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Sample records for hip dislocation congenital

  1. Hip dysplasia and congenital hip dislocation

    International Nuclear Information System (INIS)

    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. (orig.)

  2. Congenital dislocation of hips in Malaysian neonates.

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    Boo, N Y; Rajaram, T

    1989-08-01

    A prospective study was carried out in the Maternity Hospital, Kuala Lumpur over a 2-year period. During this time, 52,379 deliveries took place. 36 neonates (0.7 per 1000 births) were found to have congenital dislocation of the hips (CDH) by both the Ortolani and Barlow's manoeuvre. CDH was most common in the females (female to male ratio was 2.3:1), the first borns (50% of the affected cases) and babies who had breech delivery (10.7 per 1000 births). In 21 (58.3%) of the affected neonates, CDH occurred in both hips. According to the classification of newborn infants' hips by Finlay et al, 88.9% of the neonates had unstable hips while 8.3% had pathological hips. Family history of CDH was present in 5% of the patients. 8 (22.2%) of the neonates had other associated congenital abnormalities. PMID:2814540

  3. Screening for congenital dislocation of the hip

    International Nuclear Information System (INIS)

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

  4. Congenital hip dislocation: Radiological screening or diagnosis?

    International Nuclear Information System (INIS)

    Congenital hip dislocation is a perfect example of public health problems: its incidence is high 0.6, to 2% of newborns in France and an early detection allows an easy and successful treatment. The current situation in our country is not satisfactory for several reasons: - Too many children are treated without reasons because of misleading radiological pictures; - Conversely, some dislocations are discovered only at the walking age, the treatment becoming then more difficult and less effective; - Almost 300,000 radiological examinations of the hip for screening are performed each year and among them 100,000 in newborns. This is not satisfactory as it is commonly admitted now that radiological examination at birth is unreliable and frequently misleading. For all these reasons a special working group has been settled up by the General Direction of Health, including physicians of different practices, from different specialities. The conclusion of this group will be published in a special booklet and can be summarized as follows: The group recommends to perform detection of congenital hip dislocation mainly by the clinical examination. This examination may be difficult but it must be performed very early, the first day of life, repeated several times, at the end of the first week and during the first, second, and third month. Every baby in this country must undergo several clinical examinations up to one year of age

  5. Late presentation of congenital dislocation of the hip: an audit.

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    Gillam, S J; FOSS, M.; Woolaway, M

    1990-01-01

    Despite the widespread introduction of neonatal screening programmes, the late presentation of congenital dislocation of the hip remains a considerable problem. Important gaps in our understanding of the natural history of this condition make it difficult to assess the effectiveness of screening. An audit of late presenting cases of congenital dislocation of the hip in south Bedfordshire between 1980 and 1988 suggests that improved liaison between hospital doctors and general practitioners an...

  6. MR imaging evaluation of persistent congenital hip dislocation in children

    International Nuclear Information System (INIS)

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

  7. Infantile and congenital hip dislocation: Assessment by MR imaging

    International Nuclear Information System (INIS)

    Dislocations of the infant hip, particularly those that responded poorly to standard treatment, were imaged using a 1.5-T MR imaging unit. Excellent detail of the cartilaginous structures of the femoral head, acetabulum, labrum, pulvinar, and capsular abnormalities was achieved. The most detailed images were obtained using a 3-inch surface coil. The shape and orientation of the acetabulum and femoral head cannot otherwise be as well evaluated, nor can their relationship be as clearly established. Technical factors and considerations of imaging with a 1.5-T magnet, the anatomy of the normal and dislocated hip, and observed variations in acetabular shape and orientation are discussed. MR imaging reliably demonstrates dislocation, and the prolonged T2 of synovial fluid produced an ''arthrogram'' effect, which is useful in the treatment of complicated hip dislocation

  8. Total hip replacement in the congenitally dislocated hip using the Paavilainen technique

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    Thorup, Bjørn; Søballe, Kjeld

    2009-01-01

    Background and purpose Total hip replacement (THR) in congenitally dislocated hips (CDHs) according to Paavilainen includes placement of the cup in the original acetabulum and an extended trochanteric osteotomy with distal advancement of the trochanter. There have only been a few reports describing the outcome of this technique. Thus, we report the results of 19 THRs using the Paavilainen technique. Methods 10 women and 5 men with an average age of 38 (16–73) years at the time of surgery (19 hips) were followed for mean 4.8 (1.5–10) years. The patients were evaluated clinically with the Harris hip score (HHS) and radiographically using the Gruen and Charnley classification. Results All patients experienced substantial improvement in walking ability and relief of pain. Trendelenburg test was positive in 18 hips preoperatively, and only in 1 postoperatively. 1 case had transient incomplete peroneal palsy. There were 4 cases of intraoperative fissures of the proximal femur. No infections occurred, and no aseptic loosening was observed. 3 hips dislocated in the follow-up period; 2 were reduced open and 1 had a closed reduction. Due to wear of the polyethylene, 3 patients needed replacement of the liner. Interpretation These intermediate to long-term results indicate that the Paavilainen technique provides a functional hip with a limited rate of complications. Wear of the polyethylene liner is, however, still an unresolved issue. PMID:19424878

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

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    Mukesh Tiwari

    2013-04-01

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

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

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    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

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

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    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

  12. Ultrasound screening and follow-up of congenital hip dislocation

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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)

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

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    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 month of the age. The complex does not include two patients with teratological dislocation, the incidence of which has been determined in our study by the ratio of 2 cases in 35,550 of timely examined newborns. The role of the factor of spontaneous stabilization cannot be in this part of the study completely discounted. However, herewith we present part of an accomplished epidemiological study where the number of timely diagnosed patients including late diagnoses corresponds to the number of dislocations and subluxations determined within the conventional late diagnosis. PMID:2275305

  15. Magnetic resonance imaging of congenital dislocation of the hip with avascular necrosis of the femoral head

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) was performed on 22 patients (24 joints) with congenital dislocation of the hip (CDH) with avascular necrosis. T1 and T2 weighted images were obtained using spin echo techniques. Since positive images of the articular cartilage were obtained, it was possible to clearly image flattening or thickening of the articular cartilage of the femoral head and acetabulum in the coronal and in the axial plane of the T1 weighted image. There was a high intensity region in the femoral head with avascular necrosis in the coronal T2 weighted image. The wideness of the region increased with severity. Much information can be obtained with MRI and it is a useful technique in evaluating the pathology of CDH with avascular necrosis. (author)

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

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    Strelkova I.G.

    2012-12-01

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

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

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    Pozdniakova ?.N.

    2011-06-01

    Full Text Available The aim of the research was to develop a new rehabilitation method for patients with congenital dislocation of hip in the late postoperative period. It is based on anatomical, physiological, pathogenetic, functional and ontogenetic foundations and prevents coxarthrosis development and progress. Materials. The data from examination and treatment of 71 patients are presented. The main group consisted of 48 children and the comparison group consisted of 23 children. Methods. Data processing was made by «Statistica 6,0» programme. Normalcy of distribution was estimated by the Shapiro-Wilktest. Hypothesis proof of two means equality was provided by the Wilcoxon signed-ranktest. Correlation analysis was made by definition of the Pearson correlation coefficient and the Spearman»s rank correlation coefficient. Rate difference was considered as a reliable rate if p<0,05. Results. According to the results, a proper short-term gait stereotype formation has been attained as opposed to the routine rehabilitation methods. Conclusion. Due to advantages of the new method, therapy efficiency is extended and reoperation risks are decreased

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

    International Nuclear Information System (INIS)

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

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

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    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

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

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    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.

  1. The ranking of computed tomography in congenital hip dysplasia and hip dislocation

    International Nuclear Information System (INIS)

    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. (orig.)

  2. X-ray method for diagnosis of congenital dislocation of the hip in children

    International Nuclear Information System (INIS)

    The method proposed is easy for application even for infants from 0 to 3 months of age. The diagnosis is made by two points, which makes it more reliable for dislocation determination. The method could be used also for providing control on the treatment process. Auxiliary lines are drawn from the outmost contours of the acetabular fossae which in normal hip joints cross each other at a point in the middle of the symphysis. In case of left-sided dislocation the crossing point of the auxiliary lines is displaced to the left from the midsymphysis and in right-sided dislocation - to the right. In case of bilateral dislocation the diagnosis is established by extending the auxiliary lines beyond their crossing point, which depends on the distance caudally from the lesser trochanter, where they cross the opposite femoral bone. 9 refs

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

    International Nuclear Information System (INIS)

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

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

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    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

  5. Cost-benefit evaluation of systematic radiological diagnosis of congenital dislocated hip

    International Nuclear Information System (INIS)

    The interest of radiological mass screening of congential dislocated hip is still debated. We have tried to evaluate the cost-benefit ratio of radiological detection at the age of 3-4 months, taking into account the socio-economic cost and radiation risk. Assuming a frequency of this disorder of 1% the average cost of treatment of one case detected by X-ray screening at the age of 3-4 months, including the price of X-ray examinations of 99 normal babies is 23.374 FF. The average cost of treatment of a case detected at walking-age, i.e. after 9 months, is 84.230 FF. The cost-benefit ratio is 3.6. In countries where the frequency reaches 2% the cost benefit ratio is 4.57. It also appears from our study that the irradiation of the patient is much smaller when the diagnosis is made earlier. Comparing the slight irradiation delivered to normal infants by this mass screening to the heavy irradiation received by a few individuals whose treatment is started after 9 months, the calculated risk of leukemia or of genetic disorder for the whole population still favours a systematic X-ray film of the pelvis at age 3-4 months. However, if it were decided to make obligatory this mass radiological detection programme during the fourth month of life, this would necessitate a serious effort to train all radiologists to obtain adequate films with the best radiation protection. (orig.)

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

    International Nuclear Information System (INIS)

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

  7. Anteversion of the femoral neck in congenital dislocation of the hip.

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    Koshimune,Gisaburo

    1985-06-01

    Full Text Available A ten year follow-up study was made of 107 hips of 97 patients to find if derotation osteotomy affected the growth of the hip joint. The anteversion angles before and after treatment were measured in four groups classified according to treatment method: Pavlik harness, frog plaster, Colonna operation and derotation osteotomy. The difference in the angle was greatest in the derotation osteotomy group. However, no significant relation between the CE angles and the anteversion angles or the degree of derotation at the time of the follow-up study was found. The author concluded that the growth of the hip is not influenced by the extent of anteversion as much as was previously believed before.

  8. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

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    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.

  9. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    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

  10. Dysplasia of the contralateral hip in patients with unilateral late-detected congenital dislocation of the hip: 50 years' follow-up of 48 patients.

    Science.gov (United States)

    Terjesen, T

    2014-09-01

    The aim of this study was to investigate the incidence of dysplasia in the 'normal' contralateral hip in patients with unilateral developmental dislocation of the hip (DDH) and to evaluate the long-term prognosis of such hips. A total of 48 patients (40 girls and eight boys) were treated for late-detected unilateral DDH between 1958 and 1962. After preliminary skin traction, closed reduction was achieved at a mean age of 17.8 months (4 to 65) in all except one patient who needed open reduction. In 25 patients early derotation femoral osteotomy of the contralateral hip had been undertaken within three years of reduction, and later surgery in ten patients. Radiographs taken during childhood and adulthood were reviewed. The mean age of the patients was 50.9 years (43 to 55) at the time of the latest radiological review. In all, eight patients (17%) developed dysplasia of the contralateral hip, defined as a centre-edge (CE) angle femoral head; the dysplasia improved in two after varus femoral osteotomy and in two after an acetabular shelf operation. During long-term follow-up the dysplasia deteriorated to subluxation in two patients (CE angles 4° and 5°, respectively) who both developed osteoarthritis (OA), and one of these underwent total hip replacement at the age of 49 years. In conclusion, the long-term prognosis for the contralateral hip was relatively good, as OA occurred in only two hips (4%) at a mean follow-up of 50 years. Regular review of the 'normal' side is indicated, and corrective surgery should be undertaken in those who develop subluxation. PMID:25183584

  11. Study of hip joint dislocation after total hip arthroplasty

    OpenAIRE

    Masaoka, Toshinori; Yamamoto, Kengo; Shishido, Takaaki; Katori, Yoichi; Mizoue, Tatsuro; Shirasu, Hideo; Nunoda, Daisuke

    2005-01-01

    The present study was undertaken to identify the factors responsible for hip joint dislocation after total hip arthroplasty, laying emphasis on analysis of the background variables of the patients. Of the 317 hips included in the study, ten (3.2%) dislocated. Only the anteversion angle of the cup differed significantly between the dislocation group and the dislocation-free group. The safe zone of the anteversion angle seems to be between 20 and 30 degrees. but it is also essential to set the ...

  12. Traumatic hip dislocation: early MRI findings

    International Nuclear Information System (INIS)

    Objective of this study was to present the spectrum of early magnetic resonance imaging (MRI) findings following traumatic dislocation of the femoral head, and to identify any associated injuries. Prospective MRI of both hips was performed on 18 patients within 5 weeks of a traumatic femoral head dislocation. The interval between the time of injury and the imaging studies ranged from 2 to 35 days. Posterior dislocation was present in 14 patients and anterior dislocation in 4 patients. In the majority of cases, we performed axial T1, coronal T1, and coronal T2* (MPGR) sequences. MRI can effectively identify and quantify the muscle injury and joint effusion that invariably accompany traumatic hip dislocations. It is also useful for demonstrating trabecular bone contusion (trabecular injury) and iliofemoral ligament injury, which occur commonly with acute hip dislocation. (orig./VHE)

  13. Arthrography in congenital hip discbocation

    International Nuclear Information System (INIS)

    The paper is concerned with the results of contrast arthrography in 73 children with hip joint dysplasia, among which true dislocations prevailed (70 patients). In addition to bone alterations, arthography revealed various soft tissue changes like hypertrophy and deformity of limbus, soft tissue interposition, separation of the articular sac with the presence of an isthmus, disintegration of articular cartilages. These findings are used to define indications for surgical intervention as well as for planning the area of operation

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

    Science.gov (United States)

    ... ?uid) Symptoms Some babies born with a dislocated hip will show no outward signs. Contact your pediatrician if your baby has: • Legs of di?erent lengths • Uneven skin folds on the thigh • Less mobility or ?exibility on one side • Limping, toe walking, ...

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

    LENUS (Irish Health Repository)

    Galbraith, John G

    2011-01-01

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

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

    Science.gov (United States)

    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. The surgical treatment for congenital atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    WANG Kun

    2012-08-01

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

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

    Science.gov (United States)

    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

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

    DEFF Research Database (Denmark)

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

    Science.gov (United States)

    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

  1. CT findings of traumatic posterior hip dislocation after reduction

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. Traumatic hip dislocation with associated femoral head fracture

    DEFF Research Database (Denmark)

    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....

  3. [Radical reduction for developmental dislocation of the hip (Cakirgil's procedure)].

    Science.gov (United States)

    Kinik, Hakan; Mergen, Ertan

    2007-01-01

    This paper describes the so called "radical reduction of the hip" (Cakirgil's) procedure for children above four years of age, with high developmental dislocation of the hip. The procedure is a combined one-stage operation including adductor tenotomy, open reduction, femoral shortening, proximal femoral varus-derotation osteotomy and Dega's osteotomy. Radical reduction is a safe and effective procedure for high dislocations with shallow acetabulum. PMID:17483623

  4. Posterior dislocation of the hip while playing basketball

    OpenAIRE

    Tennent, T. D.; Chambler, A. F.; Rossouw, D J

    1998-01-01

    Injuries in basketball are usually to the ankles and knees. Dislocation of the hip is usually associated with severe trauma--for example, road traffic accidents. A case is reported here in which a 22 year old club basketball player slipped on landing from a jump shot, forcing him into a side splits position from which he sustained a posterior dislocation of the hip resulting in a sciatic nerve palsy. ?????

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Long Term Outcomes of Total Hip Arthroplasty With Custom Made Femoral Implants in Patients With Congenital Disease of Hip.

    Science.gov (United States)

    Pakos, Emilios E; Stafilas, Kosmas S; Tsovilis, Aristomenis E; Vafiadis, John N; Kalos, Nikolaos K; Xenakis, Theodoros A

    2015-12-01

    We evaluated the outcomes of total hip arthroplasty in 67 patients (86 hips) with congenital hip disease and excessive abnormal anatomy of the proximal femur with the use of custom-made femoral stems. The design of the stem was based on CT data following the principles of CAD-CAE-CAM technique. No serious complications attributed to the femoral stem were seen. Within a median follow-up of 127.5 months the 10-year survival of any of the components was 95.4% and respective value when aseptic loosening of the stem was considered was 98.1%. Patients with high dislocations had a 10-fold risk for loosening compared to those with low dislocations. No other parameter was associated with outcomes. The clinical and radiological evaluation was in consistency with the above outcomes. PMID:26187384

  8. Posterior dislocation of the hip with ipsilateral displaced

    OpenAIRE

    Trikha Vivek; Goyal Tarun; Jha Ram K

    2011-01-01

    ?Abstract?Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had uni...

  9. Differentiating subluxation from developmental dislocation of the hip

    Directory of Open Access Journals (Sweden)

    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.

  10. Voluntary habitual dislocation of the hip in children

    International Nuclear Information System (INIS)

    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.)

  11. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

    Directory of Open Access Journals (Sweden)

    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.

  12. Impingement and dislocation in total hip arthroplasty: mechanisms and consequences.

    Science.gov (United States)

    Brown, Thomas D; Elkins, Jacob M; Pedersen, Douglas R; Callaghan, John J

    2014-01-01

    In contemporary total hip arthroplasty, instability has been a complication in approximately 2% to 5% of primary surgeries and 5% to 10% of revisions. Due to the reduction in the incidence of wear-induced osteolysis that has been achieved over the last decade, instability now stands as the single most common reason for revision surgery. Moreover, even without frank dislocation, impingement and subluxation are implicated in a set of new concerns arising with advanced bearings, associated with the relatively unforgiving nature of many of those designs. Against that backdrop, the biomechanical factors responsible for impingement, subluxation, and dislocation remain under-investigated relative to their burden of morbidity. This manuscript outlines a 15-year program of laboratory and clinical research undertaken to improve the scientific basis for understanding total hip impingement and dislocation. The broad theme has been to systematically evaluate the role of surgical factors, implant design factors, and patient factors in predisposing total hip constructs to impinge, sublux, and/or dislocate. Because this class of adverse biomechanical events had not lent itself well to study with existing approaches, it was necessary to develop (and validate) a series of new research methodologies, relying heavily on advanced finite element formulations. Specific areas of focus have included identifying the biomechanical challenges posed by dislocation-prone patient activities, quantifying design parameter effects and component surgical positioning effects for conventional metal-on-polyethylene implant constructs, and the impingement/dislocation behavior of non-conventional constructs, quantifying the stabilizing role of the hip capsule (and of surgical repairs of capsule defects), and systematically studying impingement and edge loading of hard-on-hard bearings, fracture of ceramic liners, confounding effects of patient obesity, and subluxation-mediated worsening of third body particle challenge. PMID:25328453

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Asymmetric traumatic bilateral dislocation of hip. Case report

    Directory of Open Access Journals (Sweden)

    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.

  15. Imaging of traumatic dislocation of the hip in childhood

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  16. Scintigraphical observation of the femoral head in traumatic hip dislocation

    International Nuclear Information System (INIS)

    99mTc-MDP uptake of the femoral head in traumatic hip dislocation of 7 cases was examined by serial bone scintigraphy after reduction. The cases of dislocation were type I (6 cases) and type II (1 case) by the classification of Thompson and Epstein. Five cases with normal healing showed the increased uptake of 99mTc-MDP in the whole femoral head within a few months of the accident. Then, the degree of uptake decreased gradually and returned to the normal level. The roentgenographical changes in the femoral head were observed in 2 cases within 2 years of the accident. One was the mottled sclerotic change and the other was late segmental collapse. These cases showed severe band-like uptake in the femoral neck and circular uptake around the femoral head by early scintigraphy. The findings of those uptake patterns were recognized over 2 years and differed from that of normal healing. It is thought that bone scintigraphy is a useful method for the observation of pathological changes in the femoral head of traumatic hip dislocation. (author)

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

    Directory of Open Access Journals (Sweden)

    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 option for femoral neck fracture in these patients.

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

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    Chun-Chien Cheng

    2010-06-01

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

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

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2012-09-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

    Jakobsen, Thomas; Kappel, Andreas; Hansen, Flemming; Jensen, Niels Harry Krarup

    2014-01-01

    INTRODUCTION: Recurrent dislocations of hip replacements are a difficult challenge. One treatment option for recurrent dislocations is the use of a dual mobility cup. The aim of this study was to retrospective investigate the effect of dual mobility cups as a treatment for recurrent dislocations in...... loosening of the acetabular component, and one due to infection. Harris Hip Score improved from a mean of 76 before index surgery to 87 within one year after index surgery. CONCLUSION: This study advocates the use of a dual mobility cup for treatment of recurrent dislocations of THR. However, studies with a...

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

    Directory of Open Access Journals (Sweden)

    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.  

  4. Relationship Between Developmental Dislocation of the Hip in Infant and Acetabular Dysplasia at Skeletal Maturity

    Science.gov (United States)

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

    2015-01-01

    Abstract 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

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

    OpenAIRE

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

    2012-01-01

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

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

    LENUS (Irish Health Repository)

    Forde, James C

    2012-02-01

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

  7. Proximal femoral excision with interposition myoplasty for cerebral palsy patients with painful chronic hip dislocation

    OpenAIRE

    Patel, Nirav K.; Sabharwal, Sanjeeve; Gooding, Christopher R.; Hashemi-Nejad, Aresh; Eastwood, Deborah M.

    2015-01-01

    Purpose Proximal femoral excision is a salvage procedure for painful chronic hip dislocation in cerebral palsy (CP) patients. The primary objective of this article is to describe our experience of an amplified interposition myoplasty, with appropriate peri-operative pain and tone management strategies, in a cohort of non-ambulatory CP patients with painful chronic hip dislocation. Our secondary objective is to present the clinical outcomes of these patients. Methods We describe our experience...

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Venkatachalam Santosh

    2009-12-01

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

  10. Surgical Dislocation of the Hip Versus Arthroscopic Treatment of Femoro-acetabular Impingment

    OpenAIRE

    Jackson, Timothy J.; Stake, Christine E; Bitar, Youssef El; Lindner, Dror; Botser, Itamar; Domb, Benjamin G

    2013-01-01

    Objectives: Femoroacetabular impingement (FAI) can be treated by arthroscopy or by surgical dislocation of the hip. Advocates of each have suggested advantages of each technique. To date, there have been no studies that directly compare these two treatment modalities, using patient-reported outcomes (PRO), in a single surgeon design. The purpose of this study was to prospectively compare outcomes of patients receiving surgical hip dislocation to arthroscopic treatment for FAI, using a matched...

  11. Posterior dislocation of the hip with bilateral femoral fractures: An unusual combination.

    Science.gov (United States)

    Qi, Bao-Chang; Zhao, Yi; Wang, Cheng-Xue; Wang, Tie-Jun; Zhang, Ji-Ting; Ju, Wei-Na; Sun, Da-Hui

    2016-03-14

    Posterior hip dislocation with concomitant femoral fracture is very rare. Here, we report a rare case of a 43-year-old man who was injured in a car accident. The patient sustained right posterior hip dislocation with concomitant right acetabular transverse and posterior wall fracture, ipsilateral femoral shaft fracture, and contralateral proximal femoral fracture (AO type 31-A3). Closed reduction of the hip was attempted, but failed. The acetabular fracture and posterior hip dislocation were reduced and acetabular fracture was fixed using plates through the Kocher-Langenbeck approach. The ipsilateral femoral fracture was treated with closed reduction and intramedullary nailing. The contralateral femoral fracture was treated with closed reduction and Gamma 3 nailing. Postoperative X-rays revealed reduction of the fractures. The patient achieved bone union and recovered function of the hip 4 months after surgery. PMID:26578280

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-12-01

    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.)

  14. Habitual anterior dislocation of the hip in cerebral palsy: a case report.

    Science.gov (United States)

    Agashe, Mandar Vikas; Mehta, Rujuta; Aroojis, Alaric John

    2012-05-01

    Habitual anterior dislocation of the hip joint is extremely rare. We believe this is the first case reported of a habitual anterior dislocation of the hip occurring in a child with cerebral palsy. The dislocation was painless, voluntary and used to occur every time the child would extend and externally rotate the limb. Operative intervention in the form of a varus derotation femoral osteotomy and anterior capsulorraphy was planned, but the caregivers of the patient were unwilling for the same. Hence, the patient was given an adduction and internal rotation brace and was counselled not to perform the activity needed to dislocate the hip. This case report calls attention to a unique problem previously not reported in cerebral palsy. PMID:21857541

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

    Directory of Open Access Journals (Sweden)

    Lidder Surjit

    2009-08-01

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

  16. US of the infant hip: A reliable screening method for congenital dysplasia of the hip

    International Nuclear Information System (INIS)

    Standardization of US technique and quantification of US findings are the most important problems in the US evaluation of congenital dysplasia of the hip (CDH). Postmorten studies in 15 infants and cross-section anatomic studies have provided insight in US pitfalls in searching for CDH and have helped define a standard coronal plane in which the infant hip should be investigated. A semiquantitative method for evaluation of hip sonographs was used in a prospective study of 150 patients and compared with results of conventional radiographic and physical examinations. US performed in this way had a negative predictive value of 97% and a positive predictive value of 63%. Overall accuracy was 87%. No cases of luxation were missed. The method has inherent limitations and pitfalls, which are demonstrated. Nevertheless, it proved to be a reliable aid in US screening of their patient group for CDH

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

    Directory of Open Access Journals (Sweden)

    Wang Chen-Ti

    2008-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Plate Johannes F

    2012-10-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Higuchi, Yoshitoshi; HASEGAWA, YUKIHARU; Ishiguro, Naoki

    2015-01-01

    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 57.5 point...

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

    Directory of Open Access Journals (Sweden)

    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

  2. Computed tomography in abnormalities of the hip

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-06-26

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

  3. Computed tomography in abnormalities of the hip

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Surgical Dislocation of the Hip Versus Arthroscopic Treatment of Femoro-acetabular Impingment

    Science.gov (United States)

    Jackson, Timothy J.; Stake, Christine E.; Bitar, Youssef El; Lindner, Dror; Botser, Itamar; Domb, Benjamin G.

    2013-01-01

    Objectives: Femoroacetabular impingement (FAI) can be treated by arthroscopy or by surgical dislocation of the hip. Advocates of each have suggested advantages of each technique. To date, there have been no studies that directly compare these two treatment modalities, using patient-reported outcomes (PRO), in a single surgeon design. The purpose of this study was to prospectively compare outcomes of patients receiving surgical hip dislocation to arthroscopic treatment for FAI, using a matched-pair analysis. Our hypothesis is the arthroscopic group will demonstrate improved clinical outcomes when compared to patients receiving open surgical dislocation. Methods: During the study period between January 2008 and August 2011, data was prospectively collected on all patients 1, and previous hip surgery were excluded. The patients in the surgical dislocation cohort were pair-matched in a 1:2 ratio to patients treated arthroscopically, based on age within 2 years, gender, workers’ compensation status and diagnosis of FAI. PRO tools, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score – Sport Specific Subscale (HOS - SSS) and Hip Outcome Score - Activity of Daily Living (HOS - ADL), were obtained in all patients pre-operatively and post-operatively at 3 months, 1 year, and 2 years, and at latest follow up. Alpha angles were measured pre and post- surgery for both groups. Revision surgery and complications were recorded for each group. Results: Ten patients were included in the surgical dislocation group, and 20 pair-matched patients were included in the arthroscopic group. 100% patient follow-up was obtained at mean 24.8 months in the open group and 25.5 months in the arthroscopic group. Preoperative mHHS, NAHS, HOS-ADL and HOS-SSS were similar between the two groups. Both the arthroscopic group and the surgical dislocation group had significant postoperative improvement at 3 months, 1 year and final follow-up for all scores. In comparing the two groups, the ΔHOS-SSS was significantly higher in the arthroscopic group at final follow-up, improving 42.8 points versus 23.5 in the surgical dislocation (p=0.047). The arthroscopic group also had significantly better NAHS at 3 months (88.1 vs. 75.3, p=0.016) and at final follow-up. (94.2 vs. 85.7, p=0.01). Nine out of 10 patients in the dislocation group had good/excellent results, and 19 out of 20 patients in the arthroscopic group had good/excellent results. Patient satisfaction for the open group was 8.1, and 9.2 in the arthroscopic group (p=0.07). Both groups showed a significant decrease in the alpha angle postoperatively, from 58° to 40° in the dislocation group, and 57° to 40° in the arthroscopic group, with no difference between the groups (p=0.775). The dislocation group had 8 patients undergo hardware removal, and two required hip arthroscopy for continued pain. Conclusion: This is the first study to directly compare surgical dislocation to arthroscopic management of FAI in single surgeon design. Favorable results were shown with both approaches, with significant improvement in all PRO measures and high patient satisfaction ratings. However, arthroscopic treatment of FAI showed greater improvement in the HOS-SSS and a higher absolute NAHS score at 2 year follow-up.

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

    Directory of Open Access Journals (Sweden)

    Samet Karabulut

    2011-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Luxación congénita de rodilla, a propósito de un caso / Congenital dislocation of the Knee, a case report

    Scientific Electronic Library Online (English)

    Rolando, Azurduy Ance; Rodrigo, Peña Orozco; Diego, Salinas Emcinas; Rossy, Quimbert Montes.

    Full Text Available La luxación congénita de rodilla es una entidad de muy baja incidencia (0.017 casos por mil nacidos vivos) y 1 por 100.000 casos en relación con la displasia de cadera y que puede presentarse en forma aislada o como parte de algunas entidades teratológicas (síndrome de Down, artrogriposis, mielomeni [...] ngocele, etc.). Describimos a un neonato, de sexo femenino, que presenta una rodilla izquierda en hiper-extensión, asociado a genu valgo, pie plano valgo y displasia de cadera del mismo lado. De inicio, el manejo fue conservador, pero frente al fracaso terapéutico tuvo que ser intervenido quirúrgicamente para lograr la rehabilitación del paciente. Concluimos que la intervención quirúrgica debe ser precoz y oportuna en esta afección. Abstract in english Congenital dislocation of the knee is a very rare disease (0.017 cases/1000 live newborns and 1/100.000 in relation to hip dysplasia). Usually is an isolated finding, but some times it is associated to other entities (Down syndrome, arthrogriposis, myelomeningocele, etc). We describe a female newbor [...] n who presented at birth hyperextend left knee, genu valgo, flat foot and hip dysplasia of the same side. She was treated conservatively with no improvement, so she underwent surgery and later rehabilitation. We conclude that surgery should be early and the first line of treatment of this condition.

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

    OpenAIRE

    Chatley Anooj; Jaiswal Awadesh; Jain Manoj; Behari Sanjay

    2008-01-01

    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-hypointen...

  10. 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

    Directory of Open Access Journals (Sweden)

    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.

  11. Neglected, developmental hip dislocation treated with external iliofemoral distraction, open reduction, and pelvic osteotomy.

    Science.gov (United States)

    Wojciechowski, Piotr; Kusz, Damian J; Cieli?ski, ?ukasz S; Dudko, S?awomir; Bereza, Przemys?aw L

    2012-05-01

    Between 1995 and 2003, we operated upon 18 children with 20 hips involved, aged 5-11 years (average: 7.5 years) suffering from an inveterate high developmental dislocation of the hip joint. An average follow-up period of our middle-term study was 51 months (range: 34-96 months). A two-staged management was applied. First, femoral head was lowered back to the level of acetabulum with an external fixator or a distractor device. The second stage involved open reduction combined with pelvic osteotomy and, in four cases with femoral derotation osteotomy. We noted two cases of avascular necrosis. Equal limb length was achieved in 15 cases. There were two cases of 0.5-cm length discrepancy, two cases of 1-cm length inequalities, and one case of 5-cm limb shortening. We endorse this method in neglected cases of previously untreated unilateral high developmental hip dislocations in children aged 8-10 years. It results in a usable hip joint without the need of femoral shaft shortening and facilitates future joint replacement. PMID:22473084

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

    Directory of Open Access Journals (Sweden)

    Koutsostathis Stefanos D

    2010-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Sebastian S. Mukka

    2013-06-01

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

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

    Scientific Electronic Library Online (English)

    Luísa Neiva, Araújo; Eduardo, Almeida.

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

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

    Directory of Open Access Journals (Sweden)

    Jaswant Kumar

    2014-01-01

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

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

    OpenAIRE

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

    2011-01-01

    【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 wa...

  17. Dislocations

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

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

  19. A 4 year-old child with posterior hip dislocation and simultaneous subtrochanteric and anterior column fracture

    Directory of Open Access Journals (Sweden)

    Mousavian Alireza

    2013-09-01

    Full Text Available Traumatic hip dislocation is an uncommon injury in children and consists of less than 5% of their dislocations; but it’s one of the real orthopedic urgency. Its mechanism is low energy trauma in below 6 years old and high energy trauma above it.One of the common associated complications with hip dislocation is posterior wall injuries but column fractures are very rare. We reported an uncommon case of posterior hip dislocation with simultaneous subtrochanteric fracture and anterior column fracture, in which close reduction was impossible. Because of sever associated injuries surgery was done with 48 hours delay including open reduction of dislocation and fracture, and internally fixation of the subtrochanteric fracture with 3.5mm locked plate.In 6 month follow up that was done in ICU, range of motion and stability was good and union sign was visible on radiography. After 15 months the patient general conditions was good and no sign of avascular necrosis was seen

  20. A Novel Approach for Dynamic Testing of Total Hip Dislocation under Physiological Conditions

    Science.gov (United States)

    Herrmann, Sven; Kluess, Daniel; Kaehler, Michael; Grawe, Robert; Rachholz, Roman; Souffrant, Robert; Zierath, János; Bader, Rainer; Woernle, Christoph

    2015-01-01

    Constant high rates of dislocation-related complications of total hip replacements (THRs) show that contributing factors like implant position and design, soft tissue condition and dynamics of physiological motions have not yet been fully understood. As in vivo measurements of excessive motions are not possible due to ethical objections, a comprehensive approach is proposed which is capable of testing THR stability under dynamic, reproducible and physiological conditions. The approach is based on a hardware-in-the-loop (HiL) simulation where a robotic physical setup interacts with a computational musculoskeletal model based on inverse dynamics. A major objective of this work was the validation of the HiL test system against in vivo data derived from patients with instrumented THRs. Moreover, the impact of certain test conditions, such as joint lubrication, implant position, load level in terms of body mass and removal of muscle structures, was evaluated within several HiL simulations. The outcomes for a normal sitting down and standing up maneuver revealed good agreement in trend and magnitude compared with in vivo measured hip joint forces. For a deep maneuver with femoral adduction, lubrication was shown to cause less friction torques than under dry conditions. Similarly, it could be demonstrated that less cup anteversion and inclination lead to earlier impingement in flexion motion including pelvic tilt for selected combinations of cup and stem positions. Reducing body mass did not influence impingement-free range of motion and dislocation behavior; however, higher resisting torques were observed under higher loads. Muscle removal emulating a posterior surgical approach indicated alterations in THR loading and the instability process in contrast to a reference case with intact musculature. Based on the presented data, it can be concluded that the HiL test system is able to reproduce comparable joint dynamics as present in THR patients. PMID:26717236

  1. Microform holoprosencephaly with bilateral congenital elbow dislocation; increasing the phenotypic spectrum of Steinfeld syndrome.

    Science.gov (United States)

    Jones, Gabriela E; Robertson, Lisa; Maniyar, Amit; Shammas, Christos; Phelan, Marie M; Vasudevan, Pradeep C; Tanteles, George A

    2016-03-01

    Steinfeld syndrome (MIM #184705) was first reported in 1982. It is characterised by holoprosencephaly and limb defects, however other anomalies may also be present. Following the initial description, three further cases have been reported in the literature. We report on a 23-year-old girl, with features of microform holoprosencephaly and bilateral congenital elbow dislocation in association with hypoplastic radial heads. She was identified to have a variant in the CDON gene inherited from her father who had ocular hypotelorism, but no other clinical features. We discuss the clinical features of Steinfeld syndrome, and broaden the phenotypic spectrum of this condition. Structural analysis suggests that this variant could lead to destabilisation of binding of CDON with hedgehog proteins. Further work needs to be done to confirm whether mutations in the CDON gene are the cause of Steinfeld syndrome. © 2016 Wiley Periodicals, Inc. PMID:26728615

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

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Munhoz da Rocha

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stojkovi?-Jovanovi? Tatjana

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yamamoto K

    2004-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Shirin Mardookhpour

    2012-06-01

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

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

    International Nuclear Information System (INIS)

    We present the results obtained in the Instituto de Ortopedia Infantil Roosevelt for the treatment of the hip dislocation in adolescent patients and young adults with spastic cerebral palsy with the open reduction of the hip, accompanied by femoral osteotomy and, if as necessary, pelvic osteotomy. 14 hips (10 patients) were intervened from January of 1996 to July of 2003. Pain was completely released in 54 percent and improved in 36 percent of cases. Abduction improved in 63 percent of patients allowing the perinea cleaning in 63 percent and better tolerance to scar in 64% of the cases. Our complications were one patient developed a sacred pressure ulcer with the spica cast treated with a free flap transposition; one hip had redislocation at 31 months from surgery; another hip had instability without clinical repercussion; one patient had a not displaced supracondylar femoral fracture treated with immobilization. The results of our study showed that the open reduction of the spastic hip in adolescents and young adults is a procedure that improves, in most of the cases, the stability, mobility and pain of the hip and provides better quality life for these patients

  7. Satisfaction and pain levels after proximal femoral valgus osteotomy according to Schanz in patients with cerebral palsy and hip dislocation.

    Science.gov (United States)

    Harmsen, Annelieke M K; Witbreuk, Melinda M E H; Pruijs, Hans J E H; Buizer, Annemieke I; van der Sluijs, Johannes A

    2016-05-01

    Outcome after Schanz osteotomy in the treatment of chronic hip dislocation in children with cerebral palsy was evaluated. Medical charts and questionnaires were used to assess pain, functional outcome and satisfaction. A total of 24 children, with a mean age of 13.8 years (±8.9), were included in the study, out of which 11 were classified with Gross Motor Function Classification System (GMFCS) level IV and 13 with GMFCS level V. Current pain was comparable to patients without chronic hip dislocation, and satisfaction was intermediate. Functional outcome improved in several domains. Longer postoperative time was associated with improved pain and satisfaction. The Schanz osteotomy allowed improvement in pain levels; however, it did not completely meet caregiver's expectation and has high reoperation rates. PMID:26588835

  8. Tenomyoplasty of the flexor muscles in the surgical treatment of congenital recurvatum, subluxation and dislocation of the knee.

    Science.gov (United States)

    Dal Monte, A; Manes, E; Marchiodi, L; Rubbini, L

    1982-12-01

    The writers present eight cases of congenital recurvatum or dislocation of the knee in which tenomyoplasty of the flexor muscles of the knee was performed. The operation was the only one used in cases with flexion greater than 60 degrees, while in cases of more severe loss of flexion, it was supplementary to mobilisation of the quadriceps according to Judet's technique. The technique of tenomyoplasty is described and the results are reported. These are considered to be favourable. PMID:7183654

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Chatley Anooj

    2008-01-01

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

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

    Science.gov (United States)

    Chatley, Anooj; Jaiswal, Awadesh K; Jain, Manoj; Behari, Sanjay

    2008-01-01

    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. PMID:19127046

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

    OpenAIRE

    Gatrad, A R

    1981-01-01

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

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

    International Nuclear Information System (INIS)

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

  14. Dual mobility design socket use in preventing total hip replacement dislocation following tumor resection

    OpenAIRE

    PHILIPPEAU, Jean-Marie; DURAND, Jean-Marc; Carret, Jean-Paul; Leclercq, Sylvain; WAAST, Denis; GOUIN, François

    2010-01-01

    An overall rate of 9.8% dislocation was observed, taking into account all etiologies and contexts together. More precisely, this rate resulted from a compound figure of 5.2% in bone metastasis and 15% in primitive bone tumor. Dislocation risk depended less on etiology than on the surgical management of the abductor system, being 3.5% in the case of abductor conservation, 9.5% in the case of abductor sectioning/reinsertion, and 18% in case of gluteus medius muscle or nerve resection. Functiona...

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

    DEFF Research Database (Denmark)

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

    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....

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

    OpenAIRE

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

    2008-01-01

    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...

  17. Seasonality of congenital anomalies in Europe

    DEFF Research Database (Denmark)

    Luteijn, Johannes Michiel; Dolk, Helen; Addor, Marie-Claude; Arriola, Larraitz; Barisic, Ingeborg; Bianchi, Fabrizio; Calzolari, Elisa; Draper, Elizabeth; Garne, Ester; Gatt, Miriam; Haeusler, Martin; Khoshnood, Babak; McDonnell, Bob; Nelen, Vera; O'Mahony, Mary; Mullaney, Carmel; Queisser-Luft, Annette; Rankin, Judith; Tucker, David; Verellen-Dumoulin, Christine; de Walle, Hermien; Yevtushok, Lyubov

    2014-01-01

    /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...

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

    Directory of Open Access Journals (Sweden)

    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 supra-acetabular area in the absence of axial bearing on the operated extremity during the whole postoperative period. Thus, an articular cartlage has significant potential for recovery, and the obtained results enable to help lay down optimal conditions for such a recovery.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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 open surgical treatment were universally recognized on MRI but not on CT scans. MRI should be considered for evaluation of the hip following closed reduction for the treatment of a posterior dislocation in children and adolescents as it reliably allows assessment of intra-articular pathology without the risk of radiation exposure. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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 open surgical treatment were universally recognized on MRI but not on CT scans. MRI should be considered for evaluation of the hip following closed reduction for the treatment of a posterior dislocation in children and adolescents as it reliably allows assessment of intra-articular pathology without the risk of radiation exposure. (orig.)

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

    OpenAIRE

    Porter, David; Michael, Shona; Kirkwood, Craig

    2008-01-01

    Objective: To investigate: (a) associations between the direction of scoliosis, direction of pelvic obliquity, direction of windswept deformity and side of hip subluxation/dislocation in non-ambulant people with cerebral palsy; and (b) the lateral distribution of these postural asymmetries. Design: Cross-sectional observational study. Setting: Posture management services in three centres in the UK. Subjects: Non-ambulant people at level five on the gross motor function classification system f...

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

    International Nuclear Information System (INIS)

    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. Realtime 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. (orig.)

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

    DEFF Research Database (Denmark)

    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...

  7. Atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    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.

  8. Atlantoaxial dislocation.

    Science.gov (United States)

    Jain, Vijendra K

    2012-01-01

    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. PMID:22406773

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Shirin Mardookhpour; Amir Sobhani Eraghi; Ramin Espandar

    2012-01-01

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

  12. Redundant anomalous vertebral artery in a case of congenital irreducible atlantoaxial dislocation: Emphasizing on the differences from the first intersegemental artery and operative steps to prevent injury while performing C1-2 joint manipulation

    OpenAIRE

    Patra, Devi P; Salunke, Pravin S; Sahoo, Sushanta K.; Ghuman, Mandeep S

    2015-01-01

    Anomalous vertebral artery (VA), commonly the persistent first intersegmental artery (FIA) is often seen with congenital atlantoaxial dislocations (AAD). An unusual redundant/ectatic loop of VA passing below the C1 (upside down VA) has been described below and appears to be different from FIA. The operative technique to protect it while C1-2 joint manipulation has been described. A 35 year old male presented with progressive spastic quadriparesis after trivial trauma. Radiology showed irreduc...

  13. Bilateral inverted vertebral arteries (V3 segment in a case of congenital atlantoaxial dislocation: Distinct entity or a lateral variant of persistent first intersegmental artery?

    Directory of Open Access Journals (Sweden)

    Pravin Salunke

    2014-01-01

    Full Text Available Background: Anomalous vertebral arteries (VAs, commonly involving the persistent first intersegmental artery (FIA, are often seen with congenital atlantoaxial dislocations (AAD. Here we describe an unusual variant consisting of bilateral VAs with normal loops but passing below the C1 (inverted VA arch, distinctly different from the FIA. Case Description: A 9-year-old boy presented with a spastic quadriparesis. Preoperative radiographic studies showed an irreducible AAD with an occipitalized CO-C1 and C2-3 fusion. Although both VAs exhibited proximal and distal loops like normal VA, the distal loops did not pass through the C1 transverse foramina and coursed inferior to the C1 arch instead. With this critical preoperative information, both VAs could be better safeguarded during dissection of the C1-2 facets. Conclusion: In the case presented, although the course of the inverted VAs is similar, the norm, they coursed inferior to both C1 arches. Careful evaluation of the preoperative radiological studies allowed for careful dissection of the inverted VA (horizontal loop while opening the C1-2 joint for subsequent alignment (e.g. reduction and bony fusion. This information also facilitates safer insertion of lateral mass screws (e.g. choosing the appropriate C1 screw length to gain adequate bony purchase without compromising anomalous VA.

  14. Congenital Anomalies in Infant with Congenital Hypothyroidism

    Directory of Open Access Journals (Sweden)

    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.

  15. Early radiodiagnosis of dysplasia of the hip joint in children

    International Nuclear Information System (INIS)

    The author proposes a method of differential diagnosis of hip dislocations and hip joint dysplasia in infants aged 3 months. The ?-angle of hip dislocation with relation to trochanterian space is determined on an anteroposterior radiogram of the hip joints; 64 deg means hip dysplasia, 65-69 deg and more mean dislocation. This method was tested in 75 children (150 joints) aged 3 months. A mean diagnostic accuracy was 90.1 %

  16. Roentgenography of hip-joint using tubus in infants

    International Nuclear Information System (INIS)

    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.)

  17. Imaging of hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

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

    Scientific Electronic Library Online (English)

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

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

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

    International Nuclear Information System (INIS)

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

  20. Redundant anomalous vertebral artery in a case of congenital irreducible atlantoaxial dislocation: Emphasizing on the differences from the first intersegemental artery and operative steps to prevent injury while performing C1-2 joint manipulation.

    Science.gov (United States)

    Patra, Devi P; Salunke, Pravin S; Sahoo, Sushanta K; Ghuman, Mandeep S

    2015-10-01

    Anomalous vertebral artery (VA), commonly the persistent first intersegmental artery (FIA) is often seen with congenital atlantoaxial dislocations (AAD). An unusual redundant/ectatic loop of VA passing below the C1 (upside down VA) has been described below and appears to be different from FIA. The operative technique to protect it while C1-2 joint manipulation has been described. A 35 year old male presented with progressive spastic quadriparesis after trivial trauma. Radiology showed irreducible atlantoaxial dislocation with occipitalised C1 and C2-3 fusion. The left VA was anomalous passing beneath the C1 arch with a redundant loop lying posterior to the C1-2 joint. This was unlike the persistent first intersegmental artery (FIA) and was safeguarded while dissecting the C1-2 facet. The artery was dissected and safeguarded while performing C1-2 joint manipulation. A redundant/ectatic loop lying posterior to C1-2 joint is an unusual variant of anomalous VA. Evaluation of preoperative radiology helps in diagnosing such anomalous VA. Dissection of the entire redundant loop of the anomalous artery is important in opening the C1-2 joint required for reduction and placement of spacer/ bone grafts to achieve good bony fusion. Also mobilizing the loop allows safe insertion of lateral mass screw. Care needs to be taken while fastening screws to prevent compression of the loop. PMID:26527042

  1. Dislocation Theory

    International Nuclear Information System (INIS)

    1. Introduction; basic definitions; the slip process in crystalline solids; the Burgers vector. 2. The elementary theory of discrete dislocations in an isotropic elastic continuum; plane and anti-plane strain. 3. Dislocation solutions in an isotropic elastic medium; stresses and strains; elastic energy of a dislocation; interactions with other dislocations. 4. Defect sources and the complete decomposition of distortion fields. 5. The general field-theoretic theory of dislocations; an elementary introduction using Green's function methods; infinitesimal loops, rational dislocation elements; incompatibility elements. 6. Discrete dislocations in anisotropic bodies; significance of anisotropy; examples. 7. Partially discrete models of dislocations; Peierls and Van-der-Merwe models; core effects. 8. Fully atomic models; harmonic lattices and general case. 9. The interaction of dislocations in crystals; dislocation nodes and sources. 10. The interaction of dislocations with point defects and the kinetics of the segregation process. 11. Work-hardening in face centred cubic metal crystals; 12. Dislocation boundaries. 13. The non-linear theory of the continuously dislocated lattice. (author)

  2. Techniques and Results for Open Hip Preservation

    Science.gov (United States)

    Levy, David M.; Hellman, Michael D.; Haughom, Bryan; Stover, Michael D.; Nho, Shane J.

    2015-01-01

    While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is the 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 may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy. PMID:26649292

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

    OpenAIRE

    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...

  4. Hip Ultrasound

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Hip Ultrasound Hip ultrasound uses sound waves to produce ... the Hip? What is Ultrasound Imaging of the Hip? Ultrasound images of the hip provide pictures of ...

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

    Directory of Open Access Journals (Sweden)

    Gilberto Francisco Brandão

    2010-01-01

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

  6. Subtalar dislocation

    International Nuclear Information System (INIS)

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

  7. Pelvic osteotomy in the neurogenic unstable hip.

    Science.gov (United States)

    Chomiak, Jiri; Dungl, Pavel

    2006-02-28

    Background. The purpose of our study was to evaluate treatment outcome in pelvic osteotomy for neurogenic hip instability, mainly in combination with soft tissue procedures, open reduction in dislocated hips, and proximal femoral osteotomy. Material and methods. 19 patients with neurogenic hip instability were treated from 1996 to 2005, with 29 pelvic osteotomies: 23 for cerebral palsy (15 patients), 5 for meningomyelocoele (3 patients), and 1 for sciatic nerve palsy. There were 19 subluxated and 10 dislocated hips. Results. In the CP patients, 13 patients reported improvement, one patient reported no change, and one patient reported deterioration. In objective assessment, improvement in gross motor function was found in 13 patients, in one patient unchanged, and in one patient walking ability deteriorated. In radiological evaluation, normal or dysplastic hips were achieved in 15 hips (66%). Eight hips (34%) progressively subluxated in follow-up with no redislocation. The subluxations led to repeated surgery in 2 patients. Avascular necrosis of the femoral head occurred in 2 hips (8%). All the MMC and paralytic patients improved in their movement activities. In radiological criteria, all hips were initially improved, but in the follow-up, 3 hips remained dysplastic and 3 hips resubluxated, leading to repeated surgery in one patient. Conclusions. Different types of pelvic osteotomies should be chosen in neuromuscular hip instability according to the hip deformities in order to achieve a stable and congruent hip. The combination with soft tissue release and femoral varus derotation osteotomy offer satisfactory outcomes mainly in the early stage of instability. PMID:17603455

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

    Science.gov (United States)

    Srivastava, Sudhir Kumar; Nemade, Pradip Sharad; Bhoale, Sunil Krishna

    2016-01-01

    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

  9. Congenital transverse deficiency of the tibia and fibula: a report of two cases

    International Nuclear Information System (INIS)

    We report two similar, but unrelated, patients with congenital bilateral partial deficiencies of the tibia and fibula associated with intact feet. In both patients, the tibia and fibula were absent on initial radiographs, while the femur and the tarsal bones were well developed and there was bilateral teratologic dislocation of the hips. Ultrasound and magnetic resonance imaging (MRI) studies suggested the presence of cartilaginous remnants of the tibia and fibula. There were multidirectional instabilities in the knees and ankles. The clinical and radiological features of these cases are distinct from those of congenital longitudinal deficiency of the tibia, in which the fibula is always preserved, and from longitudinal deficiency of the fibula, in which the tibia is present and the foot is usually involved. We suggest that the bilateral partial deficiencies of the tibia and fibula associated with the intact foot and teratologic dislocation of the hips is a single-entity disorder, possibly categorized as an intercalary transverse deficiency of the lower limb. (orig.)

  10. Kneecap dislocation

    Science.gov (United States)

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

  11. Hip sonography in the newborn

    International Nuclear Information System (INIS)

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

  12. Hip Replacement

    Science.gov (United States)

    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. ...

  13. Congenital Hypothyroidism

    Science.gov (United States)

    ... Body in Balance › Congenital Hypothyroidism Fact Sheet Congenital Hypothyroidism March, 2012 Download PDFs English Espanol Editors Rosalind S. ... MD Susan R. Rose, MD What is congenital hypothyroidism? Newborn babies who are unable to make enough ...

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    2016-05-09

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

  16. Postural deformities in congenital nephrotic syndrome.

    OpenAIRE

    Morgan, G; Postlethwaite, R J; Lendon, M.; Houston, I. B.; Savage, J. M.

    1981-01-01

    Six successive cases of congenital nephrotic syndrome are described. Each one showed flexion deformities of the knees and hips, widely open anterior and posterior fontanelles, and wide separation of the skull sutures. These abnormalities were present not only in cases in which the renal histology was of the microcystic Finnish type of congenital nephrotic syndrome, but also in those in which the histological picture was one of the variants associated with congenital nephrotic syndrome. It is ...

  17. Screening programmes for developmental dysplasia of the hip in newborn infants

    Scientific Electronic Library Online (English)

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

    2013-04-01

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

  18. Evaluation of the patient with hip pain.

    Science.gov (United States)

    Wilson, John J; Furukawa, Masaru

    2014-01-01

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

  19. Management of hip instability in trisomy 21.

    Science.gov (United States)

    Kelley, Simon P; Wedge, John H

    2013-01-01

    The unstable hip in Trisomy 21 presents with a spectrum of hip instability with different problems at different ages. What links this multiphase problem, in many patients, is the final common pathway of untreated instability, that of a stiff, dislocated, and often-painful hip, leading to significant functional disability. Historically, the results of treating hip instability in Trisomy 21 were variable with a notable frequency of poor results. With an improved understanding of the Trisomy 21 hip in terms of its pathoanatomy and a more contemporary surgical approach to hip reconstruction, much improved results can be expected and indeed have recently been shown. The mainstay of treatment for the habitual dislocation group presenting before 8 years of age is the femoral varus derotation osteotomy. The older group presenting with painful subluxation often show signs of secondary acetabular dysplasia and thus are best treated with redirectional acetabular osteotomy with or without the use of femoral varus derotation osteotomy. The presence of radiographic features of degenerative arthritis in the fixed dislocation group precludes the use of joint-preserving techniques for hip reconstruction, and these patients can achieve excellent results with total joint arthroplasty. The natural history, historical results, assessment, treatment, and management of complications of hip instability in Trisomy 21 are addressed in this paper. PMID:23764791

  20. Magnetic resonance imaging of hip joint cartilage and labrum

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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 ten hips in eight patients with cerebral palsy with spastic quadriplegia treated with surgery from 2003 to 2005, by the same surgical technique. Were assessed clinical and radiological outcomes before and after surgery, as well as the preoperative planning with the use of fluoroscope. The clinical parameters analyzed were: pain, difficulty performing personal hygiene, and sitting balance. The radiological parameters were Reimer's index, acetabular index and neck-shaft angle. These results were submitted to statistical analysis. RESULTS: We obtained good results with this technique. After an average follow-up of three years, all hips were stable in the last assessment, and there was a high level of satisfaction among the families in relation to the treatment. We also show that preoperative planning with fluoroscopy enables the reduction and stabilization of the hips without the need for capsuloplasty. CONCLUSION: The authors conclude that in the treatment of hip dislocation in patients with Cerebral Palsy with spastic quadriplegia, it is not necessary to open the joint capsule to stabilize the coxofemoral joint.

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

    Science.gov (United States)

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

    2009-01-01

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

  3. Hip Revision

    Medline Plus

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

  4. Hip Revision

    Medline Plus

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

  5. Hip replacement - discharge

    Science.gov (United States)

    Hip arthroplasty - discharge; Total hip replacement - discharge; Hip hemiarthroplasty - discharge; Osteoarthritis - hip ... You had a hip joint replacement surgery to replace all or part of your hip joint with an artificial joint. This artificial joint ...

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2009-02-01

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  10. Congenital neutropenia.

    Science.gov (United States)

    Klein, Christoph

    2009-01-01

    Congenital neutropenia comprises a variety of genetically heterogeneous phenotypic traits. Molecular elucidation of the underlying genetic defects has yielded important insights into the physiology of neutrophil differentiation and function. Non-syndromic variants of congenital neutropenia are caused by mutations in ELA2, HAX1, GFI1, or WAS. Syndromic variants of congenital neutropenia may be due to mutations in genes controlling glucose metabolism (SLC37A4, G6PC3) or lysosomal function (LYST, RAB27A, ROBLD3/p14, AP3B1, VPS13B). Furthermore, defects in genes encoding ribosomal proteins (SBDS, RMRP) and mitochondrial proteins (AK2, TAZ) are associated with congenital neutropenia syndromes. Despite remarkable progress in the field, many patients with congenital neutropenia cannot yet definitively be classified by genetic terms. This review addresses diagnostic and therapeutic aspects of congenital neutropenia and covers recent molecular and pathophysiological insights of selected congenital neutropenia syndromes. PMID:20008220

  11. Computerized tomography in children with dysplasia of the hip joint

    International Nuclear Information System (INIS)

    The hip joints in 10 children were investigated with computerized tomography (CT). The method permitted the determination of the geometry of hip joints. It was used for a study of the pathogenesis of asceptic necrosis at early stages of its development in children with congenital dysplasia of the hip joint at early stages of disease. CT made it possible to establish anteversion of the cotyloid cavity, its degree, the shape and structure of the anterior and posterior wall of the cotyloid cavity, and a shift of the proximal hip end enteriorly in combination with the above changes in the shole hip joint

  12. Congenital contractural arachnodactyly (Beals syndrome).

    OpenAIRE

    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...

  13. Management of hip posture in cerebral palsy.

    OpenAIRE

    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.

  14. Congenital microcephaly

    OpenAIRE

    Alcantara, Diana; O'Driscoll, Mark

    2014-01-01

    The underlying etiologies of genetic congenital microcephaly are complex and multifactorial. Recently, with the exponential growth in the identification and characterization of novel genetic causes of congenital microcephaly, there has been a consolidation and emergence of certain themes concerning underlying pathomechanisms. These include abnormal mitotic microtubule spindle structure, numerical and structural abnormalities of the centrosome, altered cilia function, impaired DNA repair, DNA ...

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

    International Nuclear Information System (INIS)

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

  16. Hip Revision

    Medline Plus

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

  17. Hip Revision

    Medline Plus

    Full Text Available ... those dislocations. And so it's a matter of managing that capsule -- that trochanter -- so you get it ... of reduce things, everything's going to shift and change its tightness. Do you just kind of put ...

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

    Science.gov (United States)

    2013-02-12

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

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

    Science.gov (United States)

    2015-09-21

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    2014-09-04

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

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

    Science.gov (United States)

    2013-05-29

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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    2014-08-13

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-05

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

  7. Hip Revision

    Medline Plus

    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 ...

  8. Hip Revision

    Medline Plus

    Full Text Available ... Here's Scott's initial preoperative x-ray, where we see a hybrid hip arthroplasty with a cemented femoral stem and an acetabular shell. You can see the lucent lines behind the acetabular shell, and ...

  9. Hip Revision

    Medline Plus

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

  10. Hip ultrasound

    International Nuclear Information System (INIS)

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

  11. Hip arthroscopy

    Directory of Open Access Journals (Sweden)

    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.

  12. Hip arthroscopy☆

    Science.gov (United States)

    de Amorim Cabrita, Henrique Antônio Berwanger; de Castro Trindade, Christiano Augusto; de Campos Gurgel, Henrique Melo; Leal, Rafael Demura; de Souza Marques, Ricardo da Fonseca

    2014-01-01

    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. PMID:26229924

  13. Hip ultrasound

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  14. Osteochondritis Dissecans of the Hip

    International Nuclear Information System (INIS)

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

  15. A constrained acetabular component for recurrent dislocation.

    Science.gov (United States)

    Khan, R J K; Fick, D; Alakeson, R; Haebich, S; de Cruz, M; Nivbrant, B; Wood, D

    2006-07-01

    We treated 34 patients with recurrent dislocation of the hip with a constrained acetabular component. Roentgen stereophotogrammetric analysis was performed to assess migration of the prosthesis. The mean clinical follow-up was 3.0 years (2.2 to 4.8) and the radiological follow-up was 2.7 years (2.0 to 4.8). At the latest review six patients had died and none was lost to follow-up. There were four acetabular revisions, three for aseptic loosening and one for deep infection. Another acetabular component was radiologically loose with progressive radiolucent lines in all Gruen zones and was awaiting revision. The overall rate of aseptic loosening was 11.8% (4 of 34). Roentgen stereophotogrammetric analysis in the non-revised components confirmed migration of up to 1.06 mm of translation and 2.32 degrees of rotation at 24 months. There was one case of dislocation and dissociation of the component in the same patient. Of the 34 patients, 33 (97.1%) had no further episodes of dislocation. The constrained acetabular component reported in our study was effective in all but one patient with instability of the hip, but the rate of aseptic loosening was higher than has been reported previously and requires further investigation. PMID:16798987

  16. Congenital toxoplasmosis

    Science.gov (United States)

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

  17. Congenital syphilis

    Science.gov (United States)

    Congenital syphilis is caused by the bacterium 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 ...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  20. Geodesics around gravitational dislocations

    OpenAIRE

    de Andrade, L C Garcia

    1998-01-01

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

  1. Homogenization of dislocation dynamics

    International Nuclear Information System (INIS)

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

  2. Homogenization of dislocation dynamics

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Collective behavior of dislocations

    International Nuclear Information System (INIS)

    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

  4. US of the hips in skeletal dysplasias and chromosomal aberrations

    International Nuclear Information System (INIS)

    Since January 1984 all newborns and infants with skeletal dysplasias and chromosomal aberrations were investigated by hip US, in addition to plain x-ray surveys. The authors observed one chondroectodermal dysplasia, one congenital spondyloepiphysial dysplasia, one cleidocranial dysplasia, one fibrochondrogenesis, two diastrophic dysplasias, and eight trisomies. The abnormalities of the hip joints could be demonstrated, and were compared with the findings on plain films. Especially skeletal dysplasias with abundant presence of cartilage were well visible. The newborn with trisomies showed normal hip joints. In the authors' opinion, all newborns with skeletal dysplasias should be investigated by hip sonography, in addition to skeletal radiography

  5. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    OpenAIRE

    Lazar, Markus

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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 results hold true.

  8. Metallurgy: Starting and stopping dislocations

    Science.gov (United States)

    Minor, Andrew M.

    2015-09-01

    A comparison of dislocation dynamics in two hexagonal close-packed metals has revealed that dislocation movement can vary substantially in materials with the same crystal structure, associated with how the dislocations relax when stationary.

  9. The unstable hip and mid-lumbar myelomeningocele.

    Science.gov (United States)

    Fraser, R K; Hoffman, E B; Sparks, L T; Buccimazza, S S

    1992-01-01

    We reviewed 55 patients with mid-lumbar myelomeningocele (L3 and L4) first seen over a 17-year period from 1970 to 1986 and followed up for an average of ten years. We assessed a number of factors which might affect hip stability and ability to walk, recording the natural history of clinical and radiological hip deformity. Two-thirds of the hips had become dislocated or subluxed by the end of the first year of life, involving 86% of hips in patients with an L3 level and 45% of those with an L4 level. All the hips that developed instability secondary to muscle imbalance did so within the first year. The neurological level was the most significant determinant of walking ability: all patients with L4 neurological levels could walk but only one-third of those with L3 lesions could do so. Hip stability, intelligence quotient and fixed deformity did not influence walking ability. PMID:1732245

  10. Vascular injuries during total hip revision

    International Nuclear Information System (INIS)

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

  11. Radiological evaluation of failed total hip replacement

    International Nuclear Information System (INIS)

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

  12. Hip Revision

    Medline Plus

    Full Text Available ... type of junction. What my point is, it's a Morris taper. And we use a Morris taper in every hip we do at the head/neck junction. I think if you have motion and significant issues down below, I think that's more of a problem of technique. And although we're doing ...

  13. Hip Revision

    Medline Plus

    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 ...

  14. Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Shu-Tai Shih

    2007-02-01

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

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

    DEFF Research Database (Denmark)

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

    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...

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Robertsson Otto

    2010-08-01

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

  18. Hip replacement

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Lazar, Markus

    2009-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  1. Luxatio erecta: Inferior glenohumeral dislocation

    Directory of Open Access Journals (Sweden)

    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.

  2. Congenital diplopodia

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  3. Geodesics around a dislocation

    OpenAIRE

    Fernando MORAES

    1995-01-01

    One method of gaining some insight into the motion of particles in a medium with topological defects (e.g., electrons in a dislocated metal) is to look at the geodesics of the medium around the defect. In this work the Hamilton-Jacobi equation for the geodesics in a continuous medium containing a torsional defect, an edge dislocation, is solved by using perturbation theory to first order in the Burgers vector.

  4. GPU accelerated dislocation dynamics

    Science.gov (United States)

    Ferroni, Francesco; Tarleton, Edmund; Fitzgerald, Steven

    2014-09-01

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

  5. Dislocations in bilayer graphene

    Science.gov (United States)

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

    2014-01-01

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

  6. Bursitis of the Hip

    Science.gov (United States)

    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. ...

  7. Hip fracture surgery

    Science.gov (United States)

    ... 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 ...

  8. Hip Implant Systems

    Science.gov (United States)

    ... Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility ...

  9. Hip joint injection

    Science.gov (United States)

    Cortisone shot - hip; Hip injection; Intra-articular steroid injections - hip ... can see where to place the medicine. The steroid medicine is slowly injected into the joint. After the injection, you will remain on the table for another ...

  10. Acute traumatic patellar dislocation.

    Science.gov (United States)

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

    OpenAIRE

    Alberto Nicodemo; Chiara Arrigoni; Andrea Bersano; Alessandro Massè

    2014-01-01

    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 stud...

  12. Avoiding Hip Instability and Limb Length Discrepancy After Total Hip Arthroplasty.

    Science.gov (United States)

    Sculco, Peter K; Cottino, Umberto; Abdel, Matthew P; Sierra, Rafael J

    2016-04-01

    Two complications after total hip arthroplasty (THA) are hip instability and limb length discrepancy; instability is a common indication for revision THA. The goal of a successful THA is to maximize impingement-free range of motion, recreate appropriate offset, and equalize limb length discrepancies to produce a pain-free and dynamically stable THA. In this article, the patient risk factors for dislocation and limb length discrepancy, key elements of the preoperative template, the anatomic landmarks for accurate component placement, the leg positions for soft tissue stability testing, and the management of postoperative instability are reviewed. PMID:26772941

  13. Characteristics of children with hip displacement in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Wagner Philippe

    2007-10-01

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

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

    International Nuclear Information System (INIS)

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

  15. Total hip arthroplasty for arthrodesed hips.

    OpenAIRE

    Howard MB; Bruce WJ; Walsh W; Goldberg JA

    2002-01-01

    The benefits of converting an ankylosed or arthrodesed hip to total hip arthroplasty have been reported in the literature as have the technical difficulties associated with this procedure. This review, however, outlines the experience of a single surgeon (WJMB) at a single institution using uncemented prostheses. Between November 1991 and June 1996, 5 arthrodesed hips underwent uncemented total hip arthroplasty in 4 males and 1 female. Clinical and radiological follow-up review was for at lea...

  16. Congenital syphilis

    International Nuclear Information System (INIS)

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

  17. Radiographic observation of congenital diaphragmatic hernia

    International Nuclear Information System (INIS)

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

  18. Is There a Benefit to Head Size Greater Than 36 mm in Total Hip Arthroplasty?

    Science.gov (United States)

    Haughom, Bryan D; Plummer, Darren R; Moric, Mario; Della Valle, Craig J

    2016-01-01

    This study compares the rate of dislocation and revision for instability between 36-mm and anatomic femoral heads (large diameter metal-on-metal THA, dual-mobility bearings, and hip resurfacing arthroplasty) in patients at high risk for dislocation. A total of 501 high-risk patients, over a 10-year period, were identified (282 36-mm THA, 24 dual-mobility bearings, 83 metal-on-metal arthroplasty, and 112 hip resurfacing arthroplasty). There were 13 dislocations in the 36-mm group compared to 1 in the anatomic group (4.6% vs 0.5%; P = .005). Four patients dislocated more than once in the 36-mm group (1.4% vs 0%; P = .04), and 2 patients in the 36-mm group required a revision for instability (0.7% vs 0%; P = .11). These results suggest that anatomic head sizes significantly lower the risk of dislocation in high-risk patients. PMID:26360768

  19. Dislocation Dynamics During Plastic Deformation

    CERN Document Server

    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.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  2. Ultrasound: Infant Hip

    Science.gov (United States)

    ... ultrasound when they suspect a problem called developmental dysplasia of the hip (DDH) . DDH is a hip deformity that can ... Kids For Parents MORE ON THIS TOPIC Developmental Dysplasia of the Hip X-Ray Exam: Hip X-Ray Exam: Leg ...

  3. Effective dislocation lines in continuously dislocated crystals. III. Kinematics

    OpenAIRE

    Trzesowski, Andrzej

    2007-01-01

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

  4. Introducing Dislocation Climb by Bulk Diffusion in Discrete Dislocation Dynamics

    OpenAIRE

    Mordehai, Dan; Clouet, Emmanuel; Fivel, Marc C.; Verdier, Marc

    2008-01-01

    Abstract We report a method to incorporate dislocation climb controlled by bulk diffusion in a 3-dimensional discrete dislocation dynamics (DDD) simulation for fcc metals. In this model we couple the vacancy diffusion theory to the DDD in order to obtain the climb rate of the dislocation segments. The model capability to reproduce the motion of climbing dislocations is examined by calculating several test-cases of pure climb-related phenomena and comparing the results with existing...

  5. Dislocation of jaws

    International Nuclear Information System (INIS)

    Pluri-directional tomographic and arthrotomographic findings are described in six patients with dislocation of the jaw severe enough to require medical assistance. A grooved defect along the posterior aspect of the condylar head was noted in two of the six patients. The arthrotomographic findings that were obtained in one patient that was dislocated at the time of the arthrogram did not suggest a meniscocondyle incoordination as a mechanism. However, arthrotomographic findings in the six reported cases suggest that significant intra-articular soft tissue damage may result. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. [Congenital foot abnormalities].

    Science.gov (United States)

    Delpont, M; Lafosse, T; Bachy, M; Mary, P; Alves, A; Vialle, R

    2015-03-01

    The foot may be the site of birth defects. These abnormalities are sometimes suspected prenatally. Final diagnosis depends on clinical examination at birth. These deformations can be simple malpositions: metatarsus adductus, talipes calcaneovalgus and pes supinatus. The prognosis is excellent spontaneously or with a simple orthopedic treatment. Surgery remains outstanding. The use of a pediatric orthopedist will be considered if malposition does not relax after several weeks. Malformations (clubfoot, vertical talus and skew foot) require specialized care early. Clubfoot is characterized by an equine and varus hindfoot, an adducted and supine forefoot, not reducible. Vertical talus combines equine hindfoot and dorsiflexion of the forefoot, which is performed in the midfoot instead of the ankle. Skew foot is suspected when a metatarsus adductus is resistant to conservative treatment. Early treatment is primarily orthopedic at birth. Surgical treatment begins to be considered after walking age. Keep in mind that an abnormality of the foot may be associated with other conditions: malposition with congenital hip, malformations with syndromes, neurological and genetic abnormalities. PMID:25524290

  8. Acetabular wall augmentation in selected patients with recurrent dislocation after THA.

    Science.gov (United States)

    Sivertsen, Einar Andreas; Borgen, Pål Oliver

    2014-11-01

    We reviewed 42 patients operated with PMMA augmentation of the acetabular wall for recurrent posterior dislocation of cemented total hip arthroplasties with a cemented all-poly acetabular component. 38 patients never experienced subsequent dislocations after the procedure. 4 patients had recurrent dislocations, and two additional patients underwent a revision procedure due to aseptic loosening of the acetabular component. 1, 5 and 10 years survival of the prosthesis free of dislocation were 95%, 95% and 64% respectively. 90% of the patients were satisfied, four patients experienced pain and 3 patients sustained an infection. The procedure is simple, effective, takes less time and results in less blood loss compared to full revision surgery. It should be considered in cases of recurrent posterior dislocation in elderly patients. PMID:25052045

  9. Thermodynamically consistent continuum dislocation dynamics

    OpenAIRE

    Hochrainer, Thomas

    2015-01-01

    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...

  10. Variational approach in dislocation theory

    OpenAIRE

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

    2009-01-01

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

  11. Congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    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.

  12. Gauge theory of dislocations

    International Nuclear Information System (INIS)

    In this continuation of work by the author the notion of the distortion of an ideal crystal structure is generalized and the gauge field is defined, fundamental states (vacuum configurations) of which are the crystal structure elementary distortions due to dislocations. The form of the structure equations of the connection form defined by this gauge field is discussed

  13. Inner-City Dislocations.

    Science.gov (United States)

    Wilson, William Julius

    1983-01-01

    Although racial discrimination contributes to increasing urban social dislocation, problems such as massive joblessness, the influx of migrants to cities, and demographic shifts underlie the current crisis. Change will only come about through public policies that benefit all the poor, not just poor minorities. (Author/GC)

  14. Glenohumeral instability and dislocation.

    Science.gov (United States)

    Finnoff, Jonathan T; Doucette, Susan; Hicken, Gregory

    2004-08-01

    Glenohumeral joint instability and dislocations are common diagnoses seen by physicians. There are many different pathologic etiologies for these conditions. A thorough understanding of the history,physical examination, pathoanatomy, and classification systems is required to make an accurate diagnosis. With the appropriate diagnosis, the clinician can choose the correct treatment and improve the patient's outcome. PMID:15219891

  15. Behavior of dislocations in silicon

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Complications after total hip replacement

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2005-04-01

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

  18. Total hip arthroplasty for arthrodesed hips.

    Directory of Open Access Journals (Sweden)

    Howard MB

    2002-06-01

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

  19. Atlantoaxial dislocation associated with the maldevelopment of the posterior neural arch of axis causing compressive myelopathy

    Directory of Open Access Journals (Sweden)

    Behari Sanjay

    2004-10-01

    Full Text Available The craniovertebral junction has a predilection for a variety of congenital anomalies due to its complex development. The association of atlantoaxial dislocation (AAD with the maldevelopment of the posterior arch of axis is extremely rare. We report two such cases and present the management strategy.

  20. Congenital hypothyroidism

    Directory of Open Access Journals (Sweden)

    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. In general, the prognosis of infants detected by screening and started on treatment early is excellent, with IQs similar to sibling or classmate controls. Studies show that a lower neurocognitive outcome may occur in those infants started at a later age (> 30 days of age, on lower l-thyroxine doses than currently recommended, and in those infants with more severe hypothyroidism.

  1. Disease: H00762 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00762 SEMD, Omani type; Spondyloepiphyseal dysplasia with congenital joint dislocations SEMD, O ... al joint dislocations especially in knees. Hip and elbow ... dislocations are also common. Thoracic kyphoscolio ...

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

    Science.gov (United States)

    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.

  3. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  4. Taper Hip Prosthesis

    Medline Plus

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

  5. Thermodynamically consistent continuum dislocation dynamics

    Science.gov (United States)

    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.

  6. Congenital pachygyria

    Directory of Open Access Journals (Sweden)

    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

  7. Dislocation patterning in a 2D continuum theory of dislocations

    OpenAIRE

    Groma, Istvan; Zaiser, Michael; Ispanovity, Peter Dusan

    2016-01-01

    Understanding the spontaneous emergence of dislocation patterns during plastic deformation is a long standing challenge in dislocation theory. During the past decades several phenomenological continuum models of dislocation patterning were proposed, but few of them (if any) are derived from microscopic considerations through systematic and controlled averaging procedures. In this paper we present a 2D continuum theory that is obtained by systematic averaging of the equations of motion of disc...

  8. The radiology of total hip replacement

    International Nuclear Information System (INIS)

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

  9. Hip Injuries and Disorders

    Science.gov (United States)

    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 ...

  10. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Your Child All About Food Allergies Ultrasound: Infant Hip KidsHealth > For Parents > Ultrasound: Infant Hip Print A A A Text Size What's in ... en español Ultrasonido: cadera What It Is A hip ultrasound is a safe and painless test that ...

  11. Hip supporting device

    DEFF Research Database (Denmark)

    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...

  12. Congenital CMV Infection

    Science.gov (United States)

    ... Hand Hygiene CDC Feature on Prenatal Infections Congenital CMV Infection Language: English Español (Spanish) Recommend on Facebook ... Top of Page Treatment for Babies Born with CMV If your baby is diagnosed with congenital CMV ...

  13. Birthmark (Congenital Melanocytic Nevus)

    Science.gov (United States)

    ... Birthmark (Congenital Melanocytic Nevus) A parent's guide for infants and babies A A A Congenital melanocytic nevi ... than 1 cm to less than 20 cm (bathing suit or garment lesions cover large sections of ...

  14. Congenital Heart Defects

    Science.gov (United States)

    ... of a set of gene mutations in the development of congenital heart disease and simultaneously discovered a link between them and some neurodevelopmental abnormalities in children. These abnormalities include cognitive, motor, social, and language impairments. View all recent Congenital ...

  15. Congenital Heart Information Network

    Science.gov (United States)

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

  16. Congenital heart disease

    Science.gov (United States)

    Congenital heart disease is a problem with the heart's structure and function that is present at birth. ... Congenital heart disease (CHD) can describe a number of different problems affecting the heart. It is the most common ...

  17. Congenital platelet function defects

    Science.gov (United States)

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

  18. Minimally-incision total hip arthoplasty: Complications

    Directory of Open Access Journals (Sweden)

    Baščarević V.

    2010-01-01

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

  19. Mobility of dislocations in semiconductors

    OpenAIRE

    Stokbro, K.; Hansen, L B; Lundqvist, B. I.

    1996-01-01

    Atomic-scale calculations for the dynamics of the 90$^0$ partial glide dislocation in silicon are made using the effective-medium tight-binding theory. Kink formation and migration energies for the reconstructed partial dislocation are compared with experimental results for the mobility of this dislocation. The results confirm the theory that the partial moves in the dissociated state via the formation of stable kinks. The correlation between glide activation energy and band gap in semiconduc...

  20. Grain Orientation and Dislocation Patterns

    OpenAIRE

    Hansen, Niels; Huang, Xiaoxu; Pantleon, Wolfgang; Winther, Grethe

    2006-01-01

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

  1. Congenital sternoclavicular dermoid sinus.

    Science.gov (United States)

    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

  2. Hip arthroplasty in failed intertrochanteric fractures in elderly

    Directory of Open Access Journals (Sweden)

    Javahir A Pachore

    2013-01-01

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

  3. Dislocation dynamics in nanocrystalline nickel.

    Science.gov (United States)

    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

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

    OpenAIRE

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

    2011-01-01

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

  5. Outcomes of Dual Modular Cementless Femoral Stems in Revision Hip Arthroplasty

    OpenAIRE

    Ali Ghoz; Matthew L. Broadhead; John Morley; Shawn Tavares; David McDonald

    2014-01-01

    With an increasing number of primary hip replacements being performed every year, the burden of revision hip arthroplasty, for septic and aseptic loosening, recurrent dislocation or periprosthetic fracture, is also increasing. In recent years, different approaches to revising the femoral prosthesis have emerged; including both cemented and cementless techniques. With a stable cement mantle and good bone quality, or through the use of impaction bone grafting when bone stock is lacking, it is p...

  6. Long-term outcome of reconstruction of the hip in young children with cerebral palsy.

    Science.gov (United States)

    Dhawale, A A; Karatas, A F; Holmes, L; Rogers, K J; Dabney, K W; Miller, F

    2013-02-01

    We reviewed the long-term radiological outcome, complications and revision operations in 19 children with quadriplegic cerebral palsy and hip dysplasia who underwent combined peri-iliac osteotomy and femoral varus derotation osteotomy. They had a mean age of 7.5 years (1.6 to 10.9) and comprised 22 hip dislocations and subluxations. We also studied the outcome for the contralateral hip. At a mean follow-up of 11.7 years (10 to 15.1) the Melbourne cerebral palsy (CP) hip classification was grade 2 in 16 hips, grade 3 in five, and grade 5 in one. There were five complications seen in four hips (21%, four patients), including one dislocation, one subluxation, one coxa vara with adduction deformity, one subtrochanteric fracture and one infection. A recurrent soft-tissue contracture occurred in five hips and ten required revision surgery. In pre-adolescent children with quadriplegic cerebral palsy good long-term outcomes can be achieved after reconstruction of the hip; regular follow-up is required. PMID:23365039

  7. Annealing of dislocation loops in dislocation dynamics simulations

    International Nuclear Information System (INIS)

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

  8. Annealing of dislocation loops in dislocation dynamics simulations

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. The normal hip in the newborn infant: Sonographic standards for instability

    International Nuclear Information System (INIS)

    Despite careful clinical examinations in the nursery, some infants with significant congenital hip instability elude early diagnosis. In recent years, the use of real-time US has enabled a dynamic arthrographic type of hip examination to be performed. Preliminary experience suggests that a certain amount of instability in newborn hips is probably normal, but no standards have been established. In this study, a group of term newborn infants whose physical examinations were normal were examined by hip sonography on the first and second days of life. Each hip was imaged in the transverse plane in stressed and nonstressed positions to allow quantitation of motion. This study defines the normal range of hip instability in newborn infants

  10. Bearing Change to Metal-On-Polyethylene for Ceramic Bearing Fracture in Total Hip Arthroplasty; Does It Work?

    Science.gov (United States)

    Lee, Soong Joon; Kwak, Hong Suk; Yoo, Jeong Joon; Kim, Hee Joong

    2016-01-01

    We evaluated the short-term to midterm results of reoperation with bearing change to metal-on-polyethylene (MoP) after ceramic bearing fracture in ceramic-on-ceramic total hip arthroplasty. Nine third-generation ceramic bearing fractures (6 heads and 3 liners) were treated with bearing change to MoP. Mean age at reoperation was 52.7 years. Mean follow-up was 4.3 years. During follow-up, 2 of 3 liner-fractured hips and 1 of 6 head-fractured hips showed radiologic signs of metallosis and elevated serum chromium levels. Re-reoperation with bearing rechange to a ceramic head was performed for the hips with metallosis. One liner-fractured hip had periprosthetic joint infection. Dislocation occurred in 3 hips. From our experience, bearing change to MoP is not a recommended treatment option for ceramic bearing fracture in total hip arthroplasty. PMID:26404851

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

    Directory of Open Access Journals (Sweden)

    Won Yong Shon

    2014-01-01

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

  12. Nature of Dislocations in Silicon

    DEFF Research Database (Denmark)

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

    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...

  13. The other hip in unilateral hip dysplasia

    DEFF Research Database (Denmark)

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

    Directory of Open Access Journals (Sweden)

    Chun-Yang Chen

    2003-03-01

    Full Text Available Primary synovial chondromatosis is an uncommon disorder, and involvement of the hipjoint is rare. The clinical symptoms are usually non-specific, and a clinical diagnosis of synovialchondromatosis of the hip may be difficult and delayed, especially before the ossifyingnodules become evident. Loose bodies in the joint can cause secondary degenerativeosteoarthritis of the hip. Currently, the recommended management is surgical removal of theloose bodies and a synovectomy without dislocation of the hip joint. Herein we report on 2cases of synovial chondromatosis of the hip, which were managed with an arthroscopeassistedsynovectomy and removal of the loose bodies. We believe this is an easy and safemethod for management of this disorder.

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

    Directory of Open Access Journals (Sweden)

    Liliana SAVIN

    2012-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Mantu Jain

    2013-10-01

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

  17. Homogeneous Dislocation Nucleation

    Science.gov (United States)

    Hasan, Asad; Maloney, Craig

    2012-02-01

    We perform atomistic computer simulations to study the mechanism of homogeneous dislocation nucleation (HDN) in a 2D hexagonal crystalline film under circular indentation. The nucleation process is governed by vanishing of energy associated with a single normal mode. For fixed film thickness, L, the spatial extent, ξ, of the critical mode grows with indenter radius, R. For fixed R/L, ξ scales roughly as ξ˜L^0.4. We perform a mesoscale analysis to determine the lowest energy normal mode for regions of varying radius, rmeso, centered on the critical mode's core. The energy of the lowest normal mode λmeso->0 rapidly as rmeso->ξ. The lowest mode shows a spatial extent, ξmeso, which increases sublinearly for rmeso=1.5; ξ. Thus HDN is a quasi-local phenomenon.

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

    Science.gov (United States)

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

    2014-11-01

    The purpose of this study was to review clinical and radiographic outcomes of perilunate dislocations and fracture dislocations treated with external fixation and K-wire fixation. Twenty patients (18 males and two females) with a mean age of 38 years (range 18-59) who had an acute dorsal perilunate dislocation or fracture dislocation were treated with the use of wrist external fixator and K-wires. The injuries included 12 perilunate dislocations, seven trans-scaphoid perilunate fracture dislocations, and one trans-styloid perilunate fracture dislocation. The median time from trauma to operation was 8 h (2-12 h). Indirect reduction via ligamentotaxis was achieved in all perilunate dislocation, and provisional K-wire fixation was added. In five of seven trans-scaphoid perilunate fracture dislocations, indirect reduction was achieved; whereas in the other two as well as in the case of trans-styloid perilunate fracture dislocation, open reduction was required. External fixator was supplemented with K-wires for stabilization of the fractures and the intercarpal intervals. The interosseous and capsular ligaments were not repaired, even after open reduction of fracture dislocations. The mean follow-up was 39 months (range 18-68 months). Range of motion and grip strength were measured. Cooney's scoring system was used for the assessment of clinical function. Radiographic evaluation included time to scaphoid union, measurement of radiographic parameters (scapholunate gap, scapholunate angle, lunotriquetral gap, and carpal height ratio) and any development of arthritis. The flexion-extension motion arc and grip strength of the injured wrist averaged 80 and 88%, respectively, of the corresponding values for the contralateral wrists. According to Cooney's clinical scoring system, overall functional outcomes were rated as excellent in four patients, good in eight, fair in six, and poor in two. Eighteen patients returned to their former occupations. Two patients with a trans-scaphoid perilunate injury developed nonunion of the scaphoid; one of them required scaphoid excision and midcarpal fusion. Two patients had radiographic evidence of arthritis. The use of external fixation and provisional K-wire fixation for the treatment of acute perilunate dislocations is associated with satisfactory midterm functional and radiographic outcomes. This minimally invasive treatment option is simple, reliable, and minimally invasive method that provides proper restoration and stable fixation of carpal alignment. PMID:25301167

  19. What Is a Hip Replacement?

    Science.gov (United States)

    ... Hip Replacement Find a Clinical Trial Journal Articles Hip Replacement PDF Version Size: 123 KB Audio Version Time: ... 9.4 MB November 2014 What Is a Hip Replacement? Fast Facts: An Easy-to-Read Series of ...

  20. Hip Fractures among Older Adults

    Science.gov (United States)

    ... 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 ...

  1. Congenital malformations in Assam

    OpenAIRE

    Dutta Hemonta; Bhattacharyya N; Sarma J; Kusre Giriraj

    2010-01-01

    Aim : To determine the annual incidence of congenital malformations in Assam and to analyze the data. Materials and Methods : Data regarding babies born with congenital malformations in the state of Assam during the year 2006 were obtained through questionnaires and analyzed. The results were compared with similar Indian data. Results : The overall incidence of congenital malformation was 0.08%. This was considerably lower than similar published data from other states. Five hundred and...

  2. Quenched Dislocation Enhanced Supersolid Ordering

    OpenAIRE

    Toner, John

    2007-01-01

    I show using Landau theory that quenched dislocations can facilitate the supersolid (SS) to normal solid (NS) transition, making it possible for the transition to occur even if it does not in a dislocation-free crystal. I make detailed predictions for the dependence of the SS to NS transition temperature T_c(L), superfluid density %\\rho_S(T, L), and specific heat C(T,L) on temperature T and dislocation spacing L, all of which can be tested against experiments. The results should also be appli...

  3. Patellar Dislocations and Reduction Procedure.

    Science.gov (United States)

    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

  4. Phase Field Methods and Dislocations

    CERN Document Server

    Rodney, D

    2001-01-01

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

  5. Genetics Home Reference: congenital hypothyroidism

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions congenital hypothyroidism congenital hypothyroidism Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Congenital hypothyroidism is a partial or complete loss of function ...

  6. Impact of Congenital Heart Defects

    Science.gov (United States)

    ... 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 ...

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

    Directory of Open Access Journals (Sweden)

    Paji? Miloš

    2007-01-01

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

  8. Taper Hip Prosthesis

    Medline Plus

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

  9. Hip joint pathology

    DEFF Research Database (Denmark)

    Tijssen, M; van Cingel, R E H; de Visser, E; Hölmich, P; Nijhuis-van der Sanden, M W G

    2016-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18...... are suggested to rule out the diagnosis of symptomatic FAI and/or labral pathology....

  10. TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    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.

  11. Dislocation dynamics simulations in 2-dimensions

    International Nuclear Information System (INIS)

    In this paper two methods for simulating dislocation dynamics in 2-dimensions are described. The first method uses molecular dynamic to study the motion of individual dislocations in their slip planes. This method is atomistic in nature so the phonon emission from driven dislocation may be observed. Results on straight edge and screw dislocations, dislocation loops and Frank-Read sources will be presented. The second method extends this approach by solving the equations of motion for many dislocations. In order to handle the densities of dislocations typically found in metals (or order 1012/m2), this method must abandon the atomistic approach. Using this method we observe the formation of dislocation substructure and examine the influence of stress and dislocation density on the spatially correlated dislocation patterns

  12. Palmar dislocation of the trapezoid

    International Nuclear Information System (INIS)

    Palmar dislocation of the trapezoid is a rare injury, which results from substantial trauma to the wrist. It is associated with other bony or ligamentous injuries in the wrist. If unrecognized, loss of function of the hand and early osteoarthritis may result. Treatment of choice is open reduction and internal fixation, which generally achieves good functional results. We describe a new case of palmar dislocation of the trapezoid and review the world literature with emphasis on the radiographic findings. (orig.)

  13. Formed HIP Can Processing

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

    2014-01-01

    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. PMID:24707293

  15. Continuum theory of evolving dislocation fields

    OpenAIRE

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

    2007-01-01

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

  16. Congenital proximal radioulnar synostosis

    Directory of Open Access Journals (Sweden)

    Dogra B

    2003-01-01

    Full Text Available Congenital proximal radio-ulnar synostosis is a rare anomaly and is often part of syndromes such as Crouzon, Apert's and Poland's. We have successfully managed one such case with bilateral involvement not associated with any other congenital deformity. He has been managed by performing derotation osteotomy through the synostosis mass with gratifying results.

  17. Current Trends in Management of Atlantoaxial Dislocation.

    Science.gov (United States)

    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. MR findings of congenital anorectal malformation

    International Nuclear Information System (INIS)

    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

  19. MR findings of congenital anorectal malformation

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    Musielak, Bartosz; Idzior, Maciej; Jó?wiak, 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

  1. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavkovi? Nemanja

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Luciane Zanusso Pagnossim

    2008-09-01

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

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

    OpenAIRE

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

    2014-01-01

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

  4. Transient osteoporosis of the hip

    International Nuclear Information System (INIS)

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

  5. Magnetic resonance imaging of labral cysts of the hip

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. [Dega transiliac acetabular osteotomy in cerebral palsy hip joint].

    Science.gov (United States)

    Borowski, Andrzej; Pruszczy?ski, B?azej; Grzegorzewski, Andrzej; Synder, Marek

    2009-01-01

    Untreated hip joint in cerebral palsy children leads to subluxation or dislocation caused by muscle imbalance often with associated painful arthritis. The very strong hip joint flexors and adductors muscles overpower the abductors and extensors muscles, moving the hip joint's rotation center to shift from center of the femoral head to the lesser trochanter. The forces gradually change the shape of the acetabulum, which becomes more elliptical. Between 1994 and 2000, 136 cerebral palsy children were treated by multilevel soft tissue surgery. Among them 95 children required surgical interventions for hip problems. In 18 cases (7 girls, 11 boys) with average adduction of 10 degrees and migration index over 60%, osteotomy of proximal femur (varus and derotation osteotomy) combine with Dega pelvic osteotomy was performed. Mean age at the time of surgery was 11.2 years. The study was based on clinical examination, parents' questionnaire and radiological findings (mean follow up 8 years). The functional improvement was observed. Correction of the position of femoral head into acetabulum allowed for sufficient abduction of the leg with mean increase of 18 degrees. In ambulatory patients, gait pattern had change to less energy. In non-ambulatory patients improved ability of perineal care. Migration index decreased to an average of 25%. Hip pain decreased in all. The unsatisfactory results were noted in two cases, redislocation. Dega's acetabular osteotomy allows for correction deficiency of the acetabulum with a good coverage of femoral head. With a properly planned approach, bone surgery can bring good clinical and functional results. PMID:19514473

  7. The effect of posterior and lateral approach on patient-reported outcome measures and physical function in patients with osteoarthritis, undergoing total hip replacement

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Broeng, Leif; Jensen, Carsten; Holsgaard-Larsen, Anders; Overgaard, Søren

    2014-01-01

    BACKGROUND: Total hip replacement provides pain relief and improves physical function and quality of life in patients with end-stage hip osteoarthritis. The incidence of hip replacement operations is expected to increase due to the growing elderly population. Overall, the posterior approach and...... lateral approach are the two most commonly used approaches for hip replacement operations. The posterior approach is associated with an increased risk of revision due to dislocations, and some studies have shown that the lateral approach is associated with reduced patient-reported outcomes, including...... a prospective, double blinded, parallel-group controlled trial with balanced randomisation [1: 1]. Patients with hip osteoarthritis scheduled for hip replacement surgery, aged 45-70 years, will be consecutively recruited and randomised into two groups. Group A will receive hip replacement using the...

  8. Dislocations and other topological oddities

    Science.gov (United States)

    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.

  9. Operative treatment of developmental hip dysplasia in children aged over 8 years.

    Science.gov (United States)

    Ok, In-Young; Kim, Seok-Jung; Ok, Ji-Hoon

    2007-07-01

    Nine patients aged over 8 years with developmental dislocation of the hip were treated by an open reduction, femoral shortening and varus derotation osteotomy with or without a Chiari osteotomy. The mean age of the patients was 11.1 years (range 8-17 years), and the mean follow-up period was 7.1 years (range 1-13 years). The left hip was involved in four cases: the right in three and two cases were bilateral. One hip redislocated. The remaining patients recovered nearly full movement of the affected hip. Five out of eight patients had a normal gait without limping or pain. Two others limped secondary to a leg-length discrepancy, which was corrected with leg equalization. The remaining patient had an improvement of her preoperative limp and was pain-free. These results indicate that it is possible to obtain good hip function after open reduction of a developmentally dislocated hip, even after the age of 8 years. PMID:17527102

  10. Hip Conditioning Program

    Science.gov (United States)

    ... stomach on a firm, flat surface with a pillow under your hips. • Bend one knee 90°. • Lift ... a table or physical therapy bench with a pillow between your thighs. Place your lower arm in ...

  11. Arthroscopic hip labral repair.

    Science.gov (United States)

    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

  12. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... L Taper Hip Prosthesis with Modular Neck Kinectiv® Technology March 12, 2009 7:00 PM EDT Welcome ... start rasping. These are the rasps for the new connective system. They're diamond cutting and they ...

  13. Total Hip Replacement

    Science.gov (United States)

    ... household activities, such as sitting, standing, and climbing stairs • Specific exercises several times a day to restore ... may result in a need for more surgery. Stairs are a particular hazard until your hip is ...

  14. Treatment of hip dysplasia.

    Science.gov (United States)

    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

  15. Imaging of hip arthroplasty

    International Nuclear Information System (INIS)

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

  16. Taper Hip Prosthesis

    Medline Plus

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

  17. Taper Hip Prosthesis

    Medline Plus

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

  18. Taper Hip Prosthesis

    Medline Plus

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

  19. Hip Problems in Infants

    Science.gov (United States)

    ... take your baby to a pediatric orthopedist. A pediatric orthopedist is a doctor who has had special training in bone problems in children. Sometimes a baby's hips may be checked by ultrasound. Ultrasound uses sound waves to take a picture ...

  20. Taper Hip Prosthesis

    Medline Plus

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

  1. Taper Hip Prosthesis

    Medline Plus

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

  2. Multiscale Theory of Dislocation Climb

    Science.gov (United States)

    Geslin, Pierre-Antoine; Appolaire, Benoît; Finel, Alphonse

    2015-12-01

    Dislocation climb is a ubiquitous mechanism playing a major role in the plastic deformation of crystals at high temperature. We propose a multiscale approach to model quantitatively this mechanism at mesoscopic length and time scales. First, we analyze climb at a nanoscopic scale and derive an analytical expression of the climb rate of a jogged dislocation. Next, we deduce from this expression the activation energy of the process, bringing valuable insights to experimental studies. Finally, we show how to rigorously upscale the climb rate to a mesoscopic phase-field model of dislocation climb. This upscaling procedure opens the way to large scale simulations where climb processes are quantitatively reproduced even though the mesoscopic length scale of the simulation is orders of magnitude larger than the atomic one.

  3. Microinstability of the Hip and the Splits Radiograph.

    Science.gov (United States)

    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. [Orthopedics. 2016; 39(1):e169-e175.]. PMID:26730687

  4. Short-term results of novel constrained total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Thomas Pace

    2015-06-01

    Full Text Available Constrained acetabular components have only been recommended as a salvage option for the persistently unstable total hip arthroplasty (THA, due to limited range of motion and less than satisfactory component failure rates. This is a retrospective review of 137 patients with 154 consecutive primary constrained THAs performed between November 2003 and August 2007. We reviewed serial radiographs, postoperative complications, groin/thigh pain, and compared preoperative and postoperative Harris Hip Scores. With a mean follow-up of 6 years, there was 1.9% dislocation rate, 0% component failure rate, and 2.6% infection rate. Seven patients reported continued groin pain, and three had continued thigh pain. One patient showed radiographic evidence of 1 mm polyethylene wear. Radiographic review showed no evidence of osteolysis or stem subsidence. Harris Hip Scores improved from a mean of 68.8 (range 58-87 preoperatively to 98.9 (range 65-100 at final clinical assessment. This constrained acetabular prosthesis had a dislocation rate of less than 2%, with 0% component failure rate at a minimum of 2 years of follow-up suggesting this prosthesis may be a viable alternative for patients at risk for instability or those known to have recurrent instability.

  5. Congenital Constriction Band Syndrome

    Directory of Open Access Journals (Sweden)

    Rajesh Gupta, Fareed Malik, Rishabh Gupta, M.A.Basit, Dara Singh

    2008-04-01

    Full Text Available Congenital constriction bands are anomalous bands that encircle a digit or an extremity. Congenitalconstriction band syndrome is rare condition and is mostly associated with other musculoskeletaldisorders.We report such a rare experience.

  6. Leber Congenital Amaurosis

    Science.gov (United States)

    ... 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. ...

  7. Causes of Congenital Malformations

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-04-01

    Full Text Available 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.

  8. Congenital Ocular Motor Apraxia

    OpenAIRE

    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.

  9. Congenital orbital teratoma

    Directory of Open Access Journals (Sweden)

    Shereen Aiyub

    2013-01-01

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

  10. Identification of congenital deafblindness

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2012-01-01

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

  11. Congenital Ocular Motor Apraxia

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Lazar, Markus

    2012-01-01

    The fundamental problem of non-singular dislocations in the framework of the theory of gradient elasticity is presented in this work. Gradient elasticity of Helmholtz type and bi-Helmholtz type are used. A general theory of non-singular dislocations is developed for linearly elastic, infinitely extended, homogeneous, and isotropic media. Dislocation loops and straight dislocations are investigated. Using the theory of gradient elasticity, the non-singular fields which are produced by arbitrar...

  13. Congenital chylous ascites

    International Nuclear Information System (INIS)

    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. (authors)

  14. Congenital nephrotic syndrome

    OpenAIRE

    Claudia Fanni; Cristina Loddo; Gavino Faa; Giovanni Ottonello; Melania Puddu; Vassilios Fanos

    2014-01-01

    CNS (Congenital nephrotic syndrome) is a disorder characterized by the presence of a nephrotic syndrome in the first three months of life. Different pathologies can cause this syndrome. In general, we can distinguish primary forms (sporadic and hereditary) and secondary forms (acquired and associated with other syndromes). The most common form is the Finnish CNS (CNF, congenital nephrotic syndrome of the Finnish type), a hereditary form whose name derives from the fact that the highest incide...

  15. Congenital imprinting disorders

    DEFF Research Database (Denmark)

    Eggermann, Thomas; Netchine, Irène; Temple, I Karen; Tümer, Zeynep; Monk, David; Mackay, Deborah; Grønskov, Karen; Riccio, Andrea; Linglart, Agnès; Maher, Eamonn R

    2015-01-01

    Imprinting disorders (IDs) are a group of eight rare but probably underdiagnosed congenital diseases affecting growth, development and metabolism. They are caused by similar molecular changes affecting regulation, dosage or the genomic sequence of imprinted genes. Each ID is characterised by...... 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...

  16. Congenital distal humeral dysplasia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Directory of Open Access Journals (Sweden)

    van Raaij Jos JAM

    2008-10-01

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

  18. MR imaging in congenital lower limb deformities

    International Nuclear Information System (INIS)

    Treatment for children with cogenital deformities of the lower extremities may vary, depending on the state of the unossified skeletal structures and surrounding soft tissues. The purpose of our study was to demonstrate the spectrum of the osteochondral and extrasosseous abnormalities as depicted with MR imaging. We retrospectively reviewed MR examinations of 13 limbs of ten children (aged 1 month-9 years, mean 2.1 years) with longitudinal and transverse deformities of the lower extremities. The lesions imaged were fibular hemimelia (n=5), tibial hemimelia (n=5), and congenital constriction bands (n=3). Each examination was assessed for abnormalities in the osteocartilaginous and extraosseous (articular or periarticular components such as ligaments, tendons, and menisci; the muscles and the arteries) structures. Abnormalities were seen in all patients. Osteocartilaginous abnormalities in the patients with longitudinal deformities included abnormal distal femoral epiphyses, abnormal proximal tribial physes, hypertrophied and dislocated proximal fibular epiphyses, unsuspected fibular and tibial remnants, and absence or coalition of the tarsal bones. No osteocartilaginous abnormalities were seen in the patients with congential constriction bands. Articular abormalities in patients with either form of hemimelia included absent cruciate ligaments and menisci, dislocated or absent cartilaginous patellae, absent patellar tendons, and abnormal collateral ligaments. All but 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.)

  19. MR imaging in congenital lower limb deformities

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  20. Congenital hyperthyroidism: autopsy report Hipertireoidismo Congenital

    OpenAIRE

    Marcus Aurelho Lima; Lília Beatriz Oliveira; Neiva Paim; Maria de Fátima Borges

    1999-01-01

    We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and h...

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

    International Nuclear Information System (INIS)

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

  2. Three-dimensional continuum dislocation theory

    OpenAIRE

    Le, Khanh Chau

    2015-01-01

    A three-dimensional continuum dislocation theory for single crystals containing curved dislocations is proposed. A set of governing equations and boundary conditions is derived for the true placement, plastic slips, and loop functions in equilibrium that minimize the free energy of crystal among all admissible functions, provided the resistance to the dislocation motion is negligible. For the non-vanishing resistance to dislocation motion the governing equations are derived from the variation...

  3. Can vacancies lubricate dislocation motion in aluminum?

    OpenAIRE

    Lu, Gang; Kaxiras, Efthimios

    2002-01-01

    The interaction of vacancy with dislocations in Al is studied using the Semidiscrete Variational Peierls-Nabarro model with ab initio determined gamma surface. For the first time, we confirm theoretically the so-called vacancy lubrication effect on dislocation motion in Al, a discovery that can settle a long-standing controversy in dislocation theory for fcc metals. We provide insights on the lubrication effect by exploring the connection between dislocation mobility and its core width. We pr...

  4. Drift of dislocation tripoles under ultrasound influence.

    Science.gov (United States)

    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

  5. Scattering of phonons by dislocations

    International Nuclear Information System (INIS)

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

  6. DISLOCATION KINETICS OF SHOCK WAVE METAL DEFORMATION

    OpenAIRE

    Merzhievsky, L.; Tyagel'Sky, A.

    1991-01-01

    A construction is made for the dislocation metal deformation kinetics in a shock wave, that takes into account, besides the traditional dislocation multiplication mechanisms, the mechanism of heterogeneous dislocation nucleation on point defects. The applicability of kinetics for modelling the shock wave processes in metals is shown.

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

    Directory of Open Access Journals (Sweden)

    Julio Nazer H

    2001-01-01

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

  8. Topographic study of dislocation structure in hexagonal SiC single crystals with low dislocation density

    Science.gov (United States)

    Nakamura, Daisuke; Yamaguchi, Satoshi; Gunjishima, Itaru; Hirose, Yoshiharu; Kimoto, Tsunenobu

    2007-06-01

    We have investigated hexagonal silicon carbide with low dislocation density to reveal inherent dislocation types and structures using the bulk-sensitive synchrotron X-ray topography. This topographic study reveals that: (1) Basal-plane dislocations with the Burgers vector of {1}/{3} preferred to be screw dislocations along in straight shape. (2) Threading dislocations containing the Burgers vector component of are mostly mixed dislocations containing that of {1}/{3}. (3) Threading edge dislocations with the Burgers vector of {1}/{3} are of short lengths, about 30-100 ?m. (4) All these dislocations are connected to convert, combine and dissociate to each other. We discuss the dislocation types and structures in terms of both the Peierls energy and elastic interaction. Moreover, we propose that the source of dislocations with the Burgers vector of {1}/{3} is due to the propagation from a seed crystal rather than due to the Frank-Read mechanism.

  9. Hips at risk osteoporosis and prevention of hip fractures

    OpenAIRE

    Ekman, Anna

    2001-01-01

    Hip fractures are the most serious consequence of osteoporosis, and are one important cause of morbidity and mortality among the elderly. Prophylactic treatment for hip fractures are now available. Early detection of individuals with increased risk for hip fractures is therefor of great interest. A subset of non-institutionalised patients with a first hip fracture (cases;n=l18) and controls (n=263), aged 65-85 years, underwent dual X-ray absorptiometry (DXA) of the femoral neck, quantitative ...

  10. A patient-specific model of the biomechanics of hip reduction for neonatal Developmental Dysplasia of the Hip: Investigation of strategies for low to severe grades of Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Huayamave, Victor; Rose, Christopher; Serra, Sheila; Jones, Brendan; Divo, Eduardo; Moslehy, Faissal; Kassab, Alain J; Price, Charles T

    2015-07-16

    A physics-based computational model of neonatal Developmental Dysplasia of the Hip (DDH) following treatment with the Pavlik Harness (PV) was developed to obtain muscle force contribution in order to elucidate biomechanical factors influencing the reduction of dislocated hips. Clinical observation suggests that reduction occurs in deep sleep involving passive muscle action. Consequently, a set of five (5) adductor muscles were identified as mediators of reduction using the PV. A Fung/Hill-type model was used to characterize muscle response. Four grades (1-4) of dislocation were considered, with one (1) being a low subluxation and four (4) a severe dislocation. A three-dimensional model of the pelvis-femur lower limb of a representative 10 week-old female was generated based on CT-scans with the aid of anthropomorphic scaling of anatomical landmarks. The model was calibrated to achieve equilibrium at 90° flexion and 80° abduction. The hip was computationally dislocated according to the grade under investigation, the femur was restrained to move in an envelope consistent with PV restraints, and the dynamic response under passive muscle action and the effect of gravity was resolved. Model results with an anteversion angle of 50° show successful reduction Grades 1-3, while Grade 4 failed to reduce with the PV. These results are consistent with a previous study based on a simplified anatomically-consistent synthetic model and clinical reports of very low success of the PV for Grade 4. However our model indicated that it is possible to achieve reduction of Grade 4 dislocation by hyperflexion and the resultant external rotation. PMID:25957995

  11. The continuous theory of dislocations for a material containing dislocations to one Burgers vector only

    OpenAIRE

    Alber, Hans-Dieter

    2013-01-01

    We review the continuous theory of dislocations from a mathematical point of view using mathematical tools, which were only partly available when the theory was developed several decades ago. We define a space of dislocation measures, which includes Hausdorff measures representing the dislocation measures of single dislocation curves. The evolution equation for dislocation measures is defined on this space. It is derived from four basic conditions, which must be satisfied by the model.

  12. Early morbidity after aseptic revision hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M.; Hansen, Torben Bæk

    Data on early morbidity and complications after revision total hip replacement (THR) are limited. The aim of this nationwide study was to describe and quantify early morbidity after aseptic revision THR and relate the morbidity to the extent of the revision surgical procedure. We analysed all.......1%, dislocation rate 7.0% and infection rate 3.0%. There were no differences in these outcomes between high- and low-volume centres. Of all readmissions, 255 (63.9%) were due to 'surgical' complications versus 144 (36.1%) 'medical' complications. Importantly, we found no differences in early morbidity across the...... surgical subgroups, despite major differences in the extent and complexity of operations. However, dislocations and the resulting morbidity represent the major challenge for improvement in aseptic revision THR....

  13. Developmental dysplasia of the hip

    Science.gov (United States)

    ... surgery, a cast will be placed on the child's leg for a period of time. ... legs may persist despite appropriate treatment. Untreated, hip dysplasia will lead to arthritis and deterioration of the hip, which can be severely debilitating.

  14. The association of congenital neuroblastoma and congenital heart disease

    International Nuclear Information System (INIS)

    Several authors have reported an association between neuroblastoma and congenital heart disease; others contend that, unlike specific wellknown associations between malignancy and congenital defects (Wilm's tumor and aniridia, leukemia and Down's syndrome), no real relationship exists. We present three cases of cyanotic congenital heart disease in which subclinical neuroblastoma was found. We speculate that abnormal neural crest cell migration and development may be a common link between cardiac malformations and congenital neuroblastoma. (orig.)

  15. Posterior sternoclavicular dislocation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, So Hwa; Kim, Ki Sun; Kim, Ki Jun [Dept. of Radiology, Incheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Incheon (Korea, Republic of)

    2015-02-15

    Traumatic sternoclavicular joint dislocation is an uncommon injury, and posterior sternoclavicular dislocation occurs less frequently compared to anterior sternoclavicular dislocation. However, this type of dislocation has the potential for serious complications due to compression or laceration of the mediastinal structures. The diagnosis can be difficult using plain radiographs alone due to radiographic-anatomic superimposition. Therefore, posterior sternoclavicular dislocation is easily missed at the initial clinical evaluation. Contrast-enhanced computed tomography is required for a definite diagnosis and to assess associated mediastinal injuries.

  16. Kinetic Monte Carlo simulation of dislocation dynamics

    International Nuclear Information System (INIS)

    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

  17. IDIOPATHIC CHONDROLYSIS OF HIP

    Directory of Open Access Journals (Sweden)

    ShanmugaRaju P

    2014-06-01

    Full Text Available A 13 Year old girl with history of pain in the left hip, stiffness, walking difficulty for one month. There was no history of trauma, fever and weight loss. Physical examination revealed left side antalgic gait and pelvic obliquity. There was restriction of abduction, flexion and external rotation on the affected side. Laboratory investigations for C - reactive protein, Rheumatoid factor and serum complement were normal. The complete blood profile was normal. Conventional Radiography of the left hip showed decrease in the joint space, decrease femoral head height, sclerosis and irregularities in articular margins. Her pelvis was tilted towards femoral side, femoral head was small and flattened with irregular margins. The young girl was treated initially with bed rest, traction, physiotherapy treatment including positioning, passive mobilization exercise, active range of motion exercise, static quadriceps contraction and Gait retraining. This case of idiopathic chondrolysis of hip is a rare clinical entity.

  18. Hip Arthroscopy in The Athlete

    OpenAIRE

    Byrd, J. W. Thomas

    2007-01-01

    Sports related injuries to the hip have received relatively little attention, in the part because the clinical assessment, imaging studies, and surgical techniques are less sophisticated. The evolution of hip arthroscopy has offered a less invasive technique that allows for recognition and treatment of hip pathologies that previously went unrecognized. The success of hip arthoscopy is dependent on proper patient selection based on the patient's history and diagnosis. The purpose of this clini...

  19. CT to delineate hip pathology in cerebral palsy

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Czech Academy of Sciences Publication Activity Database

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

    2013-01-01

    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

  3. X-Ray Exam: Hip

    Science.gov (United States)

    ... Child All About Food Allergies X-Ray Exam: Hip KidsHealth > For Parents > X-Ray Exam: Hip Print A A A Text Size What's in ... en español Radiografía: cadera What It Is A hip X-ray is a safe and painless test ...

  4. Theory of interacting dislocations on cylinders.

    Science.gov (United States)

    Amir, Ariel; Paulose, Jayson; Nelson, David R

    2013-04-01

    We study the mechanics and statistical physics of dislocations interacting on cylinders, motivated by the elongation of rod-shaped bacterial cell walls and cylindrical assemblies of colloidal particles subject to external stresses. The interaction energy and forces between dislocations are solved analytically, and analyzed asymptotically. The results of continuum elastic theory agree well with numerical simulations on finite lattices even for relatively small systems. Isolated dislocations on a cylinder act like grain boundaries. With colloidal crystals in mind, we show that saddle points are created by a Peach-Koehler force on the dislocations in the circumferential direction, causing dislocation pairs to unbind. The thermal nucleation rate of dislocation unbinding is calculated, for an arbitrary mobility tensor and external stress, including the case of a twist-induced Peach-Koehler force along the cylinder axis. Surprisingly rich phenomena arise for dislocations on cylinders, despite their vanishing Gaussian curvature. PMID:23679421

  5. Search for Dislocation Free Helium 4 Crystals

    Science.gov (United States)

    Souris, F.; Fefferman, A. D.; Haziot, A.; Garroum, N.; Beamish, J. R.; Balibar, S.

    2015-02-01

    The giant plasticity of He crystals has been explained as a consequence of the large mobility of their dislocations. Thus, the mechanical properties of dislocation free crystals should be quite different from those of usual ones. In 1996-1998, Ruutu et al. published crystal growth studies showing that, in their helium 4 crystals, the density of screw dislocations along the c-axis was less than 100 per cm, sometimes zero. We have grown helium 4 crystals using similar growth speeds and temperatures, and extracted their dislocation density from their mechanical properties. We found dislocation densities that are in the range of 10-10 per cm, that is several orders of magnitude larger than Ruutu et al. Our tentative interpretation of this apparent contradiction is that the two types of measurements are somewhat indirect and concern different types of dislocations. As for the dislocation nucleation mechanism, it remains to be understood.

  6. Discrete dislocation dynamics simulations in a cylinder

    Science.gov (United States)

    Li, Maosheng; Gao, Chan; Xu, Jianing

    2015-02-01

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

  7. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft; Olsen, Jørn

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...... fetuses with Down’s syndrome (patient controls), 23 (2.8%) pregnant women were treated with nitrofurantoin. The above differences between population controls and cases may be connected with recall bias, because the case-control pair analysis did not indicate a teratogenic potential of nitrofurantoin use...... during the second and the third months of gestation, i.e. in the critical period for major congenital abnormalities. Conclusion: Treatment with nitrofurantoin during pregnancy does not present detectable teratogenic risk to the fetus....

  8. Autism and congenital blindness.

    Science.gov (United States)

    Hobson, R P; Lee, A; Brown, R

    1999-02-01

    The nature of autism in congenitally blind children has long been a source of interest and perplexity. A group of nine congenitally blind children with an autism-like syndrome were closely matched on chronological age and verbal mental age with nine sighted autistic children, and were compared on the Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1986) and the Behavior Checklist for Disordered Preschoolers, together with the Play Items for Disordered Preschoolers (Sherman, Shapiro, & Glassman, 1983). A checklist of clinical features characteristic of autism (derived from DSM-III-R) was also completed through an interview with teachers. There was substantial similarity between the groups, but also suggestive evidence of possible group differences, specifically in the domain of social-emotional responsiveness. Research on the psychological development of congenitally blind children promises to yield insights into the nature of autism itself. PMID:10097994

  9. A new technique of subtrochanteric shortening in total hip replacement for Crowe type 3 to 4 dysplasia of the hip.

    Science.gov (United States)

    Togrul, Emre; Ozkan, Cenk; Kalaci, Aydiner; Gül?en, Mahir

    2010-04-01

    A new technique of femoral fixation that uses a transverse osteotomy for subtrochanteric shortening and derotation in total hip arthroplasty for Crowe type 3 to 4 dysplasia of the hip is described. This series included 21 cases in 12 women and 2 men, with a mean age of 42.3 years. Follow-up averaged 41.2 months. Bone pegs prepared from the resected femoral segment were seated in the medullary canal around the stem for femoral fixation. Merle d'Aubigné scores for pain, motion, and walking improved from 2.9, 4.4, and 3.7 to 5.2, 5.4, and 5.5, respectively. Radiographic union was detected within 12 +/- 3.4 (range, 6-24) weeks in all cases. Complications were early dislocation in 2 cases. This technique allows correction of anteversion, provides excellent rotational stability, and eliminates the need for additional osteosynthesis regardless of the stem design. PMID:19577893

  10. Congenital spinal malformations

    International Nuclear Information System (INIS)

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

  11. Congenital preduodenal portal vein

    International Nuclear Information System (INIS)

    Congenital preduodenal portal vein, first reported by Knight in 1921, is an extremely rare congenital anomaly in which the portal vein passes anteriorly to the duodenum rather than posteriorly in its normal location. It is of surgical significance because it may cause difficulties in operations involving the gall bladder, biliary duct, or duodenum. Recently, we experienced 2 cases of preduodenal portal vein. One was found during surgical exploration for the diagnosis and correction of malrotation of the bowels and the other in a 3 day-old male newborn associated with dextrocardia, situs inversus, and duodenal obstruction by diaphragm. We report these 2 cases with a review of the literature

  12. Congenital preduodenal portal vein

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Jin; Hwang, Mi Soo; Huh, Young Soo; Park, Bok Hwan [College of Medicine, Youngnam University, Gyeongsan (Korea, Republic of)

    1991-03-15

    Congenital preduodenal portal vein, first reported by Knight in 1921, is an extremely rare congenital anomaly in which the portal vein passes anteriorly to the duodenum rather than posteriorly in its normal location. It is of surgical significance because it may cause difficulties in operations involving the gall bladder, biliary duct, or duodenum. Recently, we experienced 2 cases of preduodenal portal vein. One was found during surgical exploration for the diagnosis and correction of malrotation of the bowels and the other in a 3 day-old male newborn associated with dextrocardia, situs inversus, and duodenal obstruction by diaphragm. We report these 2 cases with a review of the literature.

  13. CONGENITAL HYPERINSULINISM (HYPERAMMONEMIA HYPERINSULINISM

    Directory of Open Access Journals (Sweden)

    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

  14. Ullrich Congenital Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Goknur Haliloglu

    2011-06-01

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

  15. Congenital pancreatic cysts

    Directory of Open Access Journals (Sweden)

    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.

  16. Congenital midline nasofrontal masses.

    Science.gov (United States)

    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

  17. Congenital syphilis in the newborn.

    OpenAIRE

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

    1988-01-01

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

  18. Simultaneous shoulder and elbow dislocation

    Science.gov (United States)

    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

  19. Lattice dislocation in Si nanowires

    Energy Technology Data Exchange (ETDEWEB)

    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.

  20. Lattice dislocation in Si nanowires

    International Nuclear Information System (INIS)

    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 A3 for the bulk and 23.63, 29.91, 34.69 and 40.46 A3 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.

  1. Taper Hip Prosthesis

    Medline Plus

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

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

    Science.gov (United States)

    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. © 2015 Wiley Periodicals, Inc. PMID:26239279

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

    International Nuclear Information System (INIS)

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

  4. 3D Dislocation dynamics modelling of interactions between prismatic loops and mobile dislocations in pure iron

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Three-dimensional formulation of dislocation climb

    Science.gov (United States)

    Gu, Yejun; Xiang, Yang; Quek, Siu Sin; Srolovitz, David J.

    2015-10-01

    We derive a Green's function formulation for the climb of curved dislocations and multiple dislocations in three-dimensions. In this new dislocation climb formulation, the dislocation climb velocity is determined from the Peach-Koehler force on dislocations through vacancy diffusion in a non-local manner. The long-range contribution to the dislocation climb velocity is associated with vacancy diffusion rather than from the climb component of the well-known, long-range elastic effects captured in the Peach-Koehler force. Both long-range effects are important in determining the climb velocity of dislocations. Analytical and numerical examples show that the widely used local climb formula, based on straight infinite dislocations, is not generally applicable, except for a small set of special cases. We also present a numerical discretization method of this Green's function formulation appropriate for implementation in discrete dislocation dynamics (DDD) simulations. In DDD implementations, the long-range Peach-Koehler force is calculated as is commonly done, then a linear system is solved for the climb velocity using these forces. This is also done within the same order of computational cost as existing discrete dislocation dynamics methods.

  6. Visualization of dislocation dynamics in colloidal crystals.

    Science.gov (United States)

    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

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

    CERN Document Server

    Lazar, Markus

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Congenital cystic adenomatoid malformation

    International Nuclear Information System (INIS)

    This case report presents the clinical picture, diagnostic methodology and surgical treatment of a female child who presented with chronic cough and dyspnoea due to congenital malformation of lung. A discussion of diagnosis and management is presented at the end. (author)

  10. Congenital temporal triangular alopecia.

    OpenAIRE

    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.

  11. Congenital Short QT Syndrome

    OpenAIRE

    Johnson Francis

    2016-01-01

    Congenital short QT syndrome (SQTS) is characterised by extremely short QT intervals, typically with QTc less than 330 ms and a propensity for life threatening ventricular arrhythmias and atrial fibrillation. The QT interval in SQTS does not change significantly with heart rate and the T waves have a narrow base and high voltage, similar to those in hyperkalemia.

  12. CONGENITAL ADRENAL HYPERPLASIA

    Directory of Open Access Journals (Sweden)

    Naushad Ali N

    2013-12-01

    Full Text Available The birth of a child with ambiguous genitalia and distressing event for the family and physician. It is important to make a diagnosis, for psychological , social, and medical reasons for particularly for recognizing accompanying life threatening disorders such as the salt losing form of congenital adrenal hyperplasia

  13. Congenital Midline Cervical Cleft

    Science.gov (United States)

    Villanueva-Meyer, Javier; Glastonbury, Christine; Marcovici, Peter

    2015-01-01

    Congenital midline cervical cleft is a rare anomaly that typically presents in the neonatal period as a thin suprasternal vertical band of erythematous skin with a nipple-like projection superiorly, which may exude fluid. We present the clinical and pathophysiologic features and the imaging findings of this uncommon, and rarely described entity in a newborn girl. PMID:25926928

  14. Congenital Absence of Tibia

    OpenAIRE

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

    2002-01-01

    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

  15. Congenital Absence of Tibia

    Directory of Open Access Journals (Sweden)

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

    2002-10-01

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

  16. Congenital aggressive lipomatosis

    International Nuclear Information System (INIS)

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

  17. Congenital Lumbar Hernia

    OpenAIRE

    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

  18. A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff.

    Science.gov (United States)

    Vanhegan, I S; Malik, A K; Jayakumar, P; Ul Islam, S; Haddad, F S

    2012-05-01

    Revision arthroplasty of the hip is expensive owing to the increased cost of pre-operative investigations, surgical implants and instrumentation, protracted hospital stay and drugs. We compared the costs of performing this surgery for aseptic loosening, dislocation, deep infection and peri-prosthetic fracture. Clinical, demographic and economic data were obtained for 305 consecutive revision total hip replacements in 286 patients performed at a tertiary referral centre between 1999 and 2008. The mean total costs for revision surgery in aseptic cases (n = 194) were £11 897 (sd 4629), for septic revision (n = 76) £21 937 (sd 10 965), for peri-prosthetic fracture (n = 24) £18 185 (sd 9124), and for dislocation (n = 11) £10 893 (sd 5476). Surgery for deep infection and peri-prosthetic fracture was associated with longer operating times, increased blood loss and an increase in complications compared to revisions for aseptic loosening. Total inpatient stay was also significantly longer on average (p tariffs. PMID:22529080

  19. Atlantoaxial dislocation and Down's syndrome.

    OpenAIRE

    Whaley, W J; Gray, W. D.

    1980-01-01

    The phenotypic features of Down's syndrome are easily recognized and include characteristic facial features, hypotonia, ligament laxity, transverse palmar creases and mental subnormality. Associated manifestations and complications are also familiar and involve almost every organ system. Congenital heart defects, bowel malformations and a tendency to leukemia are common attendant problems. Less common, however, are defects of the skeletal system; in fact, the most recent edition of a standard...

  20. Mobility Laws in Dislocation Dynamics Simulations

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Mobility laws in dislocation dynamics simulations

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. Dislocation climb in GaAs

    International Nuclear Information System (INIS)

    The weak-beam technique of transmission-electron-microscopy is used to investigate dislocation climb in GaAs, a high supersaturation of point defects being introduced by electron irradiation in a high-voltage-electron-microscope. It is shown that, at room temperature, climb of dissociated a/2 dislocations proceeds by nucleation of both Frank and perfect interstitial loops on the individual partials. Irradiation carried out at higher temperature (4500C) showed evidence for the interaction of the new loops with the non-parent partial, leading to climb of the total dislocation. Dislocations of 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

  3. Modelling of Dislocation Bias in FCC Materials

    OpenAIRE

    Chang, Zhongwen

    2013-01-01

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

  4. ANOMALOUS MODULUS DEFECT DUE TO DISLOCATION PINNING

    OpenAIRE

    Lenz, D.; Schmidt, H.

    1983-01-01

    The frequency dependence (10 - 100 MHz) of the dislocation modulus defect (MD) and damping Q-1 has been measured at RT during ?-irradiation. In very high purity single crystals (resistivity ratio RRR ? 10.000) dislocation pinning at low doses leads to an increase of MD at high frequencies. Depinning effects can be excluded because MD at low frequencies and the simultaneously measured Q-1 at all frequencies show normal dislocation pinning behaviour for all ?-doses. The presently reported anoma...

  5. Dislocation mechanism of interface point defect migration

    OpenAIRE

    Kolluri, Kedarnath; Demkowicz, Michael J.

    2010-01-01

    Vacancies and interstitials absorbed at Cu-Nb interfaces are shown to migrate by a multistage process involving the thermally-activated formation, motion, and annihilation of kinks and jogs on interface misfit dislocations. This mechanism, including the energy along the entire migration path, can be described quantitatively within dislocation theory, suggesting that analysis of misfit dislocation networks may enable prediction of point defect behaviors at semicoherent heterointerfaces.

  6. Elbow dislocation with irreparable fracture radial head

    OpenAIRE

    Dilip Tanna

    2013-01-01

    Background: Treatment of elbow dislocation with irreparable radial head fracture needs replacement of radial head to achieve stability of elbow. An alternate method in cases of elbow dislocation with radial head fracture can be resection of radial head with repair of medial collateral ligament. We report a retrospective analysis of cases of elbow dislocation with irreparable radial head treated by excision head of radius and repair of MCL. Materials and Methods: Nine patients of elbow dis...

  7. Coupled dislocation and martensitic phase transformation dynamics

    Science.gov (United States)

    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.

  8. Medial Patellofemoral Ligament Reconstruction for Patellar Dislocation

    OpenAIRE

    Mackay, Nicola D.; Smith, Nicholas A.; Parsons, Nick; Spalding, Tim; Thompson, Peter; Sprowson, Andrew P.

    2014-01-01

    Background: With improved understanding of the biomechanical importance of the medial patellofemoral ligament (MPFL), its reconstruction for patellar dislocation has become increasingly popular. The aim of this systematic review was to critically determine the effectiveness of MPFL reconstruction for patellar dislocation. Hypothesis: MPFL reconstruction for patellar dislocation leads to a low redislocation rate with improved Kujala scores. Study Design: Systematic review; Level of evidence, 4...

  9. Dislocation Mediated Melting Near Isostructural Critical Points

    OpenAIRE

    CHOU, T; NELSON, D. R.

    1995-01-01

    We study the interplay between an isostructural critical point and dislocation mediated two-dimensional melting, using a combination of Landau and continuum elasticity theory. If dislocations are excluded, coupling to the elastic degrees of freedom leads to mean field critical exponents. When dislocations are allowed, modified elastic constants lead to a new phase buried in the solid state near the critical point. Consistent with a proposal of Bladon and Frenkel, we find an intervening hexati...

  10. Dislocation dynamics analysis of dislocation intersections in nanoscale metallic multilayered composites

    Science.gov (United States)

    Akasheh, F.; Zbib, H. M.; Hirth, J. P.; Hoagland, R. G.; Misra, A.

    2007-04-01

    In this work, dislocation dynamics (DD) analysis is used to investigate the strength of nanoscale metallic multilayered composites. Several possible interactions between threading (glide) dislocations and intersecting interfacial dislocations are considered and found to lead to strength predictions in better agreement with experimental trends and significantly higher than the predictions of the simplified confined layer plasticity model based on Orowan bowing of single dislocation in a rigid channel. The strongest interaction occurs when threading and intersecting interfacial dislocations have collinear Burgers' vector and involves an annihilation reaction at their crossing points followed by the resumption of threading with a new dislocation configuration. The other possible dislocation intersections involve the formation of junctions, which are found to be more complex than simple models suggest. When the layer interfaces are modeled as impenetrable walls, as in existing analytical and some dislocation dynamics (DD) models, the predicted strengthening effect is weaker than that predicted by DD with more physical boundary conditions at the interfaces.

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

    International Nuclear Information System (INIS)

    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.

  12. Transmission electron microscopy analysis of worn alumina hip replacement prostheses

    International Nuclear Information System (INIS)

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

  13. Massively-Parallel Dislocation Dynamics Simulations

    Energy Technology Data Exchange (ETDEWEB)

    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.

  14. Enabling Strain Hardening Simulations with Dislocation Dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Arsenlis, A; Cai, W

    2006-12-20

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

  15. Dislocation-driven surface dynamics on solids.

    Science.gov (United States)

    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

  16. Moving dislocations studied by nuclear magnetic resonance

    International Nuclear Information System (INIS)

    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

  17. Anderson localization of light with topological dislocations

    CERN Document Server

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

    2013-01-01

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

  18. Robust atomistic calculation of dislocation line tension

    Science.gov (United States)

    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.

  19. Canonical Quantization of Crystal Dislocation and Electron-Dislocation Scattering in an Isotropic Medium

    OpenAIRE

    Li, Mingda; Cui, Wenping; M.S. Dresselhaus; Chen, Gang

    2015-01-01

    Crystal dislocations govern the plastic mechanical properties of materials but also affect the electrical and optical properties. However, a fundamental and quantitative quantum-mechanical theory of dislocation remains undiscovered for decades. Here by introducing a new quasiparticle "dislon", we present an exact Hamiltonian-based theory for both edge and screw dislocations in an isotropic medium, where the effective Hamiltonian of a single dislocation line can be written in a harmonic-oscill...

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

    OpenAIRE

    Lazar, Markus

    2011-01-01

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

  1. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

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

  2. Metal working and dislocation structures

    DEFF Research Database (Denmark)

    Hansen, Niels

    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...... and finer scale down to the nanometer dimension, which can be reached at ultrahigh strains. It is demonstrated that classical materials science and engineering principles apply from the largest to the smallest structural scale but also that new and unexpected structures and properties characterize...... metals with structures on the scale from about 10 nm to 1 mu m....

  3. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic resurfacing... femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be implanted to replace a portion of the hip...

  4. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint femoral (hemi-hip) metallic cemented or... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  5. Total hip replacement

    International Nuclear Information System (INIS)

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

  6. Nonarthritic hip joint pain.

    Science.gov (United States)

    Enseki, Keelan; Harris-Hayes, Marcie; White, Douglas M; Cibulka, Michael T; Woehrle, Judith; Fagerson, Timothy L; Clohisy, John C

    2014-06-01

    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these clinical practice guidelines is to describe the peer-reviewed literature and make recommendations related to nonarthritic hip joint pain. PMID:24881906

  7. IDIOPATHIC CHONDROLYSIS OF HIP

    OpenAIRE

    ShanmugaRaju P; Raghuram C; Naveen Kumar S

    2014-01-01

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

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

    Science.gov (United States)

    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.

  9. Congenital diaphramatic hernia

    International Nuclear Information System (INIS)

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

  10. Congenital diaphramatic hernia

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  11. Congenital intestinal lymphangiectasia

    Directory of Open Access Journals (Sweden)

    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.

  12. Congenital club foot

    Directory of Open Access Journals (Sweden)

    Baš?arevi? V.D.

    2010-01-01

    Full Text Available Congenital club foot is the most frequent foot deformity. It occurs in 1% of newborns, two times more frequently in boys, with family inheritance. Patoanatomicaly, entity consists of bone deformities, articular malpositions and soft tissues retraction. All these produce adduction of the forefoot and varus and equinovarus of the hindfoot. Lateral side of the foot is convex and medial side is concave. Forefoot is in adduction and plantar flexion in relation to the hindfoot. The heel is rotated medially which induces varus and eqinus of the foot. The aim of the treatment is to establish anatomically normal foot, painless, with moderate movements, which is suitable for normal shoes. At the beginning treatment is nonsurgical. If nonsurgical treatment fails further step should be surgical treatment. The success of treatment of congenital clubfoot depends on the time of diagnosis and treatment beginning.

  13. Congenital pulmonary lymphangiectasia

    OpenAIRE

    Campisi Corradino; Boccardo Francesco; Bellini Carlo; Bonioli Eugenio

    2006-01-01

    Abstract Congenital pulmonary lymphangiectasia (PL) is a rare developmental disorder involving the lung, and characterized by pulmonary subpleural, interlobar, perivascular and peribronchial lymphatic dilatation. The prevalence is unknown. PL presents at birth with severe respiratory distress, tachypnea and cyanosis, with a very high mortality rate at or within a few hours of birth. Most reported cases are sporadic and the etiology is not completely understood. It has been suggested that PL l...

  14. Congenital Malaria in China

    OpenAIRE

    Tao, Zhi-Yong; Fang, Qiang; Liu, Xue; Culleton, Richard; Li TAO; Xia, Hui; Gao, Qi

    2014-01-01

    Abstract Background Congenital malaria, in which infants are directly infected with malaria parasites from their mother prior to or during birth, is a potentially life-threatening condition that occurs at relatively low rates in malaria-endemic regions. It is recognized as a serious problem in Plasmodium falciparum–endemic sub-Saharan Africa, where recent data suggests that it is more common than previously believed. In such regions where malaria transmission is high, neonates may be protecte...

  15. Congenital Triangular Alopecia

    OpenAIRE

    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...

  16. Congenital nephrotic syndrome

    OpenAIRE

    Jalanko, Hannu

    2007-01-01

    Congenital nephrotic syndrome (CNS) is a rare kidney disorder characterized by heavy proteinuria, hypoproteinemia, and edema starting soon after birth. The majority of cases are caused by genetic defects in the components of the glomerular filtration barrier, especially nephrin and podocin. CNS may also be a part of a more generalized syndrome or caused by a perinatal infection. Immunosuppressive medication is not helpful in the genetic forms of CNS, and kidney transplantation is the only cur...

  17. Congenital ocular motor apraxia

    OpenAIRE

    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...

  18. Congenital mirror movements.

    OpenAIRE

    Schott, G. D.; Wyke, M A

    1981-01-01

    In this report are described seven patients assessed clinically and neuropsychologically in whom mirror movements affecting predominantly the hands occurred as a congenital disorder. These mirror movements, representing a specific type of abnormal synkinesia, may arise as a hereditary condition, in the presence of a recognisable underlying neurological abnormality, and sporadically, and the seven patients provide more or less satisfactory examples of each of these three groups. Despite the ap...

  19. Dislocation of large diameter metal-on-metal bearings an indicator of metal reaction?

    Science.gov (United States)

    Theruvil, Bipin; Vasukutty, Nijil; Hancock, Nick; Higgs, David; Dunlop, Douglas G; Latham, Jeremy M

    2011-09-01

    We report 3 patients who underwent total hip arthroplasty (THA) using large diameter metal-on-metal bearing. These patients initially presented with pain but went on to develop dislocation of the THA while awaiting investigations. Any pain following metal-on-metal bearing THA should be taken seriously and should trigger investigations to identify a metal reaction. If left untreated, these reactions can cause progressive soft tissue necrosis leading to instability. These patients should be considered for early revision of the bearing surface to prevent further soft tissue damage. PMID:21036007

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. The nucleation of dislocation loops

    International Nuclear Information System (INIS)

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

  3. The heart: Congenital disease

    International Nuclear Information System (INIS)

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

  4. CONGENITAL DUODENAL OBSTRUCTIONS

    Directory of Open Access Journals (Sweden)

    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.

  5. Social inequality and hip fracture

    DEFF Research Database (Denmark)

    Harvey, N. C.; Hansen, L.; Judge, A.; Javaid, M. K.; Vestergaard, P.; Cooper, C.; Abrahamsen, B.

    Social inequality appears to be increasing in many countries. We explored whether risk of hip fracture was associated with markers of inequality and whether these relationships changed with time, using data from Danish Health Registries. Methods: All patients 60 years or older with a primary hip...... year of fracture, and education and year of fracture, to describe whether the association of income or education with rates of hip fracture changed over time. Results: There were 69,774 hip fracture patients and 69,709 controls (both mean age 81.2 years) with complete data on income and education. Both...

  6. Imaging of the postoperative hip.

    Science.gov (United States)

    Carty, Fiona L; Cashman, James P; Parvizi, Javad; Zoga, Adam C; Morrison, William B

    2011-09-01

    A basic understanding of the surgical approach, technique, and potential complications in addition to the types of hardware used is essential in interpreting postoperative imaging of the hip. This article reviews the various surgical approaches to the hip and hardware components in total hip arthroplasty and hip preservation surgery and the potential complications that may arise. The various surgical treatments in the management of acetabular dysplasia and avascular necrosis and the imaging appearances of these on different imaging modalities are also discussed. PMID:21928159

  7. Formation of disorientations in dislocation structures during plastic deformation

    DEFF Research Database (Denmark)

    Pantleon, W.

    2002-01-01

    Disorientations developing during plastic deformation in dislocation structures are investigated. Based on expected mechanisms for the formation of different types of dislocation boundaries (statistical trapping of dislocations or differently activated slip systems) the formation of the disorient...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-11-15

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

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

    International Nuclear Information System (INIS)

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

  10. Electron-beam induced current investigations of dislocations and dislocation trails in Si

    International Nuclear Information System (INIS)

    Lengthy defects in silicon plastically deformed by electron-beam induced current were studied. It is shown that in the crystals deformed under clean conditions the method permits revealing solely the dislocation trails rather than the dislocations as such. From the value of contrast the concentration of electrically active defects formed in the dislocation trails was evaluated. Analysis of the results of the studies using samples featuring high density of dislocations suggested that the dislocation trails in them also produce significant effect on transport properties of secondary charge carriers

  11. Radiology of congenital heart disease

    International Nuclear Information System (INIS)

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

  12. Geometric approach to dislocation and disclination theory

    International Nuclear Information System (INIS)

    Cartan structure equations are used to create a four-dimensional geometric description of dislocations in continuum theory. It is shown that the dislocation distribution is determined by the torsion tensor, while the disclination distribution is determined by the curvature tensor. An analogy to electrodynamics is offered

  13. Atomistic simulations of dislocation processes in copper

    DEFF Research Database (Denmark)

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

    We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example, the sta...

  14. Dislocation networks in phosphorus-implanted silicon

    International Nuclear Information System (INIS)

    Observations, by transmission electron microscopy have been made on defects generated in 50 keV, high-dose (1 x 1015 to 3 x 1016 ions/cm2) phosphorus-implanted silicon (111) wafers followed by 11000C isothermal annealing in inert (dry N2) and oxidizing (wet O2) atmospheres. The formation of dislocation networks is closely associated with the generation of interstitial type dislocation loops which grow from point defects produced by ion implantation in silicon wafers. Also, dislocations grow more easily in wet O2 annealing than in dry N2. In wet O2 annealing, dislocation networks are formed by annealing within 1-2 min for samples implanted with doses above 3 x 1015 ions/cm2, and they move to deeper depths in the wafers during annealing. On the other hand, in dry N2 annealing, the critical ion dose for generation of dislocation networks is 1 x 1016 ions/cm2 and the location of dislocation networks in the wafers is usually unchanged during annealing. Such a difference in the generation and motion of dislocations between the two atmospheres can be explained in terms of the analysis of Sanders and Dobson (1969) for the vacancy flow between defect and surface. It is also shown that by implanting silicon into phosphorus-diffused layers, the generation of dislocation networks is strongly correlated with the formation of secondary defects caused by implantation and annealing. (author)

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

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Petersen, Annemette Krintel; Søballe, Kjeld; Mikkelsen, Søren Søndergaard; Mechlenburg, Inger

    2014-01-01

    group was compared to patients included the following 3 months with less restricted hip movement and use of assistive devices according to individual needs (unrestricted group). Questionnaires on function, pain, quality of life (HOOS), anxiety (HADS), working status and patient satisfaction were.......004). Return to work 6 weeks after THR for the unrestricted group compared to restricted group was: 53% versus 32% (P=0.045). No significant differences between groups in pain, symptoms, quality of life, anxiety/depression, hip dislocations and patient satisfaction. CONCLUSION: This study showed slightly......BACKGROUND: Improvements in surgical techniques and increase of femoral head size might have changed the rationale for movement restrictions after total hip replacement (THR). AIM: To evaluate the influence of movement restrictions and assistive devices on rehabilitation after fast track THR...

  16. Bone scanning as a useful supplementary examination in the evaluation of hip prothesis

    International Nuclear Information System (INIS)

    Although there are permanent improvements in material and in operation techniques the results of cement-anchored alloarthroplastic prothesis of the hip joint are effected by a remarkable rate of loosening. The diagnosis of the loosening of a hip endoprothesis is mainly based on the morphological findings in X-ray films. The only radiological sign of getting loose are unequivocal and drastic dislocations or fractures of the implant. Most of the other radiological signs and clinical findings are equivocal. In these cases the additionally performed bone scanning provides further and important information. The unstable and loosened hip prothesis is characterized by an abnormal, localized and increasing accumulation of the tracer. But a positive bone scan does not absolutely indicate an instability of the endoprothesis in each case. Therefore, static and dynamic scanning cannot replace the well-known, conventional X-ray techniques. Both methods complete each other. (orig.)

  17. Bone scanning as a useful supplementary examination in the evaluation of hip prothesis

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, C.

    1984-09-01

    Although there are permanent improvements in material and in operation techniques the results of cement-anchored alloarthroplastic prothesis of the hip joint are effected by a remarkable rate of loosening. The diagnosis of the loosening of a hip endoprothesis is mainly based on the morphological findings in X-ray films. The only radiological sign of getting loose are unequivocal and drastic dislocations or fractures of the implant. Most of the other radiological signs and clinical findings are equivocal. In these cases the additionally performed bone scanning provides further and important information. The unstable and loosened hip prothesis is characterized by an abnormal, localized and increasing accumulation of the tracer. But a positive bone scan does not absolutely indicate an instability of the endoprothesis in each case. Therefore, static and dynamic scanning cannot replace the well-known, conventional X-ray techniques. Both methods complete each other.

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

    International Nuclear Information System (INIS)

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

  19. On the range of 3D dislocation pair correlations

    OpenAIRE

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

    2008-01-01

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

  20. Screw dislocations in the field theory of elastoplasticity

    OpenAIRE

    Lazar, Markus

    2002-01-01

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

  1. Early detection of congenital syphilis.

    Science.gov (United States)

    Chowdhary, Nagalakshmi; Rani, Bs Kavya; Mukunda, K S; Kiran, N K

    2014-01-01

    Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson's teeth. PMID:25231043

  2. Early detection of congenital syphilis

    Directory of Open Access Journals (Sweden)

    Nagalakshmi Chowdhary

    2014-01-01

    Full Text Available Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson?s teeth.

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

    International Nuclear Information System (INIS)

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

  4. BILATERAL ANTERIOR GLENOHUMERAL DISLOCATION: CLINICAL CASE

    Science.gov (United States)

    Silva, Luís Pires; Sousa, Cristina Varino; Rodrigues, Elisa; Alpoim, Bruno; Leal, Miguel

    2015-01-01

    Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare.

  5. Distribution of dislocations in nanostructured bainite

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-01-01

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

  6. BILATERAL ANTERIOR GLENOHUMERAL DISLOCATION: CLINICAL CASE.

    Science.gov (United States)

    Silva, Luís Pires; Sousa, Cristina Varino; Rodrigues, Elisa; Alpoim, Bruno; Leal, Miguel

    2011-01-01

    Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare. PMID:27047826

  7. Genetics Home Reference: Hypomyelination and congenital cataract

    Science.gov (United States)

    ... OMIM Genetic disorder catalog Conditions > Hypomyelination and congenital cataract On this page: Description Genetic changes Inheritance Diagnosis ... Reviewed July 2009 What is hypomyelination and congenital cataract? Hypomyelination and congenital cataract is an inherited condition ...

  8. Genetics Home Reference: Congenital mirror movement disorder

    Science.gov (United States)

    ... Recent literature OMIM Genetic disorder catalog Conditions > Congenital mirror movement disorder On this page: Description Genetic changes ... Glossary definitions Reviewed April 2015 What is congenital mirror movement disorder? Congenital mirror movement disorder is a ...

  9. Genetics Home Reference: Congenital insensitivity to pain

    Science.gov (United States)

    ... OMIM Genetic disorder catalog Conditions > Congenital insensitivity to pain On this page: Description Genetic changes Inheritance Diagnosis ... Reviewed November 2012 What is congenital insensitivity to pain? Congenital insensitivity to pain is a condition that ...

  10. Genetics Home Reference: congenital diaphragmatic hernia

    Science.gov (United States)

    ... Home Health Conditions congenital diaphragmatic hernia congenital diaphragmatic hernia Enable Javascript to view the expand/collapse boxes. ... All Open All Close All Description Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, ...

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

    DEFF Research Database (Denmark)

    Heitmann, B L; Lissner, L

    2011-01-01

    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...... 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...

  12. Hip biomechanics in orthopaedic clinical practice.

    Science.gov (United States)

    Antolic, Vane; Kralj-Iglic, Veronika; Iglic, Ales; Pompe, Borut

    2002-01-01

    Radiographic and clinical studies, coupled with biomechanical assessment of the hip, are important tools for predicting the development of osteoarthitis of the hip. In order to better understand the treatment of hip dysplasia, it is necessary to determine the contact stress in the hip joint. In this study, a three-dimensional mathematical model was used to determine hip joint contact stress. Because of the discrepancy in the results of analyses of different radiographic indicators of hip dysplasia, the calculation of hip joint contact stress is proposed for a more accurate assessment of the severity of hip dysplasia. PMID:12097976

  13. Indirect lateral surgical approach modified in hip arthroplasty

    International Nuclear Information System (INIS)

    The authors show an another option to the surgical approach to the hip, a lateral indirect modified (ALIM) for the partial or total arthroplasty of primary hip replacement and for revision (RTC), in a retrospective study, series of cases, with average was 7,75 years of follow up (range 6 months-10 years); quick access, easy technically, provide a good orientation of the components of the placement of implants, and allow an excellent exhibition for the complex problems of the reconstruction of the acetabular and the femur. Leaves intact the greater trochanter, improving the rotational stability that is needed in its femoral implant, doesn't injured the gluteus medius and doesn't produces his deficit, reduce the time for the deambulation. This approach is designed for primary cases and complex cases of revision using the mini-incision, with better exposition and less morbid-mortality associated to the surgical technique due to the less bleeding, less incidence of dislocation, thromboembolism and infection because of the little damage and better control of the surrounding soft tissue; better stability, no paralysis or lesion of the sciatic or femoral nerve without incidence of heterotopic ossifications with a better range of external rotation in extension of the hip that with traditional approach of Hardinge, and greater versatility in its indications

  14. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... you can see we’re doing a right hip. She has mild dysplasia with cystic changes and loss of joint space. ... yeah. Now if it were a dramatically anteverted hip, DDH, something like that, I ... even with this mild dysplasia and slight anteversion. Yeah. The point here is ...

  15. Biomechanics of the hip joint

    International Nuclear Information System (INIS)

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

  16. Hip joint replacement - series (image)

    Science.gov (United States)

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

  17. Anterior Approach Total Hip Replacement

    Medline Plus

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

  18. Hip-Hop Education Resources

    Science.gov (United States)

    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.…

  19. Anterior Approach Total Hip Replacement

    Medline Plus

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

  20. Hip-Hop Education Resources

    Science.gov (United States)

    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.…