA) can be kept within the safe zone while using cementless total hip arthroplasty (THA) using the operative technique which prepares the socket first for developmental dysplasia of the hip (DDH), by estimating the anteversion of the metaphyseal fit stem using preoperative three-dimensional (3D) computerized planning and by adjusting the anteversion of the socket using a navigation system that considers CA. Our subjects were 65 patients (65 hips) that had undergone cementless THA for DDH that could be observed for 1 year or more. Clinical assessments were made using the Japanese Orthopaedic Association's (JOA) hip score. For a radiological evaluation, we investigated 3D-planned stem versions, postoperative stem versions, preoperative and postoperative CA, and the relationship between CA and dislocation tendencies with temporary intraoperative reductions. JOA hip scores improved from 52.3 ± 11.4 points to 88.9 ± 8.6 points. CT evaluations revealed that 3D-planned stem versions were strongly correlated with postoperative stem versions (r = 0.80; p hips. No intraoperative dislocation tendencies were observed in any hips. By estimating the anteversion of the cementless metaphyseal fit stem using 3D planning preoperatively and adjusting the angle of anteversion of the socket using a navigation system that considers CA intraoperatively, postoperative CA can very frequently be kept within the safe zone, even with cementless THA using the operative technique which prepares the socket first for DDH. PMID:27154291

  4. Simultaneous shoulder and elbow dislocation

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; Karataş, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to emergency service but she was diagnosed with simultaneous ipsilateral shoulder and elbow injury and treated conservatively. As a more painful pathology may mask the additional ones, one should hasten to help before performing a complete evaluation. Any harm caused to the patient due to this reason would not be a complication but a malpractice. PMID:24859563

  5. Lisfranc fracture dislocation. Clinical case

    Lora-Fernández Alberto Carlos; Cabarcas-Montes Gustavo

    2010-01-01

    The Lisfranc fracture dislocation is a serious lesion occur in tarsometatarsian joint and produce importants consequence, for anatomic complexiti of this foot area. The injury mechanisms ocasionality is asociated to automovilistic accidents. Our report of a clinical case into a patient endure fall since 8 meter altitud. Quirurgical manegement was make, open reduction and osteosíntesis with Kirschner nails. Favorable evolution and adecuate reponse to rehabilitation.RESUMENLa luxofractura de Li...

  6. Lattice dislocation in Si nanowires

    Omar, M.S., E-mail: dr_m_s_omar@yahoo.co [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq); Taha, H.T. [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq)

    2009-12-15

    Modified formulas were used to calculate lattice thermal expansion, specific heat and Bulk modulus for Si nanowires with diameters of 115, 56, 37 and 22 nm. From these values and Gruneisen parameter taken from reference, mean lattice volumes were found to be as 20.03 A{sup 3} for the bulk and 23.63, 29.91, 34.69 and 40.46 A{sup 3} for Si nanowire diameters mentioned above, respectively. Their mean bonding length was calculated to be as 0.235 nm for the bulk and 0.248, 0.269, 0.282 and 0.297 nm for the nanowires diameter mentioned above, respectively. By dividing the nanowires diameter on the mean bonding length, number of layers per each nanowire size was found to be as 230, 104, 65 and 37 for the diameters mentioned above, respectively. Lattice dislocations in 22 nm diameter wire were found to be from 0.00324 nm for the 1st central lattice to 0.2579 nm for the last surface lattice. Such dislocation was smaller for larger wire diameters. Dislocation concentration found to change in Si nanowires according to the proportionalities of surface thickness to nanowire radius ratios.

  7. 3D Dislocation dynamics modelling of interactions between prismatic loops and mobile dislocations in pure iron

    Novokshanov, Roman [Department of Materials, University of Oxford, Oxford (United Kingdom)], E-mail: novoksha@maths.ox.ac.uk; Roberts, Steve [Department of Materials, University of Oxford, Oxford (United Kingdom)

    2009-04-30

    3D Dislocation dynamics simulations have been carried out to model the interaction between prismatic loops and dislocations in pure iron subject to uniaxial loading conditions. The primary goal was to understand the mechanism of interaction of an a/2 <1 1 1> interstitial loop and a mobile dislocation. The secondary goal was to investigate the dependence of the critical stress needed for dislocations to overcome the obstacles as a function of size of loops and their orientation with respect to the glide plane. The simulations have shown a complicated 3D interaction resulting in the mobile dislocation bowing around a loop, either reacting with the loop dislocation or leaving it behind unchanged.

  8. Total hip replacement in young adults with hip dysplasia

    Engesæter, Ingvild Ø; Lehmann, Trude; Laborie, Lene B; Lie, Stein Atle; Rosendahl, Karen; Engesæter, Lars B

    2011-01-01

    Background and purpose Dysplasia of the hip increases the risk of secondary degenerative change and subsequent total hip replacement. Here we report on age at diagnosis of dysplasia, previous treatment, and quality of life for patients born after 1967 and registered with a total hip replacement due to dysplasia in the Norwegian Arthroplasty Register. We also used the medical records to validate the diagnosis reported by the orthopedic surgeon to the register. Methods Subjects born after Janua...

  9. Visualization of dislocation dynamics in colloidal crystals.

    Schall, Peter; Cohen, Itai; Weitz, David A; Spaepen, Frans

    2004-09-24

    The dominant mechanism for creating large irreversible strain in atomic crystals is the motion of dislocations, a class of line defects in the crystalline lattice. Here we show that the motion of dislocations can also be observed in strained colloidal crystals, allowing detailed investigation of their topology and propagation. We describe a laser diffraction microscopy setup used to study the growth and structure of misfit dislocations in colloidal crystalline films. Complementary microscopic information at the single-particle level is obtained with a laser scanning confocal microscope. The combination of these two techniques enables us to study dislocations over a range of length scales, allowing us to determine important parameters of misfit dislocations such as critical film thickness, dislocation density, Burgers vector, and lattice resistance to dislocation motion. We identify the observed dislocations as Shockley partials that bound stacking faults of vanishing energy. Remarkably, we find that even on the scale of a few lattice vectors, the dislocation behavior is well described by the continuum approach commonly used to describe dislocations in atomic crystals. PMID:15448265

  10. Congenital intestinal lymphangiectasia

    Popović Dušan Đ.

    2011-01-01

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

  11. Congenital diaphramatic hernia

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

    2012-01-15

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

  12. Heterotopic ossification after hip arthroscopy.

    Amar, Eyal; Sharfman, Zachary T; Rath, Ehud

    2015-12-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy. PMID:27011859

  13. Heterotopic ossification after hip arthroscopy

    Amar, Eyal; Sharfman, Zachary T.; Rath, Ehud

    2015-01-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy.

  14. 骨盆相关数据测量对髋臼发育不良髋臼定位的临床意义%Clinical implication of pelvic measurements on acetabular component location in developmental dysplasia of the hip

    杭柏亚; 曲广运

    2007-01-01

    [目的]通过对中国南方50例单侧髋关节置换患者的全骨盆X线片相关数据的测量与分析,来验证JF Crowe在"Total hip replacement in congenital dislocation and dysplasia of the hip"(J.Bone Joint Surg.Am,1979,61:15-23)一文中提到的"股骨头颈交点与股骨头上缘的垂直距离跟坐骨结节下缘与髂骨最高点的垂直距离的比率是20%"的准确性,进而提出国人髋臼发育不良真臼的正确定位.目前国内外尚无新的报道.[方法]测量股骨头颈交点与股骨头上缘的垂直距离(BC),测量坐骨结节下缘与髂骨最高点的垂直距离(AD),计算BC与AD的比率.[结果]50例样本平均值为20.2%,与Crowe观察的结果吻合,其中女性为19.5%,男性为21.3%.[结论]对于髋臼发育不良或者髋关节发育不良的患者,对于真臼的定位可以按照这个比率进行正确的定位.

  15. Congenital imprinting disorders

    Eggermann, Thomas; Netchine, Irène; Temple, I Karen;

    2015-01-01

    consortium EUCID.net (European network of congenital imprinting disorders) now aims to promote better clinical care and scientific investigation of imprinting disorders by establishing a concerted multidisciplinary alliance of clinicians, researchers, patients and families. By encompassing all IDs and...... specific clinical features, and, as each appeared to be associated with specific imprinting defects, they have been widely regarded as separate entities. However, they share clinical characteristics and can show overlapping molecular alterations. Nevertheless, IDs are usually studied separately despite...

  16. Congenital Cleft Hand

    Aritamur, Ayhan; Cakmak, Mehmet; Taser, Omer; Berk, Hasan

    2004-01-01

    Congenital cleft hand deformity, which is also known with such names as cleft hand, lobster claw hand and Ectrodactyiy, is characterized by the absence of one or two fingers in the mid portion of the hand. A case of bilateral cleft hand deformity four years old, which is considerabiy rare, was reconstructed surgically. The result obtained has been presented. Because no sufficient experience has accumulated due to the fact that it is observed considerably rare, the therapeutical principales re...

  17. Congenital Pulmonary Alveolar Proteinosis

    Saber Hammami; Khaled Harrathi; Khaled Lajmi; Samir Hadded; Chebil Ben Meriem; Mohamed Néji Guédiche

    2013-01-01

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

  18. Congenital Triangular Alopecia

    Yin Li, Vincent Chum; Yesudian, Paul Devakar

    2015-01-01

    Congenital triangular alopecia (CTA) also known as temporal triangular alopecia is a benign noncicatricial pattern of hair loss. It typically affects the frontotemporal region and rarely involves the temporoparietal or occipital scalp. It is a nonprogressive disorder that presents as a triangular, oval or lancet-shaped patch of alopecia. CTA can manifest at birth or develop later in life. The exact etiology of this condition remains unknown. Rarely, it may be associated with other disorders s...

  19. Congenital ocular motor apraxia

    Carrasquinho, S; Teixeira, S.; Cadete, A; Bernardo, M.; Pêgo, P; Prieto, I.

    2008-01-01

    PURPOSE: Congenital ocular motor apraxia is a rare disease characterized by defective or absent voluntary and optically induced horizontal saccadic movements. Jerky head movements or thrusts on attempted lateral gaze are a compensatory sign. Most affected children have delayed motor and speech development. Cases associated with systemic diseases, neurologic maldevelopment, metabolic deficits, and chromosomal abnormalities have been described. METHODS: Case report and review of the scienti...

  20. Congenital syphilis surveillance

    Antonella Marangoni; Alessandra Moroni; Elisabetta Tridapalli; Maria Grazia Capretti; Antonietta D’Antuono; Marina Biagi; Sanzio Ruscello; Franca Savioli; Roberto Cevenini

    2011-01-01

    Congenital syphilis (CS) is mainly a consequence of the lack of antenatal care and control of sexually transmitted infections.The bedrock of the prevention of CS is syphilis diagnosis by serological screening during pregnancy.Current Italian guidelines suggest that all the pregnant women should be tested in the first trimester. Due to the frequently absence of specific signs of infection at birth, laboratory tests are often the only method for a correct CS diagnosis. The aim of this study was...

  1. Congenital nasal lipoma

    The authors describe a rare case of congenital lipoma of a nose and nasopharynx in a 7 months old girl. The tumor, about 7 x 2 cm was situated in the right nasal cavity and the nasopharynx. The tumor caused complete obstruction of the right side of the nose. After CT diagnosis the tumor was excised from intranasal approach. Histological examination disclosed lipoma. The duration of follow up was 10 months without any sight of recurrence. (author)

  2. Surgery for Congenital Cataract

    David Yorston FRCS FRCOphth

    2004-01-01

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

  3. Dislocation climb in GaAs

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

  4. Mobility Laws in Dislocation Dynamics Simulations

    Cai, W; Bulatov, V V

    2003-10-21

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

  5. Mobility laws in dislocation dynamics simulations

    Cai, Wei; Bulatov, Vasily V

    2004-12-15

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

  6. CONGENITAL DUODENAL OBSTRUCTIONS

    S.G. Aprodu

    2005-07-01

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

  7. On the measure of dislocation densities from diffraction line profiles: A comparison with discrete dislocation methods

    In this work the accuracy and range of applicability of peak broadening models, from which dislocation densities can be extracted, is studied. For that purpose dislocation microstructures are generated via a discrete dislocation dynamics method and the internal elastic strains within the simulated volume are calculated. Diffraction peaks are generated from the simulations and a whole pattern line profile analysis method based on the Wilkens model is used to quantify the dislocation densities associated with the simulated microstructures. The work is applied to the case of face-centered cubic crystals deforming in coplanar slip. The accuracy of the analytical models is quantified by considering realistic three-dimensional microstructures containing curved dislocations with a specified distribution. The dependence and sensitivity of the analytical models upon dislocation density and long-range order are investigated. It was found that, provided the distribution of dislocations is rather homogeneous, line profile analysis provides fairly accurate predictions of the dislocation density.

  8. A Numeric Study on Chaotic Dislocation Emission

    HonglaiTan; WeiYang

    1996-01-01

    Crack tip atom-string model is devised to study non-linear features of dislocation emission processes under mode II loads.Dynamic analysis shows that the atom motion at the crack tip changes from periodic to chaotic as the stress intensity factor increases.Study on the dislocation emission band reveals the phenomenon of cloud-like drifting of the dislocation core ahead of the crack tip.

  9. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    Hakan Cift; Salih Soylemez; Murat Demiroglu; Korhan Ozkan; Vahit Emre Ozden; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitat...

  10. The epidemiology of shoulder dislocations in Oslo

    Liavaag, S; Svenningsen, S; Reikerås, O.; Enger, M; Fjalestad, T; Pripp, A H; Brox, J I

    2011-01-01

    There are few previous studies on the incidence of shoulder dislocation in the general population. The aim of the study was to report the incidence of acute shoulder dislocations in the capital of Norway (Oslo) in 2009. Patients of all ages living in Oslo, sustaining a dislocation of the glenohumeral joint, were identified using electronic diagnosis registers, patient protocols, radiological registers of the hospitals, and the Norwegian Patient Register (NPR). The overall incidence rate was 5...

  11. Coupled dislocation and martensitic phase transformation dynamics

    Barros, Kipton; Acharya, Amit; Lookman, Turab

    2013-03-01

    We present a field theoretic model that couples dislocation dynamics and plasticity with martensitic phase transformation. Dislocations produce long-range stress via incompatibility of the elastic-distortion field. Phase transformations are modeled with a non-convex elastic potential that contains the crystal symmetries of austenite and martensite phases. We discuss the effects of dislocation dynamics on material microstructure produced under extreme conditions.

  12. Schizophrenia, antipsychotics and risk of hip fracture

    Sørensen, Holger J; Jensen, Signe O W; Nielsen, Jimmi

    2013-01-01

    (matched to 1:3 to schizophrenia controls without hip fracture), antipsychotic polypharmacy predicted hip fracture. Analyses among antipsychotic monotherapy patients showed no differential effect of individual antipsychotics. A dose-response relationship of hip fracture and lifetime antipsychotics...

  13. Treatment of end-stage hip disease by ceramic total hip arthroplasty with large diameter(36 mm) femoral head%大直径(36 mm)股骨头陶瓷对陶瓷全髋关节置换治疗终末期髋关节病的临床应用

    鲍海星; 严清; 孙俊; 李徽; 俞胜宝; 黄定安

    2014-01-01

    36mm diameter of femoral head .There were 30 male cases and 21 female cases with an average age of 54.2 years(20~79 years).The preoperative diagnosis showed there were 32 cases of avas-cular necrosis of the femoral head ,9 cases of secondary osteoarthritis due to congenital hip dysplasia ,5 cases of ankylosing spondyli-tis,4 cases of primary osteoarthritis ,and 1 case of rheumatoid arthritis .All the replacements were unilateral ones ,with 36mm diameter of femoral head,BIOLOX Delta composite ceramics on ceramic (four generation pottery) interface,acetabular cup and femoral stem being biological type.Results The average operation time,blood loss and the follow-up duration were 85min(55~130min).320ml(100~1 000 mL),and 4~15 months(average 7.6 months).Follow up included Harris score and X-ray.Postoperative Harris score improved from preoperative average 46 points(28~55 points) to 91.2 points(82~97 points).There were no dislocation ,infection,deep vein thrombosis.X-ray results showed no heterotopic ossification and prosthesis loosening ,no ceramic fracture and “squeaking”.There were 1 case of complicated intraoperative femoral shaft fracture ,treated with row wire fixation ,1 case of complicated acetabular bottom frac-ture,which was not treated due to the stability of acetabular prosthesis and healed in 3 months,1 case of DDH(Crowe II ) congenital hip dysplasia,which felt hip instability and was still in further follow-up.Conclusions Large diameter(36mm) of femoral head for ce-ramic total hip replacement ensures more joint activities ,low rate of dislocation ,low interface wear rate ,which is more suitable for young patients.

  14. Hybrid Dislocated Control and General Hybrid Projective Dislocated Synchronization for Memristor Chaotic Oscillator System

    Junwei Sun; Chun Huang; Guangzhao Cui

    2014-01-01

    Some important dynamical properties of the memristor chaotic oscillator system have been studied in the paper. A novel hybrid dislocated control method and a general hybrid projective dislocated synchronization scheme have been realized for memristor chaotic oscillator system. The paper firstly presents hybrid dislocated control method for stabilizing chaos to the unstable equilibrium point. Based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization has been...

  15. Massively-Parallel Dislocation Dynamics Simulations

    Cai, W; Bulatov, V V; Pierce, T G; Hiratani, M; Rhee, M; Bartelt, M; Tang, M

    2003-06-18

    Prediction of the plastic strength of single crystals based on the collective dynamics of dislocations has been a challenge for computational materials science for a number of years. The difficulty lies in the inability of the existing dislocation dynamics (DD) codes to handle a sufficiently large number of dislocation lines, in order to be statistically representative and to reproduce experimentally observed microstructures. A new massively-parallel DD code is developed that is capable of modeling million-dislocation systems by employing thousands of processors. We discuss the general aspects of this code that make such large scale simulations possible, as well as a few initial simulation results.

  16. Anderson localization of light with topological dislocations

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

    2013-01-01

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

  17. Robust atomistic calculation of dislocation line tension

    Szajewski, B. A.; Pavia, F.; Curtin, W. A.

    2015-12-01

    The line tension Γ of a dislocation is an important and fundamental property ubiquitous to continuum scale models of metal plasticity. However, the precise value of Γ in a given material has proven difficult to assess, with literature values encompassing a wide range. Here results from a multiscale simulation and robust analysis of the dislocation line tension, for dislocation bow-out between pinning points, are presented for two widely-used interatomic potentials for Al. A central part of the analysis involves an effective Peierls stress applicable to curved dislocation structures that markedly differs from that of perfectly straight dislocations but is required to describe the bow-out both in loading and unloading. The line tensions for the two interatomic potentials are similar and provide robust numerical values for Al. Most importantly, the atomic results show notable differences with singular anisotropic elastic dislocation theory in that (i) the coefficient of the \\text{ln}(L) scaling with dislocation length L differs and (ii) the ratio of screw to edge line tension is smaller than predicted by anisotropic elasticity. These differences are attributed to local dislocation core interactions that remain beyond the scope of elasticity theory. The many differing literature values for Γ are attributed to various approximations and inaccuracies in previous approaches. The results here indicate that continuum line dislocation models, based on elasticity theory and various core-cut-off assumptions, may be fundamentally unable to reproduce full atomistic results, thus hampering the detailed predictive ability of such continuum models.

  18. Epidemiology of Isolated Acromioclavicular Joint Dislocation

    Claudio Chillemi

    2013-01-01

    Full Text Available Background. Acromioclavicular (AC joint dislocation is a common shoulder problem. However, information about the basic epidemiological features of this condition is scarce. The aim of this study is to analyze the epidemiology of isolated AC dislocation in an urban population. Materials and Methods. A retrospective database search was performed to identify all patients with an AC dislocation over a 5-year period. Gender, age, affected side and traumatic mechanism were taken into account. X-rays were reviewed by two of the authors and dislocations were classified according to the Rockwood’s criteria. Results. A total of 108 patients, with a mean age of 37.5 years were diagnosed with AC dislocation. 105 (97.2% had an isolated AC dislocation, and 3 (2.8% were associated with a clavicle fracture. The estimated incidence was 1.8 per 10000 inhabitants per year and the male-female ratio was 8.5 : 1. 50.5% of all dislocations occurred in individuals between the ages of 20 and 39 years. The most common traumatic mechanism was sport injury and the most common type of dislocation was Rockwood type III. Conclusions. Age between 20 and 39 years and male sex represent significant demographic risk factors for AC dislocation.

  19. Enabling Strain Hardening Simulations with Dislocation Dynamics

    Arsenlis, A; Cai, W

    2006-12-20

    Numerical algorithms for discrete dislocation dynamics simulations are investigated for the purpose of enabling strain hardening simulations of single crystals on massively parallel computers. The algorithms investigated include the /(N) calculation of forces, the equations of motion, time integration, adaptive mesh refinement, the treatment of dislocation core reactions, and the dynamic distribution of work on parallel computers. A simulation integrating all of these algorithmic elements using the Parallel Dislocation Simulator (ParaDiS) code is performed to understand their behavior in concert, and evaluate the overall numerical performance of dislocation dynamics simulations and their ability to accumulate percents of plastic strain.

  20. Dislocation-driven surface dynamics on solids.

    Kodambaka, S; Khare, S V; Swiech, W; Ohmori, K; Petrov, I; Greene, J E

    2004-05-01

    Dislocations are line defects that bound plastically deformed regions in crystalline solids. Dislocations terminating on the surface of materials can strongly influence nanostructural and interfacial stability, mechanical properties, chemical reactions, transport phenomena, and other surface processes. While most theoretical and experimental studies have focused on dislocation motion in bulk solids under applied stress and step formation due to dislocations at surfaces during crystal growth, very little is known about the effects of dislocations on surface dynamics and morphological evolution. Here we investigate the near-equilibrium dynamics of surface-terminated dislocations using low-energy electron microscopy. We observe, in real time, the thermally driven nucleation and shape-preserving growth of spiral steps rotating at constant temperature-dependent angular velocities around cores of dislocations terminating on the (111) surface of TiN in the absence of applied external stress or net mass change. We attribute this phenomenon to point-defect migration from the bulk to the surface along dislocation lines. Our results demonstrate that dislocation-mediated surface roughening can occur even in the absence of deposition or evaporation, and provide fundamental insights into mechanisms controlling nanostructural stability. PMID:15129275

  1. Interactions between dislocations and point defects

    Copper and copper-aluminum alloys were irradiated using a 3MV EM, and the interactions between straight dislocations and point defects were studied. Edge-dislocations climb up during irradiation and the interstitial-type loops are not formed around them. On the other hand, screw-dislocations turn into the helical ones by absorbing interstitials induced by irradiation. During irradiation, the number of helical turns do not change but the radius of helix increases. At the same time, the interstitial-type dislocation loops are formed close by the helical dislocations. The growth rate of these loops is the same as that of the radius of helical dislocations. From these facts, the sink efficiency of dislocations for point defects can be determined. Furthermore, when the fresh screw-dislocations are introduced by in-situ deformation during irradiation, the interstitial-type loops are preferentially formed on the active slip planes. The enhanced nucleation of the loops is closely related to the point defects formed by the motion of dislocation-jogs

  2. Moving dislocations studied by nuclear magnetic resonance

    Movements of dislocations in alkalihalogenides under strain conditions have been investigated by NMR techniques. From theory, it follows that electric quadrupole interactions contribute much more to dislocation motion than tripole interactions. Under the experimental conditions, the actual movement takes place in a time much shorter than 10-8 sec, and the period between successive jumps lasts much longer than 10-4 sec. The distance between the dislocations is found to vary from 5.10-4 cm to 5.10-5 in a deformation test. The mean distance covered by a moving dislocation agrees well with this distance

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

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

  4. Vojta method in the treatment of developmental hip dysplasia – a case report

    Dwornik, Michal; Kiebzak, Wojciech; Żurawski,Arkadiusz

    2016-01-01

    Wojciech Kiebzak,1,2 Arkadiusz Żurawski,2 Michał Dwornik3 1Center for Pediatrics, Regional Hospital in Kielce, Kielce, Poland; 2Department of Physiotherapy, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland; 3Department of Osteopathic Medicine and Physiotherapy, Medical College of Podkowa Lesna, Podkowa Lesna, Poland Background: Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and struct...

  5. Arthroscopic findings after shoulder dislocation

    Medenica Ivica

    2009-01-01

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

  6. Multiscale modeling of dislocation-precipitate interactions in Fe: From molecular dynamics to discrete dislocations

    Lehtinen, Arttu; Granberg, Fredric; Laurson, Lasse; Nordlund, Kai; Alava, Mikko J.

    2016-01-01

    The stress-driven motion of dislocations in crystalline solids, and thus the ensuing plastic deformation process, is greatly influenced by the presence or absence of various pointlike defects such as precipitates or solute atoms. These defects act as obstacles for dislocation motion and hence affect the mechanical properties of the material. Here we combine molecular dynamics studies with three-dimensional discrete dislocation dynamics simulations in order to model the interaction between different kinds of precipitates and a 1/2 {110 } edge dislocation in BCC iron. We have implemented immobile spherical precipitates into the ParaDis discrete dislocation dynamics code, with the dislocations interacting with the precipitates via a Gaussian potential, generating a normal force acting on the dislocation segments. The parameters used in the discrete dislocation dynamics simulations for the precipitate potential, the dislocation mobility, shear modulus, and dislocation core energy are obtained from molecular dynamics simulations. We compare the critical stresses needed to unpin the dislocation from the precipitate in molecular dynamics and discrete dislocation dynamics simulations in order to fit the two methods together and discuss the variety of the relevant pinning and depinning mechanisms.

  7. Hip Hip Hurrah! Hip size inversely related to heart disease and total mortality

    Heitmann, B L; Lissner, L

    2011-01-01

    obesity and/or waist circumference. These studies have been remarkable in terms of their consistency, and in the unexpected finding of an adverse effect of small hip size, after statistically correcting for differences in general and abdominal size. The hazard related to a small hip size may be stronger......During the past decade a series of published reports have examined the value of studying the relation between hip circumferences and cardiovascular end points. Specifically, in a series of recent studies the independent effects of hip circumference have been studied after adjustment for general...

  8. Genetics Home Reference: critical congenital heart disease

    ... Home Health Conditions critical congenital heart disease critical congenital heart disease Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Critical congenital heart disease (CCHD) is a term that refers to a ...

  9. Genetics Home Reference: congenital hepatic fibrosis

    ... Home Health Conditions congenital hepatic fibrosis congenital hepatic fibrosis Enable Javascript to view the expand/collapse boxes. ... All Open All Close All Description Congenital hepatic fibrosis is a disease of the liver that is ...

  10. Genetics Home Reference: congenital leptin deficiency

    ... Genetics Home Health Conditions congenital leptin deficiency congenital leptin deficiency Enable Javascript to view the expand/collapse ... Print All Open All Close All Description Congenital leptin deficiency is a condition that causes severe obesity ...

  11. Genetics Home Reference: Fukuyama congenital muscular dystrophy

    ... Health Conditions Fukuyama congenital muscular dystrophy Fukuyama congenital muscular dystrophy Enable Javascript to view the expand/collapse boxes. ... All Open All Close All Description Fukuyama congenital muscular dystrophy is an inherited condition that predominantly affects the ...

  12. Genetics Home Reference: severe congenital neutropenia

    ... Home Health Conditions severe congenital neutropenia severe congenital neutropenia Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Severe congenital neutropenia is a condition that causes affected individuals to ...

  13. Atomistic simulation of hydrogen dynamics near dislocations in vanadium hydrides

    Ogawa, Hiroshi, E-mail: h.ogawa@aist.go.jp

    2015-10-05

    Highlights: • Hydrogen–dislocation interaction was simulated by molecular dynamics method. • Different distribution of H atoms were observed at edge and screw dislocation. • Planner distribution of hydrogen may be caused by partialized edge dislocation. • Hydrogen diffusivity was reduced in both edge and screw dislocation models. • Pipe diffusion was observed for edge dislocation but not for screw dislocation. - Abstract: Kinetics of interstitial hydrogen atoms near dislocation cores were analyzed by atomistic simulation. Classical molecular dynamics method was applied to model structures of edge and screw dislocations in α-phase vanadium hydride. Simulation showed that hydrogen atoms aggregate near dislocation cores. The spatial distribution of hydrogen has a planner shape at edge dislocation due to dislocation partialization, and a cylindrical shape at screw dislocation. Simulated self-diffusion coefficients of hydrogen atoms in dislocation models were a half- to one-order lower than that of dislocation-free model. Arrhenius plot of self-diffusivity showed slightly different activation energies for edge and screw dislocations. Directional dependency of hydrogen diffusion near dislocation showed high and low diffusivity along edge and screw dislocation lines, respectively, hence so called ‘pipe diffusion’ possibly occur at edge dislocation but does not at screw dislocation.

  14. Atomistic simulation of hydrogen dynamics near dislocations in vanadium hydrides

    Highlights: • Hydrogen–dislocation interaction was simulated by molecular dynamics method. • Different distribution of H atoms were observed at edge and screw dislocation. • Planner distribution of hydrogen may be caused by partialized edge dislocation. • Hydrogen diffusivity was reduced in both edge and screw dislocation models. • Pipe diffusion was observed for edge dislocation but not for screw dislocation. - Abstract: Kinetics of interstitial hydrogen atoms near dislocation cores were analyzed by atomistic simulation. Classical molecular dynamics method was applied to model structures of edge and screw dislocations in α-phase vanadium hydride. Simulation showed that hydrogen atoms aggregate near dislocation cores. The spatial distribution of hydrogen has a planner shape at edge dislocation due to dislocation partialization, and a cylindrical shape at screw dislocation. Simulated self-diffusion coefficients of hydrogen atoms in dislocation models were a half- to one-order lower than that of dislocation-free model. Arrhenius plot of self-diffusivity showed slightly different activation energies for edge and screw dislocations. Directional dependency of hydrogen diffusion near dislocation showed high and low diffusivity along edge and screw dislocation lines, respectively, hence so called ‘pipe diffusion’ possibly occur at edge dislocation but does not at screw dislocation

  15. "Dislocation"

    Li Wei

    2006-01-01

    @@ Over the past five years since September 11, the international community has been highly focused on the increasingly serious terrorist threat. In order to strike the international terrorist force, with al Qaeda as its core, the United Nations Security Council has established a special counter-terrorism committee, drawing up 12 related resolutions, agreements and conventions; multilateral and bilateral counter-terrorism cooperation has been expanding and deepening unceasingly. Many countries have brought counter-terrorism into their national security strategy, established or revised relevant laws, increased the input of manpower, material resources, and funds, actively researched and developed new technology and strengthened all kinds of counter-terrorist measures. Theoretically, international society has created an "inescapable net" for terrorism.

  16. Hip-Hop Education Resources

    Hall, Marcella Runell

    2009-01-01

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

  17. Anterior Approach Total Hip Replacement

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

  18. Molecular and Genetic Studies of Congenital Myopathies

    2015-10-26

    Central Core Disease; Centronuclear Myopathy; Congenital Fiber Type Disproportion; Multiminicore Disease; Myotubular Myopathy; Nemaline Myopathy; Rigid Spine Muscular Dystrophy; Undefined Congenital Myopathy

  19. Dislocated interests and climate change

    Davis, Steven J.; Diffenbaugh, Noah

    2016-06-01

    The predicted effects of climate change on surface temperatures are now emergent and quantifiable. The recent letter by Hansen and Sato (2016 Environ. Res. Lett. 11 034009) adds to a growing number of studies showing that warming over the past four decades has shifted the distribution of temperatures higher almost everywhere, with the largest relative effects on summer temperatures in developing regions such as Africa, South America, southeast Asia, and the Middle East (e.g., Diffenbaugh and Scherer 2011 Clim. Change 107 615–24 Anderson 2011 Clim. Change 108 581; Mahlstein et al 2012 Geophys. Res. Lett. 39 L21711). Hansen and Sato emphasize that although these regions are warming disproportionately, their role in causing climate change—measured by cumulative historical CO2 emissions produced—is small compared to the US and Europe, where the relative change in temperatures has been less. This spatial and temporal mismatch of climate change impacts and the burning of fossil fuels is a critical dislocation of interests that, as the authors note, has ‘substantial implications for global energy and climate policies.’ Here, we place Hansen and Sato’s ‘national responsibilities’ into a broader conceptual framework of problematically dislocated interests, and briefly discuss the related challenges for global climate mitigation efforts.

  20. Evaluation of mobile dislocation density based on distribution function of dislocation segments

    周志敏; 孙艳蕊; 周海涛

    2004-01-01

    A function is offered to represent the distribution of reduced length of dislocation segments. The segment distribution of materials, e. g. , MgO and Cu, can be well described by taking appropriate values of parametersm and n. Based on this function, a model for evaluating the mobile dislocation density is developed. Provided the total dislocation density and applied stress are known, the mobile dislocation density could be readily assessed by using this model. For pure copper the mobile dislocation density and strain rates at deferent strains are evaluated. The calculated results are consistent with the known experimental data.