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Sample records for acetabulum

  1. Osteonecrosis of acetabulum after irradiation

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    Ishihara, Gintaro; Matuda, Tatsuo; Takeuchi, Norihiro; Itoh, Haruo [Tokyo Koseinenkin Hospital (Japan)

    1996-11-01

    A case of osteonecrosis 8 years post irradiation was reported. The 70 years old female patient who, 8 years ago, received abdominal hysterectomy due to cervical cancer and then radiotherapy of 92.1 Gy within about 1.5 mo, had a pain at the left hip joint with a slight elevation of ALP. The roentgenography showed the fracture and callus of the left acetabulum; bone scintigraphy, a high accumulation of {sup 99m}Tc at the site; CT, abnormal fracture; MRI, low bright T1-weighted image and equi-bright T2-image; and MRI with Gd-DTPA, enhanced image. The hip joint was surgically reconstructed with cement (THR). Surgical and histopathological findings confirmed osteonecrosis without tumoral finding and the lesion was considered radiogenic. (K.H.)

  2. A STUDY ON MORPHOMETRIC MEASUREMENT OF VOLUME OF ACETABULUM

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    Leena Khobragade,

    2014-09-01

    Full Text Available Background: Hip joint represents an unique functional unit and has complex biomechanical construction. In today’s era where total hip replacement surgeries have made their way it has become imperative for the anatomists to know the variations in acetabular dimensions. Reconstruction of acetabulum in patients with significant acetabular bone deficiency remains a challenge. Hence the present study was carried out with the aim to study the morphometric measurement of volume of acetabulum in both the sexes. Materials and Methods: Material of the study consisted of 110 human hip bones (60 males and 50 females. Volume of Acetabulum (VA was measured on these hip bones on both the sides. Statistical analysis was done using SPSS (Statistical Package for the Social Sciences version 11 and Microsoft Excel 2007. Results: The mean volume of acetabulum in male was 23.13 ml and female was 17.88 ml. The mean volume of acetabulum on right side was 20.55 ml and left side was 20.91 ml. Volume of the acetabulum was greater in males as compared to females and the differences were statistically significant. Volume was greater on the left side as compared to the right side but the difference was statistically non significant. Discussion: Analysing the differences on human acetabulum is helpful in understanding not only morphological but also medicolegal aspects. Conclusion: Volume of the acetabulum was greater in males as compared to females.

  3. Treatment of posterior Wall fractures of acetabulum

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    QI Xin; LIU Jian-guo; GONG Yu-bao; YANG Chen; LI Shu-qiang; FENG Wei

    2009-01-01

    Objective: To explore the treatment methods and outcome of posterior Wall fractures of the acetabulum.Methods: The data of 31 patients(25 males and 6females,aged 19-59 years,mean:40.5 years)with posterior wall fractures of the acetabulum hospitalized in our department from 2002 to 2006 were analyzed retrospectively in this study.The types of fractures,number of fragments,combined dislocations,and sciatic nerve function were documented before admission.All the fractures were treated with open reduction and internal fixation.Based on the fracture type and site,either screws alone or reconstructive plates were used.The Patients were immobilized for an average of 12 weeks before partial weight bearing was permitted.After follow-up for 12-70months(43.6months on average),modifled Merle d‘Aubigne score was adopted to evaluate the outcomes of the operations.Results: The percentages of the excellent,good,fair and poor results were 48.4%,41.9%,6.5%,and 3.3%,respectively.with a good to excellent rate of 90.2%.Idio-pathic sciatic nerve injury occurred in only one case.Conclusions: The sciatic nerve should be routinely exposed and protected during the surgery.The type of fixation should be based on the fracture type and site.Prolonged immobilization may be helpful in improving the final outcomes.

  4. Biomechanical Analysis of a Novel Acetabulum Reconstruction Technique with Acetabulum Reconstruction Cage and Threaded Rods after Type II Pelvic Resections

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    Vivek Ajit Singh

    2016-01-01

    Full Text Available Background. Periacetabular resections with reconstruction has high rates of complications due to the complexity of the reconstruction. We have improvised a novel technique of reconstruction for type II and type II + III pelvic resections with the use of a commercially available acetabulum reconstruction cage (gap II, Stryker and threaded rods. Objectives. The aim of our study is to determine the biomechanical strength of our reconstruction compared to the traditional cemented total hip replacement (THR designs in normal acetabulum and establish its mode of failure. Methods. Five sets of hemipelvises were biomechanically tested (Instron® 3848, MA, USA. These constructs were subjected to cyclic loading and load to failure. Results. The reconstructed acetabulum was stiffer and required a higher load to failure compared to the intact pelvis with a standard THR. The mean stiffness of the reconstructed pelvis was 1738.6±200.3 Nmm−1 compared to the intact pelvis, which was 911.4±172.7 Nmm−1 (P value = 0.01. The mean load to failure for the standard acetabular cup construct was 3297.3±117.7 N while that of the reconstructed pelvis with the acetabulum cage and threaded rods was 4863.8±7.0 N. Conclusion. Reconstruction of the pelvis with an acetabular reconstruction cage and threaded rods is a biomechanical viable option.

  5. Assessment of acetabulum anteversion aligned with the transverse acetabulum ligament: cadaveric study using image-free navigation system

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    Tomokazu Fukui

    2013-02-01

    Full Text Available The transverse acetabulum ligament (TAL has been used as an intraoperative anatomical landmark to position the acetabulum cup in total hip arthroplasty (THA. However, the validity of the use of TAL has not been clarified. The purpose of this study was to examine the orientation of the cup component aligned with the TAL in cadaveric study. The 31 hips in 25 whole-body embalmed cadavers were examined. The donors were 12 men and 13 women. Simulated THA procedure using image-free navigation system was performed and a trial cup with a diameter of approximately 2 mm less than the size of the acetabulum were inserted and snugly fitted on the TAL through the posterior wall of acetabulum. The orientation of the cup component was measured using an image-free THA navigation system. The measured radiographic anteversion and inclination angles averaged 18.2±7.2° (range: 2.0-33.2° and 43.5±4.2° (range: 33.1-51.0° respectively. Based on the Lewinnek’s safe zone criteria, 26 hips (80.6% were judged to be within the. Moreover, in the analysis of the gender difference of TAL angles, the average anteversion angle was shown to be significant larger in female than male population. The TAL can be effectively used an intraoperative landmark to align the acetabulum component helping reduce the risk of dislocation after surgery. In the intraoperative judgment, a gender difference in the alignment of the TAL should be taken into consideration.

  6. Assessment of acetabulum anteversion aligned with the transverse acetabulum ligament: cadaveric study using image-free navigation system.

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    Fukui, Tomokazu; Fukunishi, Shigeo; Nishio, Shoji; Fujihara, Yuki; Shohei, Okahisa; Yoshiya, Shinichi

    2013-02-22

    The transverse acetabulum ligament (TAL) has been used as an intraoperative anatomical landmark to position the acetabulum cup in total hip arthroplasty (THA). However, the validity of the use of TAL has not been clarified. The purpose of this study was to examine the orientation of the cup component aligned with the TAL in cadaveric study. The 31 hips in 25 whole-body embalmed cadavers were examined. The donors were 12 men and 13 women. Simulated THA procedure using image-free navigation system was performed and a trial cup with a diameter of approximately 2 mm less than the size of the acetabulum were inserted and snugly fitted on the TAL through the posterior wall of acetabulum. The orientation of the cup component was measured using an image-free THA navigation system. The measured radiographic anteversion and inclination angles averaged 18.2±7.2° (range: 2.0-33.2°) and 43.5±4.2° (range: 33.1-51.0°) respectively. Based on the Lewinnek's safe zone criteria, 26 hips (80.6%) were judged to be within the. Moreover, in the analysis of the gender difference of TAL angles, the average anteversion angle was shown to be significant larger in female than male population. The TAL can be effectively used an intraoperative landmark to align the acetabulum component helping reduce the risk of dislocation after surgery. In the intraoperative judgment, a gender difference in the alignment of the TAL should be taken into consideration. PMID:23705063

  7. Transposition of the acetabulum after iliac ischial osteotomy in the treatment of hip dysplasia in infants

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    Владимир Евгеньевич Басков

    2016-06-01

    Full Text Available Background. Transposition of the acetabulum after pelvic osteotomy is the most effective surgical method to treat dysplastic hip joint disorders in patients of different ages. According to Salter, iliac osteotomy of the pelvis is the main surgical method used to correct dysplastic acetabulum in 7- and 8-year-old children. In older patients, the pubic symphysis and pelvic ligaments become more rigid, which significantly limits the degree of rotation of the acetabulum. In these cases, a triple pelvic osteotomy is performed to enhance the mobility of the acetabular fragment. This pubic bone osteotomy is performed near the femoral neurovascular bundle, which may be damaged during the procedure.Aim. To describe a technique for transposition of the acetabulum after iliac and ischial osteotomy of the pelvis, which was developed to reduce trauma, prevent vascular complications, and increase postoperative stability of the pelvic ring.Materials and methods. A method developed by the authors for transposition of the acetabulum after iliac and sciatic pelvic osteotomy is described in detail. The surgical method was performed 99 times on 89 children with dysplastic hip joint disorders, and the results are presented.Conclusion. Transposition of the acetabulum after iliac and ischial pelvic osteotomy is an effective treatment for dysplastic instability of the acetabulum in children aged 9–16 years. The procedure is indicated when it is necessary to rotate the acetabular fragment by more than 25°, and there is no need for hip medialization.

  8. Acute osteomyelitis of the acetabulum induced by Staphylococcus capitis in a young athlete

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    Seiji Fukuda

    2010-03-01

    Full Text Available Acute hematogenous osteomyelitis (AHOM of the acetabulum is a rare condition in children and usually caused by Staphylococcus aureus. We present an 11-year-old soccer athlete who suffered from acute osteomyelitis involving the acetabulum caused by S. capitis, a normal flora of the human skin but never reported in this condition. The disease was associated with repetitive skin injuries of the knee and potential osseous microtrauma of the hip joint by frequent rigorous exercise. This unusual case suggests that osseous microtrauma of the acetabulum, in addition to repetitive skin injuries, allowed normal skin flora to colonize to the ipsilateral acetabulum, which served as a favorable niche and subsequently led to AHOM.

  9. Three dimensional finite element analysis of acetabulum loaded by static stress and its biomechanical significance

    Institute of Scientific and Technical Information of China (English)

    SU Jia-can; ZHANG Ben; YU Bao-qing; ZHANG Chun-cai; CHEN Xue-qiang; WANG Bao-hua; DING Zu-quan

    2005-01-01

    Objective:To explore the mechanical behavior of acetabulum loaded by static stress and provide the mechanical basis for clinical analysis and judgement on acetabular mechanical distribution and effect of static stress. Methods:By means of computer simulation, acetabular three dimensional model was input into three dimensional finite element analysis software ANSYS7.0. The acetabular mechanical behavior was calculated and the main stress value, stress distribution and acetabular unit displacement in the direction of main stress were analyzed when anterior wall of acetabulum and acetabular crest were loaded by 1 000 N static stress. Results :When acetabular anterior wall loaded by X direction and Z direction composition force, the stress passed along 4 directions: (1)from acetabular anterior wall to pubic symphysis a long superior branch of pubis firstly, (2)from acetabular anterior wall to cacroiliac joint along pelvic ring,(3)in the acetabulum, (4)from the suffered point to ischium. When acetabular crest loaded by X direction and Y direction composition force, the stress transmitted to 4 directions: (1)from acetabular crest to ilium firstly, (2)from suffered point to cacroiliac joint along pelvic ring, (3) in the acetabulum , (4)along the pubic branch ,but no stress transmitted to the ischium branch. Conclusion:Analyzing the stress distribution of acetabulum and units displacement when static stress loaded can provide internal fixation point for acetabular fracture treatment and help understand the stress distribution of acetabulum.

  10. Conventional versus virtual radiographs of the injured pelvis and acetabulum

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    Bishop, Julius A.; Rao, Allison J.; Pouliot, Michael A.; Bellino, Michael [Stanford University School of Medicine, Department of Orthopaedic Surgery, Stanford, CA (United States); Beaulieu, Christopher [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2015-09-15

    Evaluation of the fractured pelvis or acetabulum requires both standard radiographic evaluation as well as computed tomography (CT) imaging. The standard anterior-posterior (AP), Judet, and inlet and outlet views can now be simulated using data acquired during CT, decreasing patient discomfort, radiation exposure, and cost to the healthcare system. The purpose of this study is to compare the image quality of conventional radiographic views of the traumatized pelvis to virtual radiographs created from pelvic CT scans. Five patients with acetabular fractures and ten patients with pelvic ring injuries were identified using the orthopedic trauma database at our institution. These fractures were evaluated with both conventional radiographs as well as virtual radiographs generated from a CT scan. A web-based survey was created to query overall image quality and visibility of relevant anatomic structures. This survey was then administered to members of the Orthopaedic Trauma Association (OTA). Ninety-seven surgeons completed the acetabular fracture survey and 87 completed the pelvic fracture survey. Overall image quality was judged to be statistically superior for the virtual as compared to conventional images for acetabular fractures (3.15 vs. 2.98, p = 0.02), as well as pelvic ring injuries (2.21 vs. 1.45, p = 0.0001). Visibility ratings for each anatomic landmark were statistically superior with virtual images as well. Virtual radiographs of pelvic and acetabular fractures offer superior image quality, improved comfort, decreased radiation exposure, and a more cost-effective alternative to conventional radiographs. (orig.)

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

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    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)

  12. 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)

  13. Pathological fracture dislocation of the acetabulum in a patient with neurofibromatosis-1

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    Balaji Saibaba

    2016-01-01

    Full Text Available Skeletal neurofibromatosis (NF commonly manifests as scoliosis and tibial dysplasias. NF affecting the pelvic girdle is extremely rare. Pathological fracture of the acetabulum leading to anterior hip dislocation in a patient with NF-1 has never been reported in the literature. The paper presents the clinical symptomatology, the course of management and the successful outcome of such a rare case of NF-1. Histopathological and immunohistochemistry studies showing abundant spindle cells, which are S-100 positive and of neural origin are the classical hallmarks of neurofibromatous lesions. Tumor resection and iliofemoral arthrodesis can be considered as a valid option in young patients with pathological fracture dislocation of the acetabulum.

  14. Sex differences in anatomical parameters of acetabulum among asymptomatic Serbian population

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    Jeremić Dejan

    2011-01-01

    Full Text Available Background/Aim. Anatomical parameters of the bony components of the hip joint are essential for better understanding of etiopathogenesis of diseases like primary osteoarthrosis of the hip joint. The aim of this reserch was to examine the normal acetabular morphometry in Serbian population and to determine whether there are sex differences in anatomical parameters of the acetabulum among asymptomatic subjects. Methods. Pelvic radiographics of 320 adult asymptomatic patients (640 hips were analyzed in 170 men and 150 women to determine the morphology of the acetabulum in Serbian population. For each hip the center edge angle of Wiberg (CEA, the acetabular angle of Sharp (AA, acetabular depth (AD, acetabular roof obliquity (ARO and roof angle (RA were measured. Results. The following average measurements for acetabulum geometry were obtained (X ± SD: CEA - 33.5 ± 6.5° (33.6 ± 5.8° in male, 33.3 ± 6.9° in female, AA - 38.0 ± 3.8° (37.5 ± 3.6° in male, 38.5 ± 3.9° in female, AD - 11.9 ± 2.8 mm (12.5 ± 2.7 mm in male, 11.2 ± 2.7 mm in female, ARO - 7.6 ± 5.7° (6.2 ± 4.9° in male, 9.0 ± 6.0° in female and RA - 18.4 ± 10.0° (19.6 ± 8.5° in male, 17.1 ± 9.5° in female. There were significant differences in the CEA, AA, AD, ARO and RA related to gender (p < 0.01, t-test. Conclusion. There are significant gender differences in Serbian population for all the examined anatomical parameters of acetabulum. We found sex-related differences in acetabular morphology, female acetabulum being marginally more dysplastic than male acetabulum. There is also a clear tendency of female hips to be more dysplastic than male ones.

  15. Innovation aspects of rehabilitation methods of treatment of acetabulum dam-age

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    Muhammad Shorustamov

    2012-05-01

    Full Text Available The article is devoted to solving improvement of rehabilitation treatment methods in acetabular injuries. Offered algorithm enables to improve rehabilitation treatment methods of acetabular injuries. Algorithm of rehabilitation includes blocks of conservative (including blocks ambulatory, treatment at a health resort, medicamentous and other methods of treatment of acetabulum damage as well as control block. Block of endoprosthetics of coxofemoral joint is also provided for in case of detection of signs of coxarthrosis. Innovation algorithm of perfecting rehabilitation methods of treatment of acetabulum damage (AD contributes to expansion of an implementation sphere in traumatic surgery and orthopedics practice. It allows practical physicians to build a clear algorithm of postoperative rehabilitation for this complicated cohort of patients with AD.

  16. Comparison of ESTs from juvenile and adult phases of the giant unicellular green alga Acetabularia acetabulum

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    Grotewold Erich

    2004-03-01

    Full Text Available Abstract Background Acetabularia acetabulum is a giant unicellular green alga whose size and complex life cycle make it an attractive model for understanding morphogenesis and subcellular compartmentalization. The life cycle of this marine unicell is composed of several developmental phases. Juvenile and adult phases are temporally sequential but physiologically and morphologically distinct. To identify genes specific to juvenile and adult phases, we created two subtracted cDNA libraries, one adult-specific and one juvenile-specific, and analyzed 941 randomly chosen ESTs from them. Results Clustering analysis suggests virtually no overlap between the two libraries. Preliminary expression data also suggests that we were successful at isolating transcripts differentially expressed between the two developmental phases and that many transcripts are specific to one phase or the other. Comparison of our EST sequences against publicly available sequence databases indicates that ESTs from the adult and the juvenile libraries partition into different functional classes. Three conserved sequence elements were common to several of the ESTs and were also found within the genomic sequence of the carbonic anhydrase1 gene from A. acetabulum. To date, these conserved elements are specific to A. acetabulum. Conclusions Our data provide strong evidence that adult and juvenile phases in A. acetabulum vary significantly in gene expression. We discuss their possible roles in cell growth and morphogenesis as well as in phase change. We also discuss the potential role of the conserved elements found within the EST sequences in post-transcriptional regulation, particularly mRNA localization and/or stability.

  17. 治疗髋臼四边体骨折的现状和进展%Present Situation and the Progress of Treatment Acetabulum Quadrilateral Area Fracture

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    程鑫葵; 侯福山; 潘耀峰; 尹芸生

    2015-01-01

    髋臼四边体作为髋臼的内侧面支撑着髋臼,并联通髋臼前后柱的重要结构,其重要意义越来越被骨科医生所认识。四边体紧邻髋臼,手术中对于四边体的修复其实质是通过对四边体的复位间接复位髋臼。该文从复位四边体的常用手术入路、四边体的修复、手术新技术等方面进行综述,总结近几年复杂型髋臼骨折中四边体修复的现状和进展。%Acetabulum four sides bodies as the inner surface of the acetabulum supporting the acetabulum. Which is the medial aspect of the acetabulum supporting the acetabulum, and unicom important structure acetabulum anterior column and acetabulum posterior column, more and more orthopaedic surgeons to realize its importance. The quadrilateral area adjacent to the acetabulum, the real purpose of reset the quadrilateral area in the surgery is to hope that through reset the quadrilateral area to indirect reduc-tion the acetabulum fracture. In this paper, reviewed from Several aspects,such as commonly used surgical approach in the treat-ment of the acetabulum fracture surgery, the reset of the acetabulum quadrilateral area and the new technology of operation, to summarized the status and progress of that the technology of reset the acetabulum quadrilateral area in treatment of the complex acetabular fractures in recent years.

  18. CT measurement of acetabulum geometric parameter%髋臼几何参数的CT测量

    Institute of Scientific and Technical Information of China (English)

    胡荣慧; 贺斌; 刘力; 严睿; 刘嘉凯; 黄小波; 张剑; 丁薇

    2013-01-01

      背景:近年来尽管对髋臼形态特征的研究已经取得了一些成果,但由于髋臼结构和位置的特殊性,有关髋臼表面形态的定量描述至今尚未统一,这势必会影响髋关节病变诊断和治疗的准确性。目的:探讨髋臼几何参数的CT测量方法。方法:选取70例髋关节CT受检者,其中正常成人50例(两侧共100个髋关节),单侧先天性髋关节脱位患儿20例。对所有受检者髋关节CT图像进行冠状面重建和三维重建,比较正常成人髋臼上外倾角冠状位和三维测值,比较先天性髋关节脱位组患侧与正常侧髋臼上外倾角。选择配伍组设计方差分析,分别比较扫描床面为参照面和以身体冠状面为参照面测量左右侧髋臼后外展角、前髋臼指数及后髋臼指数。结果与结论:髋臼上外倾角在冠状位测值为(39.99±6.1)°,在三维图像上测值为(40.13±5.80)°,2者比较,差异无显著性意义(P >0.05)。先天性髋关节脱位患儿双侧上外倾角在冠状面的测量值,正常侧为(48.95±3.80)°,脱位侧为(63.56±6.35)°,二者之间差异有非常显著性意义(P 0.05)。提示以冠状面为参照平面测量双侧后外展角和前、后髋臼指数准确可靠,可客观反映髋臼情况,为髋关节区病变的诊断和治疗提供确切的量化指标。%  BACKGROUND: Although, the previous studies on acetabular morphological characteristics have yielded some results, quantitative description of the acetabular surface morphology has not yet been unified because of the special nature of acetabular structure and location, and this is bound to affect the accuracy of the diagnosis and treatment of hip disease. OBJECTIVE: To investigate the CT measuring methods to acetabulum geometric parameters. METHODS: Seventy cases performed CT scan were selected, including 50 normal adults (a total of 100 hips on both sides) and 20 cases with unilateral congenital

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

    OpenAIRE

    Vasileios Sakellariou; Michael Christodoulou; Gregory Sasalos; George Babis

    2014-01-01

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

  20. An automatic segmentation system of acetabulum in sequential CT images for the personalized artificial femoral head design.

    Science.gov (United States)

    Liu, Bin; Zhang, Hui; Hua, Shungang; Jiang, Qianfeng; Huang, Rui; Liu, Wenpeng; Zhang, Shuo; Zhang, Bingbing; Yue, Zongge

    2016-04-01

    This paper describes an automatic and accurate segmentation method to extract the acetabulum tissue from sequential CT images. The hip joint consists of acetabulum and femoral head. In the personalized femoral head prosthesis designing by reverse engineering technology, obtaining the accurate acetabulum shape is the most important task. However, due to the necrotic femoral head's complex shape and the extremely narrow inter-bone region, obtaining the accurate acetabulum shape remains a challenging work. In this paper, we overcame these difficulties and developed an automatic segmentation method. First, we obtain the rough contour of the femoral head by utilizing the constraints of the great trochanter and the shape of femoral head in the initial slice. Second, we refine the rough contour by an orthogonal line edge detection approach and obtain a refined contour which will be used as the initial contour of the snake algorithm. Then, the snake algorithm is performed slice by slice upwards and downwards to generate the adjacent contours. During this process, the contour of the femoral head in a segmented slice is used as the initial contour of the next unsegmented slice. Finally, we can obtain the accurate sequential contours of the acetabulum by removing the femoral head and the femoral regions. And the 3D models of the acetabulum can be obtained correspondingly. The experimental result shows that the 3D models obtained by the proposed method are accurate and satisfactory. On this condition, we can reconstruct the personalized femoral head 3D models and design the personalized femoral head prosthesis. PMID:26803563

  1. The role of acetabulum geometry and femoral head-neck ratio in the development of osteoarthritis in young men

    DEFF Research Database (Denmark)

    Halle, B; Halle, D M; Torfing, T;

    2007-01-01

    We studied the role of acetabulum geometry and head neck ratio in the development of osteoarthritis of the hip in young men. Contrary to previous studies we evaluated the significance of the anterior, posterior and total coverage of the femoral head, the influence of the femoral neck and the cons......We studied the role of acetabulum geometry and head neck ratio in the development of osteoarthritis of the hip in young men. Contrary to previous studies we evaluated the significance of the anterior, posterior and total coverage of the femoral head, the influence of the femoral neck...

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

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    Vasileios Sakellariou

    2014-09-01

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

  3. PROSPECTIVE STUDY ON SEVENTY-SIX CASES OF FRACTURED ACETABULUM WITH SURGICAL TREATMENT

    Science.gov (United States)

    de Almeida, André Gaudêncio Ignácio; Garrido, Carlos Antônio; Vaz Amaral, Leonardo Eustáquio; Vargas, Luiz Fernando Lindenberg

    2015-01-01

    Objective: To conduct a prospective study on unstable and incongruent fractures of the acetabulum, in comparison with the literature, covering the type of access, fixation materials, degree of reduction, type of fracture and results after surgery. Methods: The authors evaluated 76 patients with unstable and incongruent fracture of the acetabulum between January 1999 and December 2009. The Marvin Tile classification was used, and all cases were treated surgically using the technique recommended by the AO-ASIF group. Results: The radiological evaluation was done in accordance with the Ruesch criteria, and good, excellent or perfect results were obtained for 64 patients (84.2%). The clinical evaluation was done in accordance with the Harris criteria, and good or excellent results were obtained for 62 patients (81.6%). The complications were assessed and, in comparison with the literature, were shown to be compatible with previous reports even after the statistical analysis. Conclusion: It was concluded that anatomical reduction and stable fixation are important for good results. PMID:27027048

  4. A modified cementing technique using BoneSource to augment fixation of the acetabulum in a sheep model.

    NARCIS (Netherlands)

    Timperley, A.J.; Nusem, I.; Wilson, K.; Whitehouse, S.L.; Buma, P.; Crawford, R.W.

    2010-01-01

    BACKGROUND AND PURPOSE: Our aim was to assess in an animal model whether the use of HA paste at the cement-bone interface in the acetabulum improves fixation. We examined, in sheep, the effect of interposing a layer of hydroxyapatite cement around the periphery of a polyethylene socket prior to fixi

  5. Contact between the acetabulum and dome of a Kerboull-type plate influences the stress on the plate and screw.

    Science.gov (United States)

    Hara, Katsutoshi; Kaku, Nobuhiro; Tabata, Tomonori; Tsumura, Hiroshi

    2015-07-01

    We used a three-dimensional finite element method to investigate the conditions behind the Kerboull-type (KT) dome. The KT plate dome was divided into five areas, and 14 models were created to examine different conditions of dome contact with the acetabulum. The maximum stress on the KT plate and screws was estimated for each model. Furthermore, to investigate the impact of the contact area with the acetabulum on the KT plate, a multiple regression analysis was conducted using the analysis results. The dome-acetabulum contact area affected the maximum equivalent stress on the KT plate; good contact with two specific areas of the vertical and horizontal beams (Areas 3 and 5) reduced the maximum equivalent stress. The maximum equivalent stress on the hook increased when the hardness of the bone representing the acetabulum varied. Thus, we confirmed the technical importance of providing a plate with a broad area of appropriate support from the bone and cement in the posterior portion of the dome and also proved the importance of supporting the area of the plate in the direction of the load at the center of the cross-plate and near the hook. PMID:25749753

  6. An approach to comparative anatomy of the acetabulum from amphibians to primates.

    Science.gov (United States)

    Canillas, F; Delgado-Martos, M J; Touza, A; Escario, A; Martos-Rodriguez, A; Delgado-Baeza, E

    2011-12-01

    The objective of this study was to investigate the anatomy, both macroscopic and microscopic, of the soft tissue internal structures of the hip joint in animal species and in three human hips (an adult and two fetuses). We dissected the hip joints of 16 species and compared the anatomical features of the soft tissue from the respective acetabula. In addition, a histological study was made of the specimens studied. In amphibians, we found a meniscus in the acetabulum, which was not observed in any of the other species studied. The isolated round ligament is observed from birds onwards. In the group of mammals analysed, including the human specimens, we found a meniscoid structure in the acetabular hip joint. Furthermore, we found that the meniscoid structure forms an anatomo-functional unit with the round ligament and the transverse ligament of the coxofemoral joint. These discoveries suggest the participation of the soft tissue anatomy in adaptative changes of species.

  7. Massive heterotopic ossification associated with late deficits in posterior wall of acetabulum after failed acetabular fracture operation

    OpenAIRE

    Zhang, Yuntong; Xie, Yang; Xu, Shuogui; Zhang, Chuncai

    2013-01-01

    Background Heterotopic ossification is a common postoperative complication of acetabular fracture. However, functionally significant heterotopic ossification with associated late bone defects in the posterior wall of the acetabulum is rare and challenging to treat. When heterotopic ossification is a late complication of failed acetabular fracture operation, it is disabling and may only be treated by THA. THA is highly susceptible to premature failure in young and active patients and may requi...

  8. Acetabulum malignancies: technique and impact on pain of percutaneous injection of acrylic surgical cement

    Energy Technology Data Exchange (ETDEWEB)

    Weill, A.; Kobaiter, H.; Chiras, J. [Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France)

    1998-02-01

    The aim of our study was to describe the technique of percutaneous injection of acrylic surgical cement into acetabulum malignancies [percutaneous acetabuloplasty (PCA)] and determine its efficiency in relieving pain. Eighteen patients (8 men, 10 women; aged 40-81 years) with painful acetabular malignancies (18 lesions; 17 metastases, 1 multifocal bone sarcoma) were treated with PCA. Procedures were done using lateral approach with fluoroscopic guidance. The 18 procedures were evaluated and resulted in 4 (22 %) total improvement, 7 (39 %) clear improvement, 4 (22 %) moderate improvement, 1 (6 %) no improvement, and 2 (11 %) worsening in keeping with a cement leak in contact with the sciatic nerve and a leak towards the joint. Follow-up ranged from 2 to 48 months (average 9.4 months). We observed 2 cases of recurrence of pain at 6 and 39 months, both in keeping with local tumoral progression. PCA of malignancies is a minimally invasive and low-cost procedure that provides immediate and long-term pain relief. (orig.) With 6 figs., 2 tabs., 20 refs.

  9. Clinical application of spiral-type acetabulum and press-fit acetabulum%螺旋型髋臼与压配型髋臼的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    张媺; 白鹏程; 江建平; 王辉; 冯孝志; 金绍林; 童绪军; 张昌奕; 李勇

    2012-01-01

    BACKGROUND: Most studies suggest that the spiral-type acetabulum of total hip arthroplasty (THA) could provide betterstability than the press-fit acetabulum.OBJECTIVE: To compare the effects of press-fit acetabulum and spiral-type acetabulum in THA.METHODS: The retrospective analysis on the clinical data of 39 THA patients with press-fit acetabulum and spiral-typeacetabulum was preformed.RESULTS AND CONCLUSION: ?AII cases were followed-up for 4-51 months, the average time was 32.6 months. ?Harrisscores: Postoperative Harris scores were significantly improved than preoperative in the final follow-up (P < 0.05), and the scoreof the spiral-type acetabular group was slightly higher than that of press-fit acetabular group, but the difference was not significant.?Adverse reactions: The postoperative complications of the press-fit acetabular arthroplasty group included looseness of hipprosthesis 1 case after 1 year, ambulation pain 3 cases, osteogenesis around acetabular prosthesis 6 cases, translucent aroundacetabular prosthesis 3 cases, osteosclerosis around acetabular prosthesis 1 case and bone resorption around acetabularprosthesis 1 case; the spiral-type acetabular group included osteogenesis around acetabular prosthesis 3 cases, translucentaround acetabular prosthesis 1 cases and bone resorption around acetabular prosthesis 1 case. Therefore, the initial stability ofthe spiral-type acetabular prosthesis was better than that of the press-fit acetabular prosthesis.%背景:在人工全髋关节置换髋臼假体的选择上,多数研究认为螺旋型髋臼较压配型髋臼能的稳定性好.目的:对比螺旋型髋臼与压配型髋臼两种不同全髋关节置换的临床疗效.方法:回顾性分析选择螺旋型髋臼与压配型髋臼两种不同人工全髋关节置换39例患者临床资料.结果与结论:①随访时间:随访4~51个月,平均32.6个月.②Harris评分:末次随访时两组Harris评分均较置换前明显提高(P < 0.05),且螺旋型髋

  10. Estimation of age-at-death for adult males using the acetabulum, applied to four Western European populations.

    Science.gov (United States)

    Rissech, Carme; Estabrook, George F; Cunha, Eugenia; Malgosa, Assumpció

    2007-07-01

    Methods to estimate adult age from observations of skeletal elements are not very accurate and motivate the development of better methods. In this article, we test recently published method based on the acetabulum and Bayesian inference, developed using Coimbra collection (Portugal). In this study, to evaluate its utility in other populations, this methodology was applied to 394 specimens from four different documented Western European collections. Four strategies of analysis to estimate age were outlined: (a) each series separately; (b) on Lisbon collection, taken as a reference Coimbra collection; (c) on Barcelona collection, taken as a reference both Portuguese collections; and (d) on London collection taken as reference the three Iberian collections combined. Results indicate that estimates are accurate (83-100%). As might be expected, the least accurate estimates were obtained when the most distant collection was used as a reference. Observations of the fused acetabulum can be used to make accurate estimates of age for adults of any age, with less accurate estimates when a more distant reference collection is used.

  11. Evaluation of age estimation technique: testing traits of the acetabulum to estimate age at death in adult males.

    Science.gov (United States)

    Calce, Stephanie E; Rogers, Tracy L

    2011-03-01

    This study evaluates the accuracy and precision of a skeletal age estimation method, using the acetabulum of 100 male ossa coxae from the Grant Collection (GRO) at the University of Toronto, Canada. Age at death was obtained using Bayesian inference and a computational application (IDADE2) that requires a reference population, close in geographic and temporal distribution to the target case, to calibrate age ranges from scores generated by the technique. The inaccuracy of this method is 8 years. The direction of bias indicates the acetabulum technique tends to underestimate age. The categories 46-65 and 76-90 years exhibit the smallest inaccuracy (0.2), suggesting that this method may be appropriate for individuals over 40 years. Eighty-three percent of age estimates were ±12 years of known age; 79% were ±10 years of known age; and 62% were ±5 years of known age. Identifying a suitable reference population is the most significant limitation of this technique for forensic applications.

  12. Acetabular defect reconstruction with impacted morsellized bone grafts or TCP/HA particles. A study on the mechanical stability of cemented cups in an artificial acetabulum model.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2002-01-01

    In revision surgery of the acetabulum bone defects can be filled with impacted human morsellized bone grafts. Because of a worldwide limited availability of human bone, alternatives are being considered. In this study we compared the initial stability of acetabular cups after reconstructing a cavita

  13. Research on Damage in Trabecular Bone of the Healthy Human Acetabulum at Small Strains Using Nonlinear Micro-finite Element Analysis

    Institute of Scientific and Technical Information of China (English)

    DING Hai; ZHU Zhen-nan; DAI Ke-rong; YE Ming; WANG Cheng-tao

    2008-01-01

    The mechanical properties of the pelvic trabecular bone have been studied at the continuum level. However, nothing is known about the tissue-level damage in the trabecular bone of the healthy human acetabulum at apparent small strains characteristic of habitual. By a DAWING 4000 A supercomputer, nonlinear micro-finite element (μFE) analysis was performed to quantify tissue-level damage accumulation in trabecular bone at small strains. The data indicate that damage in trabecular bone commence at 0.2% apparent strain. The findings imply that tissue yielding can initiate at very low strains in the trabecular bone of the healthy acetabulum and that this local failure has negative consequences on the apparent mechanical properties of trabecular bone.

  14. Osteoid Osteoma of the Acetabulum in Children:A Case Report%儿童髋臼骨样骨瘤一例报道

    Institute of Scientific and Technical Information of China (English)

    段丽群; 尚希福; 张文志; 胡飞

    2011-01-01

    Osteoid is a kind of benign bone tumor and commonly seen in the backbone of the femoral and ibia.Osteoid osteoma of the acetabulum is very rare and its clinical and imaging features are different with the common places,such as the backbone.One case of acetabulum osteoid osteoma and its diagnsis and and treatment were introduced.%骨样骨瘤是一种良性的骨肿瘤,多见于股骨、胫骨的骨干.髋臼骨样骨瘤十分罕见,其临床及影像学表现和骨干等常见部位不同.我院收治髋臼骨样骨瘤1例,特将该病例的诊断及治疗进行介绍.

  15. Management of weight-bearing area fracture of acetabulum%涉及臼顶负重区髋臼骨折的诊疗与对策

    Institute of Scientific and Technical Information of China (English)

    章云童; 王攀峰; 张春才

    2011-01-01

    Acetabulum, as the important factor for weight bearing of the upper body, has its unique anatomic features and complicated physiological function.The integrity and stability of the lunata articular surface in the dome region of acetabulum,is the important base to bear the physiological function of acetabulum.The fracture related to this part will cause relation change of contact area and stress between head of femur and acetabulum.Furthermore,the deep anatomical position of the dome region ,the complicated surrounding anatomical relation,and the irregular bony structure will also increase the difficulty of surgical treatment.Especially for some complicated comminuted or compressed fracture,even with good explosions, it is hard to get satisfied anatomical reduction.Consequently ,forward traumatic arthritis has greater probability of occurrence.Therefore,the clinical research on the fracture in the dome region of acetabulum was getting more and more attention worldly.This paper intended to review the relation of fracture classifications and anatomic features, physiological function, diagnostic criteria, and also its clinical treating countermeasure.%髋臼作为承载上半身体重的重要关节,具有独特的解剖学特点及复杂的生理功能,而臼顶区月状关节面的完整性与稳定性是承担髋臼生理功能的重要基础,涉及此处骨折会导致股骨头与髋臼之间的接触面积和应力等关系发生改变,加之臼项区解剖位置深在,周围解剖关系复杂,骨性结构不规则,手术治疗难度较大,特别是一些复杂的粉碎压缩骨折,即使达到良好暴露也难以达到满意的解剖复位,从而使远期创伤性关节炎的发生概率大大增加.因此涉及臼顶负重区的髋臼骨折的基础及临床研究在国内外的重视程度逐年增高,本文就其解剖学特点及生理功能、诊断标准与骨折分型的关系、临床治疗对策等做一综述.

  16. Abmessung und Analyse der Bezugsfl(a)che von Acetabulum-Prothese-Transplantation in unterschiedlichen K(o)rperlagen

    Institute of Scientific and Technical Information of China (English)

    ZENG Hui; Eckart Mayr; KANG Bin; XIONG Ao; XIN Feng; Michael Nogler; Martin Krismer

    2006-01-01

    Ziel ist die Analyse der Neigungslage des Beckens im Liegen und im Stehen bzw.die Beobachtung der Stabilit(a)t der Beckenfl(a)che als Beckenfl(a)che für die Acetabulum-Prothese Transplantation. 72 Testpersonen wurden je nach Status ihres Pfannengelenks in 3 Gruppen eingeteilt:Gruppe 1 "mit gesundem Pfannengelenk", Gruppe 2 "mit Arthritis" und Gruppe 3 "nach Implantation der Hüftendoprothese". Unter dem Einsatz von 3D- Digital-Instrument wurde die Fl(a)chen-Neigung vor dem Becken jeweils im Liegen und im Stehen gemessen und die Messwerte wurden verglichen. Die Fl(a)chen-Neigungen vor dem Becken bei allen 3 Gruppen (mit gesundem Pfannengelenk/mit Arthritis/nach Operation) im Liegen sind: 6.37°± 3.70°, 6. 47°± 3.52° und 4.56°±2.39°. Im Stehen sind es 7.33°±3.08°, 6.60°±3.45° und 6.74°±3.43°. Der Fl(a)chen-Neigungsunterschied vor dem Becken im Liegen und im Stehen hat keine grosse Bedeutung (P>0.05).Die (A)nderung der Fl(a)chen-Neigung vor dem Becken vom Liegen bis zum Stehen ist kleiner als 2.5°.Die Fl(a)che vor dem Becken (pelvic anterior plane, PAP) als Bezugsfl(a)che für Hüftpfanne-Prothese Transplantation bei klinischer Operation ist stabil und verlaβlich.

  17. The upper part wall of acetabulum fractures:management and classification%髋臼上部骨折的分型与治疗体会

    Institute of Scientific and Technical Information of China (English)

    王文; 李秉胜; 王平山; 刘立峰; 曹学成

    2015-01-01

    目的:探讨髋臼上部骨折的分型与治疗。方法回顾性分析2000年1月—2013年6月收治的10例患者,根据术前经X线及CT三维重建明确诊断,对其进行分型后,根据分型的不同采用了不同治疗方法。结果2例患者采用非手术治疗,8例患者采用手术治疗。随访6~12个月,平均8个月。治疗结果优良率为80%。结论应用髋臼上部骨折的单独诊断与分型标准指导治疗,是获得良好结果的基础。%Objective To discuss the classification and management of upper part wall of acetabulum fractures. Methods From January 2000 to June 2013,10 cases of upper part wall of acetabulum fractures were retrospectively analyzed. On the basis of the X-ray and three-dimensional computed tomography,they were diagnosed and classified,treated differently according to the classification. Results Among the 10 cases 2 were received conservative treatment,8 were treated with operation. All the cases were followed up for 6 to 12 months, with an average time of 8 months;8 cases of the series were rated as fine (80%). Conclusion The upper part wall of acetabulum fractures could obtain good outcome on basis of the diagnosis and classification of it.

  18. Late Growth and Development of Acetabulum After Innominate Osteotomy%骨盆截骨术后远期髋臼发育变化

    Institute of Scientific and Technical Information of China (English)

    吉士俊; 周永德; 刘卫东; 赵群

    1991-01-01

    50 cases of congenital dislocation of the hip treated with Salter innominate osteotomy were followed up for average 6.7 years.The development of acetabulum,including acetabular index,CE angle,acetabular head index (AHI) and acetabular width,was observed.The result showed that the aeetabular width and AHI were slightly increaed in the operated group but no statistical difference from the normal.Socket pattern was observed in 86.9 percent of the cases.The inner diamet of pelvis was normal in 85.5 percent of the cases.Three dimentional changes of acetabulum,its biomechanics and mechanism of aeetabular widening were discussed.It is emphasized that the shape of femoral head is an important factor in the growth and development of the acetabulum.%本文报告通过分别测量髋臼指数、CE角、臼头指数和髋臼宽度,随访观察5年以上骨盆截骨术治疗50例先天性髋脱位的髋臼发育变化,发现该组病例髋臼宽度和臼头指数与正常组对比,差异无显著意义;髋臼呈球窝形占86.9%;骨盆内径正常者达85.5%.探讨了本术式的三维结构变化、生物力学和髋臼增宽的机理,强调股骨头形态是影响髋臼发育的重要因素.

  19. Role of bone morphogenetic protein 2 in early acetabulum development and dysplastic acetabulum remodeling%BMP-2在髋臼软骨发育早期及发育不良髋臼软骨可逆性恢复过程中的作用研究

    Institute of Scientific and Technical Information of China (English)

    莫越强; 裴新红; 马瑞雪

    2015-01-01

    目的 研究BMP-2在髋臼软骨发育早期及发育不良髋臼软骨可逆性恢复过程中的作用.方法 通过伸髋内收、模拟襁褓体位固定新生大鼠双后肢,建立发育不良髋臼软骨模型.将髋臼标本经HE染色后观察比较正常及发育不良髋臼软骨组织形态学变化特点,同时用ELISA方法和PCR方法分别检测BMP-2、BMP-4、BMP-6、BMP-7的分泌及基因表达情况.将捆绑不同时间后的大鼠松绑,其中部分当场处死,其余大鼠继续喂养,最终至30日龄,建立发育不良髋臼软骨可逆性恢复模型.研究其髋臼软骨组织形态学恢复及BMP-2分泌变化情况.结果 正常大鼠髋臼软骨呈半圆形、容积大、表面光滑.发育不良髋臼软骨髋臼上缘肥厚,软骨发生变性,与周围组织分界不清.髋臼软骨BMP-2的分泌在正常大鼠7日龄和9日龄时出现高峰,分别为(13.7±0.29) ng/ml和(13.9±0.38) ng/ml.而在发育不良髋臼软骨中这一分泌高峰消失.在发育不良髋臼软骨可逆性恢复组,捆绑4d和6d的大鼠,BMP-2的分泌高峰出现延迟,都在15日龄时出现;而在捆绑8d及以上的大鼠,在松绑后继续喂养至30日龄,髋臼软骨组织形态无法恢复正常,并且BMP-2的分泌高峰未出现.结论 BMP-2的分泌可能是髋臼软骨早期发育情况的生物学标记之一.%Objective To explore the early-stage acetabulum development in normal and dysplastic acetabula and elucidate the function of bone morphogenetic protein 2 (BMP-2) in early acetabulum development and dysplastic acetabulum remodeling.Methods The rat model of dysplastic acetabulum was established by maintaining hips in a swaddling position.By analyzing the cartilage histologic characteristics,early-stage acetabulum developments were examined in normal and dysplastic acetabulum animals.Meantime,the mRNA expression and chondrocyte secretion of functional BMP-2,bone morphogenetic protein 4 (BMP-4),bone morphogenetic protein 6 (BMP-6) and bone

  20. Acetabulum protrusio and center edge angle: new MR-imaging measurement criteria - a correlative study with measurement derived from conventional radiography

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Lina; Resnick, Donald [VASDHS-Radiology, San Diego, CA (United States); UCSD Medical Center, San Diego, CA (United States); Boonthathip, Mayura; Cardoso, Fabiano; Clopton, Paul [VASDHS-Radiology, San Diego, CA (United States)

    2009-02-15

    The goal of this study was to identify a method of measurement for acetabulum protrusio and center edge angle (CEA) using MR imaging of the pelvis that correlated with classic methods using radiographic landmarks. MR images and radiographs of the pelvis in 67 patients (132 hips) were used to identify reliable MR-imaging methods for measuring protrusio acetabulum and CEA that correlated strongly with established radiographic measurements. Protrusio acetabulum was determined using the radiographic criterion that the acetabular line projects medial to the ilioischial line by 3 mm or more in men and 6 mm or more in women. Pearson correlation factor was used to determine inter-observer variability and those methods that demonstrated the strongest correlation. The mean and standard deviation of MR-imaging and radiographic measurements for both the normal and protrusio hips were established. Several MR methods correlated strongly with radiographic measurements. The preferred method employed axial MR images at the level of the ischial spine with measurement of the distance between the medial most point of the acetabular fossa and a line perpendicular to the horizontal axis that passed through the lateral margin of the posterior inner pelvic wall. The Pearson's correlation factor between radiographic and MR measurements using this method was 0.84, and inter-observer correlation was 0.80. There were 126 hips in 63 patients (17 female and 44 male) that did not meet the radiographic criteria for protrusio acetabula. In this group of normal hips, the mean and standard deviation of radiographic measurements were 1.9 and 2.8 mm in male patients and -0.5 and 1.7 mm in female patients, and the mean and standard deviation for the preferred MR method was 1.3 and 2.5 mm in male patients and -0.8 and 1.9 mm in female patients. A total of six hips in four patients (two female and two male) met the radiographic criteria for protrusio acetabula. In this group of patients, the mean

  1. 髋臼周围恶性骨肿瘤的切除与重建%Resection and reconstruction for malignant bone tumors involving the acetabulum

    Institute of Scientific and Technical Information of China (English)

    邹昌业; 王晋; 黄纲; 尹军强; 谢显彪; 王永谦; 沈靖南

    2013-01-01

    Background:The location of the malignant tumors involving the acetabulum are comparatively deep, and they are usually very closed to some vital blood vessels, nerves and visceral organs, thus are very difficult to be resected. Methods to restore the continuity of pelvis and the function of acetabulum still need further improving. Objective: To investigate the methods and effects of the resection and reconstruction for malignant tumors involving the acetabulum. Methods:Retrospectively study 22 cases of resection and reconstruction for malignant bone tumors involving the acetabu-lum during January 2004 to December 2010. Analyze the survival of the patients, the recurrence and metastasis of the tu-mor, and the complications after the surgery, then evaluate the function of the patients via MSTS score system. Results:All the 22 patients were followed up for a mean period of 37.0 months (7.1 to 84.3 months). 15 patients gained a disease-free survival, 5 patients died of recurrence and metastasis of tumor, and 2 patients survived with the tumor. 7 pa-tients underwent local recurrence, which leads to a local recurrence rate of 31.82%. The mean interval from the operation to the local recurrence was 17.1 months (3 to 41.2 months). 4 patients had lung metastasis with an interval of 5.8 to 38.1 months after the operation, the mean interval was 16.6 months. The mean MSTS score detected six months after the opera-tion was 68.6%(32.5%-83.7%). Conclusions:Treat the malignant bone tumor involving the acetabulum with extensive resection and reconstruct the acetabu-lum with customized modular prostheses according to the degree of bone defects can achieve satisfactory curative effects and good function of the acetabulum .%  累及髋臼的恶性肿瘤由于位置较深,毗邻重要的血管神经和内脏器官,因而切除困难。切除后如何恢复骨盆连续性和髋臼功能的方法仍需完善。目的:探讨累及髋关节恶性肿瘤切除和重建的方法和

  2. Selection of acetabulum prosthesis in total hip revision procedures and repair effect of the acetabulum bone defect%全髋关节翻修术中髋臼假体的选择和髋臼骨缺损的修复效果

    Institute of Scientific and Technical Information of China (English)

    刘如月; 郝玉梅

    2016-01-01

    目的:探讨全髋关节翻修术中髋臼假体的选择和髋臼骨缺损的处理效果。方法选择2010年1月至2014年1月需行全髋关节翻修术患者24例,术前依据初次手术类型及骨缺损情况制作髋臼及股骨骨床断层模型,根据断层模型选择植骨材料及髋臼假体,均采取全髋关节翻修术治疗,观察患者疗效。结果24例患者均完成手术,术后 Harris 评分均高于术前,差异有统计学意义(P <0.05)。24例患者平均随访36个月,术后脱位1例,经手法复位及下肢固定2周维持,骨溶解伴有髋疼痛3例,经非甾体类药物治疗后好转,未见深静脉血栓、切口感染等术后并发症。结论全髋关节翻修术中髋臼假体的选择应结合患者初次手术类型及骨缺损情况,髋臼骨缺损少则采取自体髂骨颗粒骨移植,缺损较多则采取同种异体颗粒骨加自体颗粒骨混合应用,可取得较佳效果。%Objective To explore the selection of acetabulum prosthesis on total hip revision procedures and the repair effect of the acetabulum bone defect. Methods 24 patients requiring total hip revision procedures were selected from January 2010 to January 2014,and made acetabulum and femoral bone bed fault model according to the first surgery and bone defect in preoperative,and selected aggre-gate and acetabulum prosthesis according to the fault model. All of the patients were given total hip revi-sion procedures,and the effects of them were observed. Results Twenty-four patients had completed surgery,the postoperative Harris scores was higher than that of preoperative,and the difference was significant( P < 0. 05). The 24 patients were followed for 36 months,and there was 1 case of post-operative patients with dislocation by manual reduction and limb immobilization 2 weeks without dis-location,3 cases with bone dissolve with hip pain,and they had made improvement after treatment with non-steroidal drugs. There

  3. Fractures of the acetabulum

    NARCIS (Netherlands)

    Heeg, Minne

    1990-01-01

    Acetabulumfracturen zijn zeldzaam. Veelal betreft het patienten met meervoudig ernstige, soms levensbedreigende verwondingen. De ernst van deze verwondingen bepaalt de aard en omvang van de eerste hulp aan de patient. Na deze eerste opvang zal een behandelingsplan voor de acetabulumfractuur gemaakt

  4. 手术治疗C型髋臼骨折的研究分析%Surgical Treatment for Type C Acetabulum Fracture

    Institute of Scientific and Technical Information of China (English)

    纪少军; 康锦; 高杰

    2014-01-01

    目的:探讨C型髋臼骨折严重粉碎骨软骨关节面的手术重建方法、可行性及疗效分析。方法:回顾总结2009年10月至2011年6月手术治疗严重髋臼粉碎性骨折23例23髋( AO分型均为C型),均为C型髋臼骨折;选择髂腹股沟及髋臼后侧( Kocher-langebeck )联合入路。术中先纠正稳定且累及范围较广的髋臼周边部位骨折块,基本使头臼关系恢复,再采用可吸收螺钉、植骨、骨软骨折块镶嵌挤压等重建粉碎严重的髋臼关节面(碎裂软骨下骨及未游离的关节软骨),后用骨盆重建接骨板整体固定髋臼骨折部。术后根据稳定程度酌情给予矫形鞋或皮牵引制动4-6周,后床上进行静力肌肉舒缩功能锻炼及关节被动功能锻炼,术后3月渐进下地活动。结果:随访12个月至36月,平均16.6月。对位质量采用Matta标准:解剖复位21髋,不满意1髋,差1髋。临床结果评分依照改良Mered, Aubigne-Postel(3):优21髋,良1髋,差1髋。术后股骨头坏死率(5.3%),异位骨化率(46.8%)。结论:首先通过复位髋关节外骨盆骨折及复位髋关节对位关系,其次借助可吸收螺钉、植骨、骨软骨折块间的镶嵌挤压等方法可完成C型髋臼骨折的重建,术后达到满意关节功能。%Objective:To study the surgery feasibility and curative effect of articular cartilage recon-struction in severe type C crushed fracture at acetabulum .Method: A retrospective analysis was conducted from the data of 23 cases operated for severe acetabulum comminuted fracture from October 2009 to June 2011, AO classification showed Type C fractures in all the 20 males and 3 females.Koaher-langenbeck and ilioinguinal approaches were adopted .A wide range of stable area surrounding the acetabulum fracture were removed at first , to recover the relationshipof head mortar positions .Absorbable screw fracture , bone graft , cartilages

  5. 髋臼隐匿性骨折CT与X线平片检查诊断率对比分析%Comparative Analysis of CT and X-ray Diagnosis Rate of Occult Acetabulum Fracture

    Institute of Scientific and Technical Information of China (English)

    李国良

    2011-01-01

    Objective To investigate the appropriate diagnostic imaging method for evaluating occult acetabulum fracture in order to improve the diagnostic accuracy. Methods Retrospective analysis of 48 patients with occult acetabulum fracture was undertaken by X-ray and CT scans. We evaluated the detection rate of occult acetabulum fracture between CT and X-ray. Results According to Letournel Classification, there were 16 cases of anterior wall, 14 cases of posterior wall, 8 cases of anterior column and 10 cases of posterior column fractures. 28 (58.3% ) patients were suspected as having fracture line on the X -ray film. On the contrary, 48 (100.0% ) patients demonstrated occult acetabulum fracture line on CT. Conclusion CT has higher sensitivity than X-ray in detecting occult acetabulum fracture. Compared with X-ray, CT scanning allows a more precise determination of the degree of occult acetabulum fracture involvement and therefore is helpful in the planning of orthopedic surgery.%目的 探讨髋臼隐匿性骨折适宜的影像学诊断方法,提高其诊断准确性.方法 回顾性分析48例髋臼隐匿性骨折CT与X线平片影像学资料,评价CT与X线平片检查对髋臼隐匿性骨折的诊断率.结果 本组48例按Letournel分类,骨折位于髋臼前壁16例、后壁14例、前柱8例、后柱10例.CT检查诊断髋臼隐匿性骨折48例,诊断率100.0%;X线平片检查疑有髋臼隐匿性骨折28例,诊断率58.3%.结论 CT检查对髋臼隐匿性骨折的诊断率明显高于X线平片检查,X线平片检查可作为髋臼隐匿性骨折的初筛方法,CT检查则可为髋臼隐匿性骨折及其伴随损伤提供更准确的诊断信息.

  6. Treatment of Ischemic Necrosis of Femeral Head by Acetabulum Extension in Children%髋臼延伸术治疗儿童股骨头缺血性坏死

    Institute of Scientific and Technical Information of China (English)

    王雅芹; 马承宣; 房论光

    1991-01-01

    Acetabulum extension procedures were performed on 20 cases of ischemic necrosis of femerai head.Among them,2 were classified as stage Ⅱ and 18 as stage Ⅲ or Ⅳ.Follow-up ranged from 8 months to 4 years.18 revealed excellent results and 2 good.This procedure improves the spherity of the femeral head and the congruency between femeral head and acetabulum.The late degenerative osteoarthritis would be avoided.Of course,the leg length discrepency and increase of the pressure against femeral head resulted from innominate osteotomy won't happen in acetabulum extension procedure.%报道髋臼延伸术治疗儿童股骨头缺血性坏死20例,Ⅱ期2例,Ⅲ~Ⅳ期18例.随访时间最短8个月,最长4年.疗效优者18例,良2例.本手术能明显改善股骨头骨骺的高度、弧度、直径,保证股骨头与髋臼的相容性塑造,防止退变性关节炎的发生,同时克服了髂骨截骨等造成肢体短缩以及股骨头承受压力增大的不足.

  7. 手术治疗髋臼骨折的临床疗效%Clinical curative effect observation on surgical treatment of acetabulum fracture

    Institute of Scientific and Technical Information of China (English)

    张发平; 李玉桥; 罗仕武; 何罗彬; 杨勇; 尚庆; 胡晓刚

    2014-01-01

    目的:探讨手术治疗髋臼骨折的临床疗效,并对相关因素进行分析。方法分别采用K-L入路、髂腹股沟入路、前后联合入路行切开复位骨盆重建钢板、螺钉内固定治疗48例髋臼骨折患者。结果术后按Matta影像学评分,解剖复位28例,满意复位14例,不满意复位6例。患者均获随访,时间12~58个月。按改良的Merle d’Aubigné和Postel评分标准:优28例,良9例,可7例,差4例。简单骨折和复合骨折临床优良率分别为94.4%和66.7%,解剖复位和非解剖复位的临床优良率分别为96.4%和50%,差异均有统计学意义( P<0.05)。结论手术治疗髋臼骨折可获得满意的疗效,骨折的复位质量、骨折类型与疗效密切相关。%Objective To investigate the clinical curative effect of surgical treatment of acetabulum fracture, and to analysis the related factors. Methods A total of 48 patients with fracture of acetabulum were treated with Kocher-Langenbeck approach, iliac inguinal approach, joint into the road line before and after pelvic reconstruction plate ( ORIF) and screw internal fixation. Results According to the Matta imaging score, 28 cases got anatomical reat-tachment, 14 satisfactory reattachment, and 6 poor reattachment. All the patients received a follow-up from 12 to 58 months. According to the improved Merle d’Aubigné and Postel rating standards, 28 cases were excellent, 9 good,7 fair, and 4 poor. Simple fractures clinical excellent-good rate was 94. 4% and composite fractures clinical excellent-good rate was 66. 7%, anatomy reset and non anatomy reset of clinical excellent-good rate were 96. 4% and 50% re-spectively, these difference comparison had statistical significance ( P<0. 05 ) . Conclusions Surgical treatment of acetabulum fracture can obtain satisfactory curative effect, the quality of fracture reduction and fracture type are close-ly related with curative effect.

  8. 活血灵在髋臼骨折围手术期的应用%Application of Huoxueling Decoction on Patients in Perioperative Period of Acetabulum Fracture

    Institute of Scientific and Technical Information of China (English)

    汤金城; 谭旭仪; 成传德; 高书图

    2015-01-01

    目的:总结活血灵在髋臼骨折围手术期的应用效果。方法:75例髋臼骨折患者按时间分为观察组38例和对照组37例,对照组在围手术期间给以常规处理,观察组在对照组基础上结合活血灵口服,观察两组术后2周血液流变学指标,统计深静脉血栓发生情况。结果:观察组在术后14 d血液流变学指标与对照组比较,差异有统计学意义(P<0.05)。同时,观察组术后14 d时D-二聚体为(2.57±0.51)mg/L,较术前(4.26±1.72)mg/L比较,差异有统计学意义(P<0.05),且观察组术后14 d时D-二聚体、下肢深静脉血栓较对照组减少(P<0.05)。结论:髋臼骨折围手术期应用活血灵,能有效改善术后血液流变学和D-二聚体指标,减少下肢深静脉血栓的发生。%Objective To observe the therapeutic effects of Huoxueling decoction on patients in periopera⁃tive period of acetabulum fracture. Methods Seventy-five acetabulum fracture patients were randomly divid⁃ed into the observation group(38 patients) and the control group(37 patients);the control group attended symptom⁃atic treatment during perioperative period,while the observation group had Huoxueling decoction, then the wound drainage, hemorheology indexes,D-dimmer, and lower extremity deep venous thrombosis of both groups were ob⁃served. Results Compared with the preoperative conditions,the hemorheology indexes of observation group on the 14 d postoperative was lower(P<0.05). Meanwhile,the D-dimmer of observation group was declined from (4.26 ± 1.72) mg/L preoperatively to (2.57 ± 0.51) mg/L on 14 d postoperatively,the difference was statistically significant (P<0.05). In addition,the D-dimmer,lower extremity deep venous thrombosis of observation group on the 14 d was lower than that of control group (P<0.05). Conclusion The application of Huoxueling de⁃coction on patients in perioperative period of acetabulum fracture can effectively

  9. Estudo prospectivo de 76 casos de fratura do acetábulo tratados cirurgicamente Prospective study on seventy-six cases of fractured acetabulum with surgical treatment

    Directory of Open Access Journals (Sweden)

    André Gaudêncio Ignácio de Almeida

    2011-10-01

    Full Text Available OBJETIVO: Fazer estudo prospectivo sobre fratura instável e incongruente do acetábulo, comparativo com a literatura, abordando o tipo de acesso, material de fixação, grau de redução, tipo de fratura e seus resultados após cirurgia. MÉTODOS: Os autores avaliaram 76 pacientes com fratura instável e incongruente do acetábulo entre janeiro de 1999 e dezembro de 2009. A classificação utilizada foi a de Marvin Tile e todos foram tratados cirurgicamente segundo a técnica preconizada pelo grupo AO-ASIF. RESULTADOS: A avaliação radiológica foi feita segundo os critérios de Ruesch; foram obtidos resultados bons, ótimos e perfeitos em 64 pacientes (84,2%. Quanto à avaliação clínica, segundo os critérios de Harris, os resultados foram bons e ótimos em 62 pacientes (81,6%. As complicações foram avaliadas e, quando comparadas com a literatura, mostraram-se compatíveis mesmo após a análise estatística. CONCLUSÃO: Os autores concluem que a redução anatômica e a fixação estável são importantes para um bom resultado.OBJECTIVE: To conduct a prospective study on unstable and incongruent fractures of the acetabulum, in comparison with the literature, covering the type of access, fixation materials, degree of reduction, type of fracture and results after surgery. METHODS: The authors evaluated 76 patients with unstable and incongruent fracture of the acetabulum between January 1999 and December 2009. The Marvin Tile classification was used, and all cases were treated surgically using the technique recommended by the AO-ASIF group. RESULTS: The radiological evaluation was done in accordance with the Ruesch criteria, and good, excellent or perfect results were obtained for 64 patients (84.2%. The clinical evaluation was done in accordance with the Harris criteria, and good or excellent results were obtained for 62 patients (81.6%. The complications were assessed and, in comparison with the literature, were shown to be compatible

  10. The treatment of bone tumour around the acetabulum by semi-pelvic prosthesis made in China%国产人工半骨盆假体置换治疗髋臼周围骨肿瘤

    Institute of Scientific and Technical Information of China (English)

    张敬东; 祖启明; 刘贵堂; 韩文锋; 孙蕊; 项良碧

    2012-01-01

    BACKGROUND: The treatment of bone tumour around the acetabulum is a challenge of orthopedics, but the limb-sparing surgeries of bone tumour around the acetabulum become the main trend along with the development of the diagnosis techniques and the application of neoadjuvant chemotherapy and the establishment of the tumour excision principle.OBJECTIVE: To analyze the treatment effect semi-pelvic prosthesis made in China on bone tumour around the acetabulum.METHODS: From 2001 to 2010, 19 patients with bone tumour around the acetabulum were enrolled and six patients were cured by removing the tumour and assembling the semi-pelvic prosthesis made in China. All the patients were followed-up for 6-72months (mean 50 months).RESULTS AND CONCLUSION: According to Enneking criteria, four cases were rated as good, two cases as fair. There was a good effect of semi-pelvic prosthesis made in China on the treatment of bone tumour around the acetabulum when the indications of resection and reconstruction of pelvic tumour were selected strictly.%背景 髋臼周围骨肿瘤的治疗对骨科医生来说是一种挑战,但随着诊断技术的提高、新辅助化疗方案的应用以及肿瘤切除原则的确立,保肢手术成为一种趋势.目的 分析应用国产人工半骨盆假体治疗髋臼周围骨肿瘤的效果.方法 2001/2010 共收治19 例髋臼周围骨肿瘤病人,其中6 例行国产半骨盆人工假体置换,术后随访6~72 个月(平均50个月).结果与结论 按Enneking 方法评估疗效,良4 例,一般2 例.提示只要严格掌握骨盆肿瘤切除重建的手术适应证,应用国产人工半骨盆假体治疗髋臼周围骨肿瘤具有较好的疗效.

  11. Anatomic Study of Safe Zone for Screw Insertion Around the Acetabulum in Modified Stoppa Approach%改良Stoppa入路中髋臼周围螺钉安全区的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    王朝晖; 刘华武; 何波涌; 刘小龙; 熊波

    2014-01-01

    目的:通过测量改良Stoppa入路沿真骨盆缘钢板螺钉固定骨盆髋臼骨折时髋臼周围螺钉安全区,为安全置入螺钉提供解剖学依据。方法:24例成人干燥髋骨标本,平行真骨盆缘下移重建钢板宽度一半垂直真骨盆内表面完成截骨,再在白纸上拓印出髋骨的横切面,以髂耻隆起为基准作图分析、测量髋臼周围螺钉安全区、相对安全区和危险区。结果:髂耻隆起内侧(9.66±8.28)mm与外侧(12.58±7.94)mm之间区域为髋臼周围螺钉置入危险区,置入螺钉会穿入髋臼。髂耻隆起外侧(12.58±7.94)~(21.09±6.09)mm ,内侧(9.66±8.28)~(16.53±6.57)mm之间区域为髋臼周围螺钉置入相对安全区,以最大偏转角远离髋臼置入螺钉不会穿入髋臼。髂耻隆起外侧>(21.09±6.09)mm和内侧>(16.53±6.57)mm的区域为髋臼周围螺钉置入的安全区,垂直钢板或远离髋臼置入螺钉不会穿入髋臼。髋臼周围螺钉安全置入的最长长度为外侧(38.35±6.09)m m ,内侧(25.28±3.60)m m。左右侧比较无统计学差异。结论:改良Stoppa入路沿真骨盆缘钢板螺钉固定可以髂耻隆起为标志指导髋臼周围螺钉安全置入,应避开危险区,可在安全区和相对安全区内置入,建议首选安全区。%Objective :To study the safe zone for screw around the acetabulum in modified Stoppa approach for treating pelvic and acetabular fractures with plate and screws along pelvic brim ,and afford anatomical data for inserting screw around the acetabulum safely .Methods :24 dry human adult innominate bones were seen open vertically to the inner sur-face along the line parallel and inferior to the pelvic brim about half width of the reconstruction plate .Then copied the boundary of the transection of the acetabulum on the white paper and measured the safe zone ,relatively safe zone and danger

  12. Treatment of Dysplasia of the Acetabulum in Children by Combined Operations%联合手术治疗儿童髋臼发育不良

    Institute of Scientific and Technical Information of China (English)

    姜长明; 吴汝舟; 张中柱; 于天庆; 孙作令; 蔡荣铭; 王立德; 吕德成; 孙立众

    1994-01-01

    Sixty cases (68 hips) of dysplasia of the acetabulum in children were treated by the combined operations from Jan.1974 to Jan.1992.Shelf procedures combined with Pemberton's operation were performed on 50 cases (56 hips).The results of 47 hips were excellent,3 hips were good.The excellent and good cases occupied 89.3%.Salter's operation combined with Pemberton's one were performed on 10 cases (12 hips).10 hips were excellent,and 1 good.The indication of the operation and details of the technique were discussed in the article.%1974年1月~1992年1月应用联合手术治疗髋臼发育不良60例(68髋).其中髋臼造盖与关节囊周围髂骨截骨联合术50例(56髋),优47髋,良3髋;髂骨截骨与关节囊周围髂骨截骨联合术10例(12髋),优10髋,良1髋.介绍了几种联合手术的选择及手术方法.

  13. Clinical effect of operative treatment of acetabulum fractures through subinguinal approach%经髂腹股沟下入路治疗髋臼骨折32例疗效观察

    Institute of Scientific and Technical Information of China (English)

    彭朝华; 杨军; 杨彬

    2013-01-01

    Objective To investigate the clinical effect of operative treatment of acetabulum fractures through subinguinal approach.Methods During the period from May 2007 to June 2011,32 cases with acetabulum fracture underwent surgical treatment through subinguinal approach while 27 cases through classic ilioinguinal approach.Surgical time,blood loss,fracture reduction and functional recovery were compared between the two approaches.Results The differences between the two groups were all statistically significant (P < 0.05).Conclusions The subinguinal approach is a good surgical approach for operational treatment of anterior acetabulum fractures.%目的 探讨经髂腹股沟下入路治疗髋臼骨折的临床疗效.方法 59例髋臼骨折患者按照随机数字表法分为两组,分别经髂腹股沟下入路及传统髂腹股沟入路进行手术治疗,比较两组患者手术时间、出血量、骨折复位、功能恢复情况.结果 两组各项观察指标比较,差异均有统计学意义(P<0.05).结论 髂腹股沟下入路是一种较好的髋臼前方手术入路,具有解剖结构简单、出血少,显露充分、复位质量高,临床效果满意等特点.

  14. A 24-year follow-up of a patient with giant cell tumor of bone in the acetabulum%髋臼骨巨细胞瘤随访24年

    Institute of Scientific and Technical Information of China (English)

    周玉林; 祝天经; 徐萌; 陈湘

    2012-01-01

    @@ 临床资料 女性,45岁.1988年因左髋痛和跛行,照片发现左髋臼部骨质破坏约4cm×7cm,拟诊为骨巨细胞瘤(图1).1989年分2次行骨肿瘤刮除、骨胶填塞术.术中取组织活检确诊为左髋臼部骨巨细胞瘤(II级).术后疼痛消失,可弃拐跛行.%To report 1 case with giant cell tumor of bone in the acetabulum. The patient underwent subtotal hemipelvectomy, artificial hemipelvic displacement and Total hip armroplasty, on which basis autogenous bone grafting and biotic pelvic ring annuloplasty were applied to acliieve limb salvage and treat giant cell tumor of bone in the acetabulum, which belonged to the combination treatment of mechanical fixation and biotic fixation. In long-term follow-up, the feasibility and superiority of this method were observed

  15. Bernese Periacetabular Osteotomy in a Hip Extra-Articular Resection Followed by Reconstruction Using an Extracorporeal Irradiated Acetabulum Autograft with Megaprosthesis, for Proximal Femur Osteosarcoma in a Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Victor Barro

    2015-01-01

    Full Text Available Osteosarcoma is the most common primary malignant tumour of bone. The oncologic surgery of a proximal femur osteosarcoma affecting the hip joint can be very challenging. We present an 8-year-old boy with a 5-month history of right hip pain. Radiographs and magnetic resonance imaging (MRI showed a lytic lesion of the proximal femur extending 13 cm to the diaphysis. Histological evaluation was consistent with high-grade osteoblastic osteosarcoma. After completing chemotherapy we performed an extra-articular resection of the hip. Reconstruction was accomplished by reimplanting the acetabulum after irradiation and modular proximal femur megaprosthesis. Endoprosthetic reconstruction following proximal femur resection is a good treatment alternative achieving good postoperative function. Extra-articular resection of the hip using a periacetabular osteotomy technique enabled us to achieve wide margins and leave an intact posterior column to optimize acetabular reconstruction stability. Extracorporeal irradiation and reimplantation is a valuable treatment option in a situation such as this where allograft geometric fit is a priority. We conclude that an extra-articular resection of the hip, followed by reconstruction with an extracorporeally irradiated acetabulum and a proximal femur modular megaprosthesis, is a useful combined treatment option for malignant lesions involving the hip joint, especially in paediatric patients.

  16. 真骨盆缘完整的髋臼高位前柱骨折的治疗%The characteristic and treatment of high anterior column fracture of acetabulum with intact true pelvic brim

    Institute of Scientific and Technical Information of China (English)

    谭国庆; 周东生; 王伯珉; 何吉亮; 傅佰圣

    2011-01-01

    Objective To investigate the results of open reduction with internal fixation for high anterior column fracture of acetabulum with intact true pelvic brim.Methods From January 2006 to January 2010,12 patients suffered high anterior column fracture of acetabulum without involvement of true pelvic brim were identified.There were 9 males and 3 females,with the average of 35.6 years (range,29-46).The injury was caused by crush in 7 cases,smash of heavy object in 3 cases,and fall-down from height in 2 cases.These fractures were classified into three types:isolated high anterior column fracture of acetabulum without involvement of true pelvic brim,high anterior column fracture of acetabulum without involvement of true pelvic brim with posterior wall fracture of acetabulum and commminuted high anterior column fracture of acetabulum without involvement of true pelvic brim according to present and unpresent of posterior wall fracture.Five cases suffered isolated fracture and 2 cases associated smaller and nondisplacement fracture fragment of posterior wall were reduced and fixed by buttress plate of iliac crest and lag screw of anterior border of ilium through an iliofemoral approach; 4 cases with displacement posterior wall fracture of acetabulum were reduced and reconstructed by buttress plate and lag screws of through combinations of anterior and posterior approaches.One case suffered comminuted fracture were reduced and reconstructed by plates and screws of through extended iliofemoral approach.Results The mean follow-up time of all patients was 26.7 months (range,14-37months).The quality of reduction was grade as anatomical in 8 patients,imperfect in 3,poor in 1 by Matta's score system.The fracture union was uneventful.There was nonunion and loss of internal fixation.At the final follow-up,the mean score was 16.8 (range,11-18),7 cases were graded as excellent,4 good,1 fair,according to modified Merle d'Aubigne and Postel score system.Heterotopic ossification and

  17. Application of 3D Printing Technology in the Acetabulum Fracture Intraoperative and Postoperative Rehabilitation%3 D打印技术在髋臼骨折术中及术后康复中的应用

    Institute of Scientific and Technical Information of China (English)

    张锐

    2015-01-01

    目的:分析3 D打印技术应用在髋臼骨折手术和康复中的临床方法和效果。方法选取我院收治的髋臼骨折患者,应用3 D技术将患者的骨盆模型仿真出来,按照模型对钢板螺钉位置、进入途径以及螺钉长度进行设计测量等模拟手术,参照模拟手术情况给予患者行复位手术,并在术后给予康复锻炼,分析术后效果。结果手术圆满成功,且手术时间短,伤害小,恢复快。结论应用3 D打印技术进行髋臼骨折手术治疗,临床效果更佳精确,术中创伤小,有效缩短手术周期,提高患者预后,降低成本。%ObjectiveAnalysis clinical methods and effects of 3 D printing technology application in the acetabulum fracture surgery and rehabilitation. Methods Selected our hospital patients with fracture of acetabulum, application of 3 D technology to patients with pelvic model simulation, according to the model of steel screw location, access, and the length of the screw design measurement simulation operation, such as reference simulation surgery to give patients reduction surgery, and to give rehabilitation training after surgery, postoperative effect were analyzed. ResultsThe success of operation and operation time was short, that small injury, rapid recovery. Conclusion The application of 3 D printing acetabulum fracture surgery treatment, clinical effect is better precision, intraoperative trauma is small, shorten the development period of operation, and improve the prognosis of patients, reduce the cost.

  18. 全髋关节置换术中髋臼横韧带对髋臼假体前倾定位的作用%Total Hip Arthroplasty in the Transverse Ligament of Acetabulum Anteversion Positioning Function

    Institute of Scientific and Technical Information of China (English)

    张宏宇; 辜念样

    2013-01-01

    Objective:Investigate the surgery in total hip arthroplasty acetabular transverse ligament of acetabulum anteversion positioning reference, for clinical reference. Methods:Choose 67 cases of total hip arthroplasty in our hospital as the research object, transverse acetabular ligament acetabulum anteversion positioning as the anatomical reference, after a follow-up of 12 months, observed postoperative healing, complication rate, measurement of acetabular anteversion angle, and with comparison of normal value. Results:All the patients achieved primary healing of incision, I stage healing rate was 100.00%;no patient of incision infection, dislocation of the hip and other complications, the complication rate was 0.00%. The postoperative acetabular anteversion angle was (15.20±3.96)°, with normal anteversion angle, there was no statistical difference (P>0.05). Conclusion:In total hip arthroplasty in the transverse acetabular ligament acetabulum anteversion positioning as the anatomical reference ideal.%目的:探讨在全髋关节置换术中髋臼横韧带对髋臼假体前倾定位的参照作用,以供临床参考。方法:以我院接受全髋关节置换术的患者67例为研究对象,术中将髋臼横韧带作为髋臼假体前倾定位的解剖参照物,术后随访12个月,观察患者术后愈合情况、并发症发生率,测量髋臼假体前倾角度,并与正常值进行比较。结果:所有患者切口均达到Ⅰ期愈合效果,Ⅰ期愈合率为100.00%;术后未发生一例切口感染、髋关节脱位等并发症,并发症发生率为0.00%。术后髋臼假体前倾角度为(15.20±3.96)°,与正常前倾角度比较,无统计学差异(P>0.05)。结论:将髋臼横韧带作为全髋关节置换术中髋臼假体前倾定位的解剖参照物效果较为理想。

  19. Comparison of application value between spiral CT and DR plain film in diagnosis of acetabulum fracture%对比螺旋 CT 与 DR 平片在髋臼骨折诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    刘金全; 海忠; 崔凌; 郭锐

    2015-01-01

    目的:对比螺旋 CT 与 DR 平片在髋臼骨折诊断中的应用价值。方法58例髋臼骨折患者作为研究对象。所有患者均经手术证实为髋臼骨折,术前行螺旋 CT 与 DR 摄影,其中螺旋 CT 采用多平面重建(MPR)、三维表面重建(SSD)、容积重建(VR)等三维重建技术进行图像后处理,对比两种检查方案的诊断结果。结果CT 确诊髋臼骨折55例,高疑骨折3例, DR 确诊骨折42例,高疑8例,无骨折8例,两组确诊结果比较,差异有统计学意义(P<0.05);CT 诊断准确率更高。结论螺旋 CT 三维重建技术具有扫描快速、成像清晰的特点,在髋臼骨折诊断中具有重要的应用价值,较常规 DR 平片具有更高的确诊率,同时可有效评估患者骨折病情,为手术治疗方案提供指导。%Objective To compare the application value between spiral CT and DR plain film in diagnosis of acetabulum fracture. Methods There were 58 patients with acetabulum fracture as study subjects, and they were all diagnosed by operation. They received spiral CT and DR filming before operation. 3D reconstruction by multiple planar reconstruction (MPR), surface shading display (SSD), and volume reconstruction (VR) were applied for image postprocessing in spiral CT. Diagnosis results of the two examination methods were compared. Results CT showed 55 diagnosed acetabulum fracture cases and 3 highly suspected fracture cases. DR showed 42 diagnosed fracture cases, 8 highly suspected cases, and 8 cases without fracture. The difference between diagnosis results of the two groups had statistical significance (P<0.05). CT provided more accuracy in diagnosis. Conclusion Spiral CT 3D reconstruction method has advantages of quick scanning and clear imaging, and it contains important application value in diagnosis of acetabulum fracture. It provides higher diagnosis rate than common DR plain film with effective assessment of fracture condition, and it can

  20. Generation mechanism and treatment progress of common complications of the acetabulum fracture%髋臼骨折常见并发症的产生机制及治疗进展

    Institute of Scientific and Technical Information of China (English)

    张长杰

    2014-01-01

    With the development of the transportation, high-energy injuries caused by traffic accidents are on the rise, acetabular fractures have been increasing recently. We take surgical therapy or conservative therapy considering a variety of factors and the patient’s conditions. Due to the particularity of acetabular anatomy and the complexity of its physiological functions, there are many complications caused by the acetabular fractures and its treatment no matter what method we take, such as nerve injury, heterotopic ossiifcation, thromboembolism, traumatic arthritis et al. All these will seriously affect the patient’s daily activities. This paper aims to give a general review on the generation mechanism and treatment progress of common complications of the acetabulum fracture.

  1. One Stage Plasty for Acetabulum and Femoral Neck to Treat Congenital Hip Dislocation%先天性髋脱位髋臼股骨颈一次成形术

    Institute of Scientific and Technical Information of China (English)

    朱葆伦; 严幼华; 应灏; 沈金根

    1994-01-01

    1971年9月~1988年8月,共手术治疗先天性髋脱位患儿101例.采用髋臼、股骨颈一次成形术,由于大部分畸肜得到矫正,股骨头获得满意的覆盖,符合生物力学的要求,远期效果良好者达80.2%.%From 1971 to 1988,101 children with congenital hip dislocation were treated.The method was to curet the acetabulum and correct the anteversion of femoral neck by one stage procedure.The femoral head has been got a nice cover.It was adapted to biomechanics of hip joint.96 patients were followed up for 6 months to 10 years with a satisfactory rate of 80.2%.

  2. 数字化仿真技术在髋臼前柱安全置钉的研究%The study of safe lag screw placement in the anterior column of acetabulum by the digital simulation technique

    Institute of Scientific and Technical Information of China (English)

    李佳兵; 项舟

    2016-01-01

    目的:利用数字化仿真技术求解髋臼前柱的安全置钉通道。方法通过将48例正常成人骨盆CT图像导入Mimics15.0中进行数字化处理得到96例髋臼前柱阴模模型,结合立体解析几何求解髋臼前柱的安全置钉通道。结果安全置钉通道:最大半径男性为(4.65±0.54)mm,女性为(3.71±1.68) mm;进钉深度男性为(114.91±6.52)mm,女性为(102.97±6.24)mm;进钉最狭窄处位于髋臼前壁内,最狭窄处到顺行进钉点的距离:男性为(34.57±2.16)mm,女性为(29.82±1.94)mm;最狭窄处到逆行进钉点的距离:男性为(73.32±3.27)mm,女性为(69.49±2.52)mm;螺钉与水平面夹角男性为(45.22±1.54)°,女性为(43.59±3.24)°;螺钉与矢状面夹角男性为(41.65±5.37)°,女性为(47.82±4.12)°;螺钉与冠状面夹角男性为(18.71±2.36)°,女性为(19.23±2.49)°。安全进钉通道参数男女对比“最大半径”、“进钉深度”、“螺钉与矢状面夹角”有统计学意义(P<0.05)。结论利用数字化仿真技术能够精确求解髋臼前柱安全置钉通道。%Objective To find and measure the safe lag screw placement channel (SLSC) in the anterior column of acetabulum by the digital simulation technique (DST). Methods To find and measure the safe lag screw placement channel in the anterior column of the acetabulum under the standard 3D coordinate system and the three-dimensional coordinate system of the pelvis by establishing 96 cases of 3D finite element female die of the anterior column of acetabulum through 3D reconstruction of 48 cases of normal adult pelvic spiral CT data by Mimics 15.0. Results The parameters of SLSC of the anterior column of acetabulum:The max radius is(4.65±0.54)mm in male, and(3.71±1.68)mm in female;The depth is(114.91±6.52)mm in male, and(102.97±6.24)mm in female;The narrowest screw placement site is in the anterior wall of the

  3. 髋臼后壁钢板螺钉固定安全区域的应用解剖学研究%Applied anatomic study of surgical safe zone for placement plates and screws in treatment of fracture of the posterior wall of acetabulum

    Institute of Scientific and Technical Information of China (English)

    周程鹏; 高仕长; 刘杰; 倪卫东; 蒋电明; 孙善权; 李咏梅

    2013-01-01

    目的 测量髋臼后壁三维重建模型参数和行虚拟钢板螺钉固定,明确髋臼后壁钢板放置的安全位置及螺钉置入角度.方法 用Mimics软件对25例(50侧)骨盆薄层CT行三维重建,切割出髋臼后壁三维模型,测量相关参数.用SolidWorks2010软件设计髋臼后壁虚拟钢板,导入Mimics软件,得出髋臼后壁虚拟钢板放置位置和螺钉安全角度.然后在15具(30侧)尸体髋臼后壁标本上进行钢板螺钉固定.结果 髋臼纵径为55mm,横径为52 mm.髋臼后壁最宽处位于上缘,为51mm,最窄处位于髋臼后壁中下部,为38 mm.螺钉能够拧入Zimmer重建钢板钉孔所允许最小角度范围为50~66°.Mimics模拟置钉后,将钢板放置在距尸体标本髋臼后壁外缘6mm处行钢板螺钉固定,螺钉未进入髋臼.结论 重建钢板放置在距髋臼后壁外缘6mm以远时,螺钉可以安全置入,且钢板距外缘越远,螺钉的安全范围越大.%Objective To investigate the safe position of the plates and safe angles of the screws through measurement of the parameter of the acetabulum and virtual plate-screw placement in the three-dimensional posterior wall of the acetabulum. Methods The thin slice CT data of 50 pelvics and 15 normal cadavers were used in this study. Three-dimensional reconstruction of pelvics were achieved by Mimics 10.0; then the virtual 3-dimensional acetabulum was resliced ,and the transverse, longitudinal diameter of the acetabulum and the width of the posterior wall of the acetabulum were measured, respectively. The virtual plate was designed by the software of Solidworks2010 and was introduced into the software of Mimics 10.0. The position of the plates and the angle of the screws were measured and the safe zones of the plate and the safe angles of the screws were deduced. Based on the above-mentioned data, the plates were fixed on the 30 posterior walls of the acetabulum 6mm away from the posterior edge of the acetabulum. Results The longitudinal

  4. 幼鼠髋臼发育与机械应力相关性实验研究%Correlation between development of acetabulum in infant rat and mechanical stress force

    Institute of Scientific and Technical Information of China (English)

    梁庆威; 李良满; 范广宇; 原银栋

    2004-01-01

    BACKGROUND: The previous researches on the hypogenesis of acetabulum concentrated on X-ray morphology. And there are few researches on the impact of mechanical stress force on the development of acetabulum and the evolution disciplinarian in the restoration of acetabular dysplasia after the removal of mechanical pressure.OBJECTIVE: To clarify the impact of abnormal mechanical stress force on the development of acetabulum, especially on the proliferation of chondrocytes in the chondral growth plate of acetabulum, for the discussion of the restorative methods in acetabular dysplasia.DESIGN: A randomized controlled study was conducted.SETTING and PARTICIPANTS: Setting was in China Medical University. Subjects were 60 females, 3-week old Wistar rats in cleanness grade with a body mass from 150 g to 200 g obtained from the Experimental Animal Center of China Medical University, which were fed at 18 - 25 ℃ and in the humidity of 40% to 70%.INTERVENTION: Three-week old Wistar rats were randomly allocated into 3 groups according to random number table with 20 rats each. The left hip joint was set as study side and the right side was set as control side. Group A: hit joint was repeated dislocated and repositioned by manipulation within 2 weeks; Group B: the knee joint was straightened for fixation by Kirschner wire to establish the animal model of acetabular dysplasia. Kirschner wire was removed after 2 weeks; Group C: the knee joint was straightened for continuous fixation.MAIN OUTCOME MEASURES: Molybdenum X-ray, histomorphologyand transmision electron microscope observations were operated at age of 5,7, 9 and 12 weeks respectively.RESULTS: Group A: at 5-week old, the acetabular angle increased about 5° compared with the other side, and polar derangement of chondrocyte was found in the proliferation layer of the chondral growth plate. The changes at age 7, 9 and 12 weeks were mild with no difference between two sides. Group B: at 5-week old, the acetabular angle

  5. 动态测量非生理状态下髋臼外展角及临床意义%The dynamic measurement of acetabulum abduction angle under non-physiological state and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    李颖; 耿左军; 赵秀娟

    2016-01-01

    目的:通过MSCT三维重建骨盆,测得骨盆在不同倾斜程度下髋臼外展角数值,探讨非生理状态下全髋关节置换术( THA)个体化置入髋臼假体的放置角度。方法选择100位患者(即200个髋臼)为研究对象行螺旋CT扫描,利用容积再现(VRT)技术把骨盆重建为立体图像,为模拟病理状态进而对骨盆进行不同程度的前倾(以10°为间隔,从10°前倾到90°),利用多平面重组(MPR)重建出冠状位图像,进而分别测得两侧髋臼外展角。计算平均值和标准差,绘制出非生理状态下髋臼外展角随骨盆倾度改变而发生变化的相关性变化曲线,找到规律。结果 MSCT法检测髋臼外展角结果如下:当骨盆倾度从10°逐渐增至90°时,外展角的变化曲线呈抛物线。当骨盆倾度为70°时,外展角最大为48°,说明此状态下的髋臼对股骨头覆盖最好,关节的稳定性也最佳。性别对髋臼外展角的影响结果表明在相同条件下,不同性别间的外展角差异无统计学意义( P >0殮.05)。结论髋臼的外展角随着骨盆倾度的变化而发生改变,外展角的变化曲线呈抛物线,不同性别之间的髋臼外展角没有显著性差异;说明性别因素对髋臼外展角的影响不大,髋臼外展角随骨盆倾度动态变化的规律,可以为临床THA髋臼假体放置角度提供理论依据。%Objective To detect acetabulum abduction angle of pelvis at different sloping degrees through multi -slice spiral CT ( MSCT ) three-dimensional reconstruction pelvis , and to explore the reasonable placing angle during total hip arthroplasty ( THA) under non-physiological state .Methods One hundred patients ( 50 males and 50 females ) including 200 acetabulums were scanned by MSCT to reconstruct pelvis into stereoscopic picture by means of valume rendering technique (VRT),then to make pelvis at different inclination (10°~90°) in

  6. 髋臼后柱骨折顺行拉力螺钉置钉导向器的研究%Clinical anatomic study of the lag screw guide device for the acetabulum posterior column

    Institute of Scientific and Technical Information of China (English)

    徐勇强; 林创鑫; 王钢; 蔡道章; 彭赓; 赖剑强; 季中华

    2016-01-01

    Objective To measure anatomical parameters of the guide device for antegrade lag screw fixation of the fractures in the posterior column of acetabulum. Methods 17 females and 14 males semi pelvic bony specimens were collected for this clinical anatomic study. After successful implantation of the antegrade lag screw into the posterior column of acetabulum, the screw entry point and entry angle of inclination were separately measured and statistically analyzed. Results The average distance between the entry point and the arcuate margin was (0.96±0.32) cm in female and (0.92±0.16) cm in male (P>0.05), while the distance between the entry point and the sacroiliac joint front was (2.43 ± 0.66) cm in female and (1.87 ± 0.26) cm in male (P0.05), while the extraversion angulation was (41.27 ± 2.76)° in female and (34.31 ± 2.78)° in male (P0.05),进针点与骶髂关节前缘距离,女性为(2.43±0.66) cm,男性为(1.87±0.26) cm(P0.05)、进钉方向与髂骨内板的外倾角∠φ女性为(41.27±2.76)°,男性为(34.31±2.78)°(P<0.05)。结论髋臼后柱骨折顺行拉力螺钉进钉点和进钉方向的测量为导向器的设计提供了解剖学基础,有助于提高髋臼后柱骨折顺行拉力螺钉置钉的成功率和准确性,降低手术风险和减轻手术损伤。

  7. Total hip replacement in the treatment of traumatic arthritis after operation of acetabulum dislocation%全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎

    Institute of Scientific and Technical Information of China (English)

    许鹏雍; 凌尚准; 梁广权; 梁善校

    2015-01-01

    目的:探讨全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎( traumatic ostcoarthritis,TOA)的临床疗效。方法选择2009年3月~2013年3月我院收治的髋臼骨折脱位术后并发创伤性关节炎行全髋关节置换术的患者27例为研究对象,男性16例,女性11例;年龄32~57岁,平均(45.2±8.7)岁。对其临床资料进行回顾性分析,并于术前和术后分别评定髋关节功能,评价手术疗效。结果27例患者均顺利完成手术,所有患者术后切口均Ⅰ期愈合;术后Harris评分为76~92分,其中80分以上的患者25例,优良率达到92.6%,平均(89.1±5.78)分,与术前的(45.3±5.86)分相比,存在显著差异(P<0.05);关节屈曲、内收、外展、外旋及内旋与术前对比差异均有统计学意义( P<0.05),髋关节功能得到明显改善。结论髋臼骨折脱位术后易并发创伤性关节炎(TOA),采用全髋关节置换术治疗具有术后并发症少、髋部功能改善明显、临床效果好、患者满意度高等优点,值得临床推广应用。%Objective To evaluate the clinical efficacy of total hip replacement in the treatment of traumat-ic ostcoarthritis ( TOA) after operation of acetabulum dislocation.Methods Twenty seven patients [16 males and 11 females aged from 32-57 years with an average age of (45.2 ±8.7) years] of acetabulum fracture from Mar.2009 to Mar.2013 in our hospital were performed total hip replacement for the treatment of TOA after operation of acetab-ulum dislocation were chosen and their clinical data was retrospectively analyzed.The preoperative and postopera-tive evaluation of hip function were performed and the effect of surgery was completed.Results All patients were successfully operated and all incisions achieved primary healing;postoperative Harris score was 76 to 92,of which 25 patients were more than 80 and the good and excellent rate was 92

  8. Gross distribution and biomechanical significance of bone trabecula of the cancellous around acetabulum%髋臼区域松质骨骨小梁束的大体分布及力学

    Institute of Scientific and Technical Information of China (English)

    孙剑伟; 尹望平; 张春才; 任可; 高振巢; 朱行飞

    2012-01-01

    BACKGROUND: Although a variety of mechanics study on the mechanical characteristics of the pelvis has been performed, but the exact stress distribution in the region remains unclear. ONJECTIVE: To observe the gross distribution of bone trabecula around acetabulum and compare with existing biomechanical research results. METHODS: Four dry pelvic specimens were cut in accordance with the plane which composed of acetabular edge and the plane of obturator in order to observe the distribution patterns of trabecular bone on the cross-section, and to observe the gross distribution of trabecula around acetabulum. RESULTS AND CONCLUSION: The trabeculae of hip bone were divided into three groups. ㏒acropubic bundle: It ran from the auricular surface, posterior superior iliac spine and posterior inferior iliac spine to pubic symphsis along the iliopectinal line, and part of the trabecula terminated in the posterior superior acetabular. ㊣liocotyloid bundle: It ran from the greater sciatic notch of the auricular surface to the superior posterior acetabular, and located in the shallow layer of the sacropubic bundle. ㊣lioischial bundle: From the region of the iliac crest to the ischial tuberosity, part of the trabecula terminated in the anterior superior acetabular. High-density trabecular net transversely located at the level of the sciatic notch, defined by a distinct saltire-shaped crossing over the acetabulum between the sacropubic and the ilioischial bundles. The human hip acetabulum was constituted by iliocotyloid bundle, sacropubic bundle and ilioischial bundle. High-density trabeculum net transversely located at the level of the sciatic notch, iliopubic eminence and the cross-section of sacropubic and the ilioischial bundles. This is consistent with the stress distribution and loading of the acetabular region in the current research.%背景:虽然目前已采用多种力学研究方法对骨盆的力学特性进行了大量的研究,但是该区域的确切应力分

  9. The diagnosis and therapeutics of the juxta-articular bone cyst in the acetabulum%髋臼邻关节骨囊肿的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    李伟栩; 严世贵; 叶招明; 陶惠民; 林秾; 杨迪生

    2010-01-01

    Objective To discuss the diagnosis, differential diagnosis and therapeutics of the juxtaarticular bone cyst in the acetabulum. Methods Between August 1990 to April 2009, nineteen cases of clinical data of the juxta-articular bone cyst in the acetabulum data were collected from hospital records and analyzed retrospectively. There were 11 males and 8 females, with an average age of 42.3 years (range, 18-59). Seventeen patients felt an aching pain in the hip. The duration of symptoms was from 2 months to 20years with the median 15 months. All the radiographs showed a well-demarcated oval or circular radiolucent defect, close to subchondral bone, and outlined by a thin rim of sclerotic bone. Five cases accompanied with developmental dysplasia of the hip. After curettage of the bone cyst, 14 patients received iliac crest autogenous bone grafts, 3 patients received xenoma spongy bone-graft particles, and 2 patients received artificial bone grafts. Results Fourteen patients were precisely diagnosed as bone cyst by radiograph, and 4 patients were diagnosed by CT and MRI. The major axes of the focus were 2-4 cm in 16 patients, and 4-8 cm in 3patients. The sizes of the focus had no relationship with the symptoms and the course of the disease. Seventeen cases of the focus were located at the anterior superior of the bearing surface of the acetabulum. All patients were successfully followed up from 11 months to 13 years, averaged 6.2 years, and no relapses occurred during the follow-up period in every case. Fourteen patients felt asymptomatic, 3 patients felt uncomfortable in hip occasionally, and 2 patients with developmental dysplasia of the hip felt ameliorated in the initial stage of the therapy, followed by aggravation accompanying the hip joint space narrow. Conclusion Bone graft after thorough curettage of the capsular space was an effective therapy for the juxta-articular bone cyst in the acetabulum, and the anatomic distribution of radiological lesions indicated that

  10. 基于多平面三维测量的髋臼骨折数字化内固定植入方案%A digital solution for fixation implant of acetabulum fracture based on multi-planes three-dimensional measurements

    Institute of Scientific and Technical Information of China (English)

    张国栋; 林海滨; 陈宣煌; 郑锋; 陈国立; 陶圣祥

    2012-01-01

    目的 探讨髋臼骨折数字化内固定植入方案的实施方法 及相应规范.方法 绘制重建钢板及螺钉Solidworks零件文件,制备标准件库.将1具成人尸体骨盆标本进行薄层CT扫描及三维重建,以三维切割的方式按照AO分类进行髋臼骨折9个类型造模,虚拟复位后预设重建钢板的植入位置,进行长度及角度的三维测量,根据测量数据在Solidworks中预弯重建钢板并输出至Mimics,通过位移的方式将重建钢板植入至预设位置,测量钉孔至对侧骨面的距离,选择合适的螺钉,完成虚拟髋臼骨折内固定植入.结果 (1)完成髋臼骨折9个类型造模;(2)完成髋臼骨折9个类型的虚拟重建钢板及螺钉的内固定植入,全部重建钢板与骨面敷贴良好,所有螺钉均植入至对侧骨面.结论 多平面三维测量是实施髋臼骨折数字化内固定植入方案的决定因素.%Objective To investigate a digital solution and the corresponding standards for fixation implant of acetabulum fracture. Methods Solidworks files of reconstruction plates and screws were drawn for the preparation of standard parts library. One pelvic specimens of adult corpse was treated with thin-slice CT scan and three-dimensional reconstruction. Nine kinds of acetabulum fracture models were harvested by three -dimensional cutting according to the AO classifications. After virtual reduction ,the implanted position of reconstruction plate was presupposed to measure the three -dimensional length and angle . The prebending of reconstruction plate was performed in Solidworks and exported to Mimics , then was implanted to the presupposed position by means of reposition . The distance from countersunks of reconstruction plate to contralateral osseous surface were measured to selected suitable screws for virtual fixation implant of acetabulum fracture . Results (1 ) Nine kinds of acetabulum fracture models were made successful; (2) Virtual fixation implants of

  11. The mid - and long - term clinical outcomes of open reduction and internal fixation for dislocation of hip joint combined with posterior wall or/and column fractures of acetabulum%髋关节后脱位并髋臼后壁(柱)骨折手术治疗结果分析

    Institute of Scientific and Technical Information of China (English)

    何长街; 刘志礼; 舒勇; 黄山虎

    2011-01-01

    目的 探讨髋臼后壁(柱)骨折伴髋关节脱位手术治疗的中远期疗效.方法 回顾性分析21例髋关节脱位伴髋臼骨折患者临床资料,其中20例髋臼脱位行闭合复位,1例行急诊切开复位内固定;所有合并的髋臼骨折均采用开放复位内固定术治疗.结果 完整随访19例,失访 2例,随访时间29~86个月.按髋关节功能恢复情况评分:优13例,良3例,可2例,差1例,优良率84.2%.结论 髋关节脱位伴髋臼骨折应尽早诊断,应尽快行髋关节复位,骨折应尽早开放复位内固定,早期功能锻炼,避免过早负重.%Objectives To investigate the mid - and long - term clinical outcomes of open reduction and internal fixation(ORIF) for treating the dislocation of hip joint with posterior wall or/and column fractures of acetabulum. Methods The clinic data of 21 patients with dislocation of hip joint and posterior wall fracture of acetabulum who were given close reduction( n = 20)or open reduction and internal fixation(ORIF) ( n = 1 ) for disclocation of hip joint and then were treated with ORIF for the fracture of acetabulum were retrospectively analyzed. Results A total of 19 patients were followed up for 29 to 86 mon. According to Letournel E's hip joint functional scoring system, clinical outcome was excellent in 13 patients,good in 3 patients,fair in 2 patients,and poor in one patient. The ratio of fineness of the midand long - term clinical outcomes was 84. 2%. Conclusion The dislocation of hip joint combined with posterior wall fracture of acetabulum should be diagnosed early, and reduction of the hip joint and ORIF should be performed as soon as possible. The positive functional exercise is necessary and the premature weight bearing on the hip joint should be avoided at early time.

  12. 不同锻炼时机在股骨骨折并同侧髋臼骨折患者中康复效果的对比%The effect of rehabilitation of femoral fractures and ipsilateral acetabulum fractures patients in different exercise

    Institute of Scientific and Technical Information of China (English)

    梁卫良; 王国寿

    2014-01-01

    目的:探讨不同锻炼时机在股骨骨折并同侧髋臼骨折患者中康复效果的对比效果。方法分析2011年1月~2012年7月收治的50例股骨骨折并同侧髋臼骨折患者临床资料,依据术后锻炼时间不同进行分组,治疗Ⅰ组(术后40 d~2个月进行下地锻炼)30例和治疗Ⅱ组(术后2个月以后下地锻炼)20例,观察两组的康复效果。结果治疗Ⅰ组股骨骨折并同侧髋臼骨折患者术后6个月和术后1年Harris评分均优于治疗Ⅱ组,差异均有统计学意义(P<0.05)。结论股骨骨折并同侧髋臼骨折患者术后1.5~2个月进行负重锻炼,患者预后功能良好。%Objective To approach effect of rehabilitation of femoral fractures and ipsilateral acetabulum fractures patients in different exercise.Methods To analyze 50 cases clinical data of femoral fractures and ipsilateral acetabulum fractures patients from 2011.1 to 2012.7 in our hospital Third Department of Surgery,treatment Ⅰ group 30 cases and treatment Ⅱ group 20 cases.Results The Harris score of treatment Ⅰ group femoral fractures and ipsilateral acetabulum fractures patients after operation 6 months and 1 year were better than treatment Ⅱ group. The difference had statistical significance.Conclusion Femoral fractures and ipsilateral to acetabulum fracture patients after operation 1.5~2 months,prognosis of patients was good function.

  13. 三维影像处理技术在成人髋关节发育不良联合前倾角匹配中的应用研究%3D-CT used to determine an optimal combined anteversion angle of femoral neck-acetabulum in total hip arthroplasty for adult hip developmental dysplasia

    Institute of Scientific and Technical Information of China (English)

    许燕飞; 常敏; 郭英; 吴继昆; 杨景帆; 王涛; 艾元亮; 张俊; 孙皓民

    2015-01-01

    目的 探讨三维影像处理(3D-CT)技术在成人髋关节发育不良(DDH)全髋关节置换术(THA)中对于股骨颈~髋臼联合前倾角匹配的指导作用. 方法 回顾性分析2011年3月至2014年3月通过3D-CT技术进行THA的21例(21髋)DDH患者资料,男5例,女16例(;年龄30 ~ 78岁,平均55.3岁.DDH按Crowe分型:Ⅱ型6例,Ⅲ型11例,Ⅳ型4例.所有患者术前行薄层CT扫描并将二维原始数据导入M3D可视数字化软件进行三维重建,通过3D-CT技术进行术前预演制定最合适的股骨颈~髋臼联合前倾角调整方案,拟定最佳的联合前倾角度进行THA.术后通过3D-CT技术评估臼杯的骨性覆盖情况、测量臼杯的前倾角度及联合前倾角度,验证术后联合前倾角度与术前拟定角度的吻合情况,并采用Harris评分标准评定疗效. 结果 21例患者术后获3~36个月(平均12.8个月)随访.末次随访时采用Harris评分评定疗效:优17例,良4例.术前Harris评分[(46.2±5.3)分]与末次随访时[(86.3±4.3)分]比较差异有统计学意义(P<0.05).所有患者髋臼杯的覆盖率均大于70%,术后髋臼杯前倾角度与术前拟定角度吻合率达95%,股骨颈~髋臼联合前倾角度在安全范围内,所有患者均未出现脱位.结论 3D-CT技术可以通过术前预演制定最佳的股骨颈~髋臼联合前倾角调整方案,对成人DDH患者THA股骨颈~髋臼联合前倾角的调整具有较高的指导价值,按拟定的方案进行手术臼杯可获得最好的骨性包容、最大的初始稳定性,同时可获得最佳的头臼匹配度,降低术后假体脱位率,提高假体生存率.%Objective To investigate how 3D-CT was used to determine an optimal combined anteversion angle of femoral neck-acetabulum in total hip arthro (THA) for adult developmental dysplasia of the hip(DDH).Methods 3D-CT was used in 21 adult patients(21 hips) with DDH who had been treated by THA from March 2011 to March 2014.They were 5 men and 16

  14. 伴有“海鸥征”表现的髋臼顶压缩性骨折的手术治疗%Surgical treatment of acetabulum top compression fracture with sea gull sign

    Institute of Scientific and Technical Information of China (English)

    庄岩; 雷金来; 魏星; 卢代刚; 张堃

    2014-01-01

    Objective To investigate the surgical method and clinical curative results of acetabulum top compression fractures with sea gull sign. Methods Data of 14 patients who had acetabulum top compression fractures with sea gull sign were retrospectively analyzed and were accepted surgical therapy and followed up. There were 5 females and 9 males, aged from 28 to 71 years (average, 49.9 years). The pre-operative time was from 4 to 14 days (average, 9 days). Letournel-Judet fracture classifica-tion:eight cases for the anterior column+posterior semi-transverse, six cases for a simple anterior column. Three patients with lum-bar compression fracture, two patients with tibial plateau fracture, one patient with multiple rib fractures. All patients were accept-ed open reduction and bone graft and internal fixation through ilioinguinal approach or ilioinguinal approach+Kocher-Langenbeck approach. The quality of fracture reduction was assessed according to the Matta reduction criterion after operation. The hip func-tion was evaluated according to Matta. Results 14 patients were followed up from 6 to 60 months (average, 36 months). All pa-tients reached bone healing;healing time was from 3 months to 4 months (average, 3.4 months). According to the Matta reset stan-dard after operation, there were 6 excellent cases, 5 good cases, 2 fair cases, 1 poor case, the excellent and good rate was 78.5%(11/14). The Matta was from 10 to 18 scores (average, 16.4 scores), 5 excellent cases, 5 good cases, 3 fair cases, 1 poor case, the ex-cellent and good rate was 71.4%(10/14). Traumatic arthritis occurred in 3 patients. Pain was serious in two patients and disap-peared after total hip joint replacement. Pain was mild for one patient and disappeared after accepted non steroidal painkiller. One patient had heterotopic ossification after operation, which was not treatmented because of no obvious symptom. Conclusion The appropriate operation time of acetabular roof compression fracture with sea

  15. 计算机辅助导航热塑膜定位固定无移位髋臼后柱骨折的实验研究%Computer.assisted thermoplastic elustomer film localization system for screw insertion to fix posterior column of acetabulum

    Institute of Scientific and Technical Information of China (English)

    鲁洋; 潘进社; 张英泽; 翟福山; 郑占乐; 王涛; 郝睿峥

    2008-01-01

    目的 评估应用计算机辅助热塑膜定位系统微刨置入螺钉固定髋臼后柱骨折的准确性和有效性. 方法应用计算机辅助热塑膜定位系统将20枚空心钉置人10具标本的髋臼后柱.置入螺钉后,通过CR、CT检查螺钉的位置.结果 在计算机辅助热塑膜定位系统辅助下,直接置入螺钉,20枚髋臼后柱螺钉均在安全区内. 结论计算机辅助热塑膜定位系统为微创置入髋臼后柱螺钉提供准确的窄间定位和稳定的路径导航,操作时手术创伤明显减少,具备较好的安全性和准确性,为进一步应用于临床奠定了基础.%Objective To assess accuracy and efficacy of the mini-invasive screw insertion for fix-ation of the posterior column of acetabulum by the computer-assisted thermoplastic elastomer film localization system. Methods In a simulated surgical setup, 20 cannulated screws were placed into the posterior column of acetabulum in 10 corpses under the guidance of the computer-assisted thermoplastic elastomer film localization system. The positions of the screws were checked with CR and CT. Results All the 20 screws were in the safe area. Radiation exposure was totally avoided. Conclusion The system can pro-vide precise, effective and safe navigation for screw insertion to fix the posterior column of acetabulum, and markedly prevent the patient and the staff from exposure to the radiation.

  16. Joint into the road before and after treatment in 42 modalities of acetabulum fracture care%对行前后联合入路治疗的42例复杂型髋臼骨折患者进行综合护理的效果研究

    Institute of Scientific and Technical Information of China (English)

    吴玲

    2016-01-01

    objective: to study the discussion before and after the joint complexity into the road treatment acetabulum fracture clinical nursing measures. Methods: our hospital in February 2014 - February 2015 the complexity of the 42 patients with acetabulum fractures as the research object. All of the patients adopt joint into the road treatment before and after treatment, and also the corresponding nursing measures. Results: nursing, according to the results of all patients were recovered, and none of the patients with deep vein thrombosis or pulmonary embolism complications such as; At the same time, one year after the treatment of patients with follow-up, 35 patients with anatomical reduction and treatment effect to achieve optimal, the other 7 cases of patients with the reset. Conclusions:In the complexity of acetabulum fracture patients, give patients the corresponding nursing measures can maximum reduce patients disability.%目的:探讨对进行前后联合入路治疗的复杂型髋臼骨折患者实施综合护理的临床效果。方法:对2014年2月~2015年2月期间我院收治的42例复杂型髋臼骨折患者的临床资料进行回顾性研究。我院对所有患者均进行前后联合入路治疗,在其进行治疗期间,对其实施综合护理。治护结束后,观察所有患者的治护效果及结束治护一年后患者骨折部分的恢复情况。结果:经过治护,所有患者均痊愈,且无患者出现深静脉血栓或肺栓塞等并发症。在患者结束治护一年后对其进行随访,有35例患者达到解剖复位且治疗效果为优,有7例患者骨折部位恢复良好。结论:对进行前后联合入路治疗的复杂型髋臼骨折患者实施综合护理的临床效果显著。此护理方法值得在临床上推广应用。

  17. 髋臼横断骨折后柱长/短钢板内固定的有限元建模及分析%FEM Modeling and Analysis of Transverse Fractured Acetabulum with Fixations of Posterior Column Long Plate and Short Plate

    Institute of Scientific and Technical Information of China (English)

    吴淑琴; 潘宏侠; 裴葆青

    2011-01-01

    目的 建立有效的髋臼横断骨折有限元模型,完成两种内固定方式的比较.方法 利用Mimics 10.0中建立髋臼骨骨折的三维模型,在逆向工程Geomagic中进行相应处理后,在ANSYS Workbench中生成短/长钢板固定模型,并进行加载分析.结果 相同加载方式下,短钢板模型的最大位移、模型整体及髋臼窝处的最大应力和最大应变,均大于长钢板模型.另外,短钢板模型更容易错位失效.结论 本文有限元模型能有效地反映骨盆应力分布,分析结果表明后壁钢板固定时,将钢板长度延伸至坐骨结节处能提供更大的稳定性.%Objective To establish a valid finite element model of the transverse fractured acetabulum and finish the analysis of inner fixation ways. Methods The three-dimensional image of the pelvis was reconstructed with the software Mimics 10. 0 and was modified with the software Geomagic. Then the 3D model of fractured pelvis was imported into ansys workbench and was established after some operations. After that the integrated 3D finite element models of transverse fractured acetabulums were established, which were fixed with posterior column long and short plates respectively. Finally the vertical load pressure was exerted on the upper terminal plate of the pelvis with some constrainer, and the distribution of stress was analyzed. Results With same loads , the maximum total deformation , von-mises stress and von-mises strain of short plate were bigger than them of long plate. In addition, the model with short plate was easier to lapse. Conclusion It was indicated that the proposed model was stable and valid to contribute the stress of pelvis. For the fixation of transverse fractured acetabulum with a posterior plate, extending the plate to hucklebone tuber was considered more stable.

  18. The Use and Analysis of Parvule- impacted Bone Graft in Revision Total Hip Arthroplasty with Bone Defect of Acetabulum%颗粒骨打压植骨治疗全髋关节翻修中髋臼侧骨缺损

    Institute of Scientific and Technical Information of China (English)

    胡忠洲; 孟凡丁; 王韶进

    2012-01-01

    This study is to investigate the use and analysis of parvule - impacted bone graft in revision total hip arthroplasty with bone defect of acetabulum. Strike off or grind bone in acetabular fossa until bone surface with cribriform blood. Bone defection of inclusive type was covered directly with morselized bone by impaction bone grafting. For Bone defection of not inclusive type, first we used titanium mesh to cover it ,then covered it with morselized bone by impaction bone grafting in order to reconstruct the hip normal anatomical configuration and restore bone mass,then install biotype or cement type acetabulum prothesis. Parvule- impacted bone graft in revision total hip arthroplasty with bone defect of acetabulum is effective in short-term follow-up, but the final therapeutic effect couldn't be determined, because of the lack long term and large amount of follow up study.%探讨颗粒骨打压植骨治疗骨缺损在全髋关节翻修中的应用及疗效分析.包容型缺损直接颗粒骨覆盖,使用打压植骨技术;对于非包容型缺损采用钛网覆盖骨缺损,再用松质骨颗粒覆盖,使用打压植骨技术,重建髋关节的正常解剖形态,恢复骨量,安装生物型或水泥性髋臼假体.结果颗粒骨打压植骨在伴有髋臼侧骨缺损的全髋关节翻修术中可有效重建髋臼侧骨缺损,恢复骨量,并能提供良好的早期稳定性,术后短期随访效果良好,但是其远期结果有待于更长时间、更大规模的随访研究.

  19. ANTERIOR COLUMN FRACTURES OF THE ACETABULUM

    NARCIS (Netherlands)

    HEEG, M; OTTER, N; KLASEN, HJ

    1992-01-01

    We retrospectively reviewed 20 patients at three to 19 years after displaced anterior fracture-dislocations of the hip. Eighteen of them were treated by traction, after ensuring that the femoral head was adequately reduced beneath the undisrupted part of the weight-bearing dome. Two required operati

  20. Hip arthroplasty for the severe comminuted proximal femoral fracture with psilateral acetabulum fracture%人工关节置换治疗修复困难的股骨近端粉碎性骨折合并同侧髋臼骨折

    Institute of Scientific and Technical Information of China (English)

    吕波; 王跃; 朱建辛; 黄崇新; 廖天成; 王安

    2014-01-01

    Objective:To investigate the results of hip arthroplasty for the treatment of severe comminuted proximal femoral fracture with ipsilateral acetabulum fracture. Methods:From June 2007 to September 2013,8 patients (8 hips) with se-vere comminuted proximal femoral fracture combined with ipsilateral acetabulum fracture were treated with hip arthroplasty. All patients were male and using biological prosthesis. Aged from 33 to 64 years old with an average of 41.9 years. According to Harris score in aspect of pain,function,range of motion to evaluate clinical effects. Results:There was no untoward reaction in 8 pa-tients. And bed rest at 3 months after operation ,waiting for acetabulum fracture healed to out of bed activity. There was no com-plications such as pneumonia ,bedsore and so on in the patients. Follow up time was from 9 to 72 months with an average of 35.8 months,the wound healed,there was no the subsidence and loosening of prosthesis,no dislocation and infection. The mean of Harris score was 87.5 points after operation. Conclusion:The effect of the hip replacement in treating severe comminuted proxi-mal femoral fracture with ipsilateral acetabulum fracture is confirmed. It can restore motor function and reduce traumatic compli-cation,may serve as a substitute for internal fixation of difficult operation. The long term efficacy is necessary to further observe.%目的:观察人工髋关节置换治疗修复困难的股骨近端严重粉碎性骨折合并同侧髋臼骨折的临床疗效。方法:对2007年6月至2013年9月收治的8例(8髋)股骨近端严重粉碎性骨折合并同侧髋臼骨折的患者采用人工髋关节置换,均为男性,年龄33~64岁,平均41.9岁。均采用生物型假体。采用Harris评分,从疼痛、功能及活动范围等方面进行随访,评价其疗效。结果:8例(8髋)患者术中无不良反应发生,术后卧床休息3个月,待髋臼骨折愈合后下床活动,无肺炎、褥疮等

  1. The curative effect analysis of acetabulum fracture treated with bridge combined fixation sys-tem or reconstruction plate%桥接组合式内固定系统与重建钢板治疗髋臼骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    关翔; 宋香全; 王洪炳; 周朝波

    2015-01-01

    Objective To investigate the clinical efficacy of reconstruction plate or bridge combined fixation system in the treatment of acetabulum fractures. Methods Fifty-five patients of acetabulum fractures treated by surgery were selected for a case-control study. Twenty-eight patients was treated by reconstruction plate, while twenty-seven pa-tients was treated by bridge combined fixation system. Operation time, intraoperative blood loss and hospital stay of two groups were observed and compared. Results The time of hospital stay, operative time, amount of bleeding of the group treated by bridge combined fixation system was better than the group treated by reconstruction plate. There are statistically significant difference between the two groups (P<0. 05). For the postoperative hip joint function of the reconstruction plate group,14 cases were excellent,9 good,4 fair, and 1 poor, and the rate of excellence and good results was 23/28. For the bridge combined fixation system group,13 cases were excellent,11 good,2 fair, and 1 poor, and the rate of excellence and good results was 24/27. There are statistically significant difference between the two groups of curative effect ( P<0. 05 ) . Conclusions The bridge combined fixation system has the advantages of less trauma, better functional recovery and less postoperative complications, which can be used as the preferred way for the surgical treatment of acetabulum fracture.%目的:探讨重建钢板与桥接组合式内固定系统治疗髋臼骨折临床疗效。方法手术治疗55例髋臼骨折的患者,分别行重建钢板(28例)和桥接组合式内固定系统(27例)内固定,观察两组的手术时间、术中出血量、住院时间,比较两组疗效。结果桥接组合式内固定系统组的手术时间、术中出血量、住院时间均优于重建钢板组,差异有统计学意义(P<0.05)。术后髋关节功能:重建钢板组优14例,良9例,可4例,差1例,优良率23/28;桥接

  2. The influence in anterior column with posterior hemi-transverse fractures of the acetabulum fixed by DPASQ which caused by the stability of the contralateral pelvic ring:a finite element analysis%对侧骨盆环稳定性对前柱伴后半横行髋臼骨折动力化前路方形区钛板螺钉系统内固定影响的有限元分析

    Institute of Scientific and Technical Information of China (English)

    董石磊; 蔡贤华; 王志华; 刘曦明; 王威; 董鹏飞; 王锋

    2015-01-01

    Objective To study the influence of sitting position in anterior column with the hemi-transverse fractures of the acetabulum fixed by dynamic anterior plate-screw system for quadrilateral area (DAPSQ) which caused by the the stability of the contralateral pelvic ring.Methods Using the finite element analysis method to build the pelvis model of right high anterior column with posterior hemi-transverse lesion fractures of the acetabulum,and fixing the right side of the acetabulum fractures by DAPSQ,we construct three sets of internal fixation models individually:keep the contralateral pelvic ring in its integrity (A),complete for superior and inferior ramus of pubis fracture internal fixation (B) and keep the contralateral superior and inferior ramus of pubis fractures unfixed ?,finally contract the displacement and stress distribution on the right side of the fracture between groups under load 600 N of physiological load imitating sitting position.Results It has no significant sense in the differences of longitudinal displacement of the dome region of acetabulum between the three internal fixation models of group A,group B and group C.The lateral displacements of posterior column inner lining were (0.903 ± 0.034),(0.910 ±0.038),(1.117 ±0.380) mm,the force on DASPQ square area screw shows that A > B > C and the differences are significant.Conclusion The biomechanical stability of anterior column with posterior hemi-transverse fractures of acetabulum fixed by DAPSQ is well,under the premise that the contralateral pelvic ring is stable.%目的 利用有限元方法研究对侧骨盆环稳定性对动力化前路方形区钛板螺钉系统(DAPSQ)治疗前柱伴后半横行髋臼骨折的生物力学稳定性的影响.方法 运用有限元分析方法构建右侧高位前柱伴后半横行髋臼骨折的全骨盆模型,对右侧髋臼骨折采用DAPSQ固定,分别构建出3组内固定模型:对侧骨盆环完整(A)、对侧耻骨上下支骨折

  3. 髋臼横行骨折采用前后柱拉力螺钉结合重建钢板固定疗效分析%Analysis of the Effect of the Acetabular Transverse Fracture Using the Lag Screw of the Acetabulum and the Reconstruction Plate With the Reconstruction Plate

    Institute of Scientific and Technical Information of China (English)

    张立峰; 冯卫; 包道日娜; 冬梅; 佟雁翔

    2015-01-01

    Objective To investigate the clinical effect of the application of the acetabular transverse fracture in the treatment of the acetabular fracture and the reconstruction of the plate fixation with the lag screw of the acetabulum. Methods 50 cases of patients with transverse acetabular fracture were selected,and subject to acetabular posterior column lag screw combined with reconstruction plate fixation treatment,Bleeding volume,operation time, the acetabulum repositioning and hip joint function recovery after surgical of patients were observed. Results The average operation time was 3.5 hours, the average amount of bleeding was 950ml, according to Matta reduction, 25 cases of anatomic reduction, satisfactory reduction in 21 cases, 4 cases of unsatisfactory reduction, and the excellent and good rate of hip joint function was 86.0%. Conclusion The clinical effect of the acetabular transverse fracture patients with the acetabular anterior and posterior column lag screw combined with the reconstruction plate fixation is worthy of promotion.%目的:探讨对髋臼横行骨折患者应用髋臼前后柱拉力螺钉结合重建钢板固定治疗的临床疗效。方法选取髋臼横行骨折患者50例,对其进行髋臼前后柱拉力螺钉结合重建钢板固定手术治疗,观察患者手术时出血量、手术时间等,手术治疗后患者髋臼复位情况以及髋关节功能恢复情况。结果平均手术时间为3.5小时,平均出血量为950 ml,根据 matta 复位,25例解剖复位,21例满意复位,4例复位不满意,髋关节功能优良率为86.0%。结论对髋臼横行骨折患者采取髋臼前后柱拉力螺钉结合重建钢板固定手术治疗临床疗效突出。

  4. 骨盆Ⅰ-Ⅱ-Ⅳ区肉瘤整块切除后腰盆钉棒重建系统%Enbloc resection of pelvic sarcoma involving region Ⅰ , Ⅱ, IV and reconstruction with the prosthetic acetabulum pedicle screw and rod system

    Institute of Scientific and Technical Information of China (English)

    沈靖南; 王晋; 尹军强; 黄纲; 雍碧城; 李浩淼; 邹昌业

    2012-01-01

    目的 探讨骨盆Ⅰ-Ⅱ-Ⅳ区肉瘤整块切除后新设计的腰盆钉棒重建系统的临床应用.方法 回顾性研究中山大学附属第一医院骨肿瘤科,2009年6月到2010年12月期间,行骨盆Ⅰ区、Ⅱ区和Ⅳ区肉瘤整块切除和腰盆钉棒系统重建术的病例资料,评价该术式的治疗效果及术后并发症.入选条件:穿刺活检证实骨盆原发性肉瘤:肺部CT未见转移灶,Eneking分期为ⅡB期;患者能完成规范的新辅助化疗;术前MRI评估证实肉瘤未侵犯髂外动静脉、坐骨神经和盆腔脏器,确认肉瘤累及骨盆Ⅰ-Ⅱ-Ⅳ三个区域.结果 4例累及骨盆Ⅰ区、Ⅱ区和Ⅳ区的原发性肉瘤患者接受肿瘤整块切除后腰盆钉棒系统重建.患者男3例,女1例;平均年龄29.75岁(18 ~45岁).病理类型包括:尤文肉瘤2例,软骨肉瘤1例和骨肉瘤1例,尤文肉瘤和骨肉瘤完成新辅助化疗.肉瘤整块切除范围包括骨盆Ⅰ区、Ⅱ区和Ⅳ区肿瘤、肿瘤累及的髂肌、臀中小肌和部分臀大肌,同时采用骨盆髋臼和腰椎椎弓根钉棒系统重建髋臼、骨盆环和腰骶连接.术后3周患者开始进行康复治疗,术后3个月可扶拐行走.术后平均隧访14个月(9~19个月),目前尚未发现复发和转移.MSTS功能评分平均为66.67% (63% ~73%);Harris髋关节评分良2例,差2例.结论 骨盆原发性肉瘤治疗的主要目标是通过广泛切除而获得治愈,通过骨盆环重建挽救下肢的主要功能.骨盆Ⅰ区、Ⅱ区和Ⅳ区肉瘤整块切除和腰盆钉棒系统既能完整的切除肿瘤,又能有效重建骨盆和腰骶连接功能.这种重建方式近期疗效观察能够达到患者及骨肿瘤专科医生的功能期望.%Objective This study is to evaluate the effect of en bloc resection of pelvic sarcoma involving region Ⅰ, Ⅱ , Ⅳ and reconstruction with the prosthetic acetabulum pedicle screw and rod system. Methods A continuous and retrospective analysis was

  5. Finite element analysis of total hip replacement with structural bone graft for acetabulum reconstruction in dysplasia of hip%成人髋臼发育不良伴骨关节炎行髋臼结构性植骨重建关节置换术的力学分析

    Institute of Scientific and Technical Information of China (English)

    许杰; 马若凡; 蔡志清; 李登

    2014-01-01

    Objective To study the stress distribution in the acetabular cup-bone interface affected by the structural bone graft for the acetabulum reconstruction during the total hip replacement (THR) in treating the dysplasia of hip by using the three dimensional (3D) finite element analysis. Methods The acetabulumm of the hip with dysplasia was scanned by CT.The computer simulation technology was used to reconstruct the three-dimensional (3D) model of the pelvic from CT scan picture in order to observe the dysplasia of the hip.The structural bone graft for reconstruction of the acetabulum reconstruction in THR was simulated.Then the pelvis and acetabular cup models were meshed.The mechanical analysis tool was used to analyze the 3D model, and the stress data in the acetabular cup-bone interface was achieved.After the statistical analysis of the experimental results, the structural bone graft affecting the stress distribution in the acetabular cup-bone interface was observed.Results The structural bone graft augmented the deficient acetabulum and improved the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip, which leaded to greater contact area and smaller stress per unit area. The structural autograft which covered the anterior-lateral part of the cup bore greater stress.Conclusion The acetabular reconstruction with the structural bone graft improves the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip.The stress deconcentration due to the larger contact area could benefit the stability of the cup.The coverage of the cup by the graft should not be too much, otherwise, the great stress on the structural bone graft would increase the risk of loosening.%目的:利用三维有限元力学分析方法,研究髋关节发育不良患者髋臼外上缘结构性植骨重建髋臼、增加臼杯假体包容对髋臼假体-骨界面间的应力分布情况的影响。方法选取髋关节发育不良患者的骨盆为

  6. Prevention of prosthesis dislocation in hemiplegic patients subjected to total hip replacement by decreasing the abduction angle of the acetabulum%减小髋臼杯外展角预防偏瘫患者全髋关节置换后的假体脱位

    Institute of Scientific and Technical Information of China (English)

    刘志刚; 陈经勇; 陈如见; 李钟; 鲁丽莎

    2012-01-01

    背景:目前关于偏瘫患者股骨颈骨折关节置换后的脱位率报道差别很大.目的:通过减小外展角降低老年偏瘫患者患侧股骨颈骨折关节置换后的脱位率.方法:回顾性分析采用人工全髋置换治疗偏瘫侧股骨颈骨折19例患者资料.结果与结论:患者随访期为3个月~7年,平均4年3个月.除2例置换后2年内因其他疾病死亡外,所有伤口均一期愈合,无切口感染,无髋关节脱位,置换后3个月参照Harris评分标准,其中优5例,良12例,优良率达89%.说明通过减小髋臼外展角是预防偏瘫患者股骨颈骨折全髋关节置换后脱位较可行的方法.%BACKGROUND: Currently reports on dislocation rate of joint replacement in hemiplegic patients with femoral neck fracture are different.OBJECTIVE: To decrease the abduction angle can decrease dislocation rate in elderly hemiplegic patients with side of the femoral neck fractures after joint replacement.METHODS: Date of 19 patients who using total hip replacement for the treatment of hemiplegic side femoral neck fracture were retrospective reviewed.RESULTS AND CONCLUSION: All the patients were followed-up from 3 months to 7 years postoperatively (average of 4 years and 3 months). There were no infection and hip joint dislocation in all the patients whose wounds were healed except two patients died for other diseases at 2 years postoperation. At 3 months postoperation, Harries hip score showed excellent and good rate was 89%, evaluation excellent for 5 and good for 12. It is indicated that decreasing the abduction angle of the acetabulum during the joint replacement to prevent the dislocation of hip joint is a feasible method.

  7. Clinical Outcomes of Surgical Treatments for Primary Malignant Bone Tumors Arising in the Acetabulum

    Directory of Open Access Journals (Sweden)

    Tomohiro Fujiwara

    2015-01-01

    Full Text Available The functional and oncologic results of eighteen patients with primary malignant periacetabular tumors were reviewed to determine the impact of surgical treatment. The reconstruction procedures were endoprosthesis (11, hip transposition (4, iliofemoral arthrodesis (2, and frozen bone autograft (1. After a mean follow-up of 62 months, 13 patients were alive and 5 had died of their disease; the 5-year overall survival rate was 67.2%. The corresponding mean MSTS scores of patients with endoprosthesis (11 and other reconstructions (7 were 42% and 55% (49%, 68%, and 50%, respectively. Overall, postoperative complications including deep infection or dislocation markedly worsened the functional outcome. Iliofemoral arthrodesis provided better function than the other procedures, whereas endoprosthetic reconstruction demonstrated poor functional outcome except for patients who were reconstructed with the adequate soft tissue coverage. Avoiding postoperative complications is highly important for achieving better function, suggesting that surgical procedures with adequate soft tissue coverage or without the massive use of nonbiological materials are preferable. Appropriate selection of the reconstructive procedures for individual patients, considering the amount of remaining bone and soft tissues, would lead to better clinical outcomes.

  8. A Simple Mathematical Standardized Measurement of Acetabulum Anteversion after Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Chen-Kun Liaw

    2008-01-01

    Full Text Available We invented a standardization method to measure the cup's anteversion after total hip arthroplasty without the influence of patient's position. We measured 68 radiographs of 10 patients after total hip replacement (THR and calculated the error of each measurement, defined as the difference with the average of the same measuring method on the same patient. We also calculated the repeatability standard deviation (RSD of each method according to the American Society for Testing and Materials, ASTM E691.

  9. Navigated non-image-based positioning of the acetabulum during total hip replacement

    OpenAIRE

    Jenny, Jean-Yves; Boeri, Cyril; Dosch, Jean-Claude; Uscatu, Marius; Ciobanu, Eugen

    2007-01-01

    We tested the hypothesis that the non-image-based navigation system used in our department was able to measure accurately the 3D positioning of the acetabular cup of a total hip replacement (THR) and to increase the accuracy of its implantation during THR. We studied 50 consecutive navigated implantations of a THR and compared the intra-operative measurement of the cup by the navigation system to the post-operative measurement by computed tomography (CT) scan. The mean difference between the ...

  10. Standard Approaches to the Acetabulum Part 1: Kocher-Langenbeck Approach.

    Science.gov (United States)

    Gänsslen, A; Grechenig, S; Nerlich, M; Müller, M

    2016-01-01

    Historically, standard approaches for surgical treatment of displaced acetabular fractures were the KocherLangenbeck approach, the ilioinguinal approach and the extended iliofemoral approach (12). Presently, several modifications of these approaches are accepted alternatives, especially anterior modifications based on the intrapelvic approach described by Hirvensalo (8). Single access approaches allowing visualization of one acetabular column are the posterior Kocher-Langenbeck approach and the anterior ilioinguinal approach (12) and the use of a single approach is favoured (9, 24). For more complex situations, in the 80s and 90s extended approaches (extended iliofemoral approach according to Letournel (12), its modification to Reinert (19) (Baltimore approach), and the Triradiate approach according to Mears (14)) were introduced. These approaches are presently rarely choosen due to the extensive soft tissue dissection and higher complication rates (28). Alternatively, the combination of an anterior and posterior standard approach was recommended (7, 21, 22) having the disadvantage of longer operating time and blood loss and showed no superior results compared to a single approach. The meta-analysis by Giannoudis et al. stated that 48,7% of patients were treated using the Kocher-Langenbeck approach, followed by 21,9% ilioinguinal approaches and 12,4% extended approaches (6). More recent data from the years 2005-2007, showed that anterior approaches are now predominantly used according to a higher number of acetabular fractures with anterior column involvement. Overall, more than 40% of all patients with acetabular fractures are still approached via the Kocher-Langenbeck approach (18). Therefore, the Kocher-Langenbeck approach is still a "working horse" in approaching displaced acetabular fractures. The Kocher-Langenbeck approach consists of two parts. In 1874 von Langenbeck described a longitudinal incision starting from above the greater sciatic notch to the greater trochanter, dissecting the gluteal muscles for treating hip joint infections (11). Theodor Kocher in 1911 described a curved incision starting from the posterior-inferior corner of the greater trochanter, running across the postero-superior tip of the greater trochanter passing oblique in line with the fibres of the gluteus maximus muscle in direction to the posterior superior iliac spine (10). The aim of the present analysis is the detailed anatomi - cal analysis of this standard approach, focusing on fracture indication, positioning of the patient, exposure, dissection, reduction techniques of special fracture types, approach modifications/extensions, complications and approach-specific results. PMID:27484070

  11. Computed tomography measurements of the acetabulum in adult dysplastic hips: Which level is appropriate

    Energy Technology Data Exchange (ETDEWEB)

    Anda, S.; Kvistad, K.A. (Dept. of Radiology, Trondheim Univ. (Norway)); Terjesen, T. (Dept. of Orthopedic Surgery, Trondheim Univ. (Norway))

    1991-05-01

    A study has been performed to evaluate whether one or several levels are needed with comuted tomography (CT) study to provide sufficient information regarding anteversion and acetabular support to the femoral head. A total of 23 hips in 14 adults with uni- or bilateral congenital hip dysplasia (center-edge angle less than 20deg) were assessed by obtaining 5-mm contiguous CT slices and performing acetabular measurements at four levels. Both anterior and posterior acetabular supports as quantified by the anterior and posterior acetabular sector angles were significantly lower than normal at all levels. The sector angles increased in the proximal cuts, whereas the acetabular anteversin increased caudally. Because no important additional information was gained by measuring at different levels, we conclude that CT study at one level is sufficient for acetabular measurements and suggest that the slice through the center of the femoral head is the most appropriate one. (orig.).

  12. Changes in bone mineral density of the acetabulum, femoral neck and femoral shaft, after hip resurfacing and total hip replacement

    DEFF Research Database (Denmark)

    Penny, J O; Brixen, K; Varmarken, J E;

    2012-01-01

    It is accepted that resurfacing hip replacement preserves the bone mineral density (BMD) of the femur better than total hip replacement (THR). However, no studies have investigated any possible difference on the acetabular side. Between April 2007 and March 2009, 39 patients were randomised into ...

  13. A test of a recently devised method of estimating skeletal age at death using features of the adult acetabulum.

    Science.gov (United States)

    Mays, Simon

    2014-01-01

    Estimation of age at death from adult skeletal remains is highly problematic, due in great part to interpopulation variability in skeletal age changes. Thorough testing of aging methods is therefore of key importance. A method recently devised by Calce (Am J Phys Anthropol 148 (2012): 11-23) for placing adult skeletons into three broad age at death classes (17-39, 40-64, 65+ years) on the basis of acetabular morphology is tested on a collection of 18-19th century AD skeletons (N = 185) of documented age at death from London. Results showed that 45% were correctly assigned to age class using this method. This compares with 81% reported by Calce on 20th century North American material. This indicates significant interpopulation differences in the relationship between the Calce acetabular variables and age, even between populations of European ancestry. Until the sources of this variation are better understood, caution should be used before applying this method to estimate age in unknown skeletons.

  14. Comparison of Isocentric C-Arm 3-Dimensional Navigation and Conventional Fluoroscopy for Percutaneous Retrograde Screwing for Anterior Column Fracture of Acetabulum: An Observational Study.

    Science.gov (United States)

    He, Jiliang; Tan, Guoqing; Zhou, Dongsheng; Sun, Liang; Li, Qinghu; Yang, Yongliang; Liu, Ping

    2016-01-01

    Percutaneous screw insertion for minimally displaced or reducible acetabular fracture using x-ray fluoroscopy and computer-assisted navigation system has been advocated by some authors. The purpose of this study was to compare intraoperative conditions and clinical results between isocentric C-arm 3-dimensional (Iso-C 3D) fluoroscopy and conventional fluoroscopy for percutaneous retrograde screwing of acetabular anterior column fracture.A prospective cohort study was conducted. A total of 22 patients were assigned to 2 different groups: 10 patients in the Iso-C 3D navigation group and 12 patients in the conventional group. The operative time, fluoroscopic time, time of screw insertion, blood loss, and accuracy were analyzed between the 2 groups.There were significant differences in operative time, screw insertion time, fluoroscopy time, and mean blood loss between the 2 groups. Totally 2 of 12 (16.7%) screws were misplaced in the conventional fluoroscopy group, and all 10 screws were in safe zones in the navigation group. Percutaneous screw fixation using the Iso-C 3D computer-assisted navigation system significantly reduced the intraoperative fluoroscopy time and blood loss in percutaneous screwing for acetabular anterior column fracture.The Iso-C 3D computer-assisted navigation system provided a reliable and effective method for percutaneous screw insertion in acetabular anterior column fractures compared to conventional fluoroscopy.

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

    Institute of Scientific and Technical Information of China (English)

    张德文; 刘正全; 刘传康; 李明; 唐盛平

    2000-01-01

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

  16. Acetabular reconstruction of total hip replacement in congenital acetabulum displasia of adult%成人先天性髋臼发育不良全髋置换术中髋臼重建

    Institute of Scientific and Technical Information of China (English)

    魏福堂; 张洪涛; 张志明; 黄洪; 张本寿

    2006-01-01

    目的 探讨全髋关节置换治疗成人先天性髋臼发育不良术中髋臼的重建方法.方法 对24例32髋成人先天性髋臼发育不良继发骨性关节炎患者进行了全髋关节置换术,21髋行自体股骨头及髂骨移植重建髋臼,11髋单纯行髋臼加深重建髋臼.术后以Harris评分、放射学改变、步态、肢体长度、Trendelenburg征评定治疗效果.结果 所有患者均获得随访,时间6个月~5年.Harris评分由术前平均48.2分恢复到术后平均86.4分,X线片显示,自体股骨头及髂骨移植重建髋臼病例所有移植骨块均愈合良好.旋转中心平均下降55mm(37~69 mm).29髋疼痛消失,3髋术后有轻微疼痛.1例术后Trendelenburg征持续阳性.结论 根据术前评估,选择合适的髋臼重建方法进行全髋关节置换对成人先天性髋臼发育不良可获得较好疗效.

  17. Management of Adult Hip Displasia by means of Total Hip Replacement Plus Acetabulum Deepening Technique%髋臼加深全髋置换治疗成人先天髋臼发育不良

    Institute of Scientific and Technical Information of China (English)

    宋展昭; 徐朋; 张伟; 邵顺建; 赵莉

    2001-01-01

    目的:探索成人先天性髋臼发育不良伴髋关节半脱位的手术治疗方法.材料和方法:12例成人先天性髋臼发育不良伴髋关节半脱位患者采用髋臼加深髋关节置换的方法治疗.结果:经1~8年随访,假体稳定,髋关节疼痛症状消失,关节功能基本正常.结论:髋臼加深全髋关节置换是成人先天性髋臼发育不良伴髋关节半脱位的有效治疗方法.

  18. Total hip replacement using hemi-circumferential interposition acetabuloplasty for acetabular deficiency in post-Perthes deformities: technique and long-term results

    NARCIS (Netherlands)

    D. Haverkamp; H. Eijer; R.K. Marti

    2006-01-01

    We describe a technique of hemi-circumferential interposition grafting that allows placement of the cup in the anatomical position of the original acetabulum in the rare cases of post-Perthes or Perthes-like deformities of the femoral head combined with a steep and shallow acetabulum. This technique

  19. ANALYSIS AND RESEARCH OF COMPUTER-AIDED MODEL OF HIP JOINT BASED ON REVERSE ENGINEERING

    Institute of Scientific and Technical Information of China (English)

    Hu Xin; Xi Juntong; Jin Ye; Gu Dongyun; Dai Kerong

    2003-01-01

    Former research work about the modeling of hip joint focus on the upper segment of femoral, and assumes the acetabulum cup is sphere concave, and the acetabulum prostheses is semisphere. A method of acquiring the point data on the surface of the hipbone using the reverse engineering technology is presented. After analyzing the acetabulum surface fitting error, a rotation ellipsoid CAD model is applied to fit the acetabulum surface, and then optimization technique is used to find the geometric parameters of the model. The fitting error between the sphere and rotation ellipsoid is compared and gets the result that the fitting error of rotation ellipsoid is smaller than sphere, and the rotation ellipsoid can describe the shape of the acetabulum better.

  20. Sexual dimorphism of the hip joint in Greeks.

    Science.gov (United States)

    Papaloucas, Christos; Fiska, Aliki; Demetriou, Thespis

    2008-07-18

    The objective of the present study was to report our measurements of hip bones within the Greek population and review the possible implications of these differences in their health as well as in social life. For this purpose the remains of 100 male and 100 female pelvic and femoral bones were studied. The distance from the pubic tubercle to the anterior rim of the acetabulum, the acetabulum diameter between its rims, their ratio, the depth of the acetabulum, the diameter of the femoral head and the ratio between the femoral head and the diameter of the acetabulum were measured. It was found that in males, in comparison to the females, the distance from the pubic tubercle to the anterior rim of the acetabulum was smaller while the acetabulum diameter and its depth, the diameter of the femoral head and the ratio between femoral head and the acetabulum diameter were larger. The above differences reached strong statistical significance. Of the two ratios used only the first one reached statistical significance. Using this ratio alone offered the best discrimination rate of up to 99% and should be the preferred choice when available.

  1. 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

  2. Ultrasonography for evaluating abnormal values of the osseous acetabulum angle in pediatric developmental dysplasia of the hip%超声观察骨性髋臼角度评价婴幼儿发育性髋关节异常的价值

    Institute of Scientific and Technical Information of China (English)

    栗平; 郭志英; 窦蕊

    2013-01-01

    [Objective] To determine the clinical significance of Graf' s ultrasound examination in the diagnosis of pediatric developmental dysplasia of the hip.[Methods] We studied abnormal hips of 108 infants (216 hips; 35 boys,73 girls; mean age,45 days [range,8 days to 6 months]) with suspected developmental hip dysplasia between August 2010 and September 2012.Graf's conventional ultrasonography examination was used to measure angles a and b to evaluate coronal acetabular form and femoral head position in both hips.For analysis,hips were classified according to the related risk factors.[Results]According to Graf's ultrasound classification,the hips were classified as follows:type Ⅰ,186 (86.1%) ; type Ⅱa,10 (4.9%) ;type Ⅱb,12 (6.0%) ; type Ⅱc,2 (1.1%) ; type Ⅲ,4 (1.9%) ; and type Ⅳ,2 (1.0%).Type D was not seen.Angle a =60° was representative of hip joint osteoarthritis,good concave growth,concave and deep joint socket,and a femoral head that was not easily dislocated.Angle a < 60° was representative of hip joint osteoarthritis,concave dysplasia,relatively shallow or flat joint socket,and a femoral head that was easily dislocated.There was a statistical significant difference in the acetabular angle between boys and girls (P < 0.05).Therefore,sex had an influence on osseous acetabular development.A comparison of left and right hips showed that the right a angle was correlated with the left (P < 0.05).[Conclusion] Ultrasonography can be used to accurately evaluate developmental hip dysplasia in children and can contribute to early diagnosis and effective treatment.%[目的]研究Graf超声检查方法在诊断婴幼儿发育性髋关节异常中的临床价值.[方法]选择2010年8月~ 2012年9月来本院就诊临床疑似发育性髋关节异常的婴幼儿108例(216个髋关节),其中男婴幼儿35例,女婴幼儿73例;年龄8d~6个月,平均45 d;依据Graf常规超声检查法,通过测量α、β角度,评估双侧髋关节髋臼形态、股骨头位置,髋臼与股骨头的关系,并对髋关节进行分型.[结果]Ⅰ型186个(86.1%),Ⅱa型10个(4.9%),Ⅱb型12个(6.0%),Ⅱc型2个(1.1%),Ⅲ型4个(1.9%),Ⅳ型2个(1.0%),D型未见.骨顶线夹角α≥60°时,说明髋关节的骨性关节凹发育较好,关节凹较深,股骨头不易脱出关节,骨顶线夹角α<60°时,说明髋关节骨性关节凹发育不良,关节凹较浅或较平,股骨头易脱出关节,另外,男婴幼儿髋臼α角度较女婴幼儿大,两者差异有统计学意义(P<0.05),提示性别对骨性髋臼发育有影响,双侧比较左侧和右侧髋关节α角右侧较左侧大(P<0.05),提示左侧较右侧髋臼发育差.[结论]超声检查法能够早期准确评价婴幼儿髋关节发育情况,并对髋关节发育不良的治疗过程进行随访观察.

  3. 髋臼加深全髋置换治疗成人先天髋臼发育不良的临床分析%Clinical analysis for deepening acetabular total hip replacement in treatment of congenital dysplasia of acetabulum in adults

    Institute of Scientific and Technical Information of China (English)

    谭光华

    2012-01-01

    目的 通过观察髋臼加深全髋置换(THA)治疗成人髋臼发育不良(DDH)的临床效果,进行评价和分析,以期在临床效果上得到提高.方法 选取本院2000年1月~2009年12月收治的成人先天髋臼发育不良患者38例,术前Harris评分为(43.52±6.85)分,采用髋臼加深全髋置换术进行治疗.用X线平片检测,对比分析患者术前术后Harris评分.结果 患者术后Harris评分为(88.03±5.22)分,术前术后Harris评分差异具有统计学意义(P<0.05).结论 髋臼加深全髋置换术对于成人先天髋臼发育不良的治疗,可以明显消除患者症状,提高患者生活质量,是一种有效的治疗手段,值得在临床上推广应用.

  4. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... performed now is commonly attributed to the Jeu de brothers, Robert and John, who practiced orthopedic surgery ... mean this is the traditional Smith Meet Jeu De view of the acetabulum,. I mean you can ...

  5. Taper Hip Prosthesis

    Medline Plus

    Full Text Available ... We'll see if we can use a large curved retractor just posterior to the acetabulum. I ... old gentleman. Okay. So you're using a large head with very slim tapered head and neck ...

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

    Medline Plus

    Full Text Available ... incision will vary depending on a patient’s size, mass, muscle tone, flexibility, bone deformity. This particular patient ... can see that labrum is a pretty chunky mass of tissue detached from the acetabulum. On the ...

  7. Retrieval of a broken guide wire transfixing the hip through the proximal femoral nail hole

    Institute of Scientific and Technical Information of China (English)

    Saurabh Jain; Abhishek Pathak; Rajeev Kant Pandey

    2014-01-01

    Retrieval of a broken guide wire transfixing the acetabulum or with intrapelvic migration is challenging and frustrating for surgeons.We here present a case report on a method to remove a broken guide wire transfixing the acetabulum through the proximal hole of recon nail using a grasping forceps.This method is little invasive,easy,time-saving and without need for changing the inital fixation.

  8. Intra-articular membranous interposition detected by MRI in developmental dysplasia of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, W.; Itoi, Eiji; Sato, Kozo [Akita Univ. (Japan). Dept. of Orthopedic Surgery

    2000-12-01

    Intra-articular membranous interposition was detected by MRI in the hip joint with residual subluxation of a girl aged 5 years 10 months. This structure, which had low signal intensity on both T1- and T2-weighted images, separated the femoral head from the acetabulum. Histological examination revealed chondrometaplasia, which suggested that this interposition might be transformed to a surface cartilaginous tissue of the secondary acetabulum often observed in residual subluxation of the hip. (orig.)

  9. Retrieval of a broken guide wire transfixing the hip through the proximal femoral nail hole

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2014-02-01

    Full Text Available 【Abstract】Retrieval of a broken guide wire transfixing the acetabulum or with intrapelvic migration is challenging and frustrating for surgeons. We here present a case report on a method to remove a broken guide wire transfixing the acetabulum through the proximal hole of recon nail using a grasping forceps. This method is little invasive, easy, time-saving and without need for changing the inital fixation.

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

    OpenAIRE

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

    2008-01-01

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

  11. Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

    International Nuclear Information System (INIS)

    Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion

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

    Energy Technology Data Exchange (ETDEWEB)

    Rubel, Ivan F.; Kloen, Peter; Helfet, David L. [Department of Orthopaedic Surgery, Weill Medical College of Cornell University, New York, NY (United States); Potter, Hollis G. [MRI Department, Diagnostic Radiology, Hospital for Special Surgery, New York (United States)

    2002-06-01

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

  13. Femoroacetabular impingement

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Suzanne E., E-mail: andersonsembach@yahoo.com.au [The University of Notre Dame Australia, School of Medicine Sydney, 160 Oxford Street, Darlinghurst 2010, NSW, Sydney (Australia); Department of Diagnostic, Pediatric and Interventional Radiology, Inselspital, University of Bern, Bern 3010 (Switzerland); Siebenrock, Klaus Arno; Tannast, Moritz [Department of Orthopedic Surgery, Inselspital, University of Bern, Bern 3010 (Switzerland)

    2012-12-15

    Femoroacetabular impingement (FAI) is a pathomechanical concept describing the early and painful contact of morphological changes of the hip joint, both on the acetabular, and femoral head sides. These can lead clinically to symptoms of hip and groin pain, and a limited range of motion with labral, chondral and bony lesions. Pincer impingement generally involves the acetabular side of the joint where there is excessive coverage of the acetabulum, which may be focal or more diffuse. There is linear contact of the acetabulum with the head/neck junction. Cam impingement involves the femoral head side of the joint where the head is associated with bony excrescences and is aspheric. The aspheric femoral head jams into the acetabulum. Imaging appearances are reviewed below. This type is evident in young males in the second and third decades. The main features of FAI are described.

  14. Operative treatment for pincer type femoroacetabular impingement:a case report

    Directory of Open Access Journals (Sweden)

    Endo,Hirosuke

    2010-04-01

    Full Text Available

    Femoroacetabular impingement (FAI is a condition characterized by the impingement of the femur and acetabulum. In Japan, this disorder has become recognized gradually. Here we report a rare case of surgically treated FAI, associated with an osseous protrusion on the acetabulum of a 30-year-old female. Plain computed tomography (CT and reconstructive 3D-CT images clearly demonstrated an anterolateral bony protrusion. Hip arthroscopy showed no degeneration of the cartilage on either the femoral or acetabular side, but degeneration at the edge of labrum was observed in the region of the bony protrusion. The complete removal of the bony protrusion under hip arthroscopy was thus considered impracticable, and a small skin incision was therefore made anteriorly to approach the acetabulum. The Short-Form 36-Item Health Survey (SF-36 revealed improvement in all scores.

  15. Research on Transverse Acetabular Fracture Fixation Using Different Plate Attachment Methods

    Directory of Open Access Journals (Sweden)

    Gediminas Gaidulis

    2015-03-01

    Full Text Available The article deals with the problem of transverse acetabular fracture fixation using different plate attachment methods. A 3D model of pelvis and hip joint structure was created and the design of three different fixation plates using SolidWorks was made. The plates were fixed at distances of 10, 20 and 30 mm from the acetabulum. The model was meshed into finite elements, a static external load of 2500 N was added and the analysis of stress distribution in plates and fracture displacement was performed. The obtained results showed that fracture displacement was quite similar in all fixation methods. However, the maximal stress in the nearest from the acetabulum plate was higher than yield strength. Thus, this placement is not eligible. The plate fixed at a distance of 30 mm from the acetabulum appeared the most suitable because of the smallest and symmetrical stress distribution in the plate.

  16. Internal iliac artery pseudoaneurysm in primary total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Sanjay Agarwala

    2016-01-01

    Full Text Available Vascular injury is one of the rare complications of primary total hip arthroplasty (THA. We report an unusual case of lobulated pseudoaneurysm arising from one of the branches of the left internal iliac artery during acetabulum preparation in THA, which was successfully treated with coil embolization and multidisciplinary care. After 6 years follow up, patient did not have any symptoms related to the hip replacement. We recommend that surgeons should be extremely cautious while drilling medial wall of the acetabulum for depth assessment. Aggressive multidisciplinary approach, including possible support from an interventional radiologist is required for the treatment of such vascular injuries.

  17. Specific inferior dislocation of the hip: one case report

    Institute of Scientific and Technical Information of China (English)

    XU Chao

    2007-01-01

    @@ Hip joint dislocations are generally classified as anterior, posterior, and central dislocations. In 1970s, the anterior dislocation was divided into pubic type and obturator type.1 It is generally recognized that for anterior dislocation of the hip joint, the femoral head is located at anteriorinferior part of the acetabulum, characterized clinically as abduction, extorsion, slight flexion deformity, and longer limb than the opposite side. When posterior dislocation is present, the femoral head is located at posteriorsuperior part of the acetabulum and manifested clinically as flexion, adduction, intorsion, and shortening deformity.

  18. Surgical advances in periacetabular osteotomy for treatment of hip dysplasia in adults

    DEFF Research Database (Denmark)

    Troelsen, Anders

    2009-01-01

    adults with symptomatic hip dysplasia. The surgical aim of this extensive procedure is to reorient the acetabulum to improve coverage and eliminate the pathological hip joint mechanics. Intraoperative assessment of the achieved acetabular reorientation is therefore crucial. The "classic" surgical......Hip dysplasia is characterized by an excessively oblique and shallow acetabulum with insufficient coverage of the femoral head. It is a known cause of pain and the development of early osteoarthritis in young adults. The periacetabular osteotomy is the joint-preserving treatment of choice in young...

  19. Total Hip Arthroplasty for The Treatment of End-stage Acetabular Dysplasia%全髋关节置换术治疗晚期髋臼发育不良

    Institute of Scientific and Technical Information of China (English)

    李宇俊; 文立成; 曹永平; 杨昕

    2012-01-01

    Objective To explore the installing methods of hip prothesis in a total hip arthroplasty for patients of osteoarthritis secondary to end-stage acetabular dysplasia. Methods Between January 2002 and January 2008.a total of 60 hips in 52 patients with advanced osteoarthritis secondary to acetabular dysplasia underwent the total hip arthroplasty and were followed up. Among the patients,6 were male and 46 were female,with their ages ranging from 46 to 72 years and a average age of 62 years. The bilateral arthroplasty was performed in 8 patients and the unilateral arthroplasty in 44 patients. The main symptoms were pain and claudication. According to the developmental degree of acetabulums,three methods were adopted to perform the total hip arthroplasty,which were deepen acetabulum,inward deepening acetabulum and bone transplantation on external upper lip of acetabulum. The Harris scores were applied to evaluate function of the hip during follow-up. X-ray films for both joints were taken in order to learn the coalescence of acetablum with its bone bed after 3,6,9,12 months and every 1 years after operation. The follow-up time ranged from 2 years to 8 years,with an average of 4 years and 6 months. Results At the end of follow-up,the acetabulum prostheses contacted well with their beds of 45 years and the recovery of joint function was satisfactory and no sign of aseptic loosening among the cases of deepen acetabulum and inward deepened acetabulum. However,in 5 of 6 acetabulums which implanted bone on their external upper lip,there was a radiolucency between the implanted bone and the acetabulum prothesis after 2 years of the operation. No sign of aseptic loosening was found. Conclusion While performing total hip arthroplasty,various methods should be adopted according to the bed of acetabulum for the joints of osteoarthrosis due to acetabulum dysplasis. For the patient of enough bone at the bottom of acetabulum bed the acetabulum should be installed by the operation

  20. [Favourable long-term results from cemented total hip arthroplasty combined with acetabular bone impaction grafting in patients under the age of 50

    NARCIS (Netherlands)

    Busch, V.J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2007-01-01

    OBJECTIVE: Determination of long-term results of hip replacements in patients who, at the time of operation, were under the age of 50. Procedures whereby an existing acetabulum defect was filled with bone chips that were impacted into a strong layer, after which a cemented total hip prosthesis was i

  1. Four Helvella (Ascomycota: Pezizales: Helvellaceae species from the Cold Desert of Leh, Ladakh, Jammu and Kashmir, India

    Directory of Open Access Journals (Sweden)

    K. Dorjey

    2013-03-01

    Full Text Available The present paper deals with four Helvella species namely Helvella acetabulum, H.corium, H.queletii and H.macropus from Leh district in Ladakh region of the state of Jammu and Kashmir. Of these, the first three species are new fungus records for India while H.macropus constitutes first authentic record from Ladakh.

  2. Shelf acetabuloplasty for Perthes' disease: 12-year follow-up.

    NARCIS (Netherlands)

    Geest, I.C.M. van der; Kooijman, H.M.; Spruit, M.; Anderson, P.G.; Smet, P.A.G.M. de

    2001-01-01

    The goal of all therapies for Perthes' disease is to achieve an optimal shape of the acetabulum and an optimal coverage of the femoral head. Thirty patients who were included in this follow-up study (mean follow-up 12 years) underwent a shelf acetabuloplasty for Catterall group III or IV. The mean I

  3. Am Investigation of the Hip Development in Fetus and Newborn Infants%胎儿及新生儿髋关节发育的大体观察

    Institute of Scientific and Technical Information of China (English)

    许瑞江; 马承宣; 张喜恩

    1988-01-01

    The right hip joints from 47 fresh fetus and newborn infant cadavers were studied. Vernier calliper (precision of 0.02mm) was used for measuring the diameter of the femoral head and the depth of the acetabulum, and their ratio was calculated. The result shows that although the ratio between the diameter of the femoral head and the depth of the acetabulum decreased at birth, the acetabulum is big enough to hold the femoral head. So the hip joint is quite , stable. It is suggested that the relative shallowness of acetabulum do not cause CDH directly. CDH occurs readily when there are acetabular dysplasia, oligohydramnios, malposition in utero and after birth and so on.%本文对47例胎儿、新生儿尸体的右髋关节进行大体解剖研究.用游标卡尺测量股骨头直径和髋白深度.其结果发现:尽管头白比值在出生时有减少的趋势,但髋关节仍很稳定,提示单纯髋臼相对变浅不足以引起先天性髋脱位,只有在髋白发育不良、羊水过少和不良胎位或体位等因素的基础上才容易导致先天性髋脱位的发生.

  4. 关节囊周围的髂骨切骨术及其改良术在髋臼重建中的地位%Reconstruction of Acetabula With Pericapsular Iliac Osteostomy and Its Modification: a Report of 154 Cases

    Institute of Scientific and Technical Information of China (English)

    彭明惺; 周素华; 周锡华; 刘利君

    1993-01-01

    作者采用关节囊周围的髂骨切骨术及其改良术式治疗先天性髋关节脱位154例170个髋关节,疗效满意,实践证明本手术不仅能改变髋臼指向,还能改变髋臼容积,加深髋臼的深度,是重建浅平髋臼的最佳方式,改良的手术更有针对性的重塑了髋臼后沿的缺陷(而后沿缺陷是其他骨盆切骨不能解决的难题),从而扩大了治疗范围.%From Dec.1980 to Jul.1991.154 cases,aged 1-14 years,were treated with Pemberton's and modified Pemberton's osteotomy of the ilium.The results were satisfactory showing that this operation not only changed the orientation of the acetabulum but also increased the depth of the acetabulum.Pemberton's osteotomy can be a good method to those having a shallow acetabulum.The modified Pemberton's osteotomy has the advantage to remould the dificient posterior edge of the acetabulum which can not be accomplished by any other pelvic osteotomies.

  5. Modified Kocher-Langenbeck approach in combined surgical exposures for acetabular fractures management

    Directory of Open Access Journals (Sweden)

    Narender Kumar Magu

    2016-01-01

    Conclusion: We believe that modified K-L approach may be a good alternative for the standard K-L approach in the management of elementary fractures and associated fractures of the acetabulum when combined with an anterior surgical approach. It makes the procedure less invasive, shortens the operative time, minimizes blood loss and overcomes the exhaustion and fatigue of the surgical team.

  6. Patient-reported outcome of hip resurfacing arthroplasty and standard total hip replacement after short-term follow-up

    DEFF Research Database (Denmark)

    Nissen, Tina Koerner; Douw, Karla; Overgaard, Søren

    2011-01-01

    The purpose of this study was to investigate patientreported outcome in terms of satisfaction in two study groups that had undergone hip resurfacing arthro-plasty (HRA) or total hip replacement (THR). The procedure consists of placing a hollow, mushroom-shaped metal cap over the femoral head whil...... a matching metal cup is placed in the acetabulum (pelvis socket)....

  7. Thirteen-Year Evaluation of Highly Cross-Linked Polyethylene Articulating With Either 28-mm or 36-mm Femoral Heads Using Radiostereometric Analysis and Computerized Tomography

    DEFF Research Database (Denmark)

    Nebergall, Audrey K; Greene, Meridith E; Rubash, Harry;

    2016-01-01

    ' CT scans showed radiolucent regions in the acetabulum of 4.51 cm(3) and 11.25 cm(3), respectively. In one patient, this area corresponded to a partially healed degenerative cyst treated with autograft during surgery. The second patient had an acetabular protrusio treated with autograft, and the CT...

  8. No negative effects of bone impaction grafting with bone and ceramic mixtures.

    NARCIS (Netherlands)

    Arts, J.J.C.; Gardeniers, J.W.M.; Welten, M.L.M.; Verdonschot, N.J.J.; Schreurs, B.W.; Buma, P.

    2005-01-01

    Reconstructing large loaded bone defects with ceramic bone graft extenders is tempting considering the expected future donor bone shortage. However, whether there are negative effects is unknown. Standardized large defects in the acetabulum of goats were created and subsequently reconstructed with m

  9. Three-dimensional magnetic resonance imaging analysis of hip morphology in the assessment of femoral acetabular impingement

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, E.C. [Department of Radiology, Mater Misericordiae Hospital, Dublin (Ireland); Read, P.; Carty, F.; Zoga, A.C. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Parvizi, J. [The Rothman Institute of Orthopedics, Philadelphia, PA (United States); Morrison, W.B., E-mail: William.Morrison@Jefferson.edu [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    2011-08-15

    Aim: To determine a possible association between femoral-acetabular impingement (FAI) volume and the development of labral tear using a three-dimensional (3D) model reconstruction of the acetabulum and the femoral head. Materials and methods: Magnetic resonance arthrography images of the hip in 42 patients with pain and suspected labral tear were acquired using a 1.5 T MRI machine. Using 3D analysis software, outlines of the acetabular cup and femoral head were drawn and 3D reconstruction obtained. To control for differences in patient size, ratios of acetabulum : femoral head volume (AFV) and acetabulum : femoral head surface area (AFA) were used for analysis. The association between volume of acetabulum : femoral head and FAI was investigated using ANOVA analysis. Results: There were 19 men and 23 women with a mean age of 39 years (range 18-78 years). The average AFV was 0.64 (range 0.37-1.05, SD 0.16) and AFA was 0.73 (range 0.36-1.26, SD 0.23). Herniation pit was significantly associated with a small AFV. Conclusion: Femoral neck herniation pits are associated with a low AFV. Gross volume and surface area ratios do not appear to correlate with labral tears or cartilage loss. This technique will enable more advanced analysis of morphological variations associated with FAI.

  10. Gait and lower limb muscle strength in women after triple innominate osteotomy

    NARCIS (Netherlands)

    Kolk, S.; Fluit, R.; Luijten, J.; Heesterbeek, P.J.; Geurts, A.C.; Verdonschot, N.J.J.; Weerdesteyn, V.

    2015-01-01

    Background: In adult patients with developmental hip dysplasia, a surgical procedure (triple innominate osteotomy) of the pelvic bone can be performed to rotate the acetabulum in the frontal plane, establishing better acetabular coverage. Although common clinical hip scores demonstrate significant i

  11. Gait and lower limb muscle strength in women after triple innominate osteotomy

    NARCIS (Netherlands)

    Kolk, S.; Fluit, R.; Luijten, J.; Heesterbeek, P.J.; Geurts, A.C.H.; Verdonschot, N.J.; Weerdesteijn, V.G.M.

    2015-01-01

    BACKGROUND: In adult patients with developmental hip dysplasia, a surgical procedure (triple innominate osteotomy) of the pelvic bone can be performed to rotate the acetabulum in the frontal plane, establishing better acetabular coverage. Although common clinical hip scores demonstrate significant i

  12. A morphological study of the hip joint of coxarthrosis by computed tomography

    International Nuclear Information System (INIS)

    The hip joint in coxarthrosis with severe deformities was studied by CT scan. In this disease, the supero-inferior diameter increased according to the degree of incomplete dislocation, while the antero-posterior diameter remained small. The acetabulum was shallow showing a small distance from the femur axis to the outer plate of the floor, but the floor of the acetabulum was thick with a considerable distance from the axis to the inner plate of the floor. The tangenital angle of the acetabulum was around 200, without remarkable changes depending on the degree of incomplete dislocation. The angle of covering the acetabulum at the center of the capitum was normally around 1800, and became smaller in incomplete dislocation, showing poor adaptability. The anterior torsion angle in incomplete dislocation tended to be larger depending upon severity of dislocation. In the cavum medullare of proximal diaphysis of the femur, the antero-posterior diameter was larger than the right-left diameter; and this relation was reversed in the use of artificial joint. Atrophy of the gluteal muscle developed with severeness of coxarthrosis. (Ueda, J.)

  13. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... box. That’s right. Or in this case the computer. Yeah. Exactly. We’ll make some comments later ... you’re seeing the whole acetabulum, following direct vision. It’s normal anatomy. You’ve got the C- ...

  14. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... dysplastic joint; otherwise having excellent and relatively normal anatomy. Any question or comments, Roger? Yeah. I like ... the whole acetabulum, following direct vision. It’s normal anatomy. You’ve got the C-arm for a ...

  15. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... this view, I mean this is the traditional Smith Meet Jeu De view of the acetabulum,. I ... re using only part of what’s called the “Smith-Peterson approach.” The true Smith- Peterson, you would ...

  16. Analysis of the Effect of Artificial Hip Replacement in the Treatment of Acetabular Defect%髋臼缺损畸形的人工髋关节置换手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    武豪杰

    2015-01-01

    Objective To study the acetabulum defect deformity treatment methods of artificial total hip replacement. Methods 30 cases of acetabular defects were selected in our hospital, including 13 cases of acetabulum hypoplasia, acetabulum fracture malunion after trauma in 5 cases, 6 patients with rheumatoid arthritis, ankylosing spondylitis hip lesions, 6 cases were performed total hip replacement, take the acetabulum deepening, double cone spiral acetabulum, autologous bone graft and structural methods such as titanium mesh and bone graft line true acetabular reconstruction, all patients preoperative CT three-dimensional reconstruction, with Harris scoring criteria. Results Followed up for 6~36 months, has not occurred during the follow-up period of artificial hip prosthesis loosening and fracture around, etc. Harris scoring (36±6.5) preoperatively, postoperative (93±5.2). Conclusion Deformity of total hip replacement for defects of acetabulum, through the acetabulum, Zweymulle double cone spiral acetabulum, grain pressure distribution, structural bone graft autologous bone graft and titanium mesh and bone graft and so on the many kinds of methods can be a very good reconstruction of acetabulum, restore good stability and the Harris score, can achieve very good effect.%目的探讨髋臼缺损畸形的人工全髋关节置换术的处理方法。方法选取我院收治存在髋臼缺损畸形患者30例,包括髋臼发育不良13例、髋臼创伤骨折后畸形愈合5例、类风湿性关节炎6例,强直性脊柱炎髋关节病变6例,均行全髋关节置换术,采取髋臼加深、双锥  面螺旋型髋臼、自体结构性植骨及钛网加植骨等多种方法行真臼重建,全部病例术前行 CT 三维重建,评分标准采用 Harris 评分。结果随访6~36个月,随访期间未发生人工髋关节假体松动、周围骨折等。Harris 评分术前(36±6.5),术后(93±5.2)。结论对于髋臼缺损畸形的全髋关节置

  17. Computer Aided Technology Stimulation on Total Hip Replacement due to Adult Hip Developmental Dysplasia%计算机辅助技术在成人髋发育不良中的应用研究

    Institute of Scientific and Technical Information of China (English)

    许燕飞; 罗雅; 李杰; 常敏; 郭英; 吴继昆; 杨景帆; 王涛; 艾元亮; 张俊; 孙皓民

    2014-01-01

    探讨计算机辅助技术在成人髋臼发育不良全髋关节置换术(THA )中的应用价值.选择单侧髋臼发育不良需进行全髋关节置换的患者21例,男性5例5髋,女性16例16髋.按Crowe分型,Ⅱ型6例(6髋),Ⅲ型11例(11髋),Ⅳ型4例(4髋).年龄30~78岁,平均年龄55.3岁.所有患者术前行薄层CT扫描并通过M3 D可视化软件进行三维重建、术前观察、测量,手术预演、制定手术方案并行全髋关节置换术.术后21例患者均获得3~32个月随访,平均随访12.8月.术前Harris评分为(48.5±6.2)分,随访时评分为(86.3±4.3)分,差异有统计学意义(P<0.05),优17例,良4例.所有病例术后通过骨盆标准前后位X线片测量,1例患者髋臼水平距离,1例髋臼垂直距离超出安全范围,1例影像前倾角超出安全范围,合格率85.7%.术中未出现髋臼戳穿、股骨假体周围骨折,术后所有病例均未出现术口感染,1例出现大腿疼痛,所有病例随访期间均为出现假体松动、下沉.成人髋臼发育不良行THA,计算机辅助技术可以术前把握真臼的解剖特点及其与假臼的相对关系、髋臼壁的缺损类型,量化指导如何选择合适的髋臼及股骨侧假体、选择合适的髋臼重建方式、髋臼假体安放角度等,对于恢复头臼假体同心复位,实现理想的头臼匹配,恢复髋关节解剖结构,重建关节功能具有重要作用.%To investigate the stimulation worth of computer aided technology on total hip replacement due to adult acetabulum developmental dysplasia.21 cases with unilateral acetabulum developmental dysplasia are selected to proceed total hip replacement operation.Among the selected cases,6 cases are type II,1 1 type Ⅲ and 4 typeⅣaccording to the classification system of CROWE;5 cases are male and 1 9 cases female.The ages range from 30 to 78,the average being 55.3.Thin

  18. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

    Science.gov (United States)

    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture. PMID:26280957

  19. Unusual case of mixed form of femoroacetabular impingement combined with nonspecyfic synovitis of the hip joint in a young adult: A case report

    Directory of Open Access Journals (Sweden)

    Mladenović Marko

    2015-01-01

    Full Text Available Introduction. Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. Case report. We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected. Open surgery of the left hip was done. Two years after the surgery, patient was asymptomatic, painless, and free of motion, with stable x-rays. Conclusion. Hypertrophic synovial tissue further reduces the distance between the femoral head-neck junction and the acetabulum, leading to the earlier onset of femoroacetabular impingement symptoms. Surgical treatment is the method of choice.

  20. Outcome of surgical management of developmental dysplasia of hip in children between 18 and 24 months

    Directory of Open Access Journals (Sweden)

    Narasimhan Ramani

    2014-01-01

    Materials and Methods: 35 children with unilateral DDH were operated between 2002 and 2007 at our institute. Open reduction was performed in all using the standard anterior approach and peroperative test for hip stability was done. Nine children got an additional pelvic procedure in the form of Dega acetabuloplasty. All were followed up for a minimal period of 2 years (range 2-7 years. Results: No hip got redislocated. At the end of 18 months, there were seven cases of RAD with acetabular index (AI of 35° and above. These were all from the group where open reduction alone was done. Conclusion: We feel that a preoperative AI of >40° and a per-operative safe-zone <20° increases the need for supplementary pelvic osteotomy in age group of 18 to 24 months because in such cases, the remodeling capacity of the acetabulum is unable to overcome the dysplasia and to form a relatively normal acetabulum.

  1. Protrusio acetabuli (Otopelve

    Directory of Open Access Journals (Sweden)

    Chueire Alceu Gomes

    2002-01-01

    Full Text Available Protrusio acetabuli is a disease characterized by a deformity of the medial wall of the acetabulum with a progressive migration of the femoral head into the pelvic cavity, resulting in some mechanical disorders, pain and limited limb hip movement. It was first described by Otto in 1824 as an intrapelvic protusion of the femoral head. It is considered multifactorial, and it is suggested that there is a heredity background to this disease. It is classified as primary (75,3% or secundary (24,7% according to aetiology; mild, moderate and severe radiologically. This review aims to present some treatment techniques using arthroplasties which are several and little explored. As in the literature, the choice was bone graft since there is no migration of the cemented acetabulum and no necessity of a titanium cup of great diameter.

  2. Pelvic proportions in x-ray pictures of german shepherd dog, rottweiler and great dane, a contribution to hip dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Koeppel, E. (Veterinaermedizinische Univ., Vienna (Austria))

    1983-01-01

    Measurements of length and breadth were done in 439 X-ray pictures of the pelvis of German Shepherd Dog, Rottweiler and Great Dane. The relation of pelvic proportions to hip dysplasia was checked. In 66 X-ray pictures of the pelvis of young dogs the ischiadic part of the acetabulum was measured. In all breeds the ischium formed 68,8 percent of the acetabulum. Ilium and ischium showed changes in relation to hip dysplasia, which could be proved unequivocally only in Rottweilers. Changes of pelvic proportions in other breeds were not perceived. In Rottweilers also those changes can be seen distinctly only in severe cases of hip dysplasia. For the special case valid accordance with any degree of hip dysplasia could not be found.

  3. 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

  4. Computerized tomography in evaluation of decreased acetabular and femoral anteversion

    International Nuclear Information System (INIS)

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.)

  5. Treatment of congenital dislocation of the hip by the Pavlik harness. Mechanism of reduction and usage.

    Science.gov (United States)

    Iwasaki, K

    1983-07-01

    The Pavlik harness was used in the treatment of complete congenital dislocation of one or both hips in a series of infants, on either an outpatient or an inpatient basis. The results in the two groups were compared. For the children treated as outpatients the incidence of avascular necrosis of the femoral head was 7.2 per cent and for the group treated as inpatients the rate was 28 per cent. Application of the Pavlik harness allowed reduction of the hip by shifting the femoral head first to the posterior part of the acetabulum through flexion of the hip, followed by movement of the femoral head anteriorly into the acetabulum through abduction of the hip, which is possible because of stretching of the adductor muscles by the weight of the lower extremity. When the reduction is obtained by forced abduction there is a greater danger of avascular necrosis of the femoral head.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. A new pelvic fragment from Swartkrans and the relationship between the robust and gracile australopithecines.

    Science.gov (United States)

    McHenry, H M

    1975-09-01

    A recently discovered hominid pelvic fragment from Swartkrans (SK 3155) is described in detail with particular reference to the relationship of the two presently recognized forms of australopithecines in South Africa. Results of this examination and metrical analysis indicate that the acetabulum and iliac blade of the early hominids are similar to Homo sapiens except for a unique pattern of traits: a relatively small sacral articular surface, a relatively small acetabulum, a relatively large iliac fossa, and wide lateral splaying of the iliac blades. The new Swartkrans fossil expresses these traits more strongly than does the gracile australopithecine (Sts 14) and is therefore somewhat less similar to Homo sapiens but it is very unlike any pongid. PMID:810037

  8. Cinco espécies de Lecithodendriidae (Trematoda) en murcielagos de Colombia, incluyendo tres nuevos generos

    OpenAIRE

    Imelda Velez; Vernon E. Thatcher

    1990-01-01

    Velez, I. & V.E. Thatcher: Five species of Lecithodendriidae (Trematoda) in bats from Colombia, including three new genera. Three new neotropical genera and species of Lecithodendriidae (Trematoda) are described from Colombian bats. Sturniratrema umbilicata gen. et sp. nov. from Sturnira lilium differs from other genera in having an oval ventral depression, a dorso-ventrally curved cirrus and a genital pore lateral to the acetabulum. Chiropterotrema antioquiense gen. et sp. nov. from Carollia...

  9. Impingement of lesser trochanter on ischium as a potential cause for hip pain

    Energy Technology Data Exchange (ETDEWEB)

    Patti, Jay W.; Ouellette, Hugue; Bredella, Miriam A.; Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Radiology, Boston, MA (United States)

    2008-10-15

    The bony anatomy of the hip leads to a limited array of impingement syndromes, more frequently resulting from abnormal contact between the femoral neck and acetabulum. We report an unusual case of osseous impingement between the lesser trochanter and ischium, with involvement of the intervening quadratus femoris muscle. While the prevalence and etiology of this finding is unclear, it may represent a cause for hip pain. (orig.)

  10. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail

    Directory of Open Access Journals (Sweden)

    Pedro Luciano Teixeira Gomes

    2016-08-01

    Full Text Available ABSTRACT Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  11. Imaging of Developmental Dysplasia of the Hip (DDH

    Directory of Open Access Journals (Sweden)

    Nazanin Ahmadi

    2010-05-01

    Full Text Available Ultrasound is not only the best method of screening in the diagnosis of DDH, but the best method of peroperative reduction of the hip joint and the best follow up method after treatment."nHowever, in older children with an abnormal pelvic x-ray, MRI coul be very helpful to assess the degree of ossification of the acetabulum and maturation and covering of the cartilaginous labrum.

  12. Research on the Application of Bone Allograft Acetabular Bone Defect Reconstruction in Hip Revision%同种异体骨移植在髋关节翻修髋臼骨缺损重建中的应用研究

    Institute of Scientific and Technical Information of China (English)

    李强; 刘敏; 沈民仁; 钟进军

    2013-01-01

    目的:探讨同种异体骨移植在髋关节翻修髋臼骨缺损重建中的应用,评价同种异体骨在人工髋关节翻修术中的应用价值.方法:25例全髋关节翻修髋臼缺损病例,术中均应用同种异体松质骨重建髋臼骨缺损,随访时间8~24个月.结果:25例临床愈合,未发生并发症,有效率为100%.结论:同种异体松质骨治疗髋关节翻修髋臼骨缺损疗效可靠.达到了髋臼重建、修复骨缺损和固定假体的治疗目的.%Objective:To estimate the application value of allogeneic bone transplantation to reconstruct the defect of acetabulum in revision of total hip arthroplasty. Methods:In this study,retrospective analysis was conducted by using the data of 25 patients who had undergone the revision of total hip arthroplasty from December 2006 to March 2012. Bone defects of acetabulum in all of these cases were reconstructed using allogeneic bone transplantation. All patients had been followed from 8 to 24 months. Results: All these 25 cases were healed in clime without complications. The effective and excellent rate is 100%. Harris hip scores and imageological examination were used as healing standard. Conclusion: Reconstructing the defect of acetabulum with allogeneic bone is reliable in revision of total hip arthroplasty and could achieve the goal of rebuilding acetabulum, repairing bone defect and fixing prosthesis.

  13. Recent changes in macroalgae distribution patterns in the Orbetello lagoon (Italy)

    OpenAIRE

    Giovani, Andrea; Mari, Elena; Specchiulli, Antonietta; Focardi, Silvano; RENZI, Monia

    2014-01-01

    This study related recent distribution changes in seven macroalgae taxa (Acetabularia acetabulum, Chaetomorpha linum, Cladophora sp., Gracilariopsis longissima, Spyridia sp., Ulva laetevirens, Valonia aegagrophyla) to spatial (basin) and temporal (time) trophic differences in a meso-eutrophic Mediterranean coastal lagoon (Orbetello, Italy). In July 2003 and July 2009, the coverage percentage (CP) of each considered taxon was measured in 38 stations equally distributed in the Western and Easte...

  14. Hip arthroplasty by matching cups.

    Science.gov (United States)

    Gerard, Y

    1978-01-01

    A total hip surface arthroplasty consisting of matching cups and uncemented prosthetic components is a noteworthy operation. The femoral cup obtains cylindrical support from the femoral head which is reamed in the shape of a cylinder. The acetabular cup is metallic with a polyethylene liner. It is mobile over the bone but its position is constrained by contact with the femoral cup and therefore "self-centering." On the femoral side, the cup must be placed strictly in the axis of the femoral neck. The main consideration in femoral head surface replacement is the vitality of the underlying bone. Necrosis was observed in the earliest clinical trials but there have been no cases of necrosis in the past 3 1/2 years. This is attributed to a more limited surgical approach in which only the anterior part of the gluteus medius is divided and all the posterior elements of the hip are preserved. The acetabulum is sufficiently reamed to receive the cup, which protrudes beyond the external margins of the acetabulum in all positions. Errors have been committed while perfecting the prosthetic material, but the results as determined by a 6 1/2 year follow-up on purely metallic cups are encouraging. Metal-polyethylene cups presently under investigation have almost a 2 year follow-up. The reaction of the acetabulum to an uncemented cup is not yet known. However, the existence of 2 sliding surfaces and the fact that the acetabular cup moves only during the extremes of hip movement, is reason to assume that if the acetabulum is not reamed to expose cancellous bone, the risks of protrusion are minimal or delayed. Total surface arthroplasty by concentric cups has been performed in 335 hips to date. The operation is especially recommended when osteotomy is no longer possible and disabling coxarthrosis is present in relatively young patients. PMID:729253

  15. The place of computerized axial tomography in the evaluation of acetabular fractures

    OpenAIRE

    Asik, Mehmet; Akman, Senol; Taser, Omer; Aritamur, Ayhan

    2004-01-01

    Besides the importance of standard AP and Judet s 45° iliac and obturator pelvic views, CAT has proved to be very useful in the evaluation of the fractures of the acetabulum. Of 96 patients with acetabular fractures, who applied to the Orthopaedics and Traumatology Department, Istanbul Medical Faculty, Istanbul University between 1987 and 1991 in addition to conventional radiography, CAT investigation was done in 32 patients for whom it was considered necessary. The results of both convention...

  16. 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.

  17. Effect of increased pushoff during gait on hip joint forces

    OpenAIRE

    Lewis, Cara L.; Garibay, Erin J.

    2014-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditi...

  18. 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.)

  19. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients ☆

    OpenAIRE

    Richard Prazeres Canella; Guilherme Pradi Adam; Roberto André Ulhôa de Castillo; Daniel Codonho; Gerson Gandhi Ganev; Luiz Fernando de Vicenzi

    2016-01-01

    OBJECTIVE: To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). METHODS: We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used...

  20. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail.

    Science.gov (United States)

    Gomes, Pedro Luciano Teixeira; Castelo, Luís Sá; Lopes, António Lemos; Maio, Marta; Miranda, Adélia; Dias, António Marques

    2016-01-01

    Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  1. Acetabular deepening in the treatment of severe canine hip dysplasia Aprofundamento do acetábulo no tratamento de displasia coxofemoral grave em cães

    OpenAIRE

    Paulo Iamaguti; Luciana S. Iamaguti; Raquel Sartor

    2009-01-01

    A technique to restore acetabular anatomy by deepening the acetabular cavity and reconstructing the femoral head ligament and the joint capsule was tested on nine large breed dogs with severe hip dysplasia and acute subdislocation or dislocation. The technique consisted of two phases. First, all dogs were submitted to bilateral pectinotomy. In a second surgical intervention on the same dogs the acetabulum was approached and deepened, and the femoral head ligament and the joint capsule were re...

  2. Retroperitoneal hematoma with bone resorption around the acetabular component after total hip arthroplasty: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Uchida Kenzo

    2012-09-01

    Full Text Available Abstract Introduction Vascular complications related to cup-fixating screws penetrating the medial acetabular wall during total hip arthroplasty are not uncommon but rarely are associated with serious adverse events in the late post-operative period. Case presentation We present the case of a 77-year-old Japanese woman who developed progressive extensive bone resorption and large hematoma in the acetabulum 13 years after total hip arthroplasty. On admission to our hospital, she was on oral warfarin (1.5mg/day for atrial fibrillation. About 5 months after the initiation of anticoagulant therapy, she suffered a major fall followed by massive subcutaneous and pelvic girdle bleeding, predominantly on the medial side of the right thigh, but a fracture or damage of total hip arthroplasty was not evident on an emergency orthopedic evaluation. One year after the accident, a routine follow-up examination showed an asymptomatic osteolytic lesion in the acetabulum on the right pelvis, and 2 years later our patient noticed progressive pain in her right hip during walking. A large osteolytic lesion was noted in the right acetabulum on a plain radiograph. On high-resolution computed tomography and magnetic resonance imaging, a huge granulomatous lesion in the acetabulum was suggestive of chronic hematoma in intrapelvic and extrapelvic gluteal regions. A closer computed tomography examination showed that one of the screws used for fixation of the acetabular component in the total hip arthroplasty had penetrated the acetabular bone and had reached the pelvic cavity. Surgery was performed in a single session by means of two approaches: anterior midline transperitoneal address to resect the low-density mass lesion followed by posterolateral acetabular implant re-settlement. Conclusions Though rare, total hip arthroplasty-related late vascular complications could be serious and potentially affect the limb and quality of life.

  3. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    Science.gov (United States)

    Liu, Xin-Wei; Xu, Shuo-Gui; Zhang, Yun-Tong; Zhang, Chun-Cai

    2011-07-01

    We developed the acetabular tridimensional memoryalloy fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, NiTi shape memory alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Seven formalin-preserved cadaveric pelves were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelves were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; and (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40° to 90° about the acetabulur rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1485 N) as compared to the intact condition (748 N, P = 0.009). Following reduction and internal fixation, the load distributed to the superior acetabulum (1545 N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (964 N) was familiar with fixation with reconstruction plate and was not different from intact state ( P = 0.45). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

  4. Absence or interruption of the supra-acetabular line: a subtle plain film indicator of hip pathology

    Energy Technology Data Exchange (ETDEWEB)

    Major, N.M. [Department of Radiology, University of California San Francisco, Box 0628, San Francisco, CA 94143 (United States); Helms, C.A. [Department of Radiology, University of California San Francisco, Box 0628, San Francisco, CA 94143 (United States)

    1996-08-01

    Objective. To show that absence or interruption of the supraacetabular line is a subtle plain film indicator of pathology in the acetabulum. Design. Nineteen hips from 17 patients with known disease processes involving the acetabulum as demonstrated by subsequent magnetic resonance imaging, bone scan or plain film follow-up were evaluated with antero-posterior (AP) plain films of the pelvis. Three additional cases were diagnosed prospectively using interruption of the supra-acetabular line as the criterion for inclusion. Fifty AP plain films of the pelvis in patients without hip pain were examined prospectively to determine normal imaging criteria. Results and conclusions. The normal supra-acetabular line measures 2-3 mm in thickness superiorly and is a thin sclerotic line in the medial aspect. In all 22 hips (with pathology) in this series, the line was interrupted or absent. Loss or interruption of the supra-acetabular line may thus be a subtle pain film indicator of a disease process involving the acetabulum. This plain film sign has not previously been reported. (orig.). With 8 figs., 1 tab.

  5. Cause and Management in the Failed Concentric Reduction of Femoral Head in Congenital Dislocation of Hip%先天性髋关节脱臼手术后半脱位的原因及处理

    Institute of Scientific and Technical Information of China (English)

    冯家钧; 胡佐民; 王凤兰; 韩福友

    1989-01-01

    先天性髋关节脱臼病理变化比较复杂,有些病例术后发生半脱位.其原因有多种,在同一病例中可有两种以上原因,如髂腰肌短缩、股骨颈过短及头臼不对称等.作者根据术后发生半脱位的不同原因提出了处理方法.%In the open reduction of the congenital dislocation of hip,one of the common errors in the operative technique is failure to reduce the femoral head into the depth of the true acetabulum completely and concentrically.This error has occurred in 16 out of 275 hips treated by means of various procedures in our hospital since 1980.The causes of this error may be:1.the femoral head being poorly embedded in the acetabulum due to a tenotomy of the iliopsoas;2.shortening of the femoral neck;3.incongruity of the head and the acetabulum;4.incomplete excision of the reflected labium and poor capsulorrhaphy,and etc.According fo the different pathological changes procedures adopted appropriatly will acheieve satisfactory results.

  6. Efficacy of the use of templating in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Fábio Stuchi Devito

    2013-04-01

    Full Text Available OBJECTIVE: The aim was to evaluate the effectiveness of traditional preoperative planning with the use of templating. METHOD: Forty-three anteroposterior X-rays were analyzed by three experienced surgeons (A, B, C and compared. Cohen's Kappa concordance test and weighted Kappa indexes using quadratic weighting were used for statistical analysis with a confidence interval of 95%. RESULTS: The preoperative evaluations were divided into the analysis of the sizes of the acetabular cup, stem and plug of the distal femoral canal. Surgeon A obtained a moderate agreement in relation to the acetabular component and substantial agreements in relation to the stem and plug. Surgeon B had moderate agreement in relation to both the acetabulum and the stem and substantial agreement in relation to the plug. Surgeon C obtained moderate agreement in relation to the analysis of the acetabulum and the plug and substantial agreement for the stem. The intraobserver agreement test demonstrated a prevalence of slight agreement in relation to the acetabulum and substantial agreement in relation to the stem and to the plug. CONCLUSION: Templating used in preoperative planning proved effective; however, there was a prevalence of slight and moderate agreement in relation to the size of the acetabular component.

  7. The determination of male adult age at death by central and posterior coxal analysis--a preliminary study.

    Science.gov (United States)

    Rougé-Maillart, Clotilde; Telmon, Norbert; Rissech, Carme; Malgosa, Assumption; Rougé, Daniel

    2004-03-01

    In forensic anthropological analysis, the pelvis is of particular interest as it is often a comparatively well-preserved part of the skeleton. This study in age determination uses the acetabulum, the central element of the pelvis, as a complement to the examination of the auricular surface. The test sample consisted of 30 individuals. First, the authors studied the auricular surface using the Lovejoy criteria. Second, they isolated four criteria based on chronological changes in the acetabulum. Third, they conducted an evaluation of each of these variables. The study examines the correlation between these criteria and the age of the individuals. A significant correlation was found between the acetabular criteria and age, and between the acetabular criteria and the Lovejoy criteria of the auricular surface. For forensic purposes, the acetabulum is an effective predictor in the determination of age. This newly proposed method explores the same criteria of ageing as the Lovejoy method. The combination of the two methods produces relatively consistent results in the estimation of age.

  8. Effect of clearance on cartilage tribology in hip hemi-arthroplasty.

    Science.gov (United States)

    Lizhang, Jia; Taylor, Simon D; Jin, Zhongmin; Fisher, John; Williams, Sophie

    2013-12-01

    Hemi-arthroplasty of the hip (an artificial femoral head articulating against the natural acetabulum) is used to treat fractured necks of femur; however, there is evidence that articulation causes erosion of the cartilage, resulting in pain for the patient. Parameters that may influence this cartilage erosion include head material and roughness, clearance between the head and acetabulum and activity levels of the patient. This study has assessed the effect of clearance of hemi-arthroplasty articulations on the contact stress, friction and cartilage deformation in an in vitro tribological simulation of the hemi-arthroplasty joint that applied dynamic loads and motion. It has been demonstrated that peak contact stress increased from 5.6 to 10.6 MPa as radial clearance increased from small (1.8 mm). In all samples, friction factor increased with time and was significantly less with extra-large clearances compared to small (<0.6 mm), medium (0.6-1.2 mm) and large (1.2-1.8 mm) clearances. The cartilage deformation observed was significantly greater in acetabulum samples paired to give small or extra-large clearances compared to those with medium or large clearances.

  9. Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Christophe Boulay

    2014-01-01

    Full Text Available Acetabular cup orientation (inclination and anteversion is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter could determine the safe range of pelvis tilt (positional parameter for an individual and not a group.

  10. 髋关节造架手术%Shelf Operation on Hip

    Institute of Scientific and Technical Information of China (English)

    吴守义; 汪启筹; 杨根兴; 陈瑾英; 贺小桦

    1987-01-01

    本文介绍一种新的造架手术、并报道了10例临床经验.作者讨论了有关造架手术的几个重要问题,指出了生物力学、骨质电力学与造架生长的关系.%Infection,dislocation and trauma of the hip often cause destruction of the head and neck of the femur and a shallow acetabulum.To restore the normal relationship between the acetabulum and the femur head, shelf operation is a logical method. A bone graft about 4×5 cm in size is taken from ilium,the graft is set into a slot made around the acetabulum,presenting with an angle of 30-45°and it is fixed into the ilium with a long screw.The head of femur should be covered by the graft completely.Ten cases had undergone this operation and followed up more than 2 years.All the grafts have fused,graft hypertrophy has appeared in 8 of them.The movement of the hip is not limited.There has been no sign of breakage or absorption or displacement of the graft.The authors state that firm fixation of the graft and restoring the bearing stress to the ilium are the key to the success on this operation.

  11. Imaging diagnosis of acetabular dysplastic coxarthrosis in adult

    International Nuclear Information System (INIS)

    Objective: To investigate the imaging diagnosis of acetabular dysplastic coxarthrosis. Method: The imaging of the acetabular dysplasia was analyzed in 51 patients (87 hips). All but four patients were women. The age ranged from 22 to 78 years, and the mean age was 42.6 years. Pelvis radiographs were studied in all cases, and CT scan was performed in 18 cases and MRI in 10 cases. Results: The fundamental signs on the plain film included shallow acetabulum, increased obliquity and insufficient coverage of the femoral head by the acetabulum. The CE angles were determined in all the cases, ranging from -10 degree to 30 degree, mean 12.9 degree. The sharp angles ranged from 35 degree to 67 degree, mean 45.3 degree. The secondary osteoarthritis were revealed in 75 hips (84.2%). 54 hips (62.1%) had cyst-like lesions in weight-bear area of the acetabulum or femoral head. 19 hips had subluxation of femoral head. CT and MRI displayed small cyst-like lesions and forward shift of the femoral head, which could not be shown on plain film, respectively in 13 and 10 hips. Conclusion: The cyst-like lesion of subarticular region is a common sign in acetabular dysplastic coxarthrosis. CT or MRI can show the early osteolytic lesion and forward subluxations

  12. Hip Joint Replacement Using Monofilament Polypropylene Surgical Mesh: An Animal Model

    Directory of Open Access Journals (Sweden)

    Jacek Białecki

    2014-01-01

    Full Text Available Hip joint dysplasia is a deformation of the articular elements (pelvic acetabulum, head of the femur, and/or ligament of the head of the femur leading to laxity of the hip components and dislocation of the femoral head from the pelvic acetabulum. Diagnosis is based on symptoms observed during clinical and radiological examinations. There are two treatment options: conservative and surgical. The classic surgical procedures are juvenile pubic symphysiodesis (JPS, triple pelvic osteotomy (TPO, total hip replacement (THR, and femoral head and neck resection (FHNE. The aim of this experiment was to present an original technique of filling the acetabulum with a polypropylene implant, resting the femoral neck directly on the mesh. The experiment was performed on eight sheep. The clinical value of the new surgical technique was evaluated using clinical, radiological, and histological methods. This technique helps decrease the loss of limb length by supporting the femoral neck on the mesh equivalent to the femoral head. It also reduces joint pain and leads to the formation of stable and mobile pseudarthrosis. The mesh manifested osteoprotective properties and enabled the formation of a stiff-elastic connection within the hip joint. The method is very cost-effective and the technique itself is simple to perform.

  13. 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).

  14. The Analysis of X-ray and CT Features of the Femoroacetabular Impingement Syndrome%股骨髋臼撞击综合征的X线及CT表现分析

    Institute of Scientific and Technical Information of China (English)

    胡剑波; 刘冠霖; 肖林; 吴泽文; 陈焱君

    2012-01-01

    Objective Through analyzing the characteristic appearances on X-ray plain film and CT of hips with Femoroacetabular Impingement (FAI), to find and conclude the image features of FAI. Methods 78 cases FAI with 96 FAI hips in X-ray plain film and CT images were analysed and typed. Results ①The characteristic features include: aspheric femoral head, pistol-grip deformity, femoral neck Osseous bumps, deep acetabulum, cross-over sign or "eight" sign, acetabulum medial extrusion, "linear indentation sign", herniation pits; the non-characteristic features include: osteophytes, ossification or calcification in acetabulum superior, cystic lesions under the joint surface of acetabulum and femoral head, narrowed lateral joint space. ② In all 96 FAI hips, Cam-type 23 hips, Pincer-type 14 hips, Mixed-type 59 hips. Conclusion Femoral head-neck junction deformity and abnormality of acetabulum are the key image features of FAI diagnosis, the other abnormity of osseous arthritis can only be a indicative signs for diagnosis of FAI.%目的 通过对诊断为股骨髋臼撞击综合征(FAI)的髋关节的X线及CT表现的特征分析,归纳总结其影像特点.方法 对78例96个FAI髋关节的X线及CT片进行影像特征分析、分型.结果 ①、FAI的特征性X线及CT征象包括:非球形股骨头、股骨颈枪柄样畸形、股骨颈骨突.深髋臼、“交叉征”或“8”字征、髋臼内突、股骨颈前方凹痕征及皮质硬化、骨颈疝窝;FAI的非特异性改变包括:髋臼外上缘增生、髋臼外缘骨化或钙化,髋臼关节面下囊变、股骨头囊变、髋关节外侧间隙狭窄.②、96个FAI中,Cam型23个,Pincer型14个,混合型59个.结论 股骨头颈交界处的畸形和髋臼的异常形态是FAI诊断的主要征象,其他骨性关节炎的异常影像表现是诊断FAI的参考征象.

  15. 髋臼前倾角术前测量在全髋关节置换术中的临床意义%The clinical significance of preoperative measurement of acetabular anteversion in total hip replacement

    Institute of Scientific and Technical Information of China (English)

    蒲超; 张珊珊; 李伟; 吴青霞; 候小倩

    2014-01-01

    Objective Discussion the clinical significance of preoperative measurement of acetabular antever-sion in total hip replacement .Methods 121 patients were randomly assigned into normal group and preoperative measurement group .Made the statistical analysis of postoperative differ between anteversion of artificial acetabulum with preoperative measuring value within 1° and 5° ,and contrast the postoperative anteversion of artificial acetabulum in two groups .Results Postoperative error within 1° and 5° was 3 .13% ,29 .69% in preoperative measurement group respectively .There was no statistically significans in the difference of postoperative anteversion of artificial acetabu-lum between two groups .Conclusion acetabulum The preoperative measurement can improve the accuracy in playing artificial acetabulum ,but the accuracy of lay need to improve .%目的:探讨髋臼前倾角术前测量在全髋关节置换术中的临床意义。方法将121例需行全髋关节置换术的患者随机分入常规组和术前测量组。常规组按照前倾15°安放人工髋臼,术前测量组按照术前测量角度安放人工髋臼,并统计分析术前测量组术后人工髋臼前倾角度与术前测量值相差1°和5°的比例以及两组患者术后人工髋臼前倾角度差异。结果术前测量组人工髋臼前倾角度术后误差小于1°和5°的比例分别为3.13%和29.69%,常规组与术前测量组术后人工髋臼前倾角度比较,差异有统计学意义( P<0.05)。结论髋臼前倾角术前测量可提高人工髋臼安放的精确度,但安放的准确性还需进一步提高。

  16. CT false-profile view of the hip: a reproducible method of measuring anterior acetabular coverage using volume CT data

    Energy Technology Data Exchange (ETDEWEB)

    Needell, Steven D.; Borzykowski, Ross M. [Boca Radiology Group, Boca Raton, FL (United States); Carreira, Dominic S.; Kozy, John [Broward Health Orthopedics and Sports Medicine, Fort Lauderdale, FL (United States)

    2014-11-15

    To devise a simple, reproducible method of using CT data to measure anterior acetabular coverage that results in values analogous to metrics derived from false-profile radiographs. Volume CT images were used to generate simulated false-profile radiographs and cross-sectional false-profile views by angling a multiplanar reformat 115 through the affected acetabulum relative to a line tangential to the posterior margin of the ischial tuberosities. The anterolateral margin of the acetabulum was localized on the CT false-profile view corresponding with the cranial opening of the acetabular roof. Anterior center edge angle (CEA) was measured between a vertical line passing through the center of the femoral head and a line connecting the center of the femoral head with the anterior edge of the condensed line of the acetabulum (sourcil). Anterior CEA values measured on CT false-profile views of 38 symptomatic hips were compared with values obtained on simulated and projection false-profile radiographs. The CT false-profile view produces a cross-sectional image in the same obliquity as false-profile radiographs. Anterior CEA measured on CT false-profile views were statistically similar to values obtained with false-profile radiographs. CT technologists quickly mastered the technique of generating this view. Inter-rater reliability indicated this method to be highly reproducible. The CT false-profile view is simple to generate and anterior CEA measurements derived from it are similar to those obtained using well-positioned false-profile radiographs. Utilization of CT to assess hip geometry enables precise control of pelvic inclination, eliminates projectional errors, and minimizes limitations of image quality inherent to radiography. (orig.)

  17. Prediction of bone loss in elderly female subjects by MR perfusion imaging and spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, James F.; Yeung, David K.W. [Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Shatin, New Territories (China); Leung, Jason Chi Shun; Leung, Ping C. [Chinese University of Hong Kong, Jockey Club Centre for Osteoporosis Care and Control, Prince of Wales Hospital, Shatin (China); Kwok, Timothy C.Y. [Chinese University of Hong Kong, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin (China)

    2011-06-15

    To determine whether MR perfusion indices or marrow fat content at baseline can predict areal bone mineral density (BMDa) loss. Repeat dual x-ray absorptiometry (DXA) of the hip was performed in female subjects at 2 years (n = 52) and 4 years (n = 45) following baseline MR perfusion imaging and spectroscopy of the hip. Percentage reduction in femoral neck BMDa at 4 years post-baseline was greater in subjects with below median acetabulum enhancement slope (E{sup slope}) (-5.6 {+-} 1.2 Vs -1.1 {+-} 1.2 (mean {+-} standard error) p = 0.014) or muscle maximum enhancement (E{sup max}) (-5.7 {+-} 1.2 Vs -0.23 {+-} 1.2, p = 0.009) after adjusting for baseline co-variables. Baseline MR parameters correlated with reduction in BMDa at 4 years (acetabulum E{sup slope} r = 0.517, p = 0.0003; muscle E{sup max} r = 0.306, p = 0.043) as well as traditionally applied clinical risk factors. Acetabulum E{sup slope}, femoral neck E{sup max} and marrow fat content at baseline had sensitivities of 89%, 81% and 72% respectively at distinguishing between fast (>1%/annum) (n = 18) and slow (<1%/annum) (n = 27) BMD losers. Elderly female subjects with reduced perfusion indices at baseline had increased femoral neck bone loss at 4 years. Selected perfusion indices and marrow fat content have a moderate to high sensitivity in discriminating between fast and slow bone losers. (orig.)

  18. Septic Arthritis Resulting in Pathological Dislocation of the Hip in Newborns and Infants%新生儿小婴儿急性化脓性髋关节炎及晚期病理性髋脱位的治疗

    Institute of Scientific and Technical Information of China (English)

    于凤章; 陈幼容; 潘少川

    1993-01-01

    From 1977 to 1991,36 newborns and infants with acute septic arthritis were admitted for treatment.Most patients ran a low grade fever or afebrile,refused feeding and appeared irritable.Passive motion of the affected hip,as during changing diapers,may cause pain and crying.Swelling of the affected hip is an important sign.In addition to the antibiotic therapy,repeated aspiration of the hip joint and keeping in Bryant traction are vital treatments.The sequelas were classified into five types:(1) pathological dislocation of the hip,the acetabulum and the femoral head remaining intact,(2)absorption of the femoral head leaving the femoral neck a nubbin,(3) total loss of the head and neck,(4) destruction of acetabulum but an intact femoral head and neck,and (5)total breakdown of the acetabulum,the femoral head and the neck.Proper selection of surgical procedures according to the individual condition was essential.The advantages and shortcomings of different kinds of surgical procedures were discussed.%1972至1991年共收治新生儿小婴儿急性化脓性髋关节炎36例,晚期病理性髋脱位24例.本文总结了新生儿小婴儿急性化脓性髋关节炎的临床表现、体征及治疗经验.并将晚期病理性髋脱位分为五型,按各种类型的病理改变采取各种手术方法.本文介绍了各种手术方法并分析总结了其优点和存在的问题.

  19. Study of the morphology and biomechanics of sacral fracture

    Institute of Scientific and Technical Information of China (English)

    QUAN Ren-fu; YANG Di-sheng; WANG Yi-jin

    2006-01-01

    Objective: To observe the morphological characteristics of sacral fracture under different impact loads.Method: Ten fresh pelvic specimens were loaded in dynamic or static state. A series of mechanical parameters including the pressure strain and velocity were recorded.Morphological characteristics were observed under scanning electron microscope.Results: The form of sacral fracture was related to the impact energy. Under low-energy impact loads, ilium fracture, acetabulum fracture and crista iliaca fracture were found. Under high-energy impact loads, three types of sacral fracture occurred according to the classification of Denis: sacral ala fracture, Type Ⅰ fracture; sacral foramen cataclasm fracture, Type Ⅱ fracture; central vertebral canal fracture, Type Ⅲ fracture. Nerve injury of one or two sides was involved in all three types of sacral fracture.The fracture mechanism of sacrum between the dynamic impact and static compression was significantly different.When the impact energy was above 25 J, sacral foramen cataclasm fracture occurred, involving nerve root injury.When it was below 20 J, ilium and sacral fracture was most likely to occur. When it was 20 ~ 25 J, Type Ⅰ fracture would occur. While in the static test, most of the fracture belonged to ilium or acetabulum fracture. The cross section of sacrum was crackly and the bone board of Haversian system was brittle, which could lead to separation of bone boards and malposition of a few of cross bone boards.Conclusions: In dynamic state, sacrum fracture mostly belongs to Type Ⅰ and Type Ⅱ, and usually involves the nerve roots. Sacrum fracture is relevant to the microstructures, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of sacrum. The fracture of ilium and acetabulum more frequently appears in static state, with slight wound of peripheral tissues.

  20. Study of the three-dimensional orientation of the labrum: its relations with the osseous acetabular rim

    Science.gov (United States)

    Bonneau, Noémie; Bouhallier, July; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-01-01

    Understanding the three-dimensional orientation of the coxo-femoral joint remains a challenge as an accurate three-dimensional orientation ensure an efficient bipedal gait and posture. The quantification of the orientation of the acetabulum can be performed using the three-dimensional axis perpendicular to the plane that passes along the edge of the acetabular rim. However, the acetabular rim is not regular as an important indentation in the anterior rim was observed. An innovative cadaver study of the labrum was developed to shed light on the proper quantification of the three-dimensional orientation of the acetabulum. Dissections on 17 non-embalmed corpses were performed. Our results suggest that the acetabular rim is better represented by an anterior plane and a posterior plane rather than a single plane along the entire rim as it is currently assumed. The development of the socket from the Y-shaped cartilage was suggested to explain the different orientations in these anterior and posterior planes. The labrum forms a plane that takes an orientation in between the anterior and posterior parts of the acetabular rim, filling up inequalities of the bony rim. The vectors VL, VA2 and VP, representing the three-dimensional orientation of the labrum, the anterior rim and the posterior rim, are situated in a unique plane that appears biomechanically dependent. The three-dimensional orientation of the acetabulum is a fundamental parameter to understand the hip joint mechanism. Important applications for hip surgery and rehabilitation, as well as for physical anthropology, were discussed. PMID:22360458

  1. "In vivo" determination of hip joint separation and the forces generated due to impact loading conditions.

    Science.gov (United States)

    Dennis, D A; Komistek, R D; Northcut, E J; Ochoa, J A; Ritchie, A

    2001-05-01

    Numerous supporting structures assist in the retention of the femoral head within the acetabulum of the normal hip joint including the capsule, labrum, and ligament of the femoral head (LHF). During total hip arthroplasty (THA), the LHF is often disrupted or degenerative and is surgically removed. In addition, a portion of the remaining supporting structures is transected or resected to facilitate surgical exposure. The present study analyzes the effects of LHF absence and surgical dissection in THA patients. Twenty subjects (5 normal hip joints, 10 nonconstrained THA, and 5 constrained THA) were evaluated using fluoroscopy while performing active hip abduction. All THA subjects were considered clinically successful. Fluoroscopic videos of the normal hips were analyzed using digitization, while those with THA were assessed using a computerized interactive model-fitting technique. The distance between the femoral head and acetabulum was measured to determine if femoral head separation occurred. Error analysis revealed measurements to be accurate within 0.75mm. No separation was observed in normal hips or those subjects implanted with constrained THA, while all 10 (100%) with unconstrained THA demonstrated femoral head separation, averaging 3.3mm (range 1.9-5.2mm). This study has shown that separation of the prosthetic femoral head from the acetabular component can occur. The normal hip joint has surrounding capsuloligamentous structures and a ligament attaching the femoral head to the acetabulum. We hypothesize that these soft tissue supports create a passive, resistant force at the hip, preventing femoral head separation. The absence of these supporting structures after THA may allow increased hip joint forces, which may play a role in premature polyethylene wear or prosthetic loosening. PMID:11311703

  2. CT false-profile view of the hip: a reproducible method of measuring anterior acetabular coverage using volume CT data

    International Nuclear Information System (INIS)

    To devise a simple, reproducible method of using CT data to measure anterior acetabular coverage that results in values analogous to metrics derived from false-profile radiographs. Volume CT images were used to generate simulated false-profile radiographs and cross-sectional false-profile views by angling a multiplanar reformat 115 through the affected acetabulum relative to a line tangential to the posterior margin of the ischial tuberosities. The anterolateral margin of the acetabulum was localized on the CT false-profile view corresponding with the cranial opening of the acetabular roof. Anterior center edge angle (CEA) was measured between a vertical line passing through the center of the femoral head and a line connecting the center of the femoral head with the anterior edge of the condensed line of the acetabulum (sourcil). Anterior CEA values measured on CT false-profile views of 38 symptomatic hips were compared with values obtained on simulated and projection false-profile radiographs. The CT false-profile view produces a cross-sectional image in the same obliquity as false-profile radiographs. Anterior CEA measured on CT false-profile views were statistically similar to values obtained with false-profile radiographs. CT technologists quickly mastered the technique of generating this view. Inter-rater reliability indicated this method to be highly reproducible. The CT false-profile view is simple to generate and anterior CEA measurements derived from it are similar to those obtained using well-positioned false-profile radiographs. Utilization of CT to assess hip geometry enables precise control of pelvic inclination, eliminates projectional errors, and minimizes limitations of image quality inherent to radiography. (orig.)

  3. Feasibility of arthroscopic placement of autologous matrix-induced chondrogenesis grafts in the cadaver hip joint

    Directory of Open Access Journals (Sweden)

    Fritz Thorey

    2013-09-01

    Full Text Available An assortment of clinical trials have been done presenting the effectiveness of autologous matrix-induced chondrogenesis (AMIC for the regeneration of chondral leasions. The purpose of the study was to underline the accessability of the acetabulum and the femoral head through the known portals and prove i the feasibility of placing the AMIC in the different zones of the hip joint and ii check for dislocation after joint movement. Six human cadavers underwent hip arthroscopy on both hips. Two chondral lesions were set on each femoral head and two in the acetabulum to evaluate a total of 48 defects. After microfracturing an autologous matrix-induced chondrogenesis graft was placed on these lesions arthroscopically. After repeated joint movement the dislocation of the graft was checked. It was possible to place the AMIC graft in all 48 chondral lesions. The time needed for placing the graft was 8±2.9 minutes. A trend of time reduction could be detected throughout this study as the surgeon gained more experience. For the femoral head, after twenty cycles of joint movement 18/24 spots showed no displacement, 4/24 showed minor displacement (<3 mm and 2/24 showed major displacement (>3 mm. None showed total displacement. For the acetabulum 22/24 spots showed no displacement and 2/24 showed minor displacement. A combined microfracturing and placing of an AMIC graft of focal chondral lesions of the hip joint can be done arthroscopically. Prospective randomized in vivo studies should compare the results of arthroscopilally placed AMIC grafts with microfracturing and microfracturing alone.

  4. Simultaneous Periprosthetic Acetabular Fracture and Contralateral B-Type Compression Injury of the Pelvic Ring: A Case Report of a Rare Injury Combination

    Directory of Open Access Journals (Sweden)

    Sven Märdian

    2013-01-01

    Full Text Available The periprosthetic fracture of the acetabulum is a rare injury, and its management is only sporadically reported in the literature. A few case reports are available which mainly focus on periprosthetic acetabular fractures in the elderly population. In our case, a 32-year-old patient suffered from a periprosthetic acetabular fracture in combination with a pelvic ring injury following a high velocity accident. The fracture morphology allowed a salvage of the prosthesis with an open reduction and internal fixation with a good radiographic and functional outcome one year after trauma.

  5. Management of sequelae of septic arthritis of hip

    Directory of Open Access Journals (Sweden)

    Jagadishwer Rao K

    2007-01-01

    Full Text Available A nine years old boy, who had suffered septic arthritis at the age of two years and presented now with a limp, hip instability, leg length discrepancy. The patient was treated by adductor tenotomy and upper tibial pin traction. When head remnant reached the level of the acetabulum, open reduction and Pemberton osteotomy was done to achieve cover of the femoral head. The purpose of this report is to highlight the six years follow-up of reconstruction of sequale of septic arthritis of hip joint.

  6. Exclusion of COL2A1 and VDR as Developmental Dysplasia of the Hip Genes

    OpenAIRE

    Rubini, Michele; Cavallaro, Alessandra; Calzolari, Elisa; Bighetti, Giulia; Sollazzo, Vincenzo

    2008-01-01

    Developmental dysplasia of the hip (DDH) is a spectrum of disorders affecting the proximal femur and/or acetabulum leading to an abnormal formation of the hip. Genetic factors are involved in the etiology of DDH. Early recognition of DDH affords the best results from treatment and a better knowledge of the genetics of DDH could enhance early diagnosis. Variants in the Type II collagen (COL2A1) and vitamin D receptor (VDR) genes have been associated with patients with osteoarthritis of the hip...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-08-01

    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.

  8. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Papakonstantinou, Olympia [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); Mohana-Borges, Aurea V.R.; Campell, Loretta; Trudell, Debra; Resnick, Donald [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); Haghighi, Parviz [Veterans Affairs Medical Center, University of California, Department of Pathology, San Diego, California (United States)

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  9. Chronic septic arthritis of the adult hip: Computed tomographic features

    Energy Technology Data Exchange (ETDEWEB)

    Resnik, C.S.; Ammann, A.M.; Walsh, J.W.

    1987-10-01

    Abnormalities on computed tomography (CT) are described in 12 adults in whom septic arthritis of the hip was diagnosed. Presenting symptoms varied, as did CT findings. Soft tissue abnormalities ranged from intra-articular effusion to large abscess formation, and bone changes ranged from minimal erosion of articular surfaces to gross destruction of the proximal femur and acetabulum. CT can be helpful in the evaluation of septic arthritis of the hip because of its superior demonstration of soft tissue detail. An accurate diagnosis can be established in unsuspected cases and can be confirmed when clinical indicators are vague.

  10. Distant outcomes of the Chiari osteotomy 30 years follow up evaluation.

    Science.gov (United States)

    Piontek, Tomasz; Szulc, Andrzej; Głowacki, Maciej; Strzyzewski, Wojciech

    2006-02-28

    Background. The aim of my paper was to assess distant treatment results of patients who were treated because of hip displasia and the Chiari osteotomy was performed on those patients. Material and methods. I evaluated treatment outcomes of 27 patients who were treated at Poznan University of Medical Sciences, Clinic of Orthopedics, in 1965-1990. The Chiari osteotomy was performed on all patients for hip decenteration or hip subluxation after developmental displasia. 34 hips were evaluated (20 female and 7 male). The average age of patients was 13 years in the moment of the operation. The follow up examination was conducted 10-36 years after the Chiari osteotomy Results. After many years (30 years after the operation on the average), 37% of patients could fit into groups of very good and good results. I could assess the hips before the operation using only parameters marked on anteroposterior films. The radiographs of the hips showed displasia characterized by shallowness and steepness of the acetabulum, an increased apparent neck-corpus angle, low submersion of the femoral head in the acetabulum, and insufficient coverage of the femoral head by the acetabulum. On the radiographs taken one year after the operation I observed very good coverage of the femoral head proved by higher values (above quota) of the Wiberg angle, the Sharp angle, the Heyman and Herndon acetabulum-head indicator. I defined also a course of the osteotomy drafting an osteotomy angle, setting a degree of bone fragments displacement (medialisation), and a height of the osteotomy. Conclusions. 1. The Chiari osteotomy as a hip saving operation allows patients to function in satisfactory clinical conditions for many years. 2. When conducted correctly, the Chiari osteotomy considerably improves femoral head coverage not only in the frontal plane but also in the transverse plane. 3. Too wide osteotomy angle, more than 20 degrees , further than 50% displacement of a distal bone fragment and too low

  11. Radiographic signs of acetabular dysplasia of the adult hip

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, G.; von Torklus, D.

    1981-06-01

    Many papers have been published about the different types of measurements used in the evaluation of hip dysplasia in the pediatric age group. However, there are no publications that deal with this topic regarding adults. The authors present an initial series of measurements of the angle of the roof of the acetabulum in 100 randomized asymptomatic adult males. The normal value ranged from -10/sup 0/ to +10/sup 0/. These measurements were correlated with those described by Wiberg. The combination of both methods yields highly reliable information in the evaluation of hip dysplasia.

  12. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation.

    Science.gov (United States)

    Papakonstantinou, Olympia; Mohana-Borges, Aurea V R; Campell, Loretta; Trudell, Debra; Haghighi, Parviz; Resnick, Donald

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. PMID:15316682

  13. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    International Nuclear Information System (INIS)

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  14. Classification and treatment of acetabular fractures%髋臼骨折的分类与治疗策略

    Institute of Scientific and Technical Information of China (English)

    曾令源

    2012-01-01

    Fracture of acetabulum is mostly caused by high energy trauma, which exists as a whole or a part of palvic fracture. Acetabulum is characterized by complex anatomical relationships irregular bone structures, which leads to the difficulties in surgery. The surgical approach is found to be closely related to the classification of cetabular fractures. And several factors are proved to influence the clinical efficacy. In this review, we present the progress on the classification and treatment of acetabular fractures.%髋臼为不规则骨,为丰厚软组织包裹,多为挤压或传导受力导致骨折,髋臼骨折与髋关节活动大有很大关联.髋臼的解剖关系复杂、骨性结构不规则,因而手术难度大.髋臼骨折的分类与手术入路的选择密切相关,此外,还有一些因素也会影响疗效.本文主要讨论髋臼骨折的分类及相应治疗的一些内容.

  15. Multiple osteolytic lesions in a 14-year-old boy with HIV disease

    Directory of Open Access Journals (Sweden)

    S Murugan

    2015-01-01

    Full Text Available A 14 year old boy, said to have had multiple transfusions during infancy, was brought to the hospital for complaints of pain over right thigh for one week duration. MRI reveals multiple osteolytic lesions with enhancing hyperintense bone marrow lesions over iliac bones, right acetabulum and lumbar vertebral bodies and enlarged para-aortic, iliac and inguinal lymph nodes. CT of the whole body revealed osteolytic lesions on skull, mandible, right scapula, head of both humeri, L1 and L4 vertebrae, 5 th and 10 th ribs, both acetabulum and ala of sacrum along with enlargement of cervical, axillary and mesenteric, iliac and inguinal nodes. HIV ELISA was positive. Viral load was 141,700 copies/ml. CD4 count was 226 cells/mm 3 . Multiple biopsy from the lesions and bone marrow revealed no evidence of tuberculosis and malignancy. Now the boy is on ART (ZDV + 3TC + EFV since August 2013. His CD4 count improved and viral load became undetectable and he gained weight within 5 months of ART. Due to the rarity of its presentation, this case report is being reported.

  16. 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.

  17. Design optimization of cementless metal-backed cup prostheses using the concept of functionally graded material

    Energy Technology Data Exchange (ETDEWEB)

    Hedia, H S; El-Midany, T T; Shabara, M A N; Fouda, N [Production Engineering and M/C Design Department, Faculty of Engineering, Mansoura University, Mansoura (Egypt)

    2006-09-15

    Metal backing has been widely used in acetabular cup design. A stiff backing for a polyethylene liner was initially believed to be mechanically favourable. Yet, recent studies of the load transfer around acetabular cups have shown that a stiff backing causes two problems. It generates higher stress peaks around the acetabular rim than those caused by full polyethylene cups and reduces the stresses transferred to the dome of the acetabulum causing stress shielding. The aim of this study is to overcome these two problems by improving the design of cementless metal-backed acetabular cups using the two-dimensional functionally graded material (FGM) concept through finite-element analysis and optimization techniques. It is found that the optimal 2D FGM model must have three bioactive materials of hydroxyapatite, Bioglass and collagen. This optimal material reduces the stress shielding at the dome of the acetabulum by 40% and 37% compared with stainless steel and titanium metal backing shells, respectively. In addition, using the 2D FGM model reduces the maximum interface shear stress in the bone by 31% compared to the titanium metal backing shell.

  18. 全髋关节置换术中髋臼假体定位的研究进展%Progress of research on the orientation of the acetabular component in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    胡海贝; 周建生

    2016-01-01

    目前全髋关节置换术已成为治疗终末期髋关节疾病的有效手段,由于髋臼侧结构的特殊性,髋臼杯位置的定位方法尚有争议。髋臼假体定位方法主要有根据术前、术中影像学资料定位,根据髋臼局部解剖特征和(或)结合机械设备定位等,本文就髋臼假体位置定位的研究进展作一综述。%At present,total hip arthroplasty has become an effective method for the treatment of end-stage hip disease.Because of the special structure of the acetabulum,the methods for determining the position of the ace-tabular cup are disputed.The orientation methods of the acetabular components are mainly determined by the preop-erative and intraoperative imaging data,local anatomical characteristics of the acetabulum in combination with the mechanical equipment.This paper reviews the progress in research on orientating acetabular prosthesis position.

  19. Proximal focal femoral deficiency: evaluation by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [National Naval Medical Center, Department of Radiology, Bethesda, MD (United States); Uniformed Services University of Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD (United States); Davidson, Richard [The Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Pena, Andres; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2012-01-15

    Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly characterized by abnormal development of the proximal femur. The most common radiographic classification (Aitken) does not evaluate the cartilaginous and soft-tissue abnormalities. To demonstrate MR findings of PFFD focusing on features not seen with radiographs. Nine MR examinations of the hip and femurs of seven children with PFFD were retrospectively reviewed. Imaging was quantitatively and qualitatively assessed comparing the affected limb to the contralateral limb and age-matched controls. The children were classified via the Aitken classification. All children had at least mild acetabular dysplasia, and one type D patient had no acetabulum. MR demonstrated that 4/6 children had labral hypertrophy with a decreased distance from the greater trochanter to the acetabular rim, suggesting impingement (P < 0.05). The proximal femoral physis was abnormal in all cases. The connection between the femoral head and shaft if present was fibrous or fibrocartilaginous. MRI can help in evaluation of PFFD by defining the anatomy. MR demonstrates features of the acetabulum and cartilaginous femoral epiphysis and depicts ligamentous abnormalities of the knee. (orig.)

  20. 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

  1. The use of a modular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation and analysis of 37 cases

    Directory of Open Access Journals (Sweden)

    Croci Alberto Tesconi

    2000-01-01

    Full Text Available We analyzed 37 patients who underwent segmental wide resection of bone tumors and reconstruction with a modular titanium endoprosthesis at the Orthopaedic Oncology Group, between 1992 and 1998. Twelve patients were male and 25 were female, with a mean age of 30 years (9 - 81. The mean follow-up was 14 months (2 - 48. The diagnoses were: osteosarcoma (14 cases, metastatic carcinoma (10, Ewing's sarcoma (4, giant cell tumor (4, malignant fibrous histiocytoma (3, chondrosarcoma (1, and aneurysmal bone cyst (1. Eleven articulated total knee, 8 partial proximal femur with bipolar acetabulum, 8 partial proximal humerus, 3 total femur, 2 partial proximal tibia, 2 diaphyseal femur, 2 diaphyseal humerus, and 1 total proximal femur with cementless acetabulum endoprosthesis implant procedures were done. The complications related to the procedure included: infection (5 cases, dislocation (3, module loosening (1, and ulnar nerve paresthesia (1. We used the following criteria for the clinical evaluation: presence of pain, range of motion, reconstruction stability, surgical and oncologic complications, and patient acceptance. The results were good in 56.8% of the cases, regular in 32.4% and poor in 10.8%.

  2. Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

    Directory of Open Access Journals (Sweden)

    Pawel Zwolak

    2011-05-01

    Full Text Available Cement extrusion into the pelvis with subsequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consisted of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony substance in postero-superior aspect of the acetabulum. This weak bony acetabular substance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by polymerization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient underwent intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results.

  3. An anatomical study of corona mortis and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    洪华兴; 潘志军; 陈欣; 黄宗坚

    2004-01-01

    Objective: To provide detailed information of corona mortis for ilioinguinal approach as an anterior approach to the acetabulum and pelvis.Methods: The course, branches and distribution of the vascular connection between the obturator system and the external iliac or inferior epigastric systems located over the superior pubic ramus were observed on 50 hemipelvises with intact soft tissues.Results: During the dissections, 72% of the cadaveric sides had at least one communicating vessel between the obturator system and the external iliac or inferior epigastric systems on the superior pubic ramus. The average diameter of the connecting vessel was 2.6 mm (range, 2.0-4.2 mm). It coursed over the superior pubic ramus or iliopubic eminence vertically to enter the obturator foramen and exit the pelvis. The average distance from pubic symphysis to the vascular connections between the obturator and external iliac systems was 52 mm ( range, 38-68 mm).Conclusions: Vascular connections between the obturator system and the external iliac or inferior epigastric systems were found over the superior pubic ramus with a high incidence. They are prone to damage during the ilioinguinal approach as an anterior approach to the acetabulum and pelvis. Thus, corona mortis located over the superior pubic ramus deserves great attention during the ilioinguinal approach.

  4. Relationship Between Mechanical Forces and Formal Head Necrosis: An Experimental Study%机械性压力与股骨头骨骺坏死关系的动物实验研究

    Institute of Scientific and Technical Information of China (English)

    许瑞江; 马承宣; 赫荣国; 卢世壁; 房论光; 刘贵林; 张喜恩; 游联壁; 田嘉禾

    1989-01-01

    The etiology of avascular necrosis of the femoral head following the treatment for congenital dislocation of the hip(CDH)is believed to be secondary to mechanical forces between the femoral head and the acetabulum. A puppy experiment was designed to makea model of femoral head necrosis by increasing pressure between the femoral head and acetabulum. Intra-medullary pressure,isotopic scanning and histological changes of the femoral head were studied. The authors suppose the pathogenesis of the femoral head necrosis after the reduction of CDH. The prevention of the incidence of femoral head necrosis lies in avoidance of continuous compression between the femoral head and acetebulum.%本文模拟先天性髋脱位复位后股骨头受髋臼压迫的情形,将30只幼犬分为四组分别承受不同的压力,并于加压后1、2、3周进行骨内压测定、同位素骨扫描和组织学检查等.结果表明,随着股骨头与髋臼之间压力的增加,头坏死率增加,加压时间延长,坏死程度加重.

  5. Reliability of measures used in radiographic evaluation of the adult hip

    Energy Technology Data Exchange (ETDEWEB)

    Bjarnason, J.A.; Reikeras, O. [Oslo University Hospital, Department of Orthopedics, Oslo (Norway); Pripp, A.H. [Oslo University Hospital, Department of Biostatistics, Oslo (Norway)

    2015-02-20

    The reliability of radiographic measurements has been studied in pediatric hips, but less has been published on the adult hip, and none have examined the reliability of measurements for the location of the center of rotation (COR) of the hip joint. We have investigated the reliability of various radiographic variables with a focus on the COR. The study was carried out on a standardized format for anterior-posterior radiographs of the pelvis. The measured variables were; (A) the distance from a sagittal reference line to the COR, (B) the distance from the sagittal reference line to the proximal end of the lateral cortical line of the femur, (C) the distance from the sagittal reference line to the medial rim of the acetabulum, (D) the distance from the horizontal reference line to the roof of the acetabulum, and (E) the distance from the horizontal reference line to the COR. One observer (JAB) conducted the measurements twice separated by a time interval of 45-60 days to assess intra-observer reliability, and the first measurements of JAB were compared to those performed by another observer (OR) to assess inter-observer reliability. Intraclass correlation coefficients were above 0.98 for all measurements, and the minimum and maximum values that statistically include 95 % of the observer differences were all within -3 to +3 mm. These measurements proved to have high reliability and agreement of both within the same observer and between two observers. They should therefore be reproducible in a clinical setting. (orig.)

  6. Estimation of pelvic tilt on anteroposterior X-rays - a comparison of six parameters

    Energy Technology Data Exchange (ETDEWEB)

    Tannast, M. [University of Bern, Department of Orthopedic Surgery, Inselspital, Bern (Switzerland); New England Baptist Hospital, Center for Computer Assisted and Reconstructive Surgery, Boston, MA (United States); Tufts University School of Medicine, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Murphy, S.B. [New England Baptist Hospital, Center for Computer Assisted and Reconstructive Surgery, Boston, MA (United States); Tufts University School of Medicine, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Langlotz, F. [University of Bern, MEM Research Center for Orthopaedic Surgery, Institute for Surgical Technologies and Biomechanics, Bern (Switzerland); Anderson, S.E. [University of Bern, Department of Diagnostic Interventional and Pediatric Radiology, Bern (Switzerland); Siebenrock, K.A. [University of Bern, Department of Orthopedic Surgery, Inselspital, Bern (Switzerland)

    2006-03-15

    To compare six different parameters described in literature for estimation of pelvic tilt on an anteroposterior pelvic radiograph and to create a simple nomogram for tilt correction of prosthetic cup version in total hip arthroplasty. Simultaneous anteroposterior and lateral pelvic radiographs are taken routinely in our institution and were analyzed prospectively. The different parameters (including three distances and three ratios) were measured and compared to the actual pelvic tilt on the lateral radiograph using simple linear regression analysis. One hundred and four consecutive patients (41 men, 63 women with a mean age of 31.7 years, SD 9.2 years, range 15.7-59.1 years) were studied. The strongest correlation between pelvic tilt and one of the six parameters for both men and women was the distance between the upper border of the symphysis and the sacrococcygeal joint. The correlation coefficient was 0.68 for men (P<0.001) and 0.61 for women (P<0.001). Based on this linear correlation, a nomogram was created that enables fast, tilt-corrected cup version measurements in clinical routine use. This simple method for correcting variations in pelvic tilt on plain radiographs can potentially improve the radiologist's ability to diagnose and interpret malformations of the acetabulum (particularly acetabular retroversion and excessive acetabular overcoverage) and post-operative orientation of the prosthetic acetabulum. (orig.)

  7. 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.

  8. Prosthetic replacement in treatment of subcapital femoral neck fractures in the elderly

    Institute of Scientific and Technical Information of China (English)

    徐莘香; 刘一; 刘建国; 李印良

    2002-01-01

    Objective: To compare the results of femoral head replacement (FHR) and total hip replacement (THR) in treatment of subcapital femoral neck fractures (SFNF).   Methods: Between May 1987 and July 1998, 56 elderly patients (65-90 years; average 73.5 years) with SFNF were treated with prosthetic replacement. Six cases were treated with unipolar FHR, 18 cases with Bateman bipolar FHR, and 32 cases with Bateman bipolar THR. All domestic prostheses were installed with cement.   Results: There was no significant difference between the 2 groups in operating time and blood transfusion. Forty-nine patients were followed-up for an average of 5 years and 10 months. No wound infection or death was related to surgery. Complications in Group FHR were significantly higher than that in Group THR.   Conclusions: Since FHR is difficult to fit the bony acetabulum, it is only indicated for senile cases with poor conditions. However, the bipolar THR installed with cement is indicated for most elderly patients. Since the femoral head and acetabulum can fit each other completely, it is more stable for taking weight-bearing earlier with less complications.

  9. Estimation of pelvic tilt on anteroposterior X-rays - a comparison of six parameters

    International Nuclear Information System (INIS)

    To compare six different parameters described in literature for estimation of pelvic tilt on an anteroposterior pelvic radiograph and to create a simple nomogram for tilt correction of prosthetic cup version in total hip arthroplasty. Simultaneous anteroposterior and lateral pelvic radiographs are taken routinely in our institution and were analyzed prospectively. The different parameters (including three distances and three ratios) were measured and compared to the actual pelvic tilt on the lateral radiograph using simple linear regression analysis. One hundred and four consecutive patients (41 men, 63 women with a mean age of 31.7 years, SD 9.2 years, range 15.7-59.1 years) were studied. The strongest correlation between pelvic tilt and one of the six parameters for both men and women was the distance between the upper border of the symphysis and the sacrococcygeal joint. The correlation coefficient was 0.68 for men (P<0.001) and 0.61 for women (P<0.001). Based on this linear correlation, a nomogram was created that enables fast, tilt-corrected cup version measurements in clinical routine use. This simple method for correcting variations in pelvic tilt on plain radiographs can potentially improve the radiologist's ability to diagnose and interpret malformations of the acetabulum (particularly acetabular retroversion and excessive acetabular overcoverage) and post-operative orientation of the prosthetic acetabulum. (orig.)

  10. 各种髋臼重建术治疗先天性髋关节脱位的评价(附261例报告)%Experience and Evaluation of Various Acetabular Recosnstructions in the Treatment of Congenital Dislocation of the Hip

    Institute of Scientific and Technical Information of China (English)

    彭明惺; 胡廷泽; 陈绍基; 周锡华; 韦福康; 周素华

    1985-01-01

    From 1961 to 1983,various acetabular reconstructions were performed in 261 cases for 308 affected hips.The patients aged between 11/2 and 13 years.Salter Innomlnate osteotomy should be given priority on those at proper age,yet it cannot substitute other reconstruction operations.Perlcapsular illae osteotomy of Pemberton is indlctaed on those having a shallow acetabulum.However,serious incongruity between head and acetabulum and/or posterior dislocation are contraindications for the above mentioned operations.Shelf-acetabuloplasty works well for the reconstruction of the lateral edge of aceta bulum.When above-mentioned operations prove impossible,medial displacement osteostomy of the pelvis by Chlarl or capsular arthro plasty by Colonna become the chief salvage procedure.As any operation has its advantages and limitations,a good pediatric surgeon should possess the ability to choose the most appropriate operation.An operation based on the surgeon's personal preference or habit often lead to failure.%@@ 现将我院从1961年4月至1983年10月,应用各种髋臼重建手术治疗先天性髋关节位的体会总结如下.

  11. A new gorgoderid species of the urinary bladder of Rana zweifeli from Michoacán, Mexico Una nueva especie de gorgodérido de la vejiga urinaria de Rana zweifeli de Michoacán, México

    Directory of Open Access Journals (Sweden)

    Rosario Mata-López

    2006-12-01

    Full Text Available Gorgoderina tarascae n. sp. is described from the urinary bladder of Rana zweifeli, from Cutzaróndiro, Michoacán, Mexico. Gorgoderina tarascae differs from the other species of the genus by possessing the following combination of characters: follicular vitelline glands, arranged in two clusters of 4-7 follicles dorsal to the ovary, compact and smooth reproductive organs situated far from each other and from the acetabulum, suckers close to each other, and a slender, spindle shaped body with a flexed position due to the situation of the acetabulum.Gorgoderina tarascae n. sp. se describe como parásita de la vejiga urinaria de Rana zweifeli de Cutzaróndiro, Michoacán, México. Gorgoderina tarascae difiere del resto de las especies del género por la siguiente combinación de características: posee glándulas vitelógenas arregladas en dos racimos de 4-7 folículos situados dorsalmente al ovario, órganos reproductivos compactos y de bordes lisos, muy separados entre si y con respecto del acetábulo, ventosas cercanas una de la otra y cuerpo delgado, en forma de huso y flexionado debido a la posición del acetábulo.

  12. 泪点影像在观察儿童发育性髋发育不良的应用%Interpretation of the Teardrop Shadow of the Developmental Dysplasia of the Hip in Children

    Institute of Scientific and Technical Information of China (English)

    吴占金; 王承武

    1994-01-01

    观察了80例发育性髋发育不良患儿的系列X线片,其泪点影出现时间在正常侧为1岁,而脱位侧泪点的出现明显延迟,往往在股骨头复位后才能出现,并随着年龄增长而逐渐变窄.测量了部分患儿正常侧的泪点宽度,用统计学方法证实泪点宽度随年龄增大而变窄具有临床意义.%A series of pelvic roentgenograms of 80 children with developmental dysplasia of the hip(DDH)were studied.The teardrop shadow appeared at the age of 1 year in the normal hip,but never in the diseased hip before the femoral head being reduced into the acetabulum.The width of the teardrop shadow became narrower as the patient growing up.We also measured the width of teardrop shadow in some normal acetabula.That was confirmed by statistical analysis that the narrowing change of the teardrop shadow with growth of the acetabulum has its clinical significance.

  13. Cinco espécies de Lecithodendriidae (Trematoda en murcielagos de Colombia, incluyendo tres nuevos generos

    Directory of Open Access Journals (Sweden)

    Imelda Velez

    1990-01-01

    Full Text Available Velez, I. & V.E. Thatcher: Five species of Lecithodendriidae (Trematoda in bats from Colombia, including three new genera. Three new neotropical genera and species of Lecithodendriidae (Trematoda are described from Colombian bats. Sturniratrema umbilicata gen. et sp. nov. from Sturnira lilium differs from other genera in having an oval ventral depression, a dorso-ventrally curved cirrus and a genital pore lateral to the acetabulum. Chiropterotrema antioquiense gen. et sp. nov. from Carollia perspicillata is distinguished by having the acetabulum within a triangular ventral pit as well as an separation between the the male and female genital pores. Topsiturvitrema verticalia gen. et sp. nov. from Carollia perspicillata has a different orientation of the body, being nearly spherical but somewhat flatened in an anterior-posterior direction. This genus also has a deep ventral cleft separating two ventral lobes which are filled with eggs. Castroia silvai Travassos, 1928, is also reported from Anoura caudifer and Peropteryx macrotis. The first of these represents a new host record for the species. Addiotionally, Limatulum gastroides Macy, 1935, is reported from Lonchophyla robusta wich is another new host record.

  14. Congenital dislocation of the hip. A review.

    Science.gov (United States)

    Sherk, H H; Pasquariello, P S; Watters, W C

    1981-08-01

    Congenital dislocation of the hip usually results from capsular stretching caused by fetal malposition and crouching late in the third trimester. Early recognition of hip dislocation or instability soon after birth permits prompt treatment. Ortolani's and Barlow's maneuvers, respectively, reduce into and displace from the acetabulum a femoral head that is insecurely contained therein. The diagnosis of CDH in the first month of life usually depends on these clinical components of the physical examination of the newborn, because similar device, in this age group can usually maintain the displaced hip in sufficient flexion and abduction to permit reduction and normal development. By 3 months of age, the nuclei of the pelvis and upper femur have ossified enough to permit radiologic diagnosis of CDH. Problems related to treatment increase as the child grows older. In infants up to 6 months of age, closed methods with a harness usually succeed. Beyond 6 months, the soft tissues shorten and prevent easy reduction. These patients almost always require pre-reduction traction. An adductor tenotomy also facilitates reduction and apparently lessens compressive forces on the femoral head, an important consideration in preventing avascular necrosis of the head. Children over 1 year old develop bony changes, such as excessive femoral valgus and anteversion and deformity of the acetabulum. Treatment in these patients requires realignment of bony deformities with femoral or pelvic osteotomies in addition to the measures noted previously. The gentleness and high success rate of early treatment make early diagnosis of CDH an important consideration in infants and newborns.

  15. Three-fin acetabular prosthesis for superior acetabular bone defects: a three-dimensional finite element analysis

    Institute of Scientific and Technical Information of China (English)

    LIU Yu-zeng; HAI Yong; ZHAO Hui

    2012-01-01

    Background Given that three-dimensional finite element models have been successfully used to analyze biomechanics in orthopedics-related research,this study aimed to establish a finite element model of the pelvic bone and three-fin acetabular component and evaluate biomechanical changes in this model after implantation of a three-fin acetabular prosthesis in a superior segmental bone defect of the acetabulum.Methods In this study,three-dimensional finite element models of the pelvic bone and three-fin acetabular component were first established.The prosthesis model was characterized by three different conformational fins to facilitate and optimize the prosthetic design.The spongy and cortical bones were evaluated using a different modulus of elasticity in this established model.Results The maximum and minimum von Mises stresses on the fins of the acetabular component were 15.2 and 0.74,respectively.The maximum and minimum micromotion between the three-fin acetabular component and the acetabulum bone interface were 27 and 13 μm,respectively.A high primary stability and implied better clinical outcome were revealed.Conclusion Finite element analysis may be an optimal strategy for biomechanics-related research of prosthetic design for segmental acetabular bone defects.

  16. Cotylophoron panamensis (digenea: paramphistomidae) in cattle from Meta and Guaviare, Colombia

    International Nuclear Information System (INIS)

    Some species of Paramphistomidae (Trematoda: Digenea) that parasitize the digestive system of ruminants can cause decreases in milk and meat production. In Colombia, paramphistomosis cattle have been recorded from 1) dairy farms at high altitudes in the mountains of Antioquia (northwestern Colombia) where Cotylophoron cotylophorum was described as the causative agent; and 2) from lowland savannas in eastern Colombia, which has been attributed to several species of Paramphistomidae but with records remaining to be confirmed. Therefore, the discovery of digenea of cattle slaughtered in Guamal, Meta (eastern Colombia), was an opportunity to start with the description of the Paramphistomidae in this region. Between 2006 and 2008, we sampled 715 adult flukes from the rumen of 32 cattle from the departments of Meta and Guaviare. The morphological analysis shows that the adult has the following features typical of the family Paramphistomidae: Laurers canal crossing the excretory vesicle and opening posteriorly to the excretory pore; acetabulum small as in the genus Cotylophoron; pharynx as in Calicophoron; genital sucker without sphincter; absence of esophageal bulb and the lateral and dorsal vitellaria converging posteriorly in the body, below the acetabulum, as in C. panamensis. This study confirms the presence of paramfistomosis in Meta and it is the first report of Cotylophoron panamensis in cattle from the department of Guaviare, therefore expanding its geographic range in Colombia.

  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. Effects of normal and abnormal loading conditions on morphogenesis of the prenatal hip joint: application to hip dysplasia.

    Science.gov (United States)

    Giorgi, Mario; Carriero, Alessandra; Shefelbine, Sandra J; Nowlan, Niamh C

    2015-09-18

    Joint morphogenesis is an important phase of prenatal joint development during which the opposing cartilaginous rudiments acquire their reciprocal and interlocking shapes. At an early stage of development, the prenatal hip joint is formed of a deep acetabular cavity that almost totally encloses the head. By the time of birth, the acetabulum has become shallower and the femoral head has lost substantial sphericity, reducing joint coverage and stability. In this study, we use a dynamic mechanobiological simulation to explore the effects of normal (symmetric), reduced and abnormal (asymmetric) prenatal movements on hip joint shape, to understand their importance for postnatal skeletal malformations such as developmental dysplasia of the hip (DDH). We successfully predict the physiological trends of decreasing sphericity and acetabular coverage of the femoral head during fetal development. We show that a full range of symmetric movements helps to maintain some of the acetabular depth and femoral head sphericity, while reduced or absent movements can lead to decreased sphericity and acetabular coverage of the femoral head. When an abnormal movement pattern was applied, a deformed joint shape was predicted, with an opened asymmetric acetabulum and the onset of a malformed femoral head. This study provides evidence for the importance of fetal movements in the prevention and manifestation of congenital musculoskeletal disorders such as DDH. PMID:26163754

  19. Applied anatomy of the sciatic nerve injury in the artificial total hip arthroplasty%人工全髋关节置换术中坐骨神经损伤的应用解剖学观察

    Institute of Scientific and Technical Information of China (English)

    杨景武; 史晓林

    2005-01-01

    Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University from March to May in 2003. There were 56 pelvis samples of the normal human adult cadaver, 27 males and 29 females.METHODS: The origins and the pathways of the sciatic nerves and the relation of the sciatic nerve and the acetabulum were analyzed, and the sciatic nerve injury induced by the clasp and the screw fixation in the THR was measured and analyzed.MAIN OUTCOME MEASURES: The location relation of the sciatic nerve and the acetabulum.RESULTS: The distance between the sciatic nerve and the bottom of the acetabulum was(6.00 ±0. 85) mm on the left and(6.00 ±0. 71) mm on the right. The distance between the sciatic nerve and the edge of the acetabulum was(13.00 ±0. 75) mm on the left and(14.00 ±0.06) mm on the right. The SN circumference on the edge of the acetabulum was(32.00 ± 0. 28) mm on the left and(31.00 ± 0.68) mm on the right. The distance between the bottom of the acetabulum and the greater sciatic foramen was(29.00 ±0. 36)mm on the left and(29.00 ±0.24) mm on the right.CONCLUSION: It is confirmed that the clasp and the screw fixation can be done on the safe region at the 1-3 o' clock and the 5-6 o' clock. The obsolete fracture and dislocation of the acetabulum, the unsuitable clasp location and the unsuitable location of screw fixation may induce the iatrogenic sciatic nerve injury.

  20. Total hip replacement for Crowel III and IV hip dislocation:prosthesis position and stability%全髋关节置换修复CroweⅢ和Ⅳ型髋关节脱位:假体位置及其稳定性

    Institute of Scientific and Technical Information of China (English)

    丁良甲; 刘晓民; 刘莹丽

    2015-01-01

    BACKGROUND:Developmental dislocation of the hip is a type of adult hip dysplasia, including Crowe III and IV type; the type of dislocation of the hip is a severe prognosis. Total hip replacement is clinicaly used for the complex reconstruction of acetabulum. For injured acetabulum, autologous bone graft is effective to reconstruct acetabulum structure, provides good coverage and stability for the acetabulum. Postoperative combination with effective exercise can ensure the recovery of acetabulum function. OBJECTIVE:To analyze the correlation of prosthesis position selection during total hip replacement with clinical short- and middle-term effects of Crowel III and Crowel IV hip dislocation. METHODS:Clinical data of 28 cases of dysplasia and dislocation of the hip joint combined with severe osteoarthritis, who were treated in the Department of Joint Surgery, the Second Affiliated Hospital, Inner Mongolia Medical University from December 2011 to December 2012, were retrospectively analyzed. Al patients received total hip replacement. Implant was biological artificial total hip joint prosthesis. During 2-year folow-up, patients were rechecked by imaging regularly to analyze the imaging changes of acetabulum prosthesis position and bone graft fusion. Harris hip score was used to assess the recovery of hip function. The correlation of prosthesis position and short- and middle-term effects was analyzed. RESULTS AND CONCLUSION: The filing rate of medulary cavity of prosthesis was above 75%. The initial position was fixed and stable. The stability rate of femur-prosthesis interface reached 100%. Compared with pre-replacement, hip function was significantly improved at 6 months post surgery (t=25.55, 9.07;P < 0.05). These results indicate that total hip replacement for Crowel III and Crowel IV hip dislocation can effectively reconstruct the acetabulum, recover hip function, and stabilize prosthesis. Total hip replacement is characterized by good filing rate, high stability

  1. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

    Full Text Available DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Scott M. Sporer, MD. and the contributors have aimed providing the reader practical and clinically relevant information, evidence-based advices, their preferences and opinions containing current concepts for difficult and controversial clinical situations in total hip replacement surgery which are often not addressed clearly in traditional references. FEATURES The book is composed of 9 sections and 49 articles each written by a different expert designed in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected. Second section is about preoperative acetabulum questions. Third section is about preoperative femur questions. Fourth section is about intraoperative questions. Intraoperative acetabulum question is subjected in the fifth section and the intraoperative femur questions in the sixth section. The seventh section is about postoperative questions. Eighth and ninth sections are about general questions about failure and failure of acetabulum in turn. AUDIENCE Mainly practicing orthopedic surgeons, fellows and residents who are interested in hip arthroplasty have been targeted but several carefully designed scenarios of controversial and difficult situations surrounding total hip replacement surgery and the current information will also be welcomed by experienced clinicians practicing in hip arthroplasty. ASSESSMENT Scott M. Sporer

  2. Roles of radiograph, magnetic resonance imaging, threedimensional computed tomography in early diagnosis of femoro-acetabular impingement in 17 cases

    Institute of Scientific and Technical Information of China (English)

    GU Gui-shan; ZHU Dong; WANG Gang; WANG Cheng-xue

    2009-01-01

    Objective: To evaluate the roles of radiograph, magnetic resonance imaging (MRI), three-dimensional computed tomography (3-D CT) in early diagnosis of femoro-acetabular impingement (FAI) in 17 cases. Methods: Plain radiographs of the pelvis, 3-D CT, and MRI of the hip were made on 17 patients with groin pain, which was worse with prolonged sitting (i.e. hip flexion). There was no history of trauma or childhood hip disorders in the patients who did not complain of any other joint problems or neurologic symptoms. All patients had positive anterior or posterior impingement test. Plain radiographs included an antero-posterior (AP) view of the hip and a cross table lateral view with slight internal rotation of the hip. CT scan was performed with the Lightspeed 16 row spiral (General Electric Company, USA) at 1.25 mm slice reconstruction. MRI scan was performed on the Siemens Avanto (Siemens Company, Germany)1.5T supraconducfion magnetic resonance meter. The CT and MRI scans were taken from 1 cm above the acetabulum to the lesser trochanter in 5 series. Results: The plain radiographs of the pelvis showed that among the 17 patients, 12 (70.59%) had "Cam" change of the femoral head, 6 (35.29%) had positive "cross-over" sign, and 17 (100%) had positive "Pincer" change of the acetabulum. The 16 row spiral CT noncontrast enhanced scan and 3-D reconstruction could discover minus femoral offset and ossification and osteophyte of the acetabulum labrum in all the 17 cases (100%). The MRI noncontrast enhanced scan could discover more fluid in the hip joint in 15 cases (88.33%), subchondral ossification in 3 cases (17.6%), and labium tears in 3 cases (17.6%). Conclusions: Plain radiographs can provide the initial mainstay for the diagnosis of FAI, 3-D CT can tell us the femoral offset, while MRI can show labrum tears in the very early stage of FAI. Basically, X-ray examination is enough for the early diagnosis of FAI, but 3-D CT and MRI may be useful for the treatment.

  3. Radiotherapy in stage IIA and IIB testicular seminoma with reduced portals: a prospective multicenter study

    International Nuclear Information System (INIS)

    Purpose: A prospective multicenter study was carried out to estimate the treatment outcome of radiotherapy in Stage II seminoma after the application of modern staging and radiotherapy techniques. The lower margin of the iliac field was positioned on the upper rim of the acetabulum to reduce the amount of scattered irradiation to the remaining testicle. Methods and Materials: The study was carried out in 25 centers in Germany. Patients with pure seminoma, negative AFP-values, and retroperitoneal lymph node metastases of less than 5 cm in diameter were entered into the study. All patients received a ventrodorsal opposed field irradiation of the para-aortic and the ipsilateral iliac lymph nodes. The fields extended from the top of the 11th thoracic vertebra to the top of the acetabulum. Patients in Stage IIA (lymph nodes <2 cm) received 30 Gy, and patients with Stage IIB (lymph nodes between 2 and 5 cm) 36 Gy total dose. Results: 39 patients in Stage IIA and 19 patients in Stage IIB were evaluated. After a median observation time of 37 months all patients are alive and disease free. Recurrence free survival in stage IIA was 100%. Two patients in Stage IIB experienced a recurrence 10 and 17 months after the end of radiotherapy. The actuarial recurrence free survival estimate in Stage IIB was 94.1% for 1 year and 87.4% for 2 years. One recurrence in Stage IIB occurred in the mediastinum, one in the mediastinum, and one the lung. Both patients could be salvaged by chemotherapy. There were no pelvic recurrences. The treatment was well tolerated, with nausea being the most common side effect (56.9% Grade 1, 15.5% Grade 2, and 8.6% Grade 3). Diarrhea occurred in 15.5% (Grade 1), 15.5% (Grade 2), and 5.2% (Grade 3) of the patients. Conclusions: The outcome of para-aortic and ipsilateral iliac irration in Stage IIA/B testicular seminoma is excellent with the currently available staging methods and treatment facilities. The treatment is well tolerated. The lower margin of the

  4. 三维记忆内固定与髋臼重建钛板系统修复髋臼后壁骨折伴关节后脱位的比较%Three-dimensional memory fixationversusreconstruction titanium plate to repair posterior wall acetabular fracture with posterior dislocation

    Institute of Scientific and Technical Information of China (English)

    梁云扬

    2015-01-01

    通过对髋臼三维记忆内固定系统在髋臼后壁骨折伴髋臼关节后脱位中临床应用效果的分析,了解其治疗髋臼后壁骨折伴髋臼关节后脱位的可行性与特点。研究发现,其在固定时间及术后功能恢复等方面较之重建钛板内固定都具有明显的应用优势。%BACKGROUND:Posterior wal fractures of the acetabulum with posterior dislocation of the acetabular joint mostly require the operation of open reduction and internal fixation. Different materials can be chosen for internal fixation operation. OBJECTIVE: To explore the effect of acetabular three-dimensional memory fixation system on acetabular posterior wal fractures accompanying the acetabulum joint dislocation. METHODS: A retrospective analysis was performed on clinical data of 92 cases of acetabular posterior wal fracture and dislocation at the Heze Municipal Hospital of Shandong Province from February 2010 to February 2014. Al patients received the operation of open reduction and internal fixation. They were divided into three-dimensional memory fixation group (45 cases) and reconstruction titanium plate group (47 cases) according to different fixators. Al patients were folowed up for 12 months after fixation. RESULTS AND CONCLUSION:The operation time and intraoperative blood loss were significantly longer or higher in the reconstruction titanium plate group than in the three-dimensional memory fixation group (P < 0.05). Harris score was significantly greater in the three-dimensional memory fixation group than in the reconstruction titanium plate group during final folow-up (P < 0.05). Thromboembolic complications or deep infection were not detected after fixation in both groups. These findings confirm that three-dimensional memory fixation system obtained good effects in the treatment of the posterior wal fractures of the acetabulum with posterior dislocation.

  5. PATHOLOGICAL AND MORPHOLOGICAL RESEARCH OF EXPERIMENTAL ACETABULAR DYSPLASIA

    Institute of Scientific and Technical Information of China (English)

    张自明; 马瑞雪; 吉士俊; 牛之彬

    2004-01-01

    Objective To investigate the pathological mechanism of hip dysplasia. Methods The left knee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were flexed. The right side served as control. Roentgenogram was made in all animals. The changes of the xray films and the pathological findings between left and right hips were compared. Results Appearance of hip dysplasia was obvious at four weeks after plaster fixation. There were pathological changes, including shallow acetabulum and flat femoral head, increased acetabular index and decreased acetabular head index on the x-ray films.Conclusion The hip dysplasia is the result of prolonged extending position of the knee joint. Abnormal knee posture seems to be one of the important factors of hip dysplasia. This kind of deformation may be worsened with time.

  6. 髋关节假体置换成形术并发症的探讨

    Institute of Scientific and Technical Information of China (English)

    袁杰; 王志鑫; 陈森; 王国波

    2004-01-01

    Objective To analyze the complications of the hip joint prosthetic replacement. Method From 1994 to 2004,46 cases had been analyzed. (11 whole hip joint ,35 cases were artificial femoral replacements). Among them,23 cases were male,23 cases were female;the age is between 56 and 84;the longest time to make tracks for our study is 8.5 years and the shortest is 3 months.Result 46 cases had recovered from iUness;2 cases had become better;6 cases had complications (including 1 sudden death).Conclusion The transplant related complications include dislocation,luxation,the joint looseness, the acetabulum abrasion, infection, medicine complications etc. And we also put forward the preventions that can avoid these complications.

  7. 髋关节发育不良

    Institute of Scientific and Technical Information of China (English)

    罗殿中

    2010-01-01

    @@ 髋关节发育不良(Developmental dysplasia of the hip,DDH)既往又称先天性髋关节脱位(Congenital dislocation of the hip,CDH)、发育性髋关节脱(Developmental dislocation of the hip,DDH)、先天性髋关节半脱位(Congenital subdislocation of the hip)、髋臼发育不良(Dysplasia of acetabulum),是在胎儿和新生儿期因股骨头和髋臼关系紊乱,进而发育至不同程度的髋关节异常的一组疾病,包括髋臼异常、股骨头及股骨近端异常、髋关节囊与软组织异常.

  8. Pelvic Discontinuity Caused by Acetabular Overreaming during Primary Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Iori Takigami

    2011-01-01

    Full Text Available Intraoperative acetabular fracture is a rare complication of primary total hip arthroplasty (THA, typically occurring during impaction of the cementless acetabular component. Here we report an unusual case of pelvic discontinuity caused by overreaming of the acetabulum during primary THA. Restoration of posterior columnar continuity was achieved with an autologous fibular graft and a reconstruction plate. Wall defects and cavitary defects were reconstructed with metal mesh and femoral head allograft, followed by placement and fixation of a Kerboull-type acetabular reinforcement device. Previous reports of acetabular fracture during THA have indicated that it has a relatively good prognosis without extensive treatment. However, to our knowledge, there has been no report of pelvic discontinuity necessitating acetabular reconstruction surgery as an intraoperative complication of primary THA.

  9. Techniques and results for open hip preservation

    Directory of Open Access Journals (Sweden)

    David eLevy

    2015-12-01

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

  10. Clinical applications for multiplanar- and three-dimensional-reconstructions by helical-CT for the diagnosis of acetabular fractures; Klinischer Einsatz multiplanarer und 3D-Rekonstruktionen der Spiral-CT in der Diagnostik der Azetabulumfrakturen

    Energy Technology Data Exchange (ETDEWEB)

    Stroszczynski, C. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Stoeckle, U. [Unfallchirurgische Klinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Wellmann, A. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Beier, J. [Deutsches Herzzentrum Berlin, Virchow-Klinikum, Abt. Innere Medizin und Kardiologie (Germany); Wicht, L. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Hoffmann, R. [Unfallchirurgische Klinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany)

    1996-03-01

    This review describes recent visualizations of computed tomography for the diagnosis of acetabular fractures. The techniques of conventional and helical-CT for the imaging of the acetabulum are compared. Furthermore, the different methods of multiplaner and three-dimensional reconstructions e.g. shaded surface display, maximum intensity projection, and volume rendering are presented. Figures of multiplanar and three-dimensional imaging for fractures of the pelvis is discussed. (orig.) [Deutsch] Es wird eine Uebersicht moderner computertomographischer Darstellungsmethoden der Azetabulumfrakturen vorgestellt. Auf die einzelnen Charaktersitika der konventionellen und Spiral-CT-Technik wird eingegangen, weiterhin werden die multiplanaren und verschiedenen 3dimensionalen Rekonstruktionsverfahren Shaded-Surface-Display (SSD), Maximum-Intensitaetsprojektion (MIP) und Volume-Rendering (VR) beschrieben und jeweils anhand von Abbildungen erlaeutert. Darueber hinaus wird das diagnostische Potential der einzelnen Methoden diskutiert. (orig.)

  11. A Multidisciplinary Approach to the Management of Atypical Osseous Epithelioid Hemangioendothelioma

    Directory of Open Access Journals (Sweden)

    J. K. Ma

    2014-01-01

    Full Text Available Hemangioendothelioma is a rare vascular tumor of intermediate malignant potential. Though epithelioid hemangioendothelioma (EH is commonly found in soft tissues, it has been known to be present in skeletal tissues. The authors present a case of a 50-year-old woman diagnosed with EH of the iliac bone and acetabulum, who experienced pathological fracture at presentation. This report describes a multidisciplinary approach to the management that includes initial incisional biopsy, curettage, and bone grafting, followed by Intensity Modulated Radiation Therapy. The patient finally underwent hemipelvic resection with allograft reconstruction after recurrence. Histopathological study revealed osseous EH of low mitotic activity that stained positively for CD31, CD34, vimentin, and Factor VIII. Herein, the authors discuss the imaging characteristics, histopathological aspects, cytogenetic findings, and the radiobiological behavior of osseous EH. After an aggressive multidisciplinary intervention, the patient is able to achieve local control with no evidence of distal metastatic disease.

  12. Early total hip arthroplasty for severe displaced acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    YANG Shu-hua; ZHANG Yu-kun; XU Wei-hua; LI Jin; LIU Guo-hui; YANG Cao; LIU Yong; TIAN Hong-tao

    2006-01-01

    Objective : To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures.Methods: Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years (1-6 years) and the average period from fracture to operation was 8 days (5-21 day). The average age of the patients was 53 years (26-69 years).Results: At the final follow-up the Harris hip score averaged 82(69-100) points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of late loosening of the prosthesis. One patient had severe central displacement of the cup.Conclusions: In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.

  13. Contribution to the lichen biota of the Stawy Milickie nature reserve and its adjacent area (Lower Silesia, southwestern Poland

    Directory of Open Access Journals (Sweden)

    Edyta Kaźmierska

    2016-07-01

    Full Text Available The paper presents the results of lichenological investigations conducted in the eastern part of the Stawy Milickie nature reserve and its buffer zone (Barycz Valley, southwestern Poland. The study area is a famous waterfowl refuge, consisting of several fishpond complexes, together with adjacent forests, meadows, and villages. In total 72 lichen taxa were recorded, growing on bark and branches of trees and shrubs, stumps, wood, soil, and anthropogenic rock substrates (mortar, concrete, bricks, etc.. Six species, namely Evernia prunastri, Flavoparmelia caperata, Hypogymnia tubulosa, Parmelina tiliacea, Physconia distorta, and Pleurosticta acetabulum, are threatened in Poland. As represented by single young thalli, they indicate the recent improvement of environmental conditions. The lichen biota of the study area is typical for the lowland regions of western and southwestern Poland.

  14. MR evaluation of femoral neck version and tibial torsion

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, James Karl; Dwek, Jerry R. [University of California, San Diego, Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Pring, Maya E. [Rady Children' s Hospital, Department of Pediatric Orthopedic Surgery, San Diego, CA (United States)

    2012-01-15

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

  15. An Automated Size Recognition Technique for Acetabular Implant in Total Hip Replacement

    CERN Document Server

    Shapi'i, Azrulhizam; Hasan, Mohammad Khatim; Kassim, Abdul Yazid Mohd; 10.5121/ijcsit.2011.3218

    2011-01-01

    Preoperative templating in Total Hip Replacement (THR) is a method to estimate the optimal size and position of the implant. Today, observational (manual) size recognition techniques are still used to find a suitable implant for the patient. Therefore, a digital and automated technique should be developed so that the implant size recognition process can be effectively implemented. For this purpose, we have introduced the new technique for acetabular implant size recognition in THR preoperative planning based on the diameter of acetabulum size. This technique enables the surgeon to recognise a digital acetabular implant size automatically. Ten randomly selected X-rays of unidentified patients were used to test the accuracy and utility of an automated implant size recognition technique. Based on the testing result, the new technique yielded very close results to those obtained by the observational method in nine studies (90%).

  16. Endotoxins in surgical instruments of hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Vania Regina Goveia

    2016-06-01

    Full Text Available Abstract OBJECTIVE To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. METHOD A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method was used. RESULT There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. CONCLUSION Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested.

  17. Synovial hemangioma of the hip joint in a pediatric patient

    Energy Technology Data Exchange (ETDEWEB)

    Demertzis, Jennifer L.; Loomans, Rachel; Wessell, Daniel E. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Kyriakos, Michael [Washington University School of Medicine, Division of Surgical Pathology, St. Louis, MO (United States); McDonald, Douglas J. [Washington University School of Medicine, Department of Orthopedic Surgery, St. Louis, MO (United States)

    2014-01-15

    Hemangiomas of the articular synovium are rare and commonly associated with recurrent joint swelling and painful limitation of motion. The knee joint is the most commonly involved site, with most patients diagnosed in the second to third decade of life [1]. Although over 200 cases have been reported in the English-language medical literature, only three have originated within the hip joint, all of which were in adult patients reported in the surgical literature [2-4]. We describe a histologically proven synovial hemangioma of the hip joint in a pediatric patient that invaded the femur, acetabulum, and adjacent soft tissues, with a detailed discussion of the differential diagnosis based on the radiographic and magnetic resonance imaging (MRI) findings. (orig.)

  18. Bilateral Asymmetric Dislocations of Hip Joints: An Unusual Mechanism of Injury

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar Kanojia

    2013-01-01

    Full Text Available Asymmetric bilateral dislocations of the hips are rare injuries. Among the small number of reports in the literature, most have attributed the cause to high-velocity motor crashes. These dislocations are often seen to be associated with fractures of the proximal femur or the acetabulum. We present a case of a 45-year-old man with bilateral asymmetric dislocation of hips which were purely ligamentous in nature, without any fracture. He sustained his injuries due to a fall while getting on a moving bus. It was an unusual mechanism of injury as compared to the other cases of asymmetric hip dislocations reported in published studies. Both hips were reduced under general anaesthesia within three hours of the trauma. Skin traction and non-weight-bearing rehabilitation were continued for six weeks. After 35 months of followup, the patient remains asymptomatic. Early diagnosis and timely reduction of such dislocations under anaesthesia are necessary for prevention of complications.

  19. Trabecular metal acetabular revision system (cup-cage construct to address the massive acetabular defects in revision arthroplasty

    Directory of Open Access Journals (Sweden)

    Rajesh Malhotra

    2012-01-01

    Full Text Available The increasing number of total hip replacements in the younger clique has added to the demand for revision procedures. Revision situations are often encountered with infection, loss of bone stock and bone defects. There are various methods of reconstruction of acetabular defects. The management options of type 3B Paprosky acetabular defects are limited with allograft and conventional cages. Trabecular metal technology has evolved to address these bone defects. Trabecular metal acetabular revision system (TMARS cup-cage construct is a new technique to address massive acetabular defects. We describe a case of failed hip reconstruction done for a Giant cell tumour of proximal femur managed by a two stage procedure, initial debridement and second stage reconstruction of acetabulum with TMARS cup-cage construct and femur with allograft prosthesis composite.

  20. Femoroacetabular impingement

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, Ara [Department of Radiology, Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA (United States)]. E-mail: akassarjian@partners.org; Brisson, Melanie [Department of Radiology, Centre Hospitalier Universitaire de Quebec, Que. (Canada); Palmer, William E. [Department of Radiology, Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA (United States)

    2007-07-15

    Femoroacetabular impingement is a relatively recently appreciated 'idiopathic' cause of hip pain and degenerative change. Two types of impingement have been described. The first, cam impingement, is the result of an abnormal morphology of the proximal femur, typically at the femoral head-neck junction. Cam impingement is most common in young athletic males. The second, pincer impingement, is the result of an abnormal morphology or orientation of the acetabulum. Pincer impingement is most common in middle-aged women. This article reviews the imaging findings of cam and pincer type femoroacetabular impingement. Recognition of these entities will help in the selection of the appropriate treatment with the goal of decreasing the likelihood of early degenerative change of the hip.

  1. 手术治疗35例髋臼后壁骨折的临床分析

    Institute of Scientific and Technical Information of China (English)

    黄胜; 李建有; 李雄峰; 管国华

    2011-01-01

    @@ 髋臼骨折多为高能量损伤,常合并其他部位骨折和脏器损伤,治疗困难.髋臼后壁骨折(posterior wall fractures of the acetabulum,PWFA)是髋臼骨折中最常见的一种类型,约占所有髋臼骨折的25%~33%,由于其常伴有邻近关节面的塌陷、后壁骨折块的严重粉碎以及关节软骨损伤等,治疗效果不满意率高达30%.我院自1995至2006年共收治35例PWFA患者,采用手术治疗取得了满意的效果,现分析报道如下.

  2. Percutaneous augmentation of the superior pubic ramus with polymethyl methacrylate: treatment of acute traumatic and chronic insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Beall, Douglas P. [University of Oklahoma, Clinical Radiology of Oklahoma, Oklahoma City, OK (United States); D' Souza, Sharon L. [University of Oklahoma, Oklahoma City, OK (United States); Costello, Richard F.; Stapp, Annette M. [Clinical Radiology of Oklahoma, Edmond, OK (United States); Prater, Scott D. [University of Oklahoma College of Medicine, Edmond, OK (United States); Van Zandt, Bryan L. [University of Oklahoma College of Medicine, Oklahoma City, OK (United States); Martin, Hal D. [Oklahoma Sports Science and Orthopaedics, Oklahoma City, OK (United States)

    2007-10-15

    The injection of polymethylmethacrylate (PMMA) is a minimally invasive image-guided procedure that is typically used to treat vertebral body fractures due to osteoporosis or neoplastic involvement. The injection of PMMA into various other locations including the sacrum, acetabulum, pedicles, femur and tibia has been reported previously, and these procedures have, overall, been highly effective at alleviating pain and discomfort. Although the injection of PMMA into the vertebral body is a very common procedure that has been performed for over 2 decades for the percutaneous treatment of vertebral body fractures, the percutaneous injection of PMMA has not been reported in the English literature as treatment for superior pubic ramus fractures. We report the percutaneous treatment of an acute superior pubic ramus fracture and of a chronic insufficiency fracture of the superior pubic ramus using a parasymphyseal approach to access the region of injury. (orig.)

  3. Amphimerus bragai N. Sp. (Digenea: Opisthorchiidae, a Parasite of the Rodent Nectomys squamipes (Cricetidae from Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Antonio HA de Moraes Neto

    1998-03-01

    Full Text Available Amphimerus bragai n.sp. (Digenea, Opisthorchiidae from the bile ducts of a rodent from the State of Minas Gerais, Brazil, Nectomys squamipes (Cricetidae, is described. The new species was studied by both light and scanning electron microscopy. A table is presented comparing the measurements of the new species with those of A. lancea (Diesing, 1850 and A. vallecaucensis Thatcher, 1970, parasites of dolphins and marsupials, respectively. The new species is similar in size and body form to A. vallecaucensis from which it differs in having a vitellarium that extends to the acetabulum while that of the former species are limited to the posterior one-third of the body. Additionally, the new species is from a rodent.

  4. Amphimerus bragai n. sp. (Digenea: Opisthorchiidae), a parasite of the rodent Nectomys squamipes (Cricetidae) from Minas Gerais, Brazil.

    Science.gov (United States)

    de Moraes Neto, A H; Thatcher, V E; Lanfredi, R M

    1998-01-01

    Amphimerus bragai n.sp. (Digenea, Opisthorchiidae) from the bile ducts of a rodent from the State of Minas Gerais, Brazil, Nectomys squamipes (Cricetidae), is described. The new species as studied by both light and scanning electron microscopy. A table is presented comparing the measurements of the new species with those of A. lancea (Diesing, 1850) and A. vallecaucensis Thatcher; 1970, parasites of dolphins and marsupials, respectively. The new species is similar in size and body form to A. vallecaucensis from which it differs in having a vitellarium that extends to the acetabulum while that of the former species are limited to the posterior one-third of the body. Additionally, the new species is from a rodent.

  5. Open reduction and internal fixation aided by intraoperative 3-dimensional imaging improved the articular reduction in 72 displaced acetabular fractures

    DEFF Research Database (Denmark)

    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik

    2015-01-01

    Background and purpose - During acetabular fracture surgery, the acetabular roof is difficult to visualize with 2-dimensional fluoroscopic views. We assessed whether intraoperative 3-dimensional (3D) imaging can aid the surgeon to achieve better articular reduction and improve implant fixation....... Patients and methods - We operated on 72 acetabular fractures using intraoperative 3D imaging and compared the operative results, duration of surgery, and complications with those for 42 consecutive acetabular fracture operations conducted using conventional fluoroscopic imaging. Postoperative reduction...... was evaluated on reconstructed coronal and sagittal images of the acetabulum. Results - The fracture severity and patient characteristics were similar in the 2 groups. In the 3D group, 46 of 72 patients (0.6) had a perfect result after open reduction and internal fixation, and in the control group, 17 of 42 (0...

  6. Two new species of Pseudotelorchis (Digenea, Telorchiidae, parasites of the Caiman, Caiman crocodilus yacare (Reptilia, Crocodylia from the Pantanal Mato-Grossense, Brazil

    Directory of Open Access Journals (Sweden)

    Joäo B. Catto

    1993-12-01

    Full Text Available Pseudotelorchis caimanis n. sp. and P. yacarei n. sp. are described based on specimens collected from Caiman crocodilus yacare (Daudin in the Pantanal Mato-grossense, Brazil. This is the first record of any species of Telorchiidae Stunkard, 1924, parasitizing crocodilians. Pseudotelorchis caimanis n. sp. differs from P. comapactus, the only species described in the genus with seminal receptacle, testes in tandem, and genital pore lateral to acetabulum. Pseudotelorchis yacarei n. sp. differs from the two other species for its body shape, for infecting the intestine instead of the uterus, by having regularly disposed instead of irregulary disposed uterine loops, and by having the vitelline glands disposed in longitudinal lateral lines instead of in lateral bunches.

  7. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

    LENUS (Irish Health Repository)

    Brennan, S A

    2009-04-01

    PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

  8. Ipsilateral femoral neck and shaft fractures: An overlooked association

    International Nuclear Information System (INIS)

    A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG)

  9. Morphological and histological identification of Paramphistomum cervi (Trematoda: Paramiphistoma in the rumen of infected sheep

    Directory of Open Access Journals (Sweden)

    Vijayata Chaoudhary

    2015-01-01

    Full Text Available Aim: This study was undertaken to identify Paramphistomum cervi on the basis of its morphology and histology to be the common cause of paramphistomosis in infected sheep and its differentiation from other similar Paramphistomes in Gujarat. Materials and Methods: Adult rumen flukes were recovered from the rumen of naturally infected sheep slaughtered in various abattoirs in Gujarat. Some adult flukes were flattened and stained in Borax carmine, and some were sectioned in the median sagittal plane and histological slides of the flukes were prepared for detailed morphological and histological studies. Result: Microscopic pictures of the parasite used in identification define the similarity in the morphology and histology of the anterior sucker, pharynx, esophagus, genital atrium, posterior sucker (acetabulum and testes to the P. cervi. Conclusion: It can be concluded that the most common species found in sheep infected with Paramphistomosis is P. cervi on the basis of its histo-morphological appearance in Gujarat.

  10. Arthroscopic Bullet Removal From the Central and Peripheral Compartments of the Hip Joint.

    Science.gov (United States)

    Howse, Elizabeth A; Rogers, Jason P; Stone, Austin V; Mannava, Sandeep; Stubbs, Allston J

    2016-04-01

    Recent advances in hip arthroscopy offer an approach for treating an uncommon but highly disabling injury from intra-articular missile injury to the hip. Hip arthroscopy affords the patient the benefit of minimally invasive surgery while allowing for the diagnosis and treatment of concomitant pathology, which may be either acute, from the trauma of the missile, or chronic. We present a technique for the removal of projectiles from the central and peripheral compartments of the hip joint. Through a surgical series of a variety of gunshot wounds, we detail the unique aspects of retrieval for the various missile endpoints. We describe this technique for bullets or pieces of bullets lodged within the hip joint space, bone of the acetabulum, or femoral head. Furthermore, we provide an example in which hip arthroscopy is not a suitable option for treatment because of the resulting fracture pattern, which necessitates open reduction along with internal fixation. PMID:27489755

  11. Vascular complications following total hip arthroplasty: a case study and a review of the literature.

    Science.gov (United States)

    Barbier, Olivier; Pierret, Charles; Bazile, Fabrice; De Kerangal, Xavier; Duverger, Vincent; Versier, Gilbert

    2012-11-01

    Vascular complications after total hip arthroplasty (THA) are rare but represent a real risk. The diversity of clinical presentations can make diagnosis difficult. They could manifest as an immediate and acute hemorrhage or subsequent ischemia. We report the case of a patient who presented a thrombosis of the femoral artery associated with a sciatic palsy after THA for a coxa profunda. The diagnosis was actually made 3 years after surgery because of atypical symptoms. The mechanism involved was either a crash of the artery by a retractor on the anterior wall of the acetabulum, or a stretching of the artery. A review of the literature of vascular complications occurring after THA recalls the multiplicity of clinical presentations and the diagnostic difficulties. They could manifest as an immediate and acute hemorrhage or deferred ischemia, as in our case. Knowledge of these complications should help prevent them, and the diagnosis should be considered in atypical sequences after THA.

  12. Advanced containment methods for the treatment of Perthes disease: Salter plus varus osteotomy and triple pelvic osteotomy.

    Science.gov (United States)

    Wenger, Dennis R; Pandya, Nirav K

    2011-09-01

    The goal of intervention in Legg-Calvé-Perthes disease has been to prevent femoral head deformation by containing the head within the acetabulum, using it as a mold for guiding femoral head development. With appropriate proximal femoral morphology, premature arthritis can hopefully be avoided. Both nonsurgical and surgical methods of treatment have evolved over time, from abduction casts and braces to advanced surgical containment methods, which are now the mainstay of treatment. The purpose of this study is to briefly review the evolution of surgical treatment of Legg-Calvé-Perthes disease, and to concentrate on 2 advanced surgical containment methods: combined Salter innominate osteotomy with femoral varus osteotomy and triple pelvic osteotomy.

  13. Cell probing by delayed luminescence

    Science.gov (United States)

    Musumeci, Francesco; Ballerini, Monica; Baroni, Giuliana; Costato, Michele; Ferraro, Lorenzo; Milani, Marziale; Scordino, Agata; Triglia, Antonio

    1999-05-01

    Delayed luminescence (D.L.) is a measure that provides important information on biological systems fields, structures and activities, by counting impinging and emitted photons. Many recent experimental works have shown the existence of a close connection, sometimes analytically expressed between the biological state of the system and D.L. parameters. Our investigations aim to show that D.L. is a workable analytical technique covering a large number of disciplinary fields, from agriculture to pollution control and from medical diagnostics to food quality control. The authors have conducted systematic research about D.L. from unicellular alga Acetabularia acetabulum to Saccharomyces cerevisiae yeast cultures and about more complex systems such as Soya seed (Glycine max, L.) and its dependence on sample preparation, history, intracellular signaling, metabolism and pollutant presence. We will discuss the most relevant results together with theoretical considerations on the basic interaction at work between biological systems and electromagnetic fields.

  14. Automated measurement of diagnostic angles for hip dysplasia

    DEFF Research Database (Denmark)

    de Raedt, Sepp; Mechlenburg, Inger Buur; Stilling, Maiken;

    2013-01-01

    A fully automatic method for measuring diagnostic angles of hip dysplasia is presented. The method consists of the automatic segmentation of CT images and detection of anatomical landmarks on the femur and acetabulum. The standard angles used in the diagnosis of hip dysplasia are subsequently....... These values correspond to values found in evaluating interobserver and intraobserver variation for manual measurements. The method can be used in clinical practice to replace the current manual measurements performed by radiologists. In the future, the method will be integrated into an intraoperative surgical...... automatically calculated. Previous work in automating the measuring of angles required the manual segmentation or delineation of the articular joint surface. In the current work automatic segmentation is established using graph-cuts with a cost function based on a sheetness score to detect the sheet...

  15. Acetabular prosthesis: Proff of migration with ruler and pencil?

    International Nuclear Information System (INIS)

    Conventional X-ray films were made with varying degrees of tilt of a pelvic phantom containing an acetabular prosthesis. The position of the prosthesis was then reconstructed graphically. The measurement errors were calculated and an estimate was made for the tilt. There is a linear correlation between the measurement error and the tilt of the prosthesis. Therefore a tilt dependent maximum error can be calculated. This error is very small for small degrees of tilt, so that acetabular migration can in this instance be evaluated with greater confidence than with other graphical methods. The error also correlates with the determination of the selected region of the acetabulum, but not with the position of the central focus spot or image magnification. (orig.)

  16. Femoroacetabular impingement: a review of current concepts.

    Science.gov (United States)

    Sangal, Rohit B; Waryasz, Gregory R; Schiller, Jonathan R

    2014-11-01

    Femoroacetabular impingement is becoming an increasingly more common diagnosis in the orthopaedic community for hip pain in the younger population. Variations in the femoral head and acetabulum can lead to a sequelae of changes to the cartilage that can lead to osteoarthritis. Diagnosis is made through a combination of patient history, physical examination, and diagnostic imaging. Plain radiographs are a very useful tool for evaluating the bony anatomy, while CT scan and MRI have roles for surgical planning and more definitive diagnosis. Most patients should trial physical therapy prior to consideration for any arthroscopic or open procedures. Long-term outcome studies are being performed to determine if surgical intervention has any impact on quality of life and development of osteoarthritis.

  17. Ceramic-on-Ceramic Total Hip Arthroplasty in a Twelve-Year-Old Patient: Case Report with a 27-Year Follow-Up.

    Science.gov (United States)

    Save, Ameya V; Varthi, Arya; Talusan, Paul G; Gala, Raj; Nelson, Stephen; Keggi, Kristaps J

    2016-01-01

    Total hip arthroplasty in the juvenile patient with a severely diseasedjoint can provide long-term pain relief and improvement in function. We present a patient with juvenile rheumatoid arthritis who underwent a Mittelmeier ceramic-on-ceramic total hip arthroplasty at age 12 in 1986. The implant provided the patient with a functioning hip for 24 years, but subsequently required revision due to femoral component loosening. This case report represents the longest reported clinical follow-up of noncemented, ceramic-on-ceramic total hip arthroplasty in a juvenile patient and depicts an excellent outcome at 27 years. Our case is also unique in that the Mittelmeier ceramic acetabulum was left in place during revision surgery. In this report, we also describe the senior author's choice of the Mittelmeier hip prosthesis within its historical context and provide a brief review of the literature as it relates to total hip arthroplasty in the juvenile patient. PMID:27509640

  18. [Pelvic chondroblastoma in an adolescent. New treatment approach].

    Science.gov (United States)

    Rico-Martínez, G; Linares-González, L; Delgado-Cedillo, E; Cerrada-Moreno, L; Clara-Altamirano, M; Pichardo-Bahena, R

    2011-01-01

    Surgical management of tumors located in the spine and the pelvis involves greater difficulty. Moreover, these tumors are usually very large and vascularized. Preoperative embolization of the internal iliac artery is a relatively safe procedure that may reduce the risk of bleeding and local recurrence in the case of benign tumors. Chondroblastoma is a tumor that is rarely located in the pelvis; its more frequent location is the triradiate cartilage. We describe a case of a chondroblastoma with a relapsing aneurysmal cystic component in the acetabulum of an adolescent patient. Treatment consisted of embolization of the internal iliac artery, fluid hyperthermia, hydrogen peroxide and bone marrow application. The patient was found to be asymptomatic at the 5-year postoperative follow-up. The technetium (99mTc) sestamibi scan was negative for tumor activity and found no lung metastases.

  19. Analysis of slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    CT with multiplanar reconstruction (CT/MPR) was used to assess 25 adolescents with known or suspected slipped capital femoral epiphysis (SCFE). CT/MPR localizes the epiphysis in three planes, establishing its relationship to the acetabulum and the metaphyseal neck. MPR facilitates measurements of head-neck angles, residusal head-neck contact, and relative retrovision. CT/MPR may establish the true age of the epiphyseal failure and can reveal subtle SCFE in the face of normal plain films. Patients often present with confusing histories; clues to the true age of failure include subtle signs of healing, remodeling, or new bone buttressing. Characterization of acute versus chronic conditions influences preoperative planning. Postoperatively, CT/MPR confirms early results and follows epiphyseal fusion and remodelling. It also detects complications, such as pin or graft migration avascular necrosis (AVN), or chondrolysis

  20. [Pelvic chondroblastoma in an adolescent. New treatment approach].

    Science.gov (United States)

    Rico-Martínez, G; Linares-González, L; Delgado-Cedillo, E; Cerrada-Moreno, L; Clara-Altamirano, M; Pichardo-Bahena, R

    2011-01-01

    Surgical management of tumors located in the spine and the pelvis involves greater difficulty. Moreover, these tumors are usually very large and vascularized. Preoperative embolization of the internal iliac artery is a relatively safe procedure that may reduce the risk of bleeding and local recurrence in the case of benign tumors. Chondroblastoma is a tumor that is rarely located in the pelvis; its more frequent location is the triradiate cartilage. We describe a case of a chondroblastoma with a relapsing aneurysmal cystic component in the acetabulum of an adolescent patient. Treatment consisted of embolization of the internal iliac artery, fluid hyperthermia, hydrogen peroxide and bone marrow application. The patient was found to be asymptomatic at the 5-year postoperative follow-up. The technetium (99mTc) sestamibi scan was negative for tumor activity and found no lung metastases. PMID:22512105

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

    Institute of Scientific and Technical Information of China (English)

    Ashok S Gavaskar; Naveen Chowdary Tummala

    2012-01-01

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

  2. Cementless Hydroxyapatite Coated Hip Prostheses

    Directory of Open Access Journals (Sweden)

    Antonio Herrera

    2015-01-01

    Full Text Available More than twenty years ago, hydroxyapatite (HA, calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.

  3. Proximal Focal Femoral Deficiency

    Directory of Open Access Journals (Sweden)

    Vishal Kalia, Vibhuti

    2008-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contrast arthrography orMagnetic Resonance Imaging is indicated when radiological features are questionable and to disclose thepresence and location of the femoral head and any cartilagenous anlage. The disorder is more commonlyunilateral and is apparent at birth. However, bilateral involvement is rarely seen. Therapy of the disorder isdirected towards satisfactory ambulation and specific treatment depending on the severity of dysplasia.

  4. Primary multifocal osseous Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Kohler Janice

    2008-03-01

    Full Text Available Abstract Background Hodgkin's disease (HD most commonly presents with progressive painless enlargement of peripheral lymph nodes, especially around the cervical region. A few children have systemic symptoms and weight loss. At the time of diagnosis, osseous involvement is uncommon Case presentation A case is described of Primary Multifocal Osseous Hodgkin's Lymphoma in a seven-year-old boy. He presented with a painful swelling in the sternum, and further investigations revealed deposits in his L1 vertebra, the left sacro-iliac joint and the right acetabulum. Conclusion The clinical, radiological and histological features of this disease can mimic other medical conditions, including Tuberculosis, making the diagnosis difficult and often leading to delays in treatment. This is a very rare condition and we believe this to be the youngest reported case in the literature.

  5. The results of a press-fit-only technique for acetabular fixation in hip dysplasia.

    Science.gov (United States)

    Takao, Masaki; Nakamura, Nobuo; Ohzono, Kenji; Sakai, Takashi; Nishii, Takashi; Sugano, Nobuhiko

    2011-06-01

    The purpose of the present study was to evaluate the 6- to 11-year follow-up results of hemispherical porous-coated cups implanted into dysplastic hips using press-fit technique without screws focusing on the amount of host bone coverage. There were 87 patients who underwent 98 primary total hip arthroplasties. Bony coverage was measured as the angle between the vertical line and the line drawn from the cup center to the lateral edge of the acetabulum, which was named the cup center-edge angle (cup-CE angle). All 98 cups were judged to be bone ingrown. The minimum cup-CE angle was 8.4° (mean, 26.3°). Bone-cup contact of more than 8.4° of the cup-CE angle was large enough for press-fit cups to resist superior directed loads during this follow-up period. PMID:20647158

  6. Parasitic castration in Fissurella crassa (Archaeogastropoda due to an adult Digenea, Proctoeces lintoni (Fellodistomidae

    Directory of Open Access Journals (Sweden)

    Marcelo E. Oliva

    1992-03-01

    Full Text Available Specimens of Fissurella crassa (Archaeogastropoda from Ilo, southern Perú, are infected with the adult stage of the digenetic trematode Proctoeces lintoni (Fellodistomidae. The histopatological analysis of the male and female gonads show a strong effect of the parasite on the structure and function of these organs. P. lintoni live unencysted in the gonads, and the main mechanical damage is originated by the action of a well developed acetabulum. Chemical actions of parasitic secretions may also be involved. The infected gonads show altered structure and the gametogenic processes is aborted. There is no evidence of hemocytic response, but leucocite infiltration is evident at least in male infected gonads. An increased content of polysaccarides is evident in infected gonads.

  7. 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

  8. Octreotide scintigraphy localizes somatostatin receptor-positive islet cell carcinomas

    International Nuclear Information System (INIS)

    Tyr-3-octreotide is a synthetic derivative of somatostatin and a somatostatin-receptor analogue. The iodine-123-labelled compound localizes somatostatin-receptor-positive tumours. In this paper two patients are reported in whom somatostatin receptors were demonstrated in vitro. In a 60-year-old female with an islet cell carcinoma of the pancreas, multiple liver metastases and previously uncrecognized bone metastases in the right acetabulum could be diagnosed as the reason for a persistent hypoglycaemia. In a 60-year-old male an islet cell carcinoma of the pancreas was localized with 123I-Tyr-3-octreotide. The somatostatin receptors were demonstrated in vitro and the tumour was successfully treated with somatostatin. These studies demonstrate that 123I-Tyr-3-octreotide offers the possibility of localizing somatostatin-receptor-positive tumours and their metastases. Moreover the method makes it possible to determine the receptor status of a tumour in vivo. (orig.)

  9. Uma nova espécie de Dadayius Fukui, 1929 (Digenea: Cladorchiidae parasita do trato intestinal de Metynnis maculatus (Kner, 1858 (Characidae da planície de inundação do alto rio Paraná, Brasil - DOI: 10.4025/actascibiolsci.v25i2.2044 A new species of Dadayius Fukui, 1929 (Digenea: Cladorchiidae, parasite of the intestinal tract of Metynnis maculates (Kner, 1858 (Characidae from the Upper Paraná River floodplain, Brazil - DOI: 10.4025/actascibiolsci.v25i2.2044

    Directory of Open Access Journals (Sweden)

    Ricardo Massoto Takemoto

    2003-04-01

    Full Text Available Uma nova espécie de Cladorchiidae (Trematoda, Digenea foi encontrada no trato intestinal do peixe de água-doce “pacu peva”, Metynnis maculatus (Kner, 1858 na planície de inundação do Alto Rio Paraná, Brasil. A nova espécie foi classificada no gênero Dadayius Fukui, 1929 por apresentar testículos não lobados e acetábulo ventro-terminal com um “entalhe” postero-mediano na margem interior, características do gênero que possui apenas duas espécies conhecidas. Algumas características que diferem a espécie nova de D. marenzelleri (Daday, 1907 e D. pacuensis Thatcher, 1996 são cecos não alcançando o acetábulo, vitelária de extensão limitada e não atingindo o nível do testículo posterior e a presença de dois tamanhos diferentes de ovos em dois estágios de maturação diferentes.A new species of Cladorchiidae (Trematoda, Digenea was found in the intestinal tract of freshwater fish “pacu peva”, Metynnis maculates (Kner, 1858 from the Upper Paraná River floodplain, southern Brazil. The new species was classified in the genus Dadayius Fukui, 1929 by having non-lobate testis and a ventro-terminal acetabulum with postero median notch on rim, characters of the genus wich has only two previously known species. Some characters that differ the new species from D. marenzelleri (Daday, 1907 and D. pacuensis Thatcher, 1996 are: ceca not reaching acetabulum, vitellaria of limited extension, not reaching the level of posterior testis and the presence of two different egg sizes in two different maturity stages.

  10. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dandachli, Wael; Najefi, Ali; Iranpour, Farhad; Lenihan, Jonathan; Hart, Alister; Cobb, Justin [Imperial College London, Charing Cross Hospital, Department of Orthopaedic Surgery, London (United Kingdom)

    2012-10-15

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  11. Computerized tomography in evaluation of decreased acetabular and femoral anteversion; Besonderheiten bei der Bestimmung der Hueftpfannenanteversion und Schenkelhalsantetorsion durch Computertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Toennis, D.; Skamel, H.J. [Institut fuer Strahlendiagnostik, Klinikum Dortmund GmbH (Germany)

    2003-09-01

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [German] Fuer die Computertomographie hat sich eine neue Aufgabe ergeben. Es hat sich gezeigt, dass verringerte Pfannenanteversion und Schenkelhalsantetorsion haeufige Ursachen von Hueftschmerz und -arthrose sind, v. a. wenn beide gegen 0 gehen. Da operative Massnahmen vor Eintreten der Arthrose ergriffen werden sollten, sind genaue Messwerte erforderlich. Die Untersuchung sollte in Bauchlage durchgefuehrt werden, um eine einheitliche und weitgehend normale Beckenkippung zu gewaehrleisten. Die Schenkelhalstorsion wird zwischen der Kniegelenk- und der Schenkelhalsachse gemessen. Zur Festlegung der Sagittalebene legt man am besten eine Mittellinie zwischen die Beckenschaufeln. Die Messung der Pfannenanteversion sollte in der Schnitthoehe erfolgen, wo die Bewegungseinschraenkung der Innenrotation auftritt. (orig.)

  12. Multislice CT of the pelvis: dose reduction with regard to image quality using 16-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Gurung, Jessen; Khan, M. Fawad; Maataoui, Adel; Herzog, C.; Vogl, Thomas J. [Johann Wolfgang Goethe University, Institute for Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Bux, R.; Bratzke, H. [Johann Wolfgang Goethe University, Institute for Forensic Medicine, Frankfurt am Main (Germany); Ackermann, Hanns [Johann Wolfgang Goethe University, Institute for Epidemiology and Medical Statistics, Frankfurt am Main (Germany)

    2005-09-01

    To optimize examination protocols of 16-row multi-detector CT (MDCT) of pelvis for dose reduction with regard to image quality. MDCT of pelvis was performed on 12 cadaver specimens with stepwise reduction of tube current from 160 mA (113, 80, 56, 40, 28) to 20 mA at 120 kV. Scan parameters were 16 x 1.5 mm collimation. Reconstructions of axial and coronal images were used for evaluation of cortex, trabeculum, image quality, image noise, acetabulum and iliosacral (ISJ) joints. After data were blinded, evaluation of images was done by three radiologists according to 5-point Likert scale. Accuracy of the observers in sorting films according to dose reduction was determined with kappa coefficient. Mean values of image evaluation were determined. Pronounced deterioration of image quality for all criteria was observed between 80 and 28 mA. Adequate image quality was obtained at 40 mA [effective dose (E): 2.2 mSv, CTDI{sub w}: 2.8 mGy] for criterion detailed definition of acetabulum and ISJ and at 80 mA (E: 4.4 mSv, CTDI{sub w}: 5.6 mGy) for remaining criteria. Moderate agreement was observed between the three observers (kappa coefficient: 0.31). All observers were excellent in arranging images according to decreasing dose. Using 16-row MDCT image quality of pelvis is acceptable at 80 mA and 120 kV. This translates into a dose reduction of 33% of average value of the nationwide survey of the German Roentgen Society (1999) for this type of examination. (orig.)

  13. A comparative study of "plasmacup" and "porous-coated" acetabular components: survival after 10 to 12 years of follow-up

    Directory of Open Access Journals (Sweden)

    José Ricardo Negreiros Vicente

    2010-01-01

    Full Text Available OBJECTIVES: Our primary aim was to compare the long-term survivorship rates and the rates of successful osseointegration between two different types of uncemented acetabular components. INTRODUCTION: Two types of alloys have primarily been used for the manufacture of the uncemented acetabular components: titanium-based and cobalt-based alloys. A titanium-based alloy appears to be more effective with regard to interface stress transfer to the host bone because of its lower elastic modulus relative to a cobalt-based alloy. This supposed mechanical advantage of a titanium-based alloy component motivated this comparative study. METHODS: Two uncemented acetabular components, a porous-coated acetabulum and a Plasmacup®, were compared with a focus on long-term prosthesis survivorship and the development of acetabular osseointegration. Five radiographic signs of osseointegration were evaluated at the last follow-up appointment: (1 absence of radiolucent lines, (2 presence of a superolateral buttress, (3 medial stress-shielding, (4 radial trabeculae, and (5 an inferomedial buttress. We considered the presence of any three of these radiographic signs, in the absence of acetabular dislocation or symptoms, to be indicative of successful acetabular osseointegration. RESULTS: Among 70 patients implanted with the porous-coated acetabulum, 80% achieved osseointegration over a mean follow-up time of 11.9 years versus 75.3% of the 73 patients who received a Plasmacup insert over a mean of 10.7 years. Prosthesis survivorship rates were not different between the two groups. Revision surgery due to mild or severe acetabular osteolysis, polyethylene wear, and aseptic loosening occurred in eight patients (11.4% with a PCA versus nine (12.3% with a Plasmacup. CONCLUSIONS: We conclude that, during the first ten years after surgery, there is no significant difference between these two types of uncemented cups with regard to either prosthesis survivorship or successful

  14. Increasing thickness and fibrosis of the cartilage in acetabular dysplasia: a rabbit model research

    Institute of Scientific and Technical Information of China (English)

    LI Tian-you; MA Rui-xue

    2010-01-01

    Background The order and mechanism of pathological changes in acetabular dysplasia are still unclear. This study investigated cartilage changes in rabbit acetabular dysplasia models at different ages.Methods Twenty-seven 1-month-old New Zealand rabbits underwent cast immobilization of the left hind limb in knee extension. Serial acetabular dysplasia models were established by assessment of the acetabular index and Sharp's angle on radiographs. The thickness of the acetabular cartilage was measured under a microscope, and fibrosis was observed. Ultrastructural changes were investigated with scanning electron microscopy and transmission electron microscopy. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 were measured by real-time fluorescence quantitative polymerase chain reaction.Results In an immature group of rabbits, the acetabular index of the treated hip increased with animal growth. The cartilage on the brim of the left acetabulum was significantly thicker than that on the right side. The collagen fibrils on the surface of the cartilage became gross, and the chondrocytes in the enlargement layer underwent necrosis. In a mature group of rabbits, the left Sharp's angle increased in the rabbits with 6-week casting. The cartilage on the brim of the left acetabulum underwent fibrosis. The chondrocytes were weakly stained, and the number of lysosomes was much larger than normal. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 in the cartilage differed significantly at different ages.Conclusions Increasing thickness followed by fibrosis may be the order of pathological cartilage changes in acetabular dysplasia, with changes in ultrastructure and collagen expression contributing to the process.

  15. Percutaneous acetabuloplasty for metastatic acetabular lesions

    Directory of Open Access Journals (Sweden)

    Logroscino Giandomenico

    2008-05-01

    Full Text Available Abstract Background Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective. Methods We report a retrospective study in 25 such patients (30 acetabuli who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC, Eastern Cooperative Oncology Group (ECOG. The results obtained were analysed using the χ2 Test and Fisher's exact test. Significance was sent at P Results Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59% of patients, and pain reduction was achieved in the remaining 10 (41% patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12% between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences. Conclusion Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases.

  16. Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

    Energy Technology Data Exchange (ETDEWEB)

    Werner, Clement M.L. [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland); University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Copeland, Carol E.; Stromberg, Jeff; Turen, Clifford H. [University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Ruckstuhl, Thomas; Bouaicha, Samy [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland)

    2011-11-15

    Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE (<20 ) or the AI (>12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

  17. Effect of increased pushoff during gait on hip joint forces.

    Science.gov (United States)

    Lewis, Cara L; Garibay, Erin J

    2015-01-01

    Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25 m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to "push more with your foot when you walk". We collected motion data of markers placed on the subjects' trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data. The instruction to "push more with your foot when you walk" reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces were 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain. PMID:25468661

  18. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    International Nuclear Information System (INIS)

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  19. Surgical Outcome of Acetabular Fracture Using Trochanteric Flip Osteotomy

    Directory of Open Access Journals (Sweden)

    Espandar R

    2012-01-01

    Full Text Available Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy. Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS, Harris hip score (HHS, force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.Results : The mean HHS was 82.5 (55-95. Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or nonunion. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

  20. Periacetabular osteotomy for acetabular dysplasia%髋臼周围截骨术治疗髋臼发育不良

    Institute of Scientific and Technical Information of China (English)

    李华; 王云清; 魏东

    2011-01-01

    目的 探讨髋臼周围截骨术治疗髋臼发育不良的方法 及疗效.方法 对36例髋臼发育不良患者(43髋)行手术治疗,通过髋臼周围截骨、旋转髋臼向前外侧移位恢复髋臼的正确位置,并增加髋臼覆盖面.结果 36例均获随访,时间 6个月~3年.术后髋痛、跛行完全消失或有明显改善,髋关节活动范围基本正常.CE角和Sharp角均基本恢复正常.结论 髋臼周围截骨术可有效改善临床症状,恢复髋关节的生物力学特点,是治疗髋臼发育不良的有效方法.%Objective To discuss the method and effect of the treatment of acetabular dysplasia by periacetabular acetabular osteotomy. Methods Periacetabular osteotomy was performed to correct 36 patients( 43 hips )with dysplastic acetabulum through rotating the acetabulum anterolaterally, by which the position and acetabular coverage of the femoral head was restored to nearly normal. Results 36 patients with acetabular dysplasia were all followed up for six months to three years. After operation, in the majority, the hip limp or pain with exertion disappeared, and a satisfactory range of motion had been restored. CE angle and Sharp angle were restored to nearly normal value. Conclusions Periacetabular osteotomy is effectively to improve the clinical symptoms, and restore the hip biomechanics characteristics,which is ideal for the treatment of developmental acetabular dysplasia.

  1. Research Progress in the Association between Gene Polymorphism and Developmental Dysplasia of the Hip%基因多态性与髋关节发育不良的相关性研究进展

    Institute of Scientific and Technical Information of China (English)

    侯华成; 史冬泉

    2013-01-01

    Developmental dysplasia of the hip( DDH )is a common skeletal disease during the period of infant and child, and its morbidity is nearly 1‰-2‰. Hip dysplasia refers to an anomaly in the size, shape, o-rientation, or organization of the femoral head, acetabulum, or both. This disease usually comprises shallow ac-etabulum and/or lax joint capsule. Hip instability, joint pain, gait abnormalities and premature arthritis are common clinical signs. It is important to prevent,diagnose and treat DDH as early as possible. More about the etiopathogenesis should be learned for the prevention, and genetic factor is one of the most important etiologi-cal factors of the disease.%髋关节发育不良(DDH)是婴幼儿时期一种常见的骨科疾病,发病率为1‰ ~2‰.其是由股骨头和(或)髋臼的大小、形态、取向和(或)组织构成异常导致,通常指关节囊松弛和(或)髋臼太浅.DDH可导致膝关节不稳定、关节疼痛、步态异常及早发型骨性关节炎,因此早期预防、早期诊断和早期治疗显得尤为重要.预防该病必须了解病因,而遗传因素是DDH的重要病因之一.

  2. 髋臼发育不良髋关节置换前髋臼侧的三维测量%Three-dimensional measurement of acetabular side before arthroplasty for acetabular dysplasia

    Institute of Scientific and Technical Information of China (English)

    许杰; 马若凡; 李登; 蔡志清; 李亮平

    2013-01-01

    BACKGROUND:The anatomical strucure of acetabulum is smal and shal ow in adult acetabular dysplasia patients. The large amount of cal us and scar tissues in the acetabulum make it difficult to identify and instal the acetabular cup during arthroplasty. The comprehensive understanding of the acetabulum before arthroplasty is the premise for selecting the appropriate acetabular prosthesis and making the acetabular reconstruction program. OBJECTIVE:To evaluate the application value of three-dimensional reconstruction technique in choosing the size of acetabular cup before total hip arthroplasty for acetabular dysplasia. METHODS:Spiral CT was carried out in the 11 acetabular dysplasia patients who waiting for total hip arthroplasty. The acetabulum was multi-planar reconstructed, and the size of the acetabular cup was determined through digitized acetabular cup template implantation, and then the mathching degree assessment was performed to compare with the actual size. RESULTS AND CONCLUSION:Spiral CT could clearly show the acetabular morphology, and the 71.4%of the acetabular size chosen in the three-dimensional preoperative plan was the same as actual one, the intraclass correlation coefficient was 0.888. The agreement was much higher than that of two-dimensional preoperative plan based on X-ray plain film. For the patients with acetabular dysplasia, the acetabulum became saml er and shal ower, and there were various extents of bone defects in the superior-lateral acetabulum. Three-dimensional multi-planar reconstruction can effectively evaluate the acetabular morphology, and three-dimensional preoperative plan can provide useful information for the choice of implant.%背景:成人髋臼发育不良髋臼小而浅,臼内有大量骨痂和瘢痕组织等都为人工髋关节置换术中真臼的辨认、臼杯的准确安装带来极大困难,关节置换前对髋臼的全面认识是选择合适的髋臼假体和制定个性化髋臼重建方案的前提。目

  3. Management of early-stage hip dislocation after hemipelvic endoprosthesis reconstruction:14 cases of reportc%人工半骨盆置换患者术后早期髋关节脱位14例报告

    Institute of Scientific and Technical Information of China (English)

    李大森; 郭卫; 杨荣利; 唐顺; 汤小东; 燕太强

    2013-01-01

    Objective It is challenging to resect the pelvic malignancy involving the acetabulum and reconstruct it with hemipelvic endoprosthesis. The postoperative hip dislocation rate is relatively high. The aim of this study is to outline key technical considerations in dealing with early-stage hip dislocation after pelvic tumor resection and hemipelvic endoprosthesis reconstruction. Methods 169 cases who had pelvic tumor resection and hemipelvic endoprosthesis reconstruction between July 2003 and December 2011 were reviewed. After tumor resection, artificial total hip with anti-dislocation mechanism was used, and periacetabular muscular tension was carefully rebuilt. Postoperative rehabilitation was supervised by a specialized nursing team. Early-stage dislocation was defined as the dislocation occurred within 6 months postoperatively. Open reduction was considered only when closed reduction under subarachnoid anesthesia failed. A normal acetabulum abduction angle was defined between 30 and 55 degrees. The chi-square test was used to detect group differences ( dislocation group and non-group dislocation ) of acetabulum abduction angle. Results 14 patients had early-stage dislocation. The midterm time between dislocation and operation was 16 days ( range;0-94 days ). Successful close reduction was accomplished in 5 patients and the other 9 patients had to undergo open reduction. No hemipelvic prosthesis loosening or sciatic nerve injury was observed during reduction. Second hip dislocation happened in 2 cases after close reduction. No case had an acetabulum abduction angel less than 30 degree. 5 of the dislocated hip had an acetabulum abduction angle more than 55 degrees, while 50 of the non-dislocation group had that an acetabulum abduction angle ( Fisher’s Exact Test, P=0.773 ). Conclusions Despite all the techniques we applied, hip dislocation rate is high after periacetabular tumor resection and hemipelvic prosthesis reconstruction. This is partly due to the

  4. 经皮髋臼成形术穿刺部位的解剖学研究%Anatomic study on the puncture point of the percutaneous acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    蒋昆利; 梁清福; 王俊江; 田征

    2016-01-01

    目的:从解剖学角度探讨经皮髋臼成形术治疗髋臼转移瘤患者手术入路的最佳穿刺点、深度。方法选用30具经防腐固定处理的成人去肌肉骨盆髋关节标本和2具完整成人尸体标本。以髋臼中点为 O 点,过髂前上棘和 O 点做1条直线,再做1条过 O 点且垂直于该直线的直线,2条直线分别与髋臼边缘交于 A、B 点,并把髋臼分为4个象限。∠AOB 的角平分线与髋臼边缘交于 C 点。设髋臼顶点为0时,测量大转子顶点所在水平面与 A、B、C 各点所在水平面的垂直距离及 A、B、C 3点在髋臼边缘外10 mm 相对应 A’、B’、C’3点处的髋臼后壁厚度。根据测量的数据得出最佳穿刺点和深度,对2具完整尸体标本行髋臼穿刺操作并灌注骨水泥验证。结果A’点位于大转子顶点上方31.6~38.4 mm,男性平均34.9 mm,女性平均34.2 mm;B’点位于与 A’点相同距离的10~11点钟位置;C’点位于转子顶点上方33.8~42.5 mm,男性平均距离36.7 mm,女性35.5 mm 的0点钟位置。A’、B’、C’对应的体表投影点即为穿刺部位。其穿刺深度分别为6.7~8.4、17.7~20.4、14.7~17.9 mm,平均深度约分别为7.5、18.5、16.5 mm。经验证髋臼成形术最佳进针点结果成立。结论A’、B’、C’3点的体表投影点均可为行髋臼成形术的穿刺点,3个穿刺点可以较短距离到达髋臼后上象限区的肿瘤。%Objective To discuss the optimal puncture point and depth of percutaneous acetabulum forming operation for treatment of acetabular tumor on the basis of anatomical angle.Methods 30 adult pelvis and hip specimens without muscle fixed with formol and 2 complete cadavers were anatomized and measured. Set the central of acetabulum as point O,from the point O,let a vertical line intersected line which went through the point of spina iliaca anterior superior and the point O

  5. Establishment of classified pelvic and acetabular fractures and their significance%骨盆髋臼骨折三维数字化分型系统的建立及其意义

    Institute of Scientific and Technical Information of China (English)

    王会祥; 汪方; 王秋根; 林艳萍; 陈豪; 陶星光

    2013-01-01

    目的 建立骨盆、髋臼骨折三维数字化分型系统,评价其对骨科临床及教学的指导意义.方法 将一名健康男性志愿者CT扫描所得数据转换成DICOM格式并导入Mimics10.01软件中进行处理,分别重建骨盆、髋臼模型,同时模拟出国际内固定研究学会(A0)分型中各型骨盆、髋臼骨折,对各骨折块予以不同颜色渲染,并将完成制作的骨折三维模型以标准三维图形(STL)文件格式保存.利用视觉化图像工具库(VTK)及跨平台C+ +图形用户界面应用程序开发框架(Qt)等软件开发工具,完成骨盆、髋臼骨折三维数字化分型软件开发.10名骨科医生及20名医学生分别将三维数字化骨盆、髋臼骨折AO分型图谱和传统的二维分型图谱与患者影像学资料进行对比,并给予初步评价.结果 骨盆、髋臼骨折三维数字化分型软件可实现对骨折三维模型的旋转及放缩等操作,从任意角度观察骨折模型.9名骨科医生及18名医学生评价提示,三维数字化骨折分型系统与传统的二维平面分型系统相比,利于对骨盆、髋臼骨折AO分型的理解和判断.结论 骨盆、髋臼骨折三维数字化分型系统具有逼真、直观、立体、动态等特点,对于骨科临床及医学教学具有积极意义.%Objective To establish three-dimensional (3D) digital classification models of pelvic and acetabular fractures and evaluate its significance in orthopaedic clinical and teaching work. Methods Pelvic of a healthy male volunteer was scanned with CT, and the resulting data in DICOM format was imported to Mimics10. 01 software to reconstruct the model of the pelvis and acetabulum respectively. Based on the standards of AO/ASIF classification of pelvic and acetabular fractures, various types of fractures were simulated. The fracture fragments were displayed with different colors. The completed fracture models were saved in STL format. By use of VTK and Qt softwares, the software

  6. 发育性髋脱位早期髋臼软骨细胞凋亡与Caspase-3、Bcl-2表达的相关性研究

    Institute of Scientific and Technical Information of China (English)

    丁良甲; 王炳海; 刘莹丽; 韦宜山

    2014-01-01

    Objective To investigate the corelation of the apoptosis and the expression of Caspase-3 and Bcl-2 of the acetabulum chondrocytes in the early stage of development dislocation of the hip. Methods Thirty two rabbits of 4 weeks old with no restriction on the gender were used in the experiment.The hip was flexured and the left back knee was extended and then fixed with a plaster cast as DDH model group and the right side without fixation as the control group. The apoptosis was detected by TUNEL,and the expression of Caspase-3,Bcl-2 was determined by immunohistochemistry in the acetabulum chondrocytes of 24 successful models. The correlation of apoptosis and the expression of Caspase-3,Bcl-2 was analyzed by the Spearman rank correlation. Results TUNEL Results showed that the apoptosis rate of acetabulum chondrocytes in DDH model group(45.23±10.42)was higher than that in the control group(8.04±4.35,P<0.050)before 8 weeks. However,after 8 weeks the apoptosis in DDH model group did not change obviously. Immunohistochemical results showed that the expression of caspase-3 and bcl-2 in DDH model group was higher than it in the control group(56.73±7.85vs61.45±5.47 and 56.73±7.85 vs. 52.32±7.99,respectively;P<0.05). The caspase-3 expression and the apoptosis rate in acetabulum chondrocytes was negatively correlated(r=-0.896,P<0.05),while bcl-2 expression and the apoptosis rate was positively correlated(r=-0.896,P<0.05). Conclusion Caspase-3 and bcl-2 may play a role in acetabulum dysplasia and cartilage degeneration.%目的:探讨发育性髋关节脱位(development dislocation of the hip,DDH)早期髋臼软骨细胞凋亡与Caspase-3、Bcl-2表达的相关性。方法选取32只4周龄新西兰大白兔,采用兔后肢屈髋伸膝位管型石膏固定制作DDH动物模型。对24只成功模型兔采用TUNEL法检测髋臼软骨细胞凋亡情况;免疫组化法检测软骨细胞中Caspase-3和Bcl-2的表达。Spearman等级相关分

  7. Periacetabular rotational osteotomy through the medial wall of ilium for the treatment of acetabu-lar dysplasia%经髂骨内侧壁髋臼周围旋转截骨治疗髋臼发育不良

    Institute of Scientific and Technical Information of China (English)

    薛源; 冯香; 高化富; 张印峰

    2014-01-01

    Objective To investigate the effect of periacetabular rotational osteotomy through the medial wall of ilium on acetabular dysplasia. Methods Thirty-six patients with acetabular dysplasia were operated with periacetabular rotational osteotomy through medial wall of ilium. Firstly,the dissec-tion was performed in the subperiosteal plane of the medial ilium via the ilioinguinal incision to expose the medial wall of the bottom of acetabulum. Secondly,without dissecting the internal iliac vasculoneural sheaths,osteotome was used to complete the osteotomy around the acetabulum within 1. 5 cm. The supe-rior portion was greater sciatic notch and the inferior portion was pecten pubis and body of ischium. In or-der to isolate the acetabulum,the two layer cortical bone was cut through and without damaging the later-al periosteum. Thirdly,with the help of biofix rods,the acetabulum was rotated anterolaterally and inferi-orly to correct the Sharp angle to 35° and to restore the coverage rate of femoral head to 75% . Two stein-mann pins were used to put pressure on the medial wall of the bottom of acetabulum through anterior su-perior spine. Postoperatively,none of the operated patients was immobilized. Results Thirty-one of the total 36 patients had 7 to 82 months(average 22 months)of follow up. According to Mckay criteria,the effect was excellent in 21 cases and good in 8 cases. Conclusions Periacetabular rotational osteotomy through the medial wall of ilium for the treatment of acetabular dysplasia is an effective,simple method. It has the advantages of little influence on the stability of pelvis,reliable fixation without external fixa-tion,and can avoide the risk of complications. This method can not only alleviate the patients’pain in the injured hip,but also avoid or delay the development of osteoarthritis.%目的:探讨经髂骨内侧壁髋臼周围旋转截骨术治疗髋臼发育不良的疗效。方法应用经髂骨内侧壁髋臼周围旋转截骨术

  8. Acetabular lateral reconstruction after total hip arthroplasty:understanding and application of core technology%人工髋关节翻修髋臼侧重建:对技术核心的认识及应用

    Institute of Scientific and Technical Information of China (English)

    张文贤; 范有福; 王小燕; 吕江宏

    2014-01-01

    BACKGROUND:After the initial hip replacement, aseptic or infective loosening and subsidence of the prosthesis, acetabular wear, pain, osteolysis and other factors may lead to the loss of prosthesis stability and loss of joint function, which are the common cause of hip arthroplasty. Among the hip arthroplasty, acetabular lateral reconstruction is essential and largely determines the success or failure of revision surgery. OBJECTIVE:To explore the present situation of reconstructing acetabulum after total hip arthroplasty. METHODS:A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) between January 1998 and March 2014, and CNKI database (http://www.cnki.net/) from January 2003 to March 2014 was undertaken for the articles about reconstructing acetabulum after total hip arthroplasty. The key words were“artificial joint, reconstruction, acetabular lateral reconstruction, current situation”in Chinese and“reconstructed acetabulum, total hip arthroplasty”in English. Article about hip reconstruction, acetabyular reconstruction, bone defect reconstruction, prosthesis choice and reconstruction, and soft tissue balance were also selected. Repetitive researches were excluded. RESULTS AND CONCLUSION:According to inclusion criteria, 26 articles were involved in this study. A perfect acetabular revision should achieve the fol owing goals:stabilize acetabular prosthesis after acetabular revision;recover hip rotation center and biomechanical properties;repair acetabular bone defects and increase hip bone. Adequate preparation before surgery is an important prerequisite for the success of surgery and good results, aseptic and septic loosening or subsidence of the prosthesis, as wel as acetabular wear and tear are common causes of hip revision. Intraoperative reconstruction of acetabular anteversion and camber angles, acetabular rotation center reconstruction, reconstruction of acetabular bone defects, selection of reconstruction of

  9. 正常步态下髋臼底接触面积与压力分布的三维有限元分析%Three-dimensional finite analysis of hip contact area and contact pressure during normal walking

    Institute of Scientific and Technical Information of China (English)

    汪光晔; 张春才; 许硕贵

    2011-01-01

    BACKGROUND: Estimation of the hip joint contact area and pressure distribution during activities of daily living is important in predicting joint degeneration mechanism, prosthetic implant wear, providing biomechanical rationales for preoperative planning and postoperative rehabilitation.OBJECTIVE: To explore the hip joint contact area and pressure distribution during different trait phases, which is important in predicting joint degeneration mechanism.METHODS: CT scanning and computer image processing system were used to establish the model to simulate the situation of acetabulum for 32 phases during the trait. A finite element solves was used to calculate stress and contact area. RESULTS AND CONCLUSION: Stress distribution within the acetabular cartilage was obtained and regions with elevated stress at 32 phases were located. The stress distributions of 32 phases were significantly different. The stress demonstrated the bimodal shape of a pronounced phush-off often seen in trial gait cycle (4.2 MPa). The regions of elevated stress and contact area of acetabulum both occurred during stance phases of a gait cycle. Persistent stress-transfer located on medial roof, while on anterior and posterior horn there is always no stress-transfer. The elevated stress located roof during stance phases and medial acetabular cartilage during swing-phases respectively. These results can be used to rationalize rehabilitation protocols, functional restrictions after complex acetabular reconstructions, the renions of elevated stress and contact area of acetabulum are important, which provide an insight into the factors contribution to the arthritis.%背景:认识髋关节的正常压力分布特点,将有助于进一步了解正常髋关节的力学机制与异常载荷下关节软骨的病理学行为.目的:运用三维有限元的方法,分析正常步态过程中头臼间接触面积和应力分布情况.方法:应用CT扫描技术和计算机图像处理系统,建立髋臼的

  10. Assessment of a New Axis of Radiation in Hip Joint Radiographies

    Directory of Open Access Journals (Sweden)

    "A. Esmaeelzadeh

    2005-08-01

    Full Text Available Introduction & Background: The harmful effects of x-rays on sensitive cells such as those of sex gonads are a well-established fact. Therefore, special care should be taken in hip radiographies to protect the gonads. According to the most recent references, to locate the head of femur and its joint in hip radiographies, a line should be drawn from the ASIS to symphysis pubis. To locate the head of the joint, we had to move 2.5cm inferior and laterally from the middle of the men-tioned line. The outer end of this new line indicates the position of the femur head. However, due to the lack of accurate instruments in wards and the variety of diseases and also to avoid repetitive hip radiogra-phies, we decided to apply an experimental method. Patients & Methods: In this study, hip radiographies with FFD=100 were done for 50 patients of both sex with different ages. In all instances the distances be-tween symphysis pubis and the greater trocanter, the base of the lesser trocanter, and upper edge of acetabulum, and symphysis pubis and the center of femur, were measured on the radiographs by means of a standard ruler. The findings were then statisti-cally analyzed. The radiography apparatus was Phil-lips 500MA model D7. Results: In this study, it was shown that in 27 cases, the distance between symphysis pubis and the center of the head of femur was equal to the distance be-tween the base of the lesser trocanter and the upper edge of acetabulum. There was also a difference of 0.5, 1, and 2.5 centimeters in 14, 10, and 3 cases re-spectively. Conclusion: These findings were statistically signifi-cant and new. This is notable with regard to the ease of locating the hip joint in small radiographs. In addi-tion it has the advantage of a small degree of gonadal protection.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  12. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  13. 人体骨盆生物力学三维光弹性的实验研究%A experimental study on the biomechanics of the human pelvis by t he three-dim ensional photoelastics

    Institute of Scientific and Technical Information of China (English)

    郭磊; 范广宇; 高鹏飞; 董本涵

    2001-01-01

    目的 研究人体正常骨盆和髋臼发育不良骨盆的生物力学特征。方法 依据光弹性力学原理,应用光敏材料E-51环氧树脂制作人体骨盆三维光弹模型共4套,模型加载,应力冻结,测量分析骨盆的应力分布及形态改变。结果 人体双腿站立时,正常及髋臼发育不良骨盆环的应力集中在I7、I8、S4、A1、A2等处;髋臼发育不良时髋臼内壁应力异常集中于髋臼上缘,A1∶A4 =6∶1。负重后正常骨盆髋臼外口呈“椭圆形”改变。结论 人体骨盆应力分布复杂;人体双腿站立负重时髋臼可发生形态改变;髋臼发育不良时髋臼应力分布不均导致髋关节骨关节炎的发生。%Objective To investigate the biomechanic characteristic of normal human pelvis and pelvis with development displasia of h ip (DDH) by the three-dimensional photoelastics. Methods Four photoelastic models of human pelvis were made by using light-sensat ory material with hypersensitivity E-51 epoxy resin. The weight was put on mode l and performed froze stress, and the distribution of model stress and morphorlog ical change were observed. Results The stresses of human pelvic ring were concentrated on the parts, such as I7, I8, S4, A1, A2 . In DDH, stresses within acetabulum were concentrated on the parts of upper mar gin of acetabulum,such as A1∶A4=6∶1. In the loading pelvis, acetabular ou tlet became ellipse in shape. Conclusion Under standing condtion of double legs, stresses of human pelvic ring were complicated. In the loading pelvis, morphological changes of acetabulum occurred. In DDH, the abnorm al concentration of stresses within pelvis leads to the development of osteoarth ritis.

  14. Quantitative MRI Evaluation of Articular Cartilage Using T2 Mapping Following Hip Arthroscopy for Femoroacetabular Impingement

    Science.gov (United States)

    Mayer, Stephanie W.; Wagner, Naomi; Fields, Kara G.; Wentzel, Catherine; Burge, Alissa; Potter, Hollis G.; Lyman, Stephen; Kelly, Bryan T.

    2016-01-01

    Objectives: Cam-type femoroacetabular impingement (FAI) causes a shearing and delamination injury to the acetabular articular cartilage due to a mismatch between the size of the femoral head and the acetabulum. This mechanism is thought to lead to early osteoarthritis in this population. Cam decompression has been advocated to eliminate impingement, with the ultimate goal of halting the progression of articular cartilage delamination. Although outcomes following this procedure in the young adult population have been favorable at short and medium term follow up, it is not known whether the articular cartilage itself is protected from further injury by changing the biomechanics of the joint with decompression of the cam morphology. The purpose of this study is to compare the pre- and post-operative integrity of the acetabular articular cartilage using T2 mapping to determine if hip arthroscopy is protective of the articular cartilage at short- to medium term follow up. Methods: Males between 18 and 35 years of age who had pre-operative T2 mapping MRIs, underwent hip arthroscopy for cam or mixed-type FAI with an alpha angle greater than 50°, and had at least 2 year follow-up were identified. Post-operative MRIs were performed and T2 relaxation times in the transition zone and weight bearing articular cartilage in the anterosuperior acetabulum at deep and superficial chondral layers were recorded at nine points on three sagittal sequences on pre and post-operative MRIs. A paired t-test was used to compare T2 relaxation values between pre-operative and post-operative scans. Results: Eleven hips were evaluated. Mean age was 26.3 years (range 21 - 35). Mean follow up time to post-operative T2 mapping MRI was 2.6 years (range 2.4 - 2.7). The change in T2 relaxation time was not significantly different between pre- and post-operative MRI scans for any of the nine regions in the deep zone of the acetabular cartilage (p=0.065 - 0.969) or the superficial zone of the

  15. 改良Zahradnicek手术治疗大龄儿童发育性髋脱位临床应用研究%Clinical Application of Treatment of Developmental Dysplasia of the Hip in Older Children with Improved Zahradnicek Operation

    Institute of Scientific and Technical Information of China (English)

    刘金煜; 刘洋; 董平; 张楠; 李晓光

    2012-01-01

      Objective:To discuss the best methods to treat Developmental Dysplasia of the Hip in older children anddecrease the complications. Methods:41 joints of 37 cases congenital hip joint dislocation were underwent improved Zahradnicek operation.The re-construction of acetabulum arch structure were made to restore the concentric relation between head and acetabulum withspecial drill meanwhile corrected anteversive angle 5~10° and cervical shaft angle 120° with curved steel fixed. Results:The curative assessment were 22 joints excellent,14 joints good and 5 joints bad effects.The curative ratio was 88%.Conclusion:This methods could completely or nearly restore the hip joint to normal anatomic and functional position.%  目的:探讨7~12周岁大龄儿童发育性髋脱位(DDH)治疗优化方法,减少并发症。方法:自2005~2011年应用改良Zahradnicek手术治疗大龄儿童发育性髋脱位37例、41个关节,用特制的小儿髋臼钻有限切削臼软骨,重建髋臼孤形结构,恢复其头臼同心圆关系,同时矫正前倾角至5°~10°,颈干角至120°,用专用的120°鹅颈钢板固定。结果:术后疗效评定:优22髋,为54%;良14髋,为34%;可3髋,为7%;差2髋,为5%,优良率占88%。结论:此种手术在1次手术中使股骨头、髋臼、股骨颈及股骨干恢复或接近恢复正常解剖和功能的方法,使大年龄DDH患儿获得一个功能良好、稳定无痛的关节。

  16. An MRI-based semiautomated volumetric quantification of hip osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Malizos, K.N.; Siafakas, M.S.; Karachalios, T.S. [Dept. of Orthopaedics, Univ. of Thessalia, Larissa (Greece); Fotiadis, D.I. [Dept. of Computer Science, Univ. of Ioannina (Greece); Soucacos, P.N. [Dept. of Orthopaedic Surgery, Univ. of Ioannina (Greece)

    2001-12-01

    Objective: To objectively and precisely define the spatial distribution of osteonecrosis and to investigate the influence of various factors including etiology. Design: A volumetric method is presented to describe the size and spatial distribution of necrotic lesions of the femoral head, using MRI scans. The technique is based on the definition of an equivalent sphere model for the femoral head. Patients: The gender, age, number of hips involved, disease duration, pain intensity, limping disability and etiology were correlated with the distribution of the pathologic bone. Seventy-nine patients with 122 hips affected by osteonecrosis were evaluated. Results: The lesion size ranged from 7% to 73% of the sphere equivalent. The lateral octants presented considerable variability, ranging from wide lateral lesions extending beyond the lip of the acetabulum, to narrow medial lesions, leaving a lateral supporting pillar of intact bone. Patients with sickle cell disease and steroid administration presented the largest lesions. The extent of the posterior superior medial octant involvement correlated with the symptom intensity, a younger age and male gender. Conclusion: The methodology presented here has proven a reliable and straightforward imaging tool for precise assessment of necrotic lesions. It also enables us to target accurately the drilling and grafting procedures. (orig.)

  17. Pseudoachondroplasia: A case report

    Directory of Open Access Journals (Sweden)

    Radlović Vladimir

    2013-01-01

    Full Text Available Introduction. Pseudoachondroplasia (PSACH is an autosomal dominant osteochondrodysplasia due to mutations in the gene encoding cartilage oligomeric matrix protein. It is characterized by rhizomelic dwarfism, limb and vertebral deformity, joint laxity and early onset osteoarthrosis. We present the girl with the early expressed and severe PSACH born to clinically and radiographically unaffected parents. Case Outline. A 6.5-year-old girl presented with short-limbed dwarfism (body height 79.5 cm, acetabulum. Conclusion. PSACH is an achondroplasia-like rhizomelic dwarfism recognized by the absence of abnormality at birth, normal craniofacial appearance, characteristic epiphyseal and metaphyseal radiographic finding and joint hyperlaxity.

  18. Three-phase bone scintigraphy pattern of loosening in uncemented hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Rubello, D. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Borsato, N. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Chierichetti, F. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Zanco, P. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Ferlin, G. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy)

    1995-04-01

    The three-phase bone scintigraphy pattern of loosening in uncemented hip prostheses (UHPs) has not previously been elucidated. We evaluated 28 patients with complicated UHPs who had undergone total hip arthroplasty a very long time previously (range 3-20 years, mean 8.4). All the patients were surgically reviewed: 26 UHPs were found to be loosened and two infected. Nine asymptomatic UHPs were taken as controls. The dynamic phase was invariably negative in both loosened and asymptomatic UHPs while markedly positive in the infected ones. The blood pool phase was positive to various degrees in 16 of the 26 loosened UHPs as well as in the infected UHPs, but was invariably negative in painless replacements. In the bone phase, areas of significantly (discrete to marked) increased uptake were observed in all the loosened prostheses as well as in two-thirds of the asymptomatic ones. However, the regions of the lesser trochanter and/or tip and/or shaft were involved exclusively in the case of the loosened UHPs, and diffuse periprosthetic uptake was found only with loosened or infected implants. Areas of slight methylene diphosphonate (MDP) uptake were found at every periprosthetic site and areas of discrete to marked MDP uptake were commonly found in the acetabulum and/or the greater trochanter with both loosened and painless prostheses and are thus considered to be nonspecific findings. (orig.)

  19. Legg-Calvé-Perthes disease: Diagnostics and contemporary treatment

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2008-01-01

    Full Text Available Legg-Calvé-Perthes disease represents avascular necrosis of the femoral head in a growing child. It commonly affects children aged 2-14 years, mostly boys, and has familiar pattern. The etiology of this disease is unknown. It is based on avascular necrosis due to variations of the femoral head vascular supply, trauma, coagulation of endocrine disturbances. The disease presents with limping and pain localized in the hip with projection to thigh and knee, frequently accompanied by the limitation of abduction and internal rotation, as well as slight limitation in flexion of about 20 degrees. Plain radiography is most informative additional diagnostic procedure, enabling assessment of the stage of disease, containment of the femoral head within the acetabulum, acetabular coverage and the extent of disease. Main treatment goal is obtaining the spherical congruity of the hip joint. This can be achieved by abduction bracing, varization femoral osteotomies and various innominate osteotomies (sometimes combined with femoral osteotomies. Children younger than four years of age, with minimal femoral head involvement, do not need any treatment. These children with a larger involvement, older than four years of age, with possible containment in hip abducion, should be treated by one of the following procedures: Salter innominate osteotomy, Salter innominate osteotomy with femoral shortening, or triple pelvic osteotomy. The patients with containment of the hip is not possible in abduction (related to subluxation and femoral head crush, should be treated by Chiari pelvic osteotomy.

  20. Application of three-dimensional computed tomography in total hip arthroplasty of adult developmental dysplasia of hip%3DCT技术在成人髋臼发育不良全髋关节置换术中的应用

    Institute of Scientific and Technical Information of China (English)

    徐永胜; 魏宝刚; 吕龙; 马秉贤

    2012-01-01

    , male 5, female 20, aged 21 - 63 years old, mean age 47.9 years old. All of patients underwent pre—operative digital radiography (DR) and 3DCT reconstruction, and measured some parameters to obtain relevant data, then performed THA accorded guideline of the data. All the patients underwent pelvic DR after operation, the horizontal distance and vertical distance from femoral head center to ideal rotation center between contralateral and ipsilateral at pre-operation and post-operation were compared, and recovery level of rotation center in ipsilaieral hip were evaluated. Results The CT showed that anteroposterior diameter of acetabulum became smaller, posterior thickness of acetabulum became thicker and depth of acetabulum was shallower, and there were statistically significant differences in morphological parameters of femur and acetabulum between 2 groups(P 0.05). The mean horizontal distance in pre-operation was 20.15 mm (16 — 38 mm), and mean horizontal distance in post-operation was 2.95 mm (- 2.0 - 9.3 mm). The lateral side of idea center of rotation was positive numeric, and the difference between pre -operation and post -operation were statistically significant (t = 6.74, P < 0.01). The mean vertical distance in pre-operation was 23.58 mm (18 - 42 mm), and mean vertical distance in post-operation was 3.25 mm(- 6.0 - 13.4 mm). The upper side of idea center of rotation as positive numeric, and the difference between pre-operation and post-operation were statistically significant(t=4.53, P< 0.01). Conclusion It is demonstrated that 3DCT reconstruction could provide preferred design for DDH patients with THA, including the customization of acetabular prosthetic, the position of acetabular bone graft and reconstruction, and acetabular component placement angle. The 3DCT plays an important role in recovery of concentric reduction, restoration of anatomical structure and hip joint function.

  1. Functional and radiographic evaluation and quality of life analysis after cementless total hip arthroplasty with ceramic bearings: minimum of 5 years follow-up

    Directory of Open Access Journals (Sweden)

    Rafael Borghi Mortat

    2013-12-01

    Full Text Available Objective: The aim of the study is to analyze and correlate functional and radiographic results and quality of life in patients undergoing cementless total hip arthroplasty with ceramic surface, performed at Hospital Servidor Publico de Sao Paulo from 2001 to 2006. Methods: We retrospectively analyzed 35 hips treated with cementless total hip arthroplasty with ceramic surfaces with a minimum follow-up of 5 years. Functional evaluation was based on the Harris Hip Score (HHS. Radiographic evaluation was based on the method proposed by Charles Engh for evaluation of femoral osseointegration and on DeLee and Charnley zones for acetabulum. Quality of life was assessed by SF-36 questionnaire. Results: The HHS presented excellent and good results in 91% of patients postoperatively (mean of 93.14 points HHS. As for radiographic evaluation, we found excellent results in 100% of evaluated hips (proven osseointegration. SF-36 scores were not compared to the control group for the following components: pain, vitality, mental health and social aspects. The difference between HHS pre and postoperatively had a statistically significant correlation with physical functioning of the SF-36. Conclusion: Total hip arthroplasty with ceramic surface is a treatment that enables functional improvement of the hip and increases quality of life of patients to levels close to those of people without joint diseases.

  2. Massive acetabular bone loss: Limits of trabecular metal cages

    Directory of Open Access Journals (Sweden)

    Villanueva-Martínez Manuel

    2011-01-01

    Full Text Available Massive acetabular bone loss (more than 50% of the acetabular area can result in insufficient native bone for stable fixation and long-term bone ingrowth of conventional porous cups. The development of trabecular metal cages with osteoconductive properties may allow a more biological and versatile approach that will help restore bone loss, thus reducing the frequency of implant failure in the short-to-medium term. We report a case of massive bone loss affecting the dome of the acetabulum and the ilium, which was treated with a trabecular metal cage and particulate allograft. Although the trabecular metal components had no intrinsic stability, they did enhance osseointegration and incorporation of a non-impacted particulate graft, thus preventing failure of the reconstruction. The minimum 50% contact area between the native bone and the cup required for osseointegration with the use of porous cups may not hold for new trabecular metal cups, thus reducing the need for antiprotrusio cages. The osteoconductive properties of trabecular metal enhanced allograft incorportation and iliac bone rebuilding without the need to fill the defect with multiple wedges nor protect the reconstruction with an antiprotrusio cage.

  3. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients

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    Richard Prazeres Canella

    2016-04-01

    Full Text Available OBJECTIVE: To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI, using computed tomography (CT. METHODS: We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third, femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. RESULTS: There were inverse correlations between the following angles: (1 acetabular coverage versus alpha angle (p = 0.019; (2 acetabular version (supraequatorial versus alpha angle (p = 0.049. For patients with femoral anteversion lower than 15 degrees: (1 acetabular version (supraequatorial versus alpha angle (p = 0.026; (2 acetabular version (middle third versus alpha angle (p = 0.02. For patients with acetabular version (supraequatorial lower than 10 degrees: (1 acetabular version (supraequatorial versus alpha angle (p = 0.004; (2 acetabular version (middle third versus alpha angle (p = 0.009. CONCLUSION: There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases.

  4. Large aneurysmal bone cyst of iliac bone in a female child: a case report

    Directory of Open Access Journals (Sweden)

    Kumar Pawan

    2010-04-01

    Full Text Available Abstract Background Symptomatic aneurysmal bone cysts in pediatric age group with an expansile lesion in ilium is a rare occurrence. Case An 11-year-old female presented with a swelling over her right iliac region and numbness along the medial aspect of thigh. Clinicoradiological diagnosis was aneurysmal bone cyst confirmed on fine needle aspiration cytology. Excision curettage (wide margin excision of the soft tissue tumor and intralesional curettage in the region of acetabulum of the tumor was performed in view of proximity to acetabular roof and endangered hip stability. Result At follow up of 18 months, the child has full painless range of movements in the hip joint with no recurrence. Conclusions Pelvic aneurysmal bone cysts are distinctly rare in pediatric age. The lesion was associated with an atypical symptom of numbness along the femoral nerve distribution. Hip stability and range of movements were major concern in this patient. Although many treatment options are described, surgical excision still remains the mainstay. In our case, we performed excision curettage, with good outcome.

  5. Diagnostic value of pelvic radiography in the initial trauma series in blunt trauma

    Energy Technology Data Exchange (ETDEWEB)

    Their, Micael E.A.; Bensch, Frank V.; Koskinen, Seppo K. [Toeoeloe Trauma Center, Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Handolin, Lauri [Toeoeloe Trauma Center, Department of Orthopaedics and Traumatology, Helsinki (Finland); Kiuru, Martti J. [Toeoeloe Trauma Center, Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Research Institut of Military Medicine, Helsinki (Finland)

    2005-08-01

    The purpose of the study was to evaluate the diagnostic value of pelvic radiography in the initial trauma series when compared to multidetector CT (MDCT) findings in serious blunt trauma. Inclusion criteria were blunt trauma and pelvic radiography in the initial trauma series, followed by a whole-body MDCT. A total of 1386 patients (874 male, 512 female, age 16-91 years, mean 41 years) met the inclusion criteria. Imaging studies were evaluated retrospectively by anatomical region and classified, when possible, using the Tile classification. Based on MDCT, a total of 629 injuries occurred in 226 (16%) of these 1386 patients. Radiography depicted 405 fractures in these 226 patients, giving an overall sensitivity of 55%. In 24 patients (11%) radiography was false-negatively normal. The sensitivity of radiography was mainly good in the anteroinferior parts of the pelvis, fair in the acetabulum and ileum, and poor in the posterior ring. By MDCT 141 (62%) patients were classified using the Tile classification and by radiography 133 patients (59%) were classified. MDCT and radiography showed the same type of pelvic injury in 72 patients (59%) and the subtype in 17 patients (14%). In 48 patients (40%) the pelvis was shown to be stable by radiography but unstable by MDCT. In conclusion, the sensitivity of pelvic radiography is low, and it is not reliable for determining if the pelvic injury is stable or not. (orig.)

  6. Postradiation sarcomas of the pelvis after treatment for uterine cervical cancer: review of the CT and MR findings of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Katsuyuki [Osaka Seamen' s Insurance Hospital (Japan). Dept. of Radiology; Yoshikawa, Hideki [Osaka Univ. Medical School (Japan). Dept. of Orthopaedic Surgery; Ueda, Takafumi; Araki, Nobuhito [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Orthopaedic Surgery; Tanaka, Hisashi; Nakamura, Hironobu [Osaka Univ. Medical School (Japan). Dept. of Radiology; Aozasa, Katsuyuki [Osaka Medical School (Japan). Dept. of Pathology

    2001-03-01

    Objective. To characterize the radiologic features of postradiation sarcomas arising in the pelvic bones following treatment for uterine cervical carcinoma. Design and patients. Five patients who developed postradiation sarcomas in the pelvic bones following radiation therapy for carcinoma of the uterine cervix within the irradiated field were evaluated. Pelvic radiographs, computed tomography (CT) and magnetic resonance (MR) imaging were undertaken in all patients. Histologic confirmation of the tumor type was obtained. Results. Three patients whose tumors were characterized as an osteosarcoma, an angiosarcoma and a malignant fibrous histiocytoma (MFH) showed a large round or oval mass mainly in the sacroiliac joint which extended into the posterior gluteal soft tissues. In a fourth patient an osteosarcoma developed in the central ilium extending widely into the soft tissues both anteriorly and posteriorly, with calcified areas within the extraosseous mass. The fifth patient had a MFH which showed osteolytic destruction of the cortex of the acetabulum, and minimal soft tissue extension. There were no specific features or signal intensity changes on MR imaging to differentiate these cases from primary sarcomas. Conclusion. Postradiation sarcoma must be considered in patients with uterine carcinoma when a soft tissue mass is seen in the previously irradiated field, especially if the mass is posterior to the sacroiliac joint and the latent period is more than 5 years. (orig.)

  7. Imaging findings of femoroacetabular impingement syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Beall, Douglas P.; Sweet, Clifford F.; Martin, Hal D.; Lastine, Craig L.; Grayson, David E.; Ly, Justin Q.; Fish, Jon R. [University of Oklahoma Health Sciences Center, Department of Radiologal Sciences, Oklahoma City (United States)

    2005-11-01

    Femoroacetabular impingement syndrome (FAI) is a pathologic entity which can lead to chronic symptoms of pain, reduced range of motion in flexion and internal rotation, and has been shown to correlate with degenerative arthritis of the hip. History, physical examination, and supportive radiographic findings such as evidence of articular cartilage damage, acetabular labral tearing, and early-onset degenerative changes can help physicians diagnose this entity. Several pathologic changes of the femur and acetabulum are known to predispose patients to develop FAI and recognition of these findings can ultimately lead to therapeutic interventions. The two basic mechanisms of impingement - cam impingement and pincer impingement - are based on the type of anatomic anomaly contributing to the impingement process. These changes can be found on conventional radiography, MR imaging, and CT examinations. However, the radiographic findings of this entity are not widely discussed and recognized by physicians. In this paper, we will introduce these risk factors, the proposed supportive imaging criteria, and the ultimate interventions that can help alleviate patients' symptoms. (orig.)

  8. Validation of a standardized mapping system of the hip joint for radial MRA sequencing

    Energy Technology Data Exchange (ETDEWEB)

    Klenke, Frank M.; Hoffmann, Daniel B.; Cross, Brian J.; Siebenrock, Klaus A. [Bern University Hospital, Department of Orthopedic Surgery, Inselspital, Bern (Switzerland)

    2014-10-14

    Intraarticular gadolinium-enhanced magnetic resonance arthrography (MRA) is commonly applied to characterize morphological disorders of the hip. However, the reproducibility of retrieving anatomic landmarks on MRA scans and their correlation with intraarticular pathologies is unknown. A precise mapping system for the exact localization of hip pathomorphologies with radial MRA sequences is lacking. Therefore, the purpose of the study was the establishment and validation of a reproducible mapping system for radial sequences of hip MRA. Sixty-nine consecutive intraarticular gadolinium-enhanced hip MRAs were evaluated. Radial sequencing consisted of 14 cuts orientated along the axis of the femoral neck. Three orthopedic surgeons read the radial sequences independently. Each MRI was read twice with a minimum interval of 7 days from the first reading. The intra- and inter-observer reliability of the mapping procedure was determined. A clockwise system for hip MRA was established. The teardrop figure served to determine the 6 o'clock position of the acetabulum; the center of the greater trochanter served to determine the 12 o'clock position of the femoral head-neck junction. The intra- and inter-observer ICCs to retrieve the correct 6/12 o'clock positions were 0.906-0.996 and 0.978-0.988, respectively. The established mapping system for radial sequences of hip joint MRA is reproducible and easy to perform. (orig.)

  9. Percutaneous Fixation of Anterior Column Acetabular Fracture in a Renal Transplant Recipient

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    Halil Ceylan

    2013-01-01

    Full Text Available Renal transplantation, performed per million population, ranges from 30 to 60 in developed countries. The transplanted kidney is generally placed in iliac fossa; therefore the treatment procedure of the pelvic trauma in these patients should be selected carefully. The gold standard technique for the treatment of displaced acetabulum fractures is open reduction and internal fixation. Our patient had received a living-related-donor renal transplant due to chronic renal failure. In the second year of transplantation, she had been injured in a motor-vehicle accident, and radiographs showed a right acetabular anterior column fracture and left pubic rami fractures. The patient was treated with percutaneous fixation techniques and at one year of postoperative period there was no evidence of degenerative signs and the clinical outcome was good. Beside having the advantage of avoiding dissection through the iliac fossa by the standard ilioinguinal approach, percutaneous techniques, with shorter surgical time, decreasing soft tissue disruption, and the potential for early discharge from hospital might be ideal for a renal transplant recipient carrying a higher risk of infection. Percutaneous fixation of selected acetabular fractures in a renal transplant recipient would presumably have the potential to decrease the morbidity associated with traditional open surgical procedures.

  10. 髋关节撞击综合征诊断与治疗的研究进展%Advances in the research of the diagnosis and treatment of femoroacetabular impingement

    Institute of Scientific and Technical Information of China (English)

    熊元; 赵振国; 邹亮; 鲍同柱

    2014-01-01

    The etiology of femoroacetabular impingement ( FAI ) is abnormal stresses acting on the proximal femur and the acetabulum resulting from abnormally structural relationship between them caused by various factors. FAI plays an important role in inducing early hip osteoarthritis, and the main manifestation is chronic hip pain. Early diagnosis and early treatment help to improve the quality of life of patients and delay the incidence of arthritis. The common X-ray can provide an important reference for the diagnosis and classiifcation of FAI, and the CT scan can provide multi-faceted and multi-dimensional images for hip joint diseases. The sensitivity and speciifcity of MRI are better for the cartilage damages and soft tissue injuries. Therefore, the diagnosis of this disease is not difficult when the clinical symptoms, signs and imaging are combined together. Conservative treatment of FAI is ineffective, and while better therapeutic effects can be achieved with early open surgery or arthroscopic surgery according to the disease conditions. Because FAI has not been found and studied until recent decades, many doctors still do not know it and often misdiagnose it. The key words included “the femur”, “the acetabulum”, “impingement”, “imaging”, “open surgery” and “arthroscope” in this article.

  11. Pigmented Villonodular Synovitis Causing Osteonecrosis of the Femoral Head: A Case Report

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    Tomohiro Mimura

    2013-01-01

    Full Text Available We report a case of a 27-year-old man with pigmented villonodular synovitis of the hip joint with coincident osteonecrosis of the femoral head. According to our review of the English-language literature, no detailed report of osteonecrosis of the femoral head complicated with pigmented villonodular synovitis has been published. Preoperative X-ray images showed joint narrowing and severe multiple bone erosions at the acetabulum and femoral neck. Magnetic resonance imaging revealed a low-intensity band attributable to osteonecrosis of the femoral head and massive diffuse pigmented villonodular synovitis lesions. Comparison of a three-dimensional computed tomographic image of this patient with an angiographic image of a normal individual demonstrated proximity of the pigmented villonodular synovitis-induced bone erosions to the medial and lateral femoral circumflex arteries and retinacular arteries, suggesting likely the compromise of the latter by the former. We propose that the massive pigmented villonodular synovitis may have contributed to the pathogenesis of osteonecrosis of the femoral head in this patient. We performed open synovectomy and total hip arthroplasty. No operative complications occurred, and no recurrence of the pigmented villonodular synovitis was detected for 3 years after the operation.

  12. Acetabular retroversion as a rare cause of chronic hip pain: recognition of the ''figure-eight'' sign

    Energy Technology Data Exchange (ETDEWEB)

    Banks, Kevin P. [Brooke Army Medical Center, Department of Radiology, Fort Sam Houston, TX (United States); Grayson, David E. [Wilford Hall Medical Center, Department of Radiology, Lackland Air Force Base, TX (United States)

    2007-06-15

    While well-recognized in the orthopedic literature as a cause of chronic hip pain, acetabular retroversion has not been specifically described in the radiologic literature. Acetabular retroversion represents a particular form of hip dysplasia characterized by abnormal posterolateral orientation of the acetabulum. This pathophysiology predisposes the individual to subsequent anterior impingement of the femoral neck upon the anterior acetabular margin and fibrous labrum. Without treatment, cases may progress to damage of the anterior labrum and cartilage, with eventual early onset of osteoarthritic disease. This impinging condition has been described as occurring in isolation or as part of a complex dysplasia. We describe two cases of acetabular retroversion diagnosed by conventional radiographic evaluation of the pelvis, one in isolation and one occurring in the setting of a larger congenital syndrome. These cases illustrate the utility of the ''figure-eight'' sign in identifying abnormalities of acetabular version and thus assisting clinicians in properly identifying these individuals so that appropriate therapy may be instituted. (orig.)

  13. A Huge Capital Drop with Compression of Femoral Vessels Associated with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Tomoya Takasago

    2015-01-01

    Full Text Available A capital drop is a type of osteophyte at the inferomedial portion of the femoral head commonly observed in hip osteoarthritis (OA, secondary to developmental dysplasia. Capital drop itself is typically asymptomatic; however, symptoms can appear secondary to impinge against the acetabulum or to irritation of the surrounding tissues, such as nerves, vessels, and tendons. We present here a case of unilateral leg edema in a patient with hip OA, caused by a huge bone mass occurring at the inferomedial portion of the femoral head that compressed the femoral vessels. We diagnosed this bone mass as a capital drop secondary to hip OA after confirming that the mass occurred at least after the age of 63 years based on a previous X-ray. We performed early resection and total hip arthroplasty since the patient’s hip pain was due to both advanced hip OA and compression of the femoral vessels; moreover, we aimed to prevent venous thrombosis secondary to vascular compression considering the advanced age and the potent risk of thrombosis in the patient. A large capital drop should be considered as a cause of vascular compression in cases of unilateral leg edema in OA patients.

  14. Percutaneous treatment of insufficiency fractures. Principles, technique and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Beall, Douglas P. [University of Oklahoma Health Science Center, Oklahoma City, OK (United States); Clinical Radiology of Oklahoma, Edmond, OK (United States); Oklahoma City, OK (United States); Datir, Abhijit [Royal National Orthopaedic Hospital, Department of Radiology, Middlesex (United Kingdom); D' Souza, Sharon L.; D' Souza, Logan S.; Gunda, Divya; Morelli, John; Johnson, Michael Brandon; Nabavizadeh, Nima [University of Oklahoma Health Science Center, Oklahoma City, OK (United States)

    2010-02-15

    Insufficiency fractures of the pelvis, sacrum, spine, and long bones are painful, debilitating, and are common consequences of osteoporosis. Conventional treatment for these fractures varies from conservative therapy to surgery with plate and screw fixation. The former fails to address the underlying problem of fracture and frequently does not alleviate symptoms, while the latter is invasive and not always possible in older populations with low bone density and numerous co-morbidities. Osseous augmentation with polymethylmethacrylate (PMMA) has been used for over two decades to treat fractures related to osteoporosis, but has not been commonly used to treat fractures outside of the vertebral bodies. Osseous augmentation with PMMA is an image-guided procedure and various techniques have been utilized to treat fracture in different locations. We describe various techniques for image-guided osseous augmentation and treatment of insufficiency fractures with bothPMMA and allograft bone for fractures of the pelvis including sacrum, acetabulum, pubic symphysis, pubic rami ilium; appendicular skeleton including distal radius, proximal femur, and vertebral body. We also describe the potential risks and complications associated with percutaneous treatment of insufficiency fractures and techniques to avoid the pitfalls of the various procedures. We will present the process for patient follow-up and data regarding the pre- and postprocedure pain response in patients undergoing treatment for pelvic insufficiency fractures. (orig.)

  15. Driven Around the Bend: Novel Use of a Curved Steerable Needle

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Darra T., E-mail: darra.murphy@vch.ca; Korzan, Jeffrey R.; Ouellette, Hugue A.; Liu, David M. [Vancouver General Hospital, Department of Radiology (Canada); Clarkson, Paul W. [Vancouver General Hospital, Department of Orthopedic Surgery (Canada); Munk, Peter L. [Vancouver General Hospital, Department of Radiology (Canada)

    2013-04-15

    This technical note describes the novel use of a curved, steerable needle to access symptomatic osseous lesions in the pelvis and sacrum for palliative percutaneous treatment that would otherwise be difficult to treat using conventional straight needles. Seven patients with lytic bone lesions were treated. One patient had multiple myeloma; the remaining had metastatic disease: breast carcinoma (n = 2), colorectal carcinoma (n = 1), renal cell carcinoma (n = 1), squamous cell carcinoma (n = 1), and leiomyosarcoma (n = 1). Five of the seven patients had lesions in the posterior acetabulum, and the two other patients had lesions in the sacrum. Four of the seven patients received radiofrequency ablation followed by cementoplasty; three patients received cementation alone. We used a novel needle designed for vertebroplasty, which has an articulating tip allowing it to be guided into lytic bone lesions located in difficult-to-access regions of the pelvis and sacrum. All patients were successfully treated with cementoplasty either with or without thermal ablation. No serious adverse events were reported. The needle was difficult to withdraw in two patients. Steerable curved needles can be successfully used to treat lytic osseous metastases with cementoplasty when lesions are located in sites that may be difficult to reach using conventional straight needles.

  16. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavković 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.

  17. Importance of Herrings classification in predicting the outcome of aseptic necrosis of the femoral head

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    Žarko Dašić

    2015-02-01

    Full Text Available Aim To highlight the importance of values of the Herring’s classification in the treatment planning of Legg-Calve-Perthes disease (LCPD. Method The charts of 14 patients in a period of 4 years (2004-2008 were retrospectively reviewed. Inclusion criteria was unilateral LCPD and contralateral healthy hip. The patients were divided into three Herring groups according to radiographic images (A, B and C. For all patients the acetabulum/head index (AHI was determined. Results The youngest patient was 4.9 years and the oldest 9.11 years; male patients were dominant (male:female 11:3. The right hip side was more affected comparing to the left one (8:6. The distribution of patients in Herring groups was three in the Group A, six in the Group B and five patients in the Group C. The AHI index was lowest in the group C. Patients in the group C were treated surgically. Conclusion Herrings classification predicts patients with extensive changes and suggests what kind of treatment should be applied.

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

    Institute of Scientific and Technical Information of China (English)

    André-Pierre Uzel; Ricardo Bertino; Guy Daculsi; George Yves Laflamme

    2011-01-01

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

  19. 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.)

  20. Community-Associated Methicillin-Resistant Staphylococcus aureus Lacking PVL, as a Cause of Severe Invasive Infection Treated with Linezolid

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    Catarina Gouveia

    2013-01-01

    Full Text Available Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA is an emerging public health problem worldwide. Severe invasive infections have been described, mostly associated with the presence of Panton-Valentine leukocidin (PVL. In Portugal limited information exists regarding CA-MRSA infections. In this study we describe the case of a previously healthy 12-year-old female, sport athlete, who presented to the hospital with acetabulofemoral septic arthritis, myositis, fasciitis, acetabulum osteomyelitis, and pneumonia. The MRSA isolated from blood and synovial fluid was PVL negative and staphylococcal enterotoxin type P (SEP and type L (SEL positive, with a vancomycin MIC of 1.0 mg/L and resistant to clindamycin and ciprofloxacin. The patient was submitted to multiple surgical drainages and started on vancomycin, rifampicin, and gentamycin. Due to persistence of fever and no microbiological clearance, linezolid was started with improvement. This is one of the few reported cases of severe invasive infection caused by CA-MRSA in Portugal, which was successfully treated with linezolid. In spite of the severity of infection, the MRSA isolate did not produce PVL.

  1. MR imaging of transient osteoporosis

    International Nuclear Information System (INIS)

    Objective: To evaluate MR imaging of transient osteoporosis. Methods: MR imaging of transient osteoporosis in eight patients was retrospectively reviewed. In all eight patients, routine scanning was performed in axial and coronal planes, including T1-weighted and T2-weighted images. Of the eight patients, five were male and three were female, with the age ranging from 12 to 70 years. Neither of the women was pregnant when they visited our hospital. Results: The bilateral hips were affected in seven patients, the left shoulder in one. The MR images demonstrated low signal intensity in all eight patients on T1WI, and normal signal intensity (2 cases), medium-high signal intensity (3 cases), or high signal intensity (3 cases) on T2WI. The bone marrow edema (BME) pattern involved the acetabulum (one hip), both the femoral head in 5 hips, the femoral neck and the intertrochanteric region through the upper femur in 7 hips, and the upper humerus in one. A small joint effusion was observed in six hips on T2WI. Conclusion: MRI is useful in defining the location and extent of transient osteoporosis. (authors)

  2. A new genus and species of opisthogonimid (Digenea) of Liophis anomalus (Serpentes: Colubridae) from Uruguay.

    Science.gov (United States)

    Volonterio, Odile; Baletta, Silvana; Meneghel, Melitta

    2006-10-01

    During a study on the helminth fauna of Liophis anomalus specimens deposited in the Reptile Collection of the Secci6n Zoología Vertebrados, Facultad de Ciencias, Uruguay, a new genus of Opisthogoniminae was found. Paracotyletrema n. gen. is described from the buccal cavity and esophagus of specimens from Departamento de Flores, Uruguay. This new genus differs from the other 2 Opisthogoniminae, Opisthogonimus and Westella, by having much smaller body size; maximum width at level of posterior end of oral sucker; oral sucker length more than one-fourth of body length; oral sucker and acetabulum separated by a distance of about the diameter of pharynx; cirrus pouch length more than half of body length; and testes in completely coincident zones. The type and only species, Paracotyletrema poncedeleoni n. gen., n. sp., is defined by the following diagnostic characters: mean oral sucker length one-third to one-half of body length; cirrus pouch of about body length, contorted, mainly acetabular; large, round testes in nearly adjacent fields, and an ovary nearly adjacent to right testis. Besides the type locality, Paracotyletrema poncedeleoni has been found in L. anomalus specimens from the Departamentos of Artigas and Treinta y Tres; therefore, it has a widespread distribution in Uruguay.

  3. Radiographic Markers of Femoroacetabular Impingement: Correlation of Herniation Pit and Femoral Bump with a Positive Cross-Over Ratio

    Directory of Open Access Journals (Sweden)

    Max J. Scheyerer

    2014-01-01

    Full Text Available Introduction. The goal of this study was to research the association of femoral bumps and herniation pits with the overlap-ratio of the cross-over sign. Methods. Pelvic X-rays and CT-scans of 2925 patients with good assessment of the anterior and the posterior acetabular wall and absence of neutral pelvic tilt were enrolled in the investigation. Finally pelvic X-rays were assessed for the presence of a positive cross-over sign, and CT-scans for a femoral bump or a herniation pit. Additionally, if a positive cross-over sign was discovered, the overlap-ratio was calculated. Results. A femoral bump was found in 53.3% (n=1559, and a herniation pit in 27.2% (n=796 of all hips. The overlap-ratio correlated positively with the presence of a femoral bump, while a negative correlation between the overlap-ratio and the presence of a herniation pit was found. The latter was significantly more often combined with a femoral bump than without. Conclusions. We detected an increased prevalence of femoral bump with increasing overlap-ratios of the cross-over sign indicating a relation to biomechanical stress. The observed decreased prevalence of herniation pits with increasing overlap-ratios could be explained by reduced mechanical stress due to nontightened iliofemoral ligament in the presence of retroversion of the acetabulum.

  4. Morfologia externa de espécimes adultos de Paratanaisia bragai (Santos, 1934 (Digenea: Eucotylidae External morphology of the adults specimens of Paratanaisia bragai (Santos, 1934(Diginea; Eucotylidae

    Directory of Open Access Journals (Sweden)

    Solange V.P.B. Brandolini

    2007-09-01

    Full Text Available Espécimes adultos de Paratanaisia bragai foram coletados de ductos renais de Columba livia infectados naturalmente, fixados em glutaraldeído 2,5% e processados para microscopia eletrônica de varredura. Foram identificados dois tipos distintos de escamas, escamas bífidas e simples, dispostas em fileiras transversais no tegumento das faces dorsal e ventral do corpo. Também mostrando em detalhes a ventosa oral subterminal, bem desenvolvida e acetábulo de tamanho reduzido, localizado no terço médio do corpo, circundado por pequenas protuberâncias e quatro papilas dispostas regularmente na sua margem.Adult specimens of Paratanaisia bragai collected from renal ducts of Columba livia naturally infected, were fixed in glutaraldehyde 2.5% and processed for scanning electron microscopy. Two distinct types of scales had been identified, bifid and simple scales, disposed in transversal rows, on the tegument of dorsal and ventral face of the body. Also show in details the oral sucker subterminal, well developed and acetabulum of size reduced, located in third medium of the body, surrounded for small protuberance and four papillae on its edge.

  5. Developmental dysplasia of the hip

    Directory of Open Access Journals (Sweden)

    Shahryar Noordin

    2010-10-01

    Full Text Available Developmental dysplasia of the hip (DDH is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign, asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

  6. Preparation and Evaluation of Acetabularia-Modified Carbon Paste Electrode in Anodic Stripping Voltammetry of Copper and Lead Ions

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    Muhammad Raziq Rahimi Kooh

    2013-01-01

    Full Text Available Seaweed is well known about for potential in chelating heavy metals. In this study, carbon paste electrodes were fabricated with siphonous seaweed Acetabularia acetabulum as the modifiers to sense lead (II and copper (II by square-wave anodic stripping voltammetry. Various scan rates and deposition potentials were measured to obtain the optimal peak current for Pb(II and Cu(II. Optimum conditions of Acetabularia-CPE for sensing Pb(II were at the scan rate of 75 mV/s and deposition potential of −800 mV, while for Cu(II sensing were at 100 mV/s and −300 mV, respectively. The electrodes were characterized by the duration of accumulation time, preconcentration over a range of standards, supporting electrolyte, and standard solutions of various pH values. Interference studies were carried out. Both Zn(II and Cu(II were found to interfere with Pb(II sensing, whereas only Zn(II causes interference with Cu(II sensing. The electrode was found to have good regeneration ability via electrochemical cleaning. Preliminary testing of complex samples such as NPK fertilisers, black soil, and sea salt samples was included.

  7. Percutaneous radiofrequency ablation for osteoid osteoma: How we do it

    International Nuclear Information System (INIS)

    To describe our technique for performing radiofrequency ablation (RFA) in osteoid osteoma and to evaluate the results of treatment. We evaluated 40 patients in whom RFA was performed for osteoid osteomas between October 2005 and February 2008. The lesions were located in the femur (n = 22), tibia (n = 10), humerus (n = 2), acetabulum (n = 2), radius (n = 1), fibula (n = 1), patella (n = 1), and calcaneum (n = 1). The procedure was performed using a standard technique. Technical success was achieved in all patients, with intranidal localization of the needle and complete ablation. All patients were fully weight bearing 2–3 h after the procedure. Successful pain relief was achieved in all patients within 48 h. Immediate complications included a case of minor thermal skin burn and a small cortical chip fracture, which healed on its own. There were no delayed complications. The average follow-up period was 12 months. Two patients (5% of cases) had recurrence of pain after intervals of 5 and 8 months, respectively, following the ablation; this was due to recurrence of the lesion. Complete pain relief was however achieved after a second ablation in both cases. Thus, our primary and secondary clinical success rates were 95 and 100%, respectively. RFA is a safe, quick, minimally invasive, and extremely effective method for the management of osteoid osteomas

  8. Mazabraud 综合征一例%Mazabraud syndrome:1 case report

    Institute of Scientific and Technical Information of China (English)

    陆国强; 李自强

    2016-01-01

    Objective To investigate clinicopathological characteristics of Mazabraud syndrome by reviewing the data of the ifrst case of the Mazabraud syndrome in China with literature review. Methods We have analyzed the clinical data of a case of hospitalized Mazabraud syndrome patient to clearly diagnose with pathological examination. Result The patient was a 70-year-old male hospitalized for a lump in the left hip for more than half a month. The X-ray iflms of the pelvis, bilateral hip joints and bilateral upper femurs showed soap bubble-like appearance, which are typical ifndings of osteoifbrous dysplasia. The CT scan of whole pelvis showed soap-bubble-like appearance of bilateral ilium, patial sacrum, acetabulum, pubis and ischium. There was a 3-cm-diameter cystic mass in left gluteus max imus muscle, of which CT value was 2 - 7 Hu. Postoperative histopathological examination showed loose arrangement of fusiform ifbrous tissue and immature ifbrous bone, as well as irregular arrangement, English alphabet-shaped tenuity bone trabecula, which was surrounded by a few lfat osteoblasts. This was amyxoma in the left gluteus max imus. Under microscope, the tumor showed clear boundary without capsule. There were much mucus-like substance and few cells. Cells were small, star-shaped and had no speciifcity.Conclusions Mazabraud syndrome is a rare disease, which is deifned as ifbrous dysplasia associated wish intramuscular myxoma. Development of Mazabraud syndrome may be related to the Gsa gene mutation. Pathology plays an important role in diagnosis of Mazabraud syndrome.

  9. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease

    Directory of Open Access Journals (Sweden)

    Seyed Mahdi Mazloumi

    2014-06-01

    Full Text Available Legg-Calvé-Perthes disease (LCPD is an idiopathic osteonecrosis of the femoral head with variable complications and resultant deformity of the femoral head and osteoarthritis. Suggested risk factors are acetabular retroversion, obesity, latitude, hyperactivity, and coagulopathy. The most commonly applied classification is based on radiolucency in the lateral pillar of the femoral head, which is strongly correlated with the outcome. In the fragmentation stage of the disease involvement can be classified into three groups. After skeletal maturity, the outcome can be classified using the Stulberg classification based on the sphericity and congruence of the femoral head in relation to the acetabulum. The early goal of treatment is to prevent head deformation by weight transmitted forces during remodeling and ossification stages containment is the widely accepted principle of treatment. Although the Petrie cast still has a role in the short-term treatment of LCPD before and during the reossification stage, available data does not support additional benefits from braces during the course of LCPD.

  10. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease.

    Science.gov (United States)

    Mazloumi, Seyed Mahdi; Ebrahimzadeh, Mohammad H; Kachooei, Amir Reza

    2014-06-01

    Legg-Calvé-Perthes disease (LCPD) is an idiopathic osteonecrosis of the femoral head with variable complications and resultant deformity of the femoral head and osteoarthritis. Suggested risk factors are acetabular retroversion, obesity, latitude, hyperactivity, and coagulopathy. The most commonly applied classification is based on radiolucency in the lateral pillar of the femoral head, which is strongly correlated with the outcome. In the fragmentation stage of the disease involvement can be classified into three groups. After skeletal maturity, the outcome can be classified using the Stulberg classification based on the sphericity and congruence of the femoral head in relation to the acetabulum. The early goal of treatment is to prevent head deformation by weight transmitted forces during remodeling and ossification stages containment is the widely accepted principle of treatment. Although the Petrie cast still has a role in the short-term treatment of LCPD before and during the reossification stage, available data does not support additional benefits from braces during the course of LCPD.

  11. 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.)

  12. Procedure DEGA type by double approach

    International Nuclear Information System (INIS)

    The following is an observational, retrospective, descriptive study, including case studies of patients with developmental acetabular dysplasia of the hip with neuromuscular changes. We examined (11) eleven hips in (3) three women and (5) five men who undergone incomplete marginal trans-iliac DEGA osteotomy in the form of a semicircular acetabuloplasty with double surgical approach, performed in conjunction with a previous open reduction and a femoral variant twisting osteotomy. We evaluated these patients with 3DCAT scan and simple x-ray. The following were evaluated: the acetabular depth, the percentage of lateral and anterior femoral head extrusion, the center edge, anterior wall deficit, sharp angle, acetabular anteversion, percentage of unoccupied medial acetabulum and center rotation asymmetry, sphericity of the femoral head (Mose), acetabular support angle (WBZ) (Bombelliand Aronson), migration percentage (Reimers), articular consistency (Coleman), and the arthrosis according to Tonnis. The clinical follow up was carried out for 24.6 months on average, with radiological three dimensional Tomographic scans up to 23.6 months with an interval of between 6 and 49 months. Results were excellent in 80% of the cases, good in 14%, regular in 0%, bad in 6%. The results suggest that this a good alternative in the treatment of dysplasia in a number of patients, bearing in mind their indications and contraindications as well as the magnitude of correction that can be expected

  13. Cementoplasty for managing painful bone metastases outside the spine

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Gang; Jin, Peng; Liu, Xun-wei; Li, Min; Li, Li [Jinan Military General Hospital, Department of Medical Imaging, Jinan, Shandong Province (China)

    2014-03-15

    To illustrate the effect of treatment with cementoplasty in patients with painful bone metastases in the extraspinal region. A retrospective study was conducted to review 51 consecutive patients who underwent cementoplasty under CT or fluoroscopic guidance, a total of 65 lesions involving the ilium, ischium, pubis, acetabulum, humeral, femur and tibia. In 5 patients with a high risk of impending fracture in long bones based on Mirels' scoring system, an innovative technique using a cement-filled catheter was applied. The clinical effects were evaluated using the visual analogue scale (VAS) preoperatively and postoperatively. All patients were treated successfully with a satisfying resolution of painful symptoms at 3 months' follow-up. Cement leakage was found in 8 lesions without any symptoms. VAS scores decreased from 8.19 ± 1.1 preoperatively to 4.94 ± 1.6 at 3 days, 3.41 ± 2.1 at 1 month and 3.02 ± 1.9 at 3 months postoperatively. There was a significant difference between the mean preoperative baseline score and the mean score at all of the postoperative follow-up points (P < 0.01). Cementoplasty is an effective technique for treating painful bone metastases in extraspinal regions, which is a valuable, minimally invasive, method that allows reduction of pain and improvement of patients' quality of life. (orig.)

  14. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients☆

    Science.gov (United States)

    Canella, Richard Prazeres; Adam, Guilherme Pradi; de Castillo, Roberto André Ulhôa; Codonho, Daniel; Ganev, Gerson Gandhi; de Vicenzi, Luiz Fernando

    2016-01-01

    Objective To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). Methods We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. Results There were inverse correlations between the following angles: (1) acetabular coverage versus alpha angle (p = 0.019); (2) acetabular version (supraequatorial) versus alpha angle (p = 0.049). For patients with femoral anteversion lower than 15 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.026); (2) acetabular version (middle third) versus alpha angle (p = 0.02). For patients with acetabular version (supraequatorial) lower than 10 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.004); (2) acetabular version (middle third) versus alpha angle (p = 0.009). Conclusion There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was) in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases. PMID:27069890

  15. Primary malignant melanoma of cervix and vagina

    Science.gov (United States)

    Lee, Jae Hoon; Yun, Jisun; Seo, Jung-Won; Bae, Go-Eun; Lee, Jeong-Won

    2016-01-01

    Primary malignant melanoma (MM) accounts for 1% of all cancers, and only 3% to 7% of these tumors occur in the female genital tract. Data are limited with respect to the basis for treatment recommendations because of the rarity of MM. The overall prognosis of melanomas of the female genital tract is very poor. Two cases of MM of the female genital tract are presented. The first case is of a 70-year-old female patient who complained of left thigh pain and underwent magnetic resonance imaging that showed cervical cancer with involvement of the vagina, bladder, and parametrium, in addition to multiple bony metastases of the proximal femur, acetabulum, and both iliac bones. The second case is of a 35-year-old female patient who suffered from vaginal bleeding for 5 months, and she was diagnosed as having primary vaginal melanoma. The patient underwent radical surgery and two additional surgeries because of recurrence of cancer in both inguinal areas. After surgery, the patient received adjuvant immunotherapy, radiation therapy, and chemotherapy. In both the aforementioned cases, the pathologic diagnosis was made after immunohistochemical analysis, i.e., the tumor cells were stained with HMB-45 and S100, and were found to be positive for both immunostains. PMID:27668208

  16. Automated measurement of diagnostic angles for hip dysplasia

    Science.gov (United States)

    de Raedt, Sepp; Mechlenburg, Inger; Stilling, Maiken; Rømer, Lone; Søballe, Kjeld; de Bruijne, Marleen

    2013-03-01

    A fully automatic method for measuring diagnostic angles of hip dysplasia is presented. The method consists of the automatic segmentation of CT images and detection of anatomical landmarks on the femur and acetabulum. The standard angles used in the diagnosis of hip dysplasia are subsequently automatically calculated. Previous work in automating the measuring of angles required the manual segmentation or delineation of the articular joint surface. In the current work automatic segmentation is established using graph-cuts with a cost function based on a sheetness score to detect the sheet-like structure of the bone. Anatomical landmarks are subsequently detected using heuristics based on ray-tracing and the distance to the approximated acetabulur joint surface. Standard diagnositic angles are finally calculated and presented for interpretation. Experiments using 26 patients, showed a good agreement with gold standard manual measurements by an expert radiologist as performed in daily practice. The mean difference for the five angles was between -1:1 and 2:0 degrees with a concordance correlation coefficient between 0:87 and 0:93. The standard deviation varied between 2:3 and 4:1 degrees. These values correspond to values found in evaluating interobserver and intraobserver variation for manual measurements. The method can be used in clinical practice to replace the current manual measurements performed by radiologists. In the future, the method will be integrated into an intraoperative surgical guidance system.

  17. Acetabular rim and surface segmentation for hip surgery planning and dysplasia evaluation

    Science.gov (United States)

    Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Summers, Ronald M.; Ward, Michael M.

    2008-03-01

    Knowledge of the acetabular rim and surface can be invaluable for hip surgery planning and dysplasia evaluation. The acetabular rim can also be used as a landmark for registration purposes. At the present time acetabular features are mostly extracted manually at great cost of time and human labor. Using a recent level set algorithm that can evolve on the surface of a 3D object represented by a triangular mesh we automatically extracted rims and surfaces of acetabulae. The level set is guided by curvature features on the mesh. It can segment portions of a surface that are bounded by a line of extremal curvature (ridgeline or crestline). The rim of the acetabulum is such an extremal curvature line. Our material consists of eight hemi-pelvis surfaces. The algorithm is initiated by putting a small circle (level set seed) at the center of the acetabular surface. Because this surface distinctively has the form of a cup we were able to use the Shape Index feature to automatically extract an approximate center. The circle then expands and deforms so as to take the shape of the acetabular rim. The results were visually inspected. Only minor errors were detected. The algorithm also proved to be robust. Seed placement was satisfactory for the eight hemi-pelvis surfaces without changing any parameters. For the level set evolution we were able to use a single set of parameters for seven out of eight surfaces.

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

    Science.gov (United States)

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

    2016-01-01

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

  19. Imaging findings of femoroacetabular impingement syndrome

    International Nuclear Information System (INIS)

    Femoroacetabular impingement syndrome (FAI) is a pathologic entity which can lead to chronic symptoms of pain, reduced range of motion in flexion and internal rotation, and has been shown to correlate with degenerative arthritis of the hip. History, physical examination, and supportive radiographic findings such as evidence of articular cartilage damage, acetabular labral tearing, and early-onset degenerative changes can help physicians diagnose this entity. Several pathologic changes of the femur and acetabulum are known to predispose patients to develop FAI and recognition of these findings can ultimately lead to therapeutic interventions. The two basic mechanisms of impingement - cam impingement and pincer impingement - are based on the type of anatomic anomaly contributing to the impingement process. These changes can be found on conventional radiography, MR imaging, and CT examinations. However, the radiographic findings of this entity are not widely discussed and recognized by physicians. In this paper, we will introduce these risk factors, the proposed supportive imaging criteria, and the ultimate interventions that can help alleviate patients' symptoms. (orig.)

  20. Relation between fracture site of pelvic ring and severity of injury. Significance of bilateral ischiopubic fracture

    International Nuclear Information System (INIS)

    Here studied is the relation in the title since the fracture of pelvic ring often occurs along with multiple traumas by strong external force, and diagnosis of which severity is important for the following treatment of complicated injuries. Subjects are 75 patients (M 51/F 24, 18-80 years old) with the fracture, treated in authors' hospital during the time 1998-2006, whose diagnoses for the fracture site are performed by the simple X-radiography and CT. Subjects are divided in 4 groups of A-D, where the fracture is seen at the lateral (Group A, 15 cases) and bilateral (Group B, 5 cases) ischiopubis, acetabulum (Group C, 14 cases) and posterior pelvic ring (Group D, 41 cases). Made is comparison of the sites for hemoglobin value (HGV) at hospital arrival, necessity of transfusion within 1 week after injury and dose of red cell preparation (DRC), complicated traumas like musculoskeletal and organ ones, injury severity score (ISS) and death cases. B case is found to be significantly higher in ISS and rate of injuries of important organs, and to be tended high in HGV and DRC. Thus the bilateral fracture is possibly complicated with important organ injuries and can be a measure of serious injury at the early diagnosis. (T.T.)

  1. Rapidly destructive osteoarthritis of the hip joint: a case series

    Directory of Open Access Journals (Sweden)

    McMurtrie A

    2008-01-01

    Full Text Available Abstract Background Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population. Methods A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities. Results Rapid progression of hip pain and disability was a consistent clinical feature. The average duration of symptoms was 1.4 years. Radiographs obtained at various intervals before surgery (average 14 months in 18 patients documented rapid hip destruction, involvement being unilateral in 13 cases. All patients underwent total hip arthroplasty, and osteoarthritis was confirmed at pathologic examination. Conclusion The authors postulate that these cases represent an uncommon subset of osteoarthritis and regular review, both clinically and radiologically, are required to assess speed of progression and prevent rapid loss of bone stock without the surgeon being aware. These cases are unsuitable for being placed on long waiting list due to technical difficulties in delayed surgery and compromised outcome following surgery.

  2. Ocean acidification bends the mermaid's wineglass.

    Science.gov (United States)

    Newcomb, Laura A; Milazzo, Marco; Hall-Spencer, Jason M; Carrington, Emily

    2015-09-01

    Ocean acidification lowers the saturation state of calcium carbonate, decreasing net calcification and compromising the skeletons of organisms such as corals, molluscs and algae. These calcified structures can protect organisms from predation and improve access to light, nutrients and dispersive currents. While some species (such as urchins, corals and mussels) survive with decreased calcification, they can suffer from inferior mechanical performance. Here, we used cantilever beam theory to test the hypothesis that decreased calcification would impair the mechanical performance of the green alga Acetabularia acetabulum along a CO₂ gradient created by volcanic seeps off Vulcano, Italy. Calcification and mechanical properties declined as calcium carbonate saturation fell; algae at 2283 µatm CO₂ were 32% less calcified, 40% less stiff and 40% droopier. Moreover, calcification was not a linear proxy for mechanical performance; stem stiffness decreased exponentially with reduced calcification. Although calcifying organisms can tolerate high CO₂ conditions, even subtle changes in calcification can cause dramatic changes in skeletal performance, which may in turn affect key biotic and abiotic interactions. PMID:26562936

  3. WDR34 mutations that cause short-rib polydactyly syndrome type III/severe asphyxiating thoracic dysplasia reveal a role for the NF-κB pathway in cilia.

    Science.gov (United States)

    Huber, Céline; Wu, Sulin; Kim, Ashley S; Sigaudy, Sabine; Sarukhanov, Anna; Serre, Valérie; Baujat, Genevieve; Le Quan Sang, Kim-Hanh; Rimoin, David L; Cohn, Daniel H; Munnich, Arnold; Krakow, Deborah; Cormier-Daire, Valérie

    2013-11-01

    Short-rib polydactyly (SRP) syndrome type III, or Verma-Naumoff syndrome, is an autosomal-recessive chondrodysplasia characterized by short ribs, a narrow thorax, short long bones, an abnormal acetabulum, and numerous extraskeletal malformations and is lethal in the perinatal period. Presently, mutations in two genes, IFT80 and DYNC2H1, have been identified as being responsible for SRP type III. Via homozygosity mapping in three affected siblings, a locus for the disease was identified on chromosome 9q34.11, and homozygosity for three missense mutations in WDR34 were found in three independent families, as well as compound heterozygosity for mutations in one family. WDR34 encodes a member of the WD repeat protein family with five WD40 domains, which acts as a TAK1-associated suppressor of the IL-1R/TLR3/TLR4-induced NF-κB activation pathway. We showed, through structural modeling, that two of the three mutations altered specific structural domains of WDR34. We found that primary cilia in WDR34 mutant fibroblasts were significantly shorter than normal and had a bulbous tip. This report expands on the pathogenesis of SRP type III and demonstrates that a regulator of the NF-κB activation pathway is involved in the pathogenesis of the skeletal ciliopathies.

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

    Institute of Scientific and Technical Information of China (English)

    周颖; 楼跃

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘倩; 周莉; 何晓凤

    2011-01-01

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

  6. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease.

    Science.gov (United States)

    Mazloumi, Seyed Mahdi; Ebrahimzadeh, Mohammad H; Kachooei, Amir Reza

    2014-06-01

    Legg-Calvé-Perthes disease (LCPD) is an idiopathic osteonecrosis of the femoral head with variable complications and resultant deformity of the femoral head and osteoarthritis. Suggested risk factors are acetabular retroversion, obesity, latitude, hyperactivity, and coagulopathy. The most commonly applied classification is based on radiolucency in the lateral pillar of the femoral head, which is strongly correlated with the outcome. In the fragmentation stage of the disease involvement can be classified into three groups. After skeletal maturity, the outcome can be classified using the Stulberg classification based on the sphericity and congruence of the femoral head in relation to the acetabulum. The early goal of treatment is to prevent head deformation by weight transmitted forces during remodeling and ossification stages containment is the widely accepted principle of treatment. Although the Petrie cast still has a role in the short-term treatment of LCPD before and during the reossification stage, available data does not support additional benefits from braces during the course of LCPD. PMID:25207324

  7. Persistently High Hip Circumference after Bariatric Surgery Is a Major Hurdle to Successful Hip Replacement

    Directory of Open Access Journals (Sweden)

    Menachem M. Meller

    2014-01-01

    Full Text Available The prevalence of class III obesity (BMI≥40 kg/m2 in black women is 18%. As class III obesity leads to hip joint deterioration, black women frequently present for orthopedic care. Weight loss associated with bariatric surgery should lead to enhanced success of hip replacements. However, we present a case of a black woman who underwent Roux-en-Y gastric bypass with the expectation that weight loss would make her a better surgical candidate for hip replacement. Her gastric bypass was successful as her BMI declined from 52.0 kg/m2 to 33.7 kg/m2. However, her hip circumference after weight loss remained persistently high. Therefore, at surgery the soft tissue tunnel geometry presented major challenges. Tunnel depth and immobility of the soft tissue interfered with retractor placement, tissue reflection, and surgical access to the acetabulum. Therefore a traditional cup placement could not be achieved. Instead, a hemiarthroplasty was performed. After surgery her pain and reliance on external support decreased. But her functional independence never improved. This case demonstrates that a lower BMI after bariatric surgery may improve the metabolic profile and decrease anesthesia risk, but the success of total hip arthroplasties remains problematic if fat mass in the operative field (i.e., high hip circumference remains high.

  8. Comparison of standard and individually planned infradiaphragmatic field in irradiation of retroperitoneal and pelvic lymph nodes; Standard- versus individuell geplantes Bestrahlungsfeld bei Radiotherapie infradiaphragmaler Lymphknotenstationen

    Energy Technology Data Exchange (ETDEWEB)

    Nevinny-Stickel, M.; Ennemoser, S.; Lukas, P. [Universitaetsklinik fuer Strahlentherapie - Radioonkologie, Innsbruck (Austria); Bangerl, I.; Zur Nedden, D. [Universitaetsklinik fuer Radiodignostik 2, Innsbruck (Austria)

    1998-07-01

    Purpose: In prophylactic irradiation of infradiaphragmatic lymphatic nodes, the width of the paraaortic and pelvic field is given by a line joining the tips of the transverse processes of the 11th thoracic to the 4th lumbar vertebra from where the field boundary follows a straight line to the most lateral point of the acetabulum as seen in simulation film. Another way to build the field border is to project the lateral contours of the large abdominal vessels from T1-weighted coronal MR images of the abdomen on the simulator radiographs and add a 2-cm margin along the vessels delineated. In our study, we compared both methods as to full enclosure of paraaortic and pelvic lymphatics or nodal miss. Material and Methods: Abdominal CT scans of 81 patients with involvement of paraaortic lymph node regions were examined with maximum lymph node sizes of 2.5 cm. The distance from the center of the appropriate vertebra to the lateral lymph node contour referring to the transverse process as well as to the outside contour of the aorta on the left and the vena cava on the right side, respectively, the iliac vessels were measured from T12 through S1. At the level of the hip joint the measurement point was given by the caput femoris. Results: Our measurements prove that 10% of the lymph nodes were found lateral from the transverse processes of the thoracic and lumbar vertebras and 12% outside the 2-cm safety margin from the lateral contour of the large abdominal vessels. Conclusion: Our data show, that the customary fields for infradiaphragmatic lymphatic nodes have so far not been able to enclose all retroperitoneal and pelvic lymph nodes with certainty. (orig.) [Deutsch] Zielsetzung: Bei der adjuvanten Bestrahlung infradiaphragmaler Lymphknotenstationen wird die Feldgrenze entweder durch die Wirbelkoerperquerfortsaetze bzw. durch die Verbindungslinie zwischen dem Querfortsatz des Lendenwirbelkoerpers 4 und dem Dach des Acetabulums gebildet oder durch massstabsgerechte

  9. Análise radiográfica dos fatores prognósticos no tratamento do quadril displásico inveterado Radiographic analysis of prognostic factors in DDH treatment after walking age

    Directory of Open Access Journals (Sweden)

    Eduardo Ferreira Cordeiro

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento cirúrgico da Displasia do Desenvolvimento do Quadril na idade da marcha. MÉTODOS: Avaliamos 33 quadris operados entre novembro de 1992 e setembro de 1997. A média de idade foi 4 anos e 5 meses na ocasião da cirurgia e 11 anos e 7 meses quando avaliamos os resultados. O seguimento médio foi de 10 anos e 2 meses. Realizamos o encurtamento femoral, redução cruenta e osteotomia pélvica (Salter ou Chiari. Radiograficamente avaliamos: grau da luxação, índice acetabular; ângulo acetabular; arco de Shenton; linha de Hilgenheiner; coeficientes c/b, c/h, centro-acetábulo e cabeça-acetábulo; largura da cartilagem trirradiada; relação cabeça trocânter; esfericidade da epífise femoral; ângulo de Wiberg; necrose avascular e anisomelia. Os parâmetros radiográficos foram avaliados nos períodos pré-operatório, pós-operatório imediato e tardio. RESULTADOS: Verificamos estatisticamente melhora significante destes no momento pré-operatório para o pós-operatório imediato (p=0,0001 porém não houve variação significante entre o pós-operatório imediato e o tardio (p=0.5958. CONCLUSÃO: Pela classificação utilizada para avaliação dos resultados observamos 23 (69,70% bons, 5 (15,15% regulares e 5 (15,15% maus resultados.OBJECTIVE: To evaluate the results of surgical treatment of Developmental Dysplasia of the Hip (DDH treated in the walking age. METHODS: We evaluated 33 hips in 30 patients operated between November of 1992 and September of 1997. The mean age was 4 years and 5 months at surgical period and the mean age at the last evaluation was 11 years and 7 months. The mean follow up time was 10 years and 2 months. We performed femoral shortening, open reduction and pelvic osteotomy (Salter or Chiari. Radiographic assessment considered: acetabular index; acetabular angle; Shenton's line; Hilgenreiner's line; the c/b, c/h, acetabulum-center and acetabulum-head ratios; the width of

  10. 钳夹型髋关节撞击综合征的影像学表现%Imaging characteristics of pincer femoroacetabular impingement syndrome

    Institute of Scientific and Technical Information of China (English)

    杨涛; 曾卫珊; 王学松; 马方煜

    2013-01-01

    Objective To investigate the imaging features of pinccr fcmoroacctabular impingement syndrome (FAI). Methods Imaging features of pinccr FAI were investigated in 22 patients (24 abnormal hips) by using digital radiography (DR). Lateral center edge angle (LCE) , acctabular index (AI) and femoral head extrusion index (FHEI) were measured in all patients on conventional radiographs of the pelvis, which were compared with a normal control group. Among abnomal 24 hips, CT was carried out in 10, and the CT features were also observed. Results Fifteen of 24 hips with pincer FAI were manifested as extensive acctabular ovcreover-age, exhibiting the fossa acetabuli line within or overlapping the ilioischial line. Meanwhile, their LCE, AI and FHEI were different significantly compared with the control group (P<0. 05). Other nine abnormal hips were manifested as focal acctabular overcover-age, exhibiting "8" sign or posterior line of acetabulum shifting to the outside. On CT images, there were five cases with profund acetabulum and three with acctabular retrovcrsion. The osteosclcrosis, reactive ossification and calcification, and fracture of the acetabular rim, herniation pits and subchondral cystic degeneration were showed on both DR and CT images. Conclusion FAI can easily be determined by conventional radiographs of the pelvis. CT may provide more detailed and reliable images for the rational decision of clinical treatment.%目的 探讨钳夹型髋关节撞击综合征(FAI)的影像学表现.方法 采用DR观察分析22例钳夹型FAI患者,共24例异常髋关节的X线表现,在骨盆前后位上测量外侧中心边缘角(LCE)、髋臼指数(AI)、股骨头突出指数(FHEI)并与正常组比较.24例中10例另行髋关节CT平扫检查,分析其表现.结果 24例钳夹型FAI,15例属于髋臼广泛过度覆盖,表现为髂臼线与髂坐线重叠或位于其内侧,其LCE角、AI、FHEI与正常组比较均有显著差异性(P<0.05).9例属于髋臼

  11. Structural autograft for acetabular reconstruction in total hip arthroplasty of developmental hip dysplasia%结构植骨重建髋臼在髋关节发育不良全髋置换中的应用

    Institute of Scientific and Technical Information of China (English)

    任翀旻; 张元凯; 李德强; 刘培来; 李明

    2013-01-01

    Objective To evaluate the result of bulk femoral head autograft for acetabular reconstruction in total hip arthroplasty for developmental hip dysplasia patients with severe acetabular deficiency.Methods Twenty-five patients (31 hips) with development hip dysplasia were performed with bulk femoral head autograft for the acetabular reconstruction in THA during 2005-2010.Twenty-nine hips in 23 patients were successfully followed up in average 5.1 years with mean age of 52.According to Crowe classification,19 hips in 15 patients were stage Ⅲ and 10 hips in 8 patients were stage Ⅳ.The deficient acetabula were reconstructed by bulk femoral head autograft.With bone guaranteed coverage,patients had prosthesis installed at the original level or closed level of true acetabulum.Radiographic changes and Harris score were evaluated.Results None suffered from loosening and collapse during the follow-up.One was revised for dislocation.Harris scores increased from 44 preoperative to 88 at last follow-up.Conclusion To reconstruct acetabulum at true acetabular level with satisfactory bone coverage by using bulk femoral head autograft is an effective and safe way for THA in developmental hip dysplasia.%目的 评价自体股骨头结构植骨重建髋臼在髋关节发育不良的全髋关节置换术中的效果.方法 选取2005年1月至2010年11月对髋Crowe分型在Ⅲ型和Ⅳ型的髋关节发育不良患者25例31髋,34 ~ 69岁,平均52岁;Ⅲ型15例19髋,Ⅳ型8例10髋;采用结构植骨重建髋臼的全髋关节置换术.术中行股骨头结构植骨,保证覆盖率的基础上,于真臼或近真臼水平重建髋臼并安装假体.术后行影像学检查和Harris评分.成功随访23例29髋,平均随访5.1年.结果 植骨愈合良好,无植骨塌陷,1例1髋术后脱位,所有病例无假体松动发生.术前Harris评分平均44分,术后1年平均89分,最后1次随访平均88分.结论 应用自体股骨头结构植骨,满足覆盖率前提下在真

  12. The morphology and adhesion mechanism of Octopus vulgaris suckers.

    Science.gov (United States)

    Tramacere, Francesca; Beccai, Lucia; Kuba, Michael; Gozzi, Alessandro; Bifone, Angelo; Mazzolai, Barbara

    2013-01-01

    The octopus sucker represents a fascinating natural system performing adhesion on different terrains and substrates. Octopuses use suckers to anchor the body to the substrate or to grasp, investigate and manipulate objects, just to mention a few of their functions. Our study focuses on the morphology and adhesion mechanism of suckers in Octopus vulgaris. We use three different techniques (MRI, ultrasonography, and histology) and a 3D reconstruction approach to contribute knowledge on both morphology and functionality of the sucker structure in O. vulgaris. The results of our investigation are two-fold. First, we observe some morphological differences with respect to the octopus species previously studied (i.e., Octopus joubini, Octopus maya, Octopus bimaculoides/bimaculatus and Eledone cirrosa). In particular, in O. vulgaris the acetabular chamber, that is a hollow spherical cavity in other octopuses, shows an ellipsoidal cavity which roof has an important protuberance with surface roughness. Second, based on our findings, we propose a hypothesis on the sucker adhesion mechanism in O. vulgaris. We hypothesize that the process of continuous adhesion is achieved by sealing the orifice between acetabulum and infundibulum portions via the acetabular protuberance. We suggest this to take place while the infundibular part achieves a completely flat shape; and, by sustaining adhesion through preservation of sucker configuration. In vivo ultrasonographic recordings support our proposed adhesion model by showing the sucker in action. Such an underlying physical mechanism offers innovative potential cues for developing bioinspired artificial adhesion systems. Furthermore, we think that it could possibly represent a useful approach in order to investigate any potential difference in the ecology and in the performance of adhesion by different species.

  13. The morphology and adhesion mechanism of Octopus vulgaris suckers.

    Directory of Open Access Journals (Sweden)

    Francesca Tramacere

    Full Text Available The octopus sucker represents a fascinating natural system performing adhesion on different terrains and substrates. Octopuses use suckers to anchor the body to the substrate or to grasp, investigate and manipulate objects, just to mention a few of their functions. Our study focuses on the morphology and adhesion mechanism of suckers in Octopus vulgaris. We use three different techniques (MRI, ultrasonography, and histology and a 3D reconstruction approach to contribute knowledge on both morphology and functionality of the sucker structure in O. vulgaris. The results of our investigation are two-fold. First, we observe some morphological differences with respect to the octopus species previously studied (i.e., Octopus joubini, Octopus maya, Octopus bimaculoides/bimaculatus and Eledone cirrosa. In particular, in O. vulgaris the acetabular chamber, that is a hollow spherical cavity in other octopuses, shows an ellipsoidal cavity which roof has an important protuberance with surface roughness. Second, based on our findings, we propose a hypothesis on the sucker adhesion mechanism in O. vulgaris. We hypothesize that the process of continuous adhesion is achieved by sealing the orifice between acetabulum and infundibulum portions via the acetabular protuberance. We suggest this to take place while the infundibular part achieves a completely flat shape; and, by sustaining adhesion through preservation of sucker configuration. In vivo ultrasonographic recordings support our proposed adhesion model by showing the sucker in action. Such an underlying physical mechanism offers innovative potential cues for developing bioinspired artificial adhesion systems. Furthermore, we think that it could possibly represent a useful approach in order to investigate any potential difference in the ecology and in the performance of adhesion by different species.

  14. Treatment of severe bone deficiency in acetabular revision surgery using a reinforcement device and bone grafting

    Institute of Scientific and Technical Information of China (English)

    ZHAI Ji-liang; LIN Jin; JIN Jin; QIAN Wen-wei; WENG Xi-sheng

    2011-01-01

    Background Severe acetabular bone deficiency is a major challenge in acetabular revision surgery. Most cases require reconstruction of the acetabulum with bone grafting and a reinforcement device. The purpose of this study was to evaluate the results of this procedure for severe acetabular bone deficiency in acetabular revision surgery.Methods This study involved 12 patients (2 males and 10 females) with severe acetabular bone defects who underwent implantation of a reinforcement device (ring or cage) and bone grafting between February 2003 and October 2008. Using the Paprosky classification, 2 cases were Paprosky ⅡC, 6 were ⅢA, and 4 were ⅢB. The mean age at the time of surgery was 63.0 years (range, 46-78 years). During revision surgery, a reinforcement ring was implanted in 6patients, and a cage in 6 patients. The clinical and radiographic results were evaluated retrospectively. The mean duration of follow-up was 37 months (range, 9-71 months).Results The average Harris Hip Score improved from 35.2 preoperatively to 82.9 at the time of the final follow-up visit.The results were excellent in 8 hips (66.7%), good in 2 (16.7%), and fair in 2 (16.7%). Osteolysis was found in 1 case, but did not worsen. Three patients had yellow wound effusion, with healing after administration of dressing changes,debridement, and antibiotics. Dislocation occurred in a 62-year-old woman. Closed reduction was performed, and dislocation did not recur. There was no evidence of intraoperative acetabular fracture, nerve injury, ectopic ossification,aseptic loosening, or infection.Conclusion Reconstruction with a reinforcement device and bone grafting is an effective approach to the treatment of acetabular bone deficiency in acetabular revision surgery, given proper indications and technique.

  15. Metric sex determination from the pelvis in modern Greeks.

    Science.gov (United States)

    Steyn, M; Işcan, M Y

    2008-07-18

    The ability to determine sex from unknown skeletal remains is vital, and methods to do this on the various bones of the human skeleton have been researched extensively. Many researchers have emphasized the need for population specific data for methods which are based on measurements, as there are vast differences in body size in various populations. The pelvis is known to be the most sexually dimorphic part of the human body, and no discriminant function formulae for this bone are available for Greek or other Mediterranean groups. The purpose of this study was therefore to develop discriminant functions which can be used for sex determination on measurements of the pelvis of modern Greeks. A sample of 97 male and 95 female pelves in a skeletal collection housed in Heraklion, Crete, was used. Measurements were taken from the articulated pelvis, single os coxae and the sacrum. Discriminant function formulae for all measurements and various combinations were used in order to assess the degree of sexual dimorphism in various parts of the pelvis, and to make the formulae usable on fragmented remains. For the single os coxae, average accuracies of 79.7-95.4% (79.1-93.5% on cross-validation) were found. However, it was found that measurements of the sciatic notch were unreliable and yielded poor results, and it is advisable that this characteristic must only be used as a last resort. Dimensions of the sacrum were not very dimorphic (average accuracy 60.9%), while measurements from the articulated pelvis yielded poorer results than that from single innominate bones. The diameter of the acetabulum was the single most dimorphic characteristic, providing on average 83.9% accuracy when used in isolation.

  16. The fate of the hip in spondylo-epi-metaphyseal dysplasia: clinical and radiological evaluation of adults with SEMD Handigodu type

    Energy Technology Data Exchange (ETDEWEB)

    Siddesh, N.D.; Shah, Hitesh; Joseph, Benjamin [Kasturba Medical College, Paediatric Orthopaedic Service, Manipal, Karnataka State (India)

    2012-08-15

    This study was undertaken to document the fate of the hip with reference to its structure and function in patients with spondylo-epi-metaphyseal dysplasia tarda Handigodu type (SEMD{sub HG}). Radiographs of 271 adult patients with SEMD{sub HG} were studied to identify the pattern of long-term sequelae in the hips. Several measurements of the proximal femur and acetabulum were made to quantify morphological alterations in the hip. Fifty-four adult patients were examined and administered a questionnaire to evaluate the extent of disability attributable to the hips. Three patterns of changes in the hips were noted: 35% had acetabular protrusio, 33% had subluxation of the hip, and 32% had no protrusio or subluxation. Distinctly different anthropometric measurements and dimensional alterations around the hip were noted in these three patterns. Patients with protrusio were relatively tall while those with subluxation were the shortest. All the patients had developed degenerative arthritis of the hips by the fourth decade of life irrespective of the pattern of hip involvement. The reduction in the range of hip motion and fixed deformities were most severe in patients with protrusio. All the patients had significant disability and very low functional hip scores. Degenerative arthritis of the hip develops in the majority of patients with SEMD{sub HG}; the symptoms are severe enough to warrant reconstructive surgery by the fourth decade of life. Protrusio or subluxation develops in a third of the patients each; both these complications will influence the surgical approach if total hip arthroplasty is planned. (orig.)

  17. Image Guided Clinical Correlation of CDH and Calve-Legg-Perthes Disease

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Herischi

    2011-05-01

    Full Text Available Background/Objective: Anatomic condition and"nvascularization of the femoral head leads to Calve-"nLegg-Perthes disease (avascular necrosis in children"nand primary condition of acetabulum and coverage"nof hip joint as a defect, cause CDH or congenital"ndislocation of the hip joint. Early diagnosis of these"ndiseases in clinic, confirmation by imaging (US, Xray,"nX-ray CT and MRI help better treatment and less"ncomplication or sequel."nPatients and Methods: By two decade evaluation and"ntreatment we used clinical assessments by pediatric"northopedic surgeons and radiologic examinations like"nfrog-leg, AP X-rays, ultrasound examinations, 2D"nand 3D X-ray CT and 1.5 tesla MR-machine images."nTreatments were with fixation (using cast and elizarov"nvariant fixators, surgery and controlling by imaging."nResults: Ultrasound and MRI were the best methods"nin diagnosis, image guided treatment (medical or"nsurgical and treatment controlling. Many patients"nare treated with minor complications. Complications"nare rare in CDH but some complications have been"nmentioned for CLP disease."nConclusion: Image guidance in diagnosis and treatment"nalso treatment control of pediatric CDH and CLP"ndisease give the pediatric orthopedic surgeon a good"noutcome of the disease and its treatment. Ultrasound"nand MRI using highly sophisticated probes, coils and"nprotocols with new machines gives us the best result"nin diagnosis, treatment and post-op controls.

  18. 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.

  19. CT image analysis from hip joint shelf morphology of 62 normal healthy Japanese

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Hiroshi [Keio Univ., Tokyo (Japan). School of Medicine

    1997-11-01

    In the present study we measured and analyzed CT imaging of acetabulum in the hip joint of the normal Japanese who were judged normal by simple X-ray, and examined the age difference, sex difference and individual difference among the measurements. We carried out CT imaging and X-ray measurement of 124 hip joints from 62 normal adults (21 men and 41 women). The age ranged from 17 to 76 years (mean 46.2 year). We measured 7 items, which were the pelvic inclination angle, acetabular anterior index, acetabular lateral index, acetabular anteversion angle (AV), anterior acetabular sector angle (AASA), posterior acetabular sector angle, horizontal acetabular sector angle (HASA), and added the correction of pelvic inclination. We also measured Sharp angle, CE angle, and acetabular head index (AHI) which were conventionally used as the measurement values of the simple X-ray normal imaging. From the separate measurement values of men and women, we calculated the mean and the standard deviation, and examined the correlation between the values. In women, AV and Sharp angles were significantly large and AASA was significantly small. These were thought to be unique features for women. It is also suggested that the present results may be reflected that many Japanese women suffer from the luxatio coxae congenita. We found that there is a correlation between age and the measurement value reflecting the state of the sector except AASA, and that the aged subjects have the larger sector. We also found the correlation between the values from CT measurement reflecting the state of sector and that from the simple X-ray measurement, and could obtain the direction and the degree of the sector by combining these two values. (K.H.)

  20. Hip Joint Stresses Due to Cam-Type Femoroacetabular Impingement: A Systematic Review of Finite Element Simulations.

    Directory of Open Access Journals (Sweden)

    K C Geoffrey Ng

    Full Text Available The cam deformity causes the anterosuperior femoral head to obstruct with the acetabulum, resulting in femoroacetabular impingement (FAI and elevated risks of early osteoarthritis. Several finite element models have simulated adverse loading conditions due to cam FAI, to better understand the relationship between mechanical stresses and cartilage degeneration. Our purpose was to conduct a systematic review and examine the previous finite element models and simulations that examined hip joint stresses due to cam FAI.The systematic review was conducted to identify those finite element studies of cam-type FAI. The review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and studies that reported hip joint contact pressures or stresses were included in the quantitative synthesis.Nine articles studied FAI morphologies using finite element methods and were included in the qualitative synthesis. Four articles specifically examined contact pressures and stresses due to cam FAI and were included in the quantitative synthesis. The studies demonstrated that cam FAI resulted in substantially elevated contact pressures (median = 10.4 MPa, range = 8.5-12.2 MPa and von Mises stresses (median 15.5 MPa, range = 15.0-16.0 MPa at the acetabular cartilage; and elevated maximum-shear stress on the bone (median = 15.2 MPa, range = 14.3-16.0 MPa, in comparison with control hips, during large amplitudes of hip motions. Many studies implemented or adapted idealized, ball-and-cup, parametric models to predict stresses, along with homogeneous bone material properties and in vivo instrumented prostheses loading data.The formulation of a robust subject-specific FE model, to delineate the pathomechanisms of FAI, remains an ongoing challenge. The available literature provides clear insight into the estimated stresses due to the cam deformity and provides an assessment of its risks leading to early joint degeneration.

  1. Evaluation of pelvic ring injuries using SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Scheyerer, Max J. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); University Medical Center, Centre for Orthopaedic and Trauma Surgery, Cologne (Germany); Huellner, Martin; Pietsch, Carsten [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Werner, Clement M.L. [University Hospital Zurich, Division of Trauma Surgery, Department of Surgery, Zurich (Switzerland); Veit-Haibach, Patrick [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); University Hospital Zurich, Diagnostic and Interventional Radiology, Department of Medical Radiology, Zurich (Switzerland)

    2014-08-12

    The incidence of pelvic fractures is relatively low compared with other fracture locations. The low incidence is in great contrast to the high morbidity and mortality. Particularly in the elderly, with apparently isolated fractures of the pubic rami, these observations are believed to be due to additional occult lesions of the posterior pelvic ring. In these cases diagnosis cannot be established by conventional imaging alone and SPECT/CT is considered as a diagnostic adjunct. The aim of this study was to assess concomitant bony or soft tissue lesions within the pelvic ring in a population of patients with fractures of the anterior elements. In all patients with no obvious lesions of the posterior pelvic ring on X-rays and CT or with suspicious but inconclusive findings on CT an additional SPECT/CT was carried out in a non-acute setting within 3 days of the trauma. In all cases additional lesions within the pelvic ring were found. Most lesions were vertical sacral fractures, followed by transverse fractures, one non-dislocated fracture of the acetabulum on the side of the pubic rami fracture, and one post-traumatic dilatation of the sacroiliac joint with increased tracer uptake. According to our results after SPECT/CT all patients with pubic rami fracture suffered additional lesions, none detectable previously by X-ray or CT, within the pelvic ring. In this context SPECT/CT has proved to be very helpful in the clinical routine to visualize occult fractures and instability within the sacroiliac joint. (orig.)

  2. Long term results of surgery in Perthes disease: Comparison of X-ray and MR-studies; Spaetergebnisse nach operativer Behandlung des Morbus Perthes: Vergleich der roentgenologischen und kernspintomographischen Untersuchung

    Energy Technology Data Exchange (ETDEWEB)

    Tosch, U. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany); Sparmann, M. [Orthopaedische Klinik im Oskar-Helene-Heim, Berlin (Germany); Stelling, E. [Orthopaedische Klinik im Oskar-Helene-Heim, Berlin (Germany); Tomala, D. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany)

    1995-05-01

    Twenty patients treated by surgery for Perthes` disease were studied between 4 and 9 years postoperatively. In the clinical investigation eight patients complained of persistent stress-induced pain. In nine patients flexion, extension, ab- and adduction of the hip joint was limited. In the MRI-Study of ten hip joints a reduction of fatty marrow was seen in the femoral head. In 11 hip joints of patients complaining of persistent pain, a deformation of the femoral head (n = 2), a dysplasia of the femoral metaphysis (n = 2), and diaphysis (n = 4) or both (n = 2) were seen. In another five patients an additional dysplasia of the acetabulum was visualized. All these findings were diagnosed by X-ray studies as well. However, only by MRI were the extents of the postoperative defects of femoral spongiosa diagnosed in fifteen hip joints. (orig.) [Deutsch] 20 wegen eines Morbus Perthes operierte Patienten wurden 4-9 Jahre nach einer Umstellungsosteotomie klinisch, radiologisch und kernspintomographisch untersucht. Bei der klinischen Nachuntersuchung gaben 8 Patienten persistierende Beschwerden bei Belastung an. Bei der koerperlichen Untersuchung war die Flexion und Extension bei 9 sowie die Abduktion und Adduktion bei einem Patienten eingeschraenkt. Bei der kernspintomographischen Untersuchung liessen sich bei 10 Hueftgelenken Residuen des M. Perthes im Fettmark des Femurkopfs nachweisen. An 11 Hueftkoepfen wurden pathologische Veraenderungen wie eine Femurkopfentrundung (n = 2), eine Deformierung der Femurmeta- (n = 3) und -diaphyse (n = 4) bis hin zur hirtenstabfoermigen Konfiguration (n = 2) nachgewiesen. Bei 5 Patienten wurde eine Pfannendysplasie gefunden. Diese Befunde waren auch roentgenologisch darzustellen. Als postoperative Defekte waren im Schaftmark des Femurs eine langstreckige Hoehlenbildung mit Zysten oder durch Fettmark aufgefuellte Spongiosadefekte bei 15 Hueftgelenken nur kernspintomographisch nachweisbar. (orig.)

  3. Magnetic resonance imaging of para-acetabular insufficiency fractures in patients with malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Theodorou, S.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]|[Department of Clinical Radiology, University of Manchester, Manchester (United Kingdom); Theodorou, D.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]. E-mail: daphne_theodorou@hotmail.com; Schweitzer, M.E. [Department of Radiology, New York University Hospital for Joint Diseases, NY (United States); Kakitsubata, Y. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Resnick, D. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)

    2006-02-15

    AIM: To describe the characteristic magnetic resonance imaging (MRI) findings of para-acetabular insufficiency fractures in patients with malignancy, and compare the MRI appearance of these fractures with that of metastatic bone disease. MATERIALS AND METHODS: MRI examinations were reviewed in 16 patients with a known malignant tumour and severe hip pain that raised the possibility of local recurrence or metastatic disease. Six patients had received pelvic irradiation, and three patients were receiving steroid medication. RESULTS: The total number of fractures detected was 21: a solitary fracture was present in 11 patients and five patients had bilateral para-acetabular fractures. Two patients had associated sacral insufficiency fractures, and one of them had stress fractures involving both acetabular columns. Conventional radiography allowed the diagnosis of 14 (67%) fractures; six (28%) radiographic examinations were negative; and one (5%) examination was equivocal for fracture. Available scintigraphic and computed tomography (CT) studies revealed typical findings of fracture. Using MRI, insufficiency fractures appeared as linear regions of low signal intensity on T1- and T2-weighted images. Marked marrow oedema was evident in all cases. Fractures characteristically were parallel to the superior acetabulum in a curvilinear fashion in 18 (86%) instances, and were oblique in three (14%) instances. The fractures demonstrated considerable enhancement after intravenous gadolinium administration. No associated soft tissue masses were documented. CONCLUSION: Para-acetabular insufficiency fractures are a cause of hip pain, which may mimic skeletal metastasis in the patient with malignancy and pelvic irradiation. Recognition of the characteristic MRI findings of these fractures can preclude misdiagnosis and unnecessary bone biopsy.

  4. Tuberculosis of hip in children: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Myung-Sang Moon

    2012-01-01

    Full Text Available Background: Tuberculosis (TB of hip constitutes nearly 15% of all cases of osteoarticular tuberculosis. We report a retrospective study carried out on 43 children with hip TB. Materials and Methods: Forty-three children of TB hip treated between 1971 and 2000 were analysed. Twenty-four children of the early series were treated with streptomycin (S, isoniazid (H and PAS (Pa for 18 months (3HPaS, 15 HPa, while 19 children in the later series were treated with isoniazid (H, rifampicin (R and ethambutol (E or pyrazinamide (Z for 12 months [(12 RHE(Z]. Five out of 18 children with radiologically normal appearing type hip TB were treated with chemotherapy alone and 38 children were subjected to surgery; simple synovectomy alone in 31 hips, joint debridement in six hips, and proximal femoral varisation osteotomy in one. After surgery hips were immobilized in cast for one to three months according to the severity of the disease and patients pain tolerance, and then were mobilized under leg traction in bed gradually till pain subsided completely. Results: TB of hip healed with minimum sequelae in all children. In 18 Type one hip TB, normal hip (synovial form anatomy was maintained, and in 25 patients with advanced lesions some defect in the femoral head and acetabulum was noticed, though painless good hip motion was maintained. Excellent to good results were obtained in 31 children (73.1%, fair in eight (18.6%, and poor in four (9.3%. In four patients with poor results, there was some residual morphological defect in the hip. None developed ankylosis of hip. Conclusion: We achieved good outcome with minimum sequelae in this series. The management goal should be aimed not only to heal the disease but also to maintain a painless mobile hip and anatomical cephalocotyloid relationship until maturity, and retard the development of secondary osteoarthritis.

  5. Reconstruction of the hip joint in children after septic coxitis

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    Михаил Павлович Тепленький

    2016-06-01

    Full Text Available Background.Surgical treatment of destructive dislocations is problematic, and controversial. Treatment options range from active monitoring to complex multistage reconstruction protocols.Materials and methods.The results of treatment of 17 children with disruptive dislocation of the hip (class IV according to the Choi classification are presented. The mean age at which treatment was started was 6.3 ± 0.5 years (range: 3-9 years. Treatment strategies included formation of the weight-bearing contact of the proximal femur and acetabulum and ilium osteotomy using an Ilizarov frame. The follow-up period lasted from 2 to 11 years. Clinical results were assessed using Colton’s criteria. Assessment of the radiology findings included the anatomy relations and congruence of the articular surfaces. The patients were divided into two groups, according to age, for data analysis.Results.The majority (88% of the children had positive anatomical and functional outcomes. The functional results were good (12-15 points, satisfactory (9-11 points, and unsatisfactory (8 points for 3, 5, and 1, respectively, among 3-6 year olds and 2, 6, and 0, respectively, among 7-9 year olds. The distribution of joint congruence types I, III, and IV was 2, 4, and 3, respectively, in the younger group and 1, 6, and 1, respectively, in the older group.Conclusion.The use of reconstructive surgery using the Ilizarov apparatus in children with a defect of the proximal femur creates conditions for the adaptation of incongruent articular components without causing decompensation of the joint.

  6. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

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    Williams, T.R. [Portsmouth Naval Medical Center, Radiology Department, Charette Health Care Center, Portsmouth, VA (United States); Puckett, M.L.; Shin, A.Y.; Gorman, J.D. [Naval Medical Center San Diego, Radiology Department, San Diego, CA (United States); Denison, G. [US Naval Hospital Guam (United States)

    2002-05-01

    Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

  7. Radiotherapy Treatment Planning for Testicular Seminoma

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    Wilder, Richard B., E-mail: richardbwilder@yahoo.com [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States); Buyyounouski, Mark K. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Efstathiou, Jason A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States)

    2012-07-15

    Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 Multiplication-Sign 1-2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior-posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior-posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

  8. Metacercárias de Neascus sp. em Geophagus brasiliensis (Perciformes: Cichlidae do rio do Peixe, Juiz de Fora, Brasil - DOI: 10.4025/actascibiolsci.v30i3.493 Neascus-type metacercariae in Geophagus brasiliensis (Perciformes: Cichlidae of Peixe river, Juiz de Fora, Brazil - DOI: 10.4025/actascibiolsci.v30i3.493

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    José Luis Luque

    2008-10-01

    Full Text Available A metacercária de Neascus sp., causadora da doença dos pontos pretos, é descrita em espécimes de Geophagus brasiliensis coletados no Brasil. Entre março e maio de 2006, foram capturados 33 espécimes de G. brasiliensis, coletados com o auxílio de vara e anzol no Rio do Peixe, Monte Verde, município de Juiz de Fora, Estado de Minas Gerias. Dos 33 espécimes examinados, 30 (90,9% apresentaram-se parasitados por metacercárias causadoras dos pontos pretos, com intensidade média de infecção de 15,6 ± 16,1 (1 – 75. Foi observada correlação significativa entre o comprimento total de G. brasiliensis e a abundância parasitária (r = 0,459; P Neascus-type metacercariae, which cause the black spot disease, are described in specimens collected from 33 samples of Geophagus brasiliensis from the Peixe river, in Monte Verde, Juiz de Fora, state of Minas Gerais, Brazil, during March and May 2006. The main morphological features of these metacercariae are: genital primordia composed of three cell masses located in the hind body, and a median dorsal vessel of the reserve bladder around the acetabulum. Thirty fish specimens (90.9% were parasitized by metacercariae, with mean infection intensity of 15.6 ± 16.1 (1-75. Also, a positive correlation was detected between G. brasiliensis total length and the parasite abundance (r = 0.459; p < 0.01.

  9. Multiplanar and 3D CT of acetabular fractures

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    Haveri, M.; Suramo, I.; Laehde, S. [Oulu Univ., Dept. of Diagnostic Radiology (Finland); Junila, J. [Oulu Univ., Dept. of Orthopaedic Surgery (Finland)

    1998-05-01

    Purpose: To establish a standard protocol for the multiplanar (MPR) and 3D shaded surface display (SSD) reconstruction of CT data on acetabular fractures, and to assess the usefulness of these reformats. Material and Methods: Acetabular fractures in 15 patients were imaged by means of plain radiographs, transaxial CT, MPR reformats, and SSD reformats. Results: The classification of the acetabular fracture was revised in 7/15 cases when the transaxial CT images were read after the plain radiographs. Although the MPR and SSD reformats did not alter the classification, they did add to the degree of confidence in the diagnosis in 9/15 cases. In 2 patients, the MPR and SSD reformats indicated operative instead of conservative treatment. In the MPR reformats, the following views were considered essential in all cases: (a) along the anterior column; (b) along the posterior column; and (c) along both columns and the inferior ramus. In the SSD reformats, the following views were considered essential in all cases: (d) the latero-caudal en face view into the acetabulum; and 180 opposite to this, (e) the medio-cranial view (facing the quadrilateral plate). In 10/15 cases, these views were all that was needed for classification. It was, however, essential to remove the femur from the images before reconstructing the SSD views. Conclusion: Complex acetabular fractures with displacement should be evaluated by means of transaxial CT and additional MPR and SSD reformats. The use of appropriate standard MPR and SSD views shortens the time required to produce the reformats and thereby maximizes the benefit gained. (orig.).

  10. Magnetic resonance imaging of idiopathic osteonecrosis of the femoral head

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    Yamazoe, Shoichi [Kyoto Prefectural Univ. of Medicine (Japan)

    1995-02-01

    Idiopathic osteonecrosis of the femoral head (IONF) can result in disability due to bone collapse and destruction. Therefore, early diagnosis of IONF and prognosis assessment are essential for treatment planning. This study investigated the early characteristic pattern of IONF on magnetic resonance imaging (MRI) and its correlation to the prognosis of the femoral head. MRI was performed repeatedly on fifty-one patients who had undergone renal transplantation. Three abnormal patterns were found in the T{sub 1}-weighted images: a band-like low-signal pattern (band pattern), an irregular low-signal pattern (mottled pattern), and a homogeneous low-signal area localized in the subchondral region (homogeneous pattern). Abnormal changes were detected in thirteen patients; twenty-three hips (25.5%). Most changes were evident within six months after transplantation. The earliest was found six weeks after transplantation. A band pattern was the initial finding in all hips showing abnormal changes. The band pattern did not spread peripherally as time passed. There was no progression from a mottled or homogeneous pattern to a band pattern either. Band-like patterns were subclassified into four types: MR-A, MR-B, MR-C and MR-D. Each of types according to the size and location of the band in relation to the weight bearing portion of the acetabulum was correlated to the prognosis of the femoral head. Three fourths of femoral heads with MR-C resulted in collapse on roentgenographs. These results show that MRI is useful for the diagnosis and evaluation of prognosis in IONF. (author).

  11. Definition of ureterovesical junction level by computed tomography; Definicao do nivel da juncao ureterovesical pela tomografia computadorizada

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    Freire Filho, Edison de Oliveira; Leao, Alberto Ribeiro de Souza; Capobianco, Julia; Szejnfeld, Jacob; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Dept. de Diagnostico por Imagem]. E-mail: eofilho@ig.com.br

    2006-11-15

    Objective: To define, by means of computed tomography, the level of ureteral implantation into de bladder. Materials And Methods: We have measured the distances from the ureteral meatus to the acetabulum, and to the superior margin of the pubic symphysis, as well as the bladder volume, using contrast enhanced computed tomography of the pelvis in 46 patients (31 male and 15 female) in the age range between 18 and 45 years, with at least one of the ureters filled with excreted contrast material. The Student t test has been applied to determine eventual statistically significant differences between groups. Results: The level of ureteral implantation into the bladder was, on average, 10.6 +- 8.1 mm below the acetabular roof, and 29.7 +- 9.5 mm above the superior margin of the pubic symphysis. In patients with bladder repletion volume of < 200 ml and . 200 ml, the level of ureteral implantation into the bladder was, respectively, on average, 11.6 +- 7.3 mm and 10.2 +- 8.4 mm below the acetabular roof (p 0.61), and 28.3 +- 7.3 mm and 30.3 +- 10.2 mm above the superior margin of the pubic symphysis (p 0.52), and in male and female men patients, respectively, on average, 11.8 +- 8.0 mm and 8.3 +- 8.0 mm below the acetabular roof (p 0.17), and 27.7 +- 9.2 mm and 33.9 +- 8.8 mm above the superior margin of the pubic symphysis (p 0.34). Conclusion: Calcifications located < 3 cm below the acetabular roof and < 1.5 cm above the superior margin of the pubic symphysis probably do not represent ureteral calculi. Vesical repletion or sex have no significant influence on the ureteral meatus position. (author)

  12. Metacercárias tipo Neascus em Geophagus brasiliensis (Perciformes: Cichlidae do rio do Peixe, Juiz de Fora, Brasil = Neascus-type metacercariae in Geophagus brasiliensis (Perciformes: Cichlidae of Peixe river, Juiz de Fora, Brazil

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    Adriano Reder de Carvalho

    2008-07-01

    Full Text Available Metacercárias do tipo Neascus, um dos agentes causadores da doença dos pontos pretos, são descritas a partir de espécimes coletados de 33 espécimes de Geophagus brasiliensis coletados no rio do Peixe, Monte Verde, município de Juiz de Fora, Estado de Minas Gerais, Brasil, durante março e maio de 2006. As principais características morfológicas destas metacercárias foram: primórdio genital representado por três massas celulares, localizadas posteriormente na parte posterior do corpo e vaso mediano dorsal da bexiga de reserva estendendo-se em torno do acetábulo. Dos 33 espécimes de G. brasiliensis examinados, 30 (90,9% apresentaram-se parasitados por metacercárias, com intensidade média de infecção de 15,6 ± 16,1 (1-75. Foi observada correlação positiva entre o comprimento total de G. brasiliensis e a abundância parasitária (r = 0,459; p Neascus-type metacercariae, which cause the black spot disease, are described in specimens collected from 33 samples of Geophagusbrasiliensis from the Peixe river, in Monte Verde, Juiz de Fora, state of Minas Gerais, Brazil, during March and May 2006. The main morphological features of these metacercariae are: genital primordia composed of three cell masses located in the hind body, and a mediandorsal vessel of the reserve bladder around the acetabulum. Thirty fish specimens (90.9% were parasitized by metacercariae, with mean infection intensity of 15.6 ± 16.1 (1-75. Also, a positive correlation was detected between G. brasiliensis total length and the parasite abundance (r = 0.459; p < 0.01.

  13. Contribuição para o conhecimento dos parasitos de peixes do litoral do Estado da Guanabara - parte II Contribution to the knowledge of the parasites of fishes in Guanabara State

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    Delir Correa Gomes

    1974-01-01

    Full Text Available Neste presente trabalho os autores criam uma nova espécie para o subgênero Plagioporus (Plagioporus Stafford, 1904, P. (P. dollfusi sp. n. fica no grupo "b" da distribuição de travassos & cols. (1966, mais se aproximando de P. (P. multilobatus Travassos & cols. 1966, distinguindo-se principalmente por possuir o limite anterior dos vitelinos na zona acetabular, poro genital bifurcal, bolsa do cirro alcançando a zona acetabular e ovos menores. Apresentam como novas ocorrências Enenterum pimelopteri Nagaty 1942 e Pseudopecoelus priacanthi (Mac Callum, 1921 manter, 1947. Apresentam ainda Garrupa sp. como novo hospedeiro de Pseudopecoelus priacanthi. Referem a presença de Hysterolecitha elongata manter, 1931, Bucephalus varicus manter, 1940, Metadena spectanda travassos, Freitas & Bührnheim, 1967 e uma fêmea jovem de Echinorhynchideae Southwell & Macfie, 1925 (Acanthocephala.In the present work the authors propose a new species under the subgenus P. (Plagioporus Stafford, 1904, which is enclosed in the second group of Travassos & cols. (1966 distribution, nearest to p. (P. multilobatus Travassos & cols., 1966 differing from it mainly by possessing the vitelaria level at the acetabulum, genital pore level with intestinal bifurcation and smaller eggs. They present for Enenterum pimelopteri Nagaty, 1942 and Pseudopecoelus priacanthi (Mac Callum, 1921 Manter, 1947 new geographical distributions. For P. priacanthi they add Garrupa sp. as new host record. They refer Hysterolecitha elongata Manter, 1940, Metadena spectanda Travassos, Freitas & Bührnheim, 1967 and an imature acanthocephalan female under Echinorhynchideae Southwell & Macfie, 1925.

  14. Femoral neck anteversion, acetabular anteversion and combined anteversion in the normal Indian adult population: A computed tomographic study

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    Maheshwari Aditya

    2010-01-01

    Full Text Available Background: Abnormal femoral neck anteversion (FNA and/or acetabulum anteversion (AA have long been implicated in the etiogenesis of hip osteoarthritis (OA, developmental dysplasia of the hip (DDH, and impingement, instability and wear in total hip arthroplasty (THA. Since studies on the Indian population are sparse on this topic, the purpose of this study was to report the normal values of FNA, AA and the combined anteversion (CA= FNA+ AA in Indian adults. Materials and Methods: FNA, AA and CA were prospectively measured in 172 normal hips in 86 Indian adults using standardized computed tomographic (CT methods and this data was compared with the established Western values. Results: The median values and interquartile ranges were 8 o (6.5-10.0 o for FNA, 19 o (16.0-22.0 o for AA and 27 o (23.5-30.0 o for CA. AA and CA values were significantly (P< 0.05 lower in males, and there was also a trend towards lower FNA in males. Although a negative correlation was observed between the FNA and AA, this was not strong and may not be clinically relevant. Conclusion: When compared with the Western data, the FNA values were 3-12 o lower and the CA values were 3-5 o lower in Indian adults. The AA values were comparable, but were skewed towards the higher side. Further studies are needed to assess the clinical relevance of our basic science data in pathogenesis of OA, and to validate it in relation to hip surgeries like corrective osteotomies and THA.

  15. Fatigue stress injuries of the pelvic bones and proximal femur: evaluation with MR imaging

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    Kiuru, Martti J. [Department of Radiology, Helsinki University Central Hospital, P.O. Box 340, Haartmaninkatu 4, 00029 Helsinki (Finland); Research Institute of Military Medicine, Mannerheimintie 164, 00300 Helsinki (Finland); Pihlajamaki, Harri K. [Department of Surgery, Central Military Hospital, Mannerheimintie 164, 00300 Helsinki (Finland); Ahovuo, Juhani A. [Department of Radiology, Helsinki University Central Hospital, P.O. Box 340, Haartmaninkatu 4, 00029 Helsinki (Finland)

    2003-03-01

    The purpose of this study was to determine the prevalence and the distribution as well as male/female differences in patients with hip or pelvic pain based on MRI results. Three hundred forty consecutive conscripts (45 women, 295 men; age range 18-29 years; mean age 20.7 years) suffering from stress-related hip, buttock or groin pain took part in the study. All 340 patients underwent MR imaging. Radiographic data were available for 215 patients. Two radiologists interpreted the images by consensus. In MRI 174 stress injuries were diagnosed in 137 patients (32 women, 105 men). The incidence of bone stress injuries in women was significantly higher than that in men (p<0.0001). One hundred five of the injuries (60%) were related to the proximal femur, 70 (67%) to the neck, 34 (32%) to the proximal shaft, and one (1%) to the head. Sixty-nine of the 174 stress injuries (40%) concerned the pelvic bones: sacrum 28 (41%); inferior pubic ramus 34 (49%); superior pubic ramus 3 (4%); iliac bone 3 (4%); and acetabulum 1 (1%). In 31 of the 174 cases (18%) symptoms were contralateral to MR findings. Thirty-three of the 137 patients (24%) had multiple bone stress injuries, 29 had two bone stress injuries and 4 patients had three. The sensitivity of radiography was 37%, specificity 79%, accuracy 60%, positive predictive value 59% and negative predictive value 61%. The kappa value for agreement between radiography and MRI was poor (0.17, p=0.0008). Patients suffering from stress-related hip pain MRI revealed bone stress injuries in 40%; of these, 60% were located in the proximal femur and 40% in the pelvic bones. For accurate diagnosis of bone stress injuries, and to ensure appropriate treatment, the entire pelvis and both proximal femurs should be studied simultaneously by means of MRI. (orig.)

  16. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

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    Akiyama, Mio; Nakashima, Yasuharu; Fujii, Masanori; Sato, Taishi; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsuda, Shuichi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

    2012-11-15

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  17. Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications.

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    Tsai, Henry P; Holliday, Casey M

    2015-06-01

    Archosaurs evolved a wide diversity of locomotor postures, body sizes, and hip joint morphologies. The two extant archosaurs clades (birds and crocodylians) possess highly divergent hip joint morphologies, and the homologies and functions of their articular soft tissues, such as ligaments, cartilage, and tendons, are poorly understood. Reconstructing joint anatomy and function of extinct vertebrates is critical to understanding their posture, locomotor behavior, ecology, and evolution. However, the lack of soft tissues in fossil taxa makes accurate inferences of joint function difficult. Here, we describe the soft tissue anatomies and their osteological correlates in the hip joint of archosaurs and their sauropsid outgroups, and infer structural homology across the extant taxa. A comparative sample of 35 species of birds, crocodylians, lepidosaurs, and turtles ranging from hatchling to skeletally mature adult were studied using dissection, imaging, and histology. Birds and crocodylians possess topologically and histologically consistent articular soft tissues in their hip joints. Epiphyseal cartilages, fibrocartilages, and ligaments leave consistent osteological correlates. The archosaur acetabulum possesses distinct labrum and antitrochanter structures on the supraacetabulum. The ligamentum capitis femoris consists of distinct pubic- and ischial attachments, and is homologous with the ventral capsular ligament of lepidosaurs. The proximal femur has a hyaline cartilage core attached to the metaphysis via a fibrocartilaginous sleeve. This study provides new insight into soft tissue structures and their osteological correlates (e.g., the antitrochanter, the fovea capitis, and the metaphyseal collar) in the archosaur hip joint. The topological arrangement of fibro- and hyaline cartilage may provide mechanical support for the chondroepiphysis. The osteological correlates identified here will inform systematic and functional analyses of archosaur hindlimb evolution and

  18. Anthelmintic Effect of Biocompatible Zinc Oxide Nanoparticles (ZnO NPs on Gigantocotyle explanatum, a Neglected Parasite of Indian Water Buffalo.

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    Yasir Akhtar Khan

    Full Text Available Helminth parasites of veterinary importance cause huge revenue losses to agrarian economy worldwide. With the emergence of drug resistance against the current formulations, there is a need to focus on the alternative approaches in order to control this menace. In the present study, biocompatible zinc oxide nanoparticles (ZnO NPs were used to see their in vitro effect on the biliary amphistomes, Gigantocotyle explanatum, infecting Bubalus bubalis because these nanoparticles are involved in generation of free radicals that induce oxidative stress, resulting in disruption of cellular machinery. The ZnO NPs were synthesized by using egg albumin as a biotemplate and subsequently characterized by Scanning Electron Microscopy (SEM, Transmission Electron Microscopy (TEM, X-ray Diffraction and Spectrophotometrical, which showed that ZnO NPs were highly purified wurtzite type polycrystals, with a mean size of 16.7 nm. When the parasites were treated with lower concentrations (0.004% and 0.008% of the ZnO NPs, the worms mounted a protective response by stimulating the antioxidant system but the treatment of G. explanatum with 0.012% ZnO NPs produced significant inhibition of the antioxidant enzymes like superoxide dismutase (SOD (p< 0.05 and glutathione S- transferase (GST (p<0.01, while the level of malondialdehyde (MDA, a lipid peroxidation marker, was significantly (p< 0.01 elevated. SEM and histopathology revealed pronounced tegumental damage showing the disruption of surface papillae and the annulations, particularly in the posterior region near acetabulum. The under expression of a number of polypeptides, loss of worm motility in a time dependent manner, further reflect strong anthelmintic potential of ZnO NPs. It can be concluded that the anthelmintic effect might be due to the production of reactive oxygen species that target a variety of macromolecules such as nucleic acid, protein and lipids which are involved in different cellular processes.

  19. Inhalant abuse of 1,1-difluoroethane (DFE leading to heterotopic ossification: a case report

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    Hileman Barbara

    2008-10-01

    Full Text Available Abstract Background Heterotopic ossification (HO is the formation of mature, lamellar bone within soft tissues other than the periosteum. There are three recognized etiologies of HO: traumatic, neurogenic, and genetic. Presently, there are no definitively documented causal factors of HO. The following factors are presumed to place a patient at higher risk: 60 years of age or older, male, previous HO, hypertrophic osteoarthritis, ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, prior hip surgery, and surgical risk factors. Case presentation A 33-year-old male, involved in a motor vehicle crash, sustained an irreducible acetabulum fracture/dislocation, displaced proximal humerus fracture, and an impacted pilon fracture. During the time of injury, he was intoxicated from inhaling the aerosol propellant used in "dust spray" cans (1,1-difluoroethane, C2H4F2. Radiographs identified rapid pathologic bone formation about the proximal humeral metaphysis, proximal femur, elbow, and soft tissue several months following the initial injury. Discussion The patient did not have any genetic disorders that could have attributed to the bone formation but had some risk factors (male, fracture with dislocation. Surgically, the recommended precautions were followed to decrease the chance of HO. Although the patient did not have neurogenic injuries, the difluoroethane in dusting spray can cause damage to the central nervous system. Signals may have been mixed causing the patient's body to produce bone instead of tissue to strengthen the injured area. Conclusion What is unusual in this case is the rate at which the pathological bone formation appeared, which was long outside the 4–6 week window in which HO starts to appear. The authors are not certain as to the cause of this rapid formation but suspect that the patient's continued abuse of inhaled aerosol propellants may be the culprit.

  20. A visual-aided wireless monitoring system design for total hip replacement surgery.

    Science.gov (United States)

    Chen, Hong; Gao, Jiyang; Su, Shaojie; Zhang, Xu; Wang, Zhihua

    2015-04-01

    To improve the positioning accuracy of implants in Total Hip Replacement (THR) surgeries, a visual-aided wireless monitoring system for THR surgery is proposed in this paper. This system aims to measure and display the contact distribution and relative pose between femoral head and acetabulum prosthesis during the surgery to help surgeons obtain accurate position of implants. The system consists of two parts: the Sensors Array Measuring System (SAMS) and the display part. The SAMS is composed of a sensors array (including contact sensors and an image sensor), signal conditioning circuits, a low power microcontroller (MCU), and a low-power transceiver. The SAMS is designed to estimate the relative pose of femoral head component to acetabular component. The display part processes the data from sensors and demonstrates the contact distribution and the pose of the prothesis during the surgery in 3-D graphics. The two parts of the system communicate with each other on an RF link at the band of 400 MHz. The signal conditioning circuits have been designed and fabricated in 0.18 μm CMOS process. Testing results show that the resolution of the signal conditioning circuits is 60.1 μ Vpp (1.35 g) with ±100 mVpp input. The chip can operate under 1.2-to-3.6 V supply voltage for single battery applications with 116-160 μ A current consumption. The system has been verified by the simulation with rotation quaternion and translation vector. The experimental results show that the contact distribution and relative pose of the two components could be measured and demonstrated in real time. The relative error of rotation is less than 8% and the actual relative error of translation is less than 10%. PMID:25879970

  1. Femoroacetabular impingement related to Legg-Calvé-Perthes disease

    Directory of Open Access Journals (Sweden)

    Živković Zorica

    2011-01-01

    Full Text Available Femoroacetabular impingement is an undesirable contact between acetabular rim and femoral neck and presents abnormality of proximal femoral part and acetabulum, as well. Two forms may appear: cam impingement and pincer impingement. Femoroacetabular impingement related to Legg-Calvé-Perthes disease may be caused by various reasons, as the consequence of the disease itself, and as the consequence of its treatment. Coxa magna deformity (large femoral head and neck and coxa brevis deformity (shortened femoral neck may produce cam femoroacetabular impingement during hip flexion. After the disease, the flattened femoral head (coxa plana may persist. Chiari pelvic osteotomy is the only treatment option for such femoral head deformity. Acetabular labrum squeezed continuously between the femoral head and the non-articular part of the cut iliac bone lead to cam femoroacetabular impingement, as well. If Salter or triple pelvic osteotomy is used that may cause a very large iatrogenic acetabular retroversion, we can also refer to radial type pincer femoroacetabular impingement. Treatment of Legg-Calvé-Perthes disease should be conducted according to the natural course of the disease and prognosis. Treatment should start on time, well before a crushed femoral head develops, because it is the easiest way to establish hip spherical congruency at the end of treatment. This is the best option to prevent secondary hip arthrosis caused by femoroacetabular impingement or by insufficient head coverage at the end of remodelling. In each case of delayed hip pain, followed by a limited range of movements, femoroacetabular impingement should be taken into consideration, confirmed, and treated by some of the available therapeutic methods.

  2. ED-12WIDESPREAD SYSTEMIC METASTASES FROM MEDULLOBLASTOMA WITHOUT EVIDENCE OF ACTIVE CNS INVOLVEMENT: A CASE SERIES

    Science.gov (United States)

    Kumthekar, Priya; Singh, Simran; Smiley, Natasha Pillay; Lulla, Rishi

    2014-01-01

    This case series describes two patients with previously treated medulloblastoma who present with systemic metastases without evidence of central nervous system (CNS) disease. Patient #1 is male who presented at age 29 with pathology confirmed medulloblastoma treated with complete surgical resection followed by radiation (36 Gy craniospinal plus posterior fossa boost). Subsequently, he received cisplatin, cytoxan, and vincristine. One year later, he developed back pain and urinary retention. Imaging of his spine showed widespread bony metastases without parenchymal CNS disease. Biopsy of the left acetabulum confirmed metastatic medulloblastoma. He is currently enrolled on study with LDE225 versus temozolomide. Surveillance imaging to date is negative for intracranial metastasis, but does show extensive bony metastases involving the total spine, pelvis, ribs, sternum, clavicles, humeri, and femurs. Patient #2 is a female who presented at 32 years with severe headaches, nausea and vomiting found to have pathology confirmed medulloblastoma. She was lost to follow up temporarily, but presented again months later with headaches. She had a recurrent mass and underwent repeat resection. MRI of the spine showed nodular enhancement of the sacral nerve roots compatible with leptomeningeal spread. She underwent craniospinal radiation 36 Gy with a boost to the lumbar region and posterior fossa. One year after initial diagnosis, she presented with hypotension, tachycardia, and fatigue. Neuroimaging showed improved enhancement of the sacral nerve roots and brain imaging showed stable postsurgical changes. Systemic imaging, however, revealed widespread metastatic disease in the lymphatic system, liver, lung, and bones. The patient passed away a few months later. Medulloblastoma can metastasize outside the central nervous system (CNS), however typically does so concurrently with CNS progression. Here we present two adult patients with widely metastatic medulloblastoma systemically

  3. MR imaging with metal artifact-reducing sequences and gadolinium contrast agent in a case-control study of periprosthetic abnormalities in patients with metal-on-metal hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Gunilla M.; Mueller, Markus F.; Ekberg, Olle [Lund University, Skaane University Hospital, Department of Radiology, Malmoe (Sweden); Maansson, Sven [Lund University, Skaane University Hospital, Department of Medical Radiation Physics, Malmoe (Sweden); Schewelov, Thord von [Lund University, Skaane University Hospital, Department of Orthopedic Surgery, Malmoe (Sweden); Nittka, Mathias [Siemens AG, Healthcare Sector, Erlangen (Germany); Lundin, Bjoern [Lund University, Skaane University Hospital, Department of Radiology, Lund (Sweden)

    2014-08-15

    To apply and compare magnetic resonance imaging (MRI) metal artifact reducing sequences (MARS) including subtraction imaging after contrast application in patients with metal-on-metal (MoM) hip prostheses, investigate the prevalence and characteristics of periprosthetic abnormalities, as well as their relation with pain and risk factors. Fifty-two MoM prostheses (35 cases with pain and or risk factors, and 17 controls) in 47 patients were examined in a 1.5-T MR scanner using MARS: turbo spin echo (TSE) with high readout bandwidth with and without view angle tilting (VAT), TSE with VAT and slice encoding for metal artifact correction (SEMAC), short tau inversion recovery (STIR) with matched RF pulses, and post-contrast imaging. The relations of MRI findings to pain and risk factors were analyzed and in five revised hips findings from operation, histology, and MRI were compared. TSE VAT detected the highest number of osteolyses. Soft tissue mass, effusion, and capsular thickening were common, whereas osteolysis in acetabulum and femur were less frequent. Contrast enhancement occurred in bone, synovia, joint capsule, and the periphery of soft tissue mass. There was no significant relation between MRI findings and pain or risk factors. MARS and gadolinium subtraction imaging are useful for evaluation of complications to MoM prosthesis. TSE VAT had the highest sensitivity for osteolysis. Contrast enhancement might indicate activation of aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL). Pain, small head, or steep prosthesis inclination angle are not useful predictors of periprosthetic abnormalities, and wide indications for MR follow-up are warranted. (orig.)

  4. Developmental expression analysis and immunolocalization of a biogenic amine receptor in Schistosoma mansoni

    Science.gov (United States)

    El-Shehabi, Fouad; Vermeire, Jon J.; Yoshino, Timothy P.; Ribeiro, Paula

    2013-01-01

    A Schistosoma mansoni G-protein coupled receptor (SmGPCR) was previously cloned and shown to be activated by the biogenic amine, histamine. Here we report a first investigation of the receptor’s subunit organization, tissue distribution and expression levels in different stages of the parasite. A polyclonal antibody was produced in rabbits against the recombinant third intracellular loop (il3) of SmGPCR. Western blot studies of the native receptor and recombinant protein expressed in HEK293 cells showed that SmGPCR exists both as a monomer (65 kDa) and an apparent dimer of ≈130 kDa These species were verified by immunoprecipitation of SmGPCR from S. mansoni extracts, using antibody that was covalently attached to agarose beads. Further investigation determined that the SmGPCR dimer was resistant to treatment with various detergents, 4 M urea and 0.1 M DTT but could be made to dissociate at acidic pH, suggesting the dimer is non-covalent in nature. Confocal immunofluorescence studies revealed significant SmGPCR immunoreactivity in sporocysts, schistosomula and adult worms but not miracidia. SmGPCR was found to be most widely expressed in the schistosomula, particularly the tegument, the subtegumental musculature and the acetabulum. In the adult stage we detected SmGPCR immunofluorescence mainly in the tubercles of male worms and, to a lesser extent, the body wall musculature. Localization in sporocysts was mainly confined to the tegument and cells within parenchymal matrices. A realtime quantitative reverse-transcription PCR analysis revealed that SmGPCR is upregulated at the mRNA level in the parasitic stages compared to the free-living miracidium and cercariae, and it is particularly elevated during early sporocyst and schistosomula development. The results identify SmGPCR as an important parasite receptor with potential functions in muscle and the tegument of S. mansoni. PMID:19545530

  5. Uncemented allograft-prosthetic composite reconstruction of the proximal femur

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    Li Min

    2014-01-01

    Full Text Available Background: Allograft-prosthetic composite can be divided into three groups names cemented, uncemented, and partially cemented. Previous studies have mainly reported outcomes in cemented and partially cemented allograft-prosthetic composites, but have rarely focused on the uncemented allograft-prosthetic composites. The objectives of our study were to describe a surgical technique for using proximal femoral uncemented allograft-prosthetic composite and to present the radiographic and clinical results. Materials and Methods: Twelve patients who underwent uncemented allograft-prosthetic composite reconstruction of the proximal femur after bone tumor resection were retrospectively evaluated at an average followup of 24.0 months. Clinical records and radiographs were evaluated. Results: In our series, union occurred in all the patients (100%; range 5-9 months. Until the most recent followup, there were no cases with infection, nonunion of the greater trochanter, junctional bone resorption, dislocation, allergic reaction, wear of acetabulum socket, recurrence, and metastasis. But there were three periprosthetic fractures which were fixed using cerclage wire during surgery. Five cases had bone resorption in and around the greater trochanter. The average Musculoskeletal Tumor Society (MSTS score and Harris hip score (HHS were 26.2 points (range 24-29 points and 80.6 points (range 66.2-92.7 points, respectively. Conclusions: These results showed that uncemented allograft-prosthetic composite could promote bone union through compression at the host-allograft junction and is a good choice for proximal femoral resection. Although this technology has its own merits, long term outcomes are yet not validated.

  6. The morphology and adhesion mechanism of Octopus vulgaris suckers.

    Science.gov (United States)

    Tramacere, Francesca; Beccai, Lucia; Kuba, Michael; Gozzi, Alessandro; Bifone, Angelo; Mazzolai, Barbara

    2013-01-01

    The octopus sucker represents a fascinating natural system performing adhesion on different terrains and substrates. Octopuses use suckers to anchor the body to the substrate or to grasp, investigate and manipulate objects, just to mention a few of their functions. Our study focuses on the morphology and adhesion mechanism of suckers in Octopus vulgaris. We use three different techniques (MRI, ultrasonography, and histology) and a 3D reconstruction approach to contribute knowledge on both morphology and functionality of the sucker structure in O. vulgaris. The results of our investigation are two-fold. First, we observe some morphological differences with respect to the octopus species previously studied (i.e., Octopus joubini, Octopus maya, Octopus bimaculoides/bimaculatus and Eledone cirrosa). In particular, in O. vulgaris the acetabular chamber, that is a hollow spherical cavity in other octopuses, shows an ellipsoidal cavity which roof has an important protuberance with surface roughness. Second, based on our findings, we propose a hypothesis on the sucker adhesion mechanism in O. vulgaris. We hypothesize that the process of continuous adhesion is achieved by sealing the orifice between acetabulum and infundibulum portions via the acetabular protuberance. We suggest this to take place while the infundibular part achieves a completely flat shape; and, by sustaining adhesion through preservation of sucker configuration. In vivo ultrasonographic recordings support our proposed adhesion model by showing the sucker in action. Such an underlying physical mechanism offers innovative potential cues for developing bioinspired artificial adhesion systems. Furthermore, we think that it could possibly represent a useful approach in order to investigate any potential difference in the ecology and in the performance of adhesion by different species. PMID:23750233

  7. Radiographic measurements of hip dysplasia at skeletal maturity - new reference intervals based on 2,038 19-year-old Norwegians

    Energy Technology Data Exchange (ETDEWEB)

    Laborie, Lene Bjerke; Rosendahl, Karen [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Engesaeter, Ingvild Oevsteboe [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Radiology, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Lehmann, Trude Gundersen; Engesaeter, Lars Birger [University of Bergen, Department of Surgical Sciences, Bergen (Norway); Haukeland University Hospital, Department of Orthopaedic Surgery, Bergen (Norway); Sera, Francesco; Dezateux, Carol [UCL Institute of Child Health, MRC Centre of Epidemiology for Child Health, London (United Kingdom)

    2013-07-15

    Normative references for radiographic measurements commonly used in the diagnosis of developmental dysplasia of the hip at skeletal maturity are incomplete. The present study therefore aimed to establish new gender-specific standards for measurements reflecting the acetabular morphology, namely Sharp's angle, the acetabular roof angle of Toennis (AA) and the acetabular depth-width ratio (ADR), and measurements reflecting the position of the femoral head related to the acetabulum, namely the center-edge (CE) angle of Wiberg, the refined CE angle of Ogata, and the femoral head extrusion index (FHEI). The joint space width (JSW) is also reported. The population-based 1989 Bergen Birth Cohort (n = 3,935) was invited at age 19 years to a follow-up during 2007-09, of which 2,038 (52 %) attended. A standardized antero-posterior radiograph was assessed. The normative references are presented as mean {+-} standard deviation (SD) and 2.5-97.5 percentiles with 95 % confidence intervals. A total of 2,011 (841 males, 1,170 females, mean age 18.6 (SD 0.6)) radiographs were analyzed. Sharp's angle was 38.8 {+-} 3.5 in males and 40.7 {+-} 3.5 in females, with 97.5 percentiles of 46 and 47 , respectively. The CE angle was 32.1 {+-} 6.1 in males and 31.0 {+-} 6.1 in females, with 2.5 percentiles of 21 and 20 , respectively. The FHEI was 86.0 % {+-} 6.3 % in males and 85.6 % {+-} 6.6 % in females, with 2.5 percentiles of 74 and 73 , respectively. Updated gender-specific reference ranges for radiographic measurements commonly used for hip dysplasia at skeletal maturity are reported, similar to or slightly wider than those described in the literature. Statistically significant gender differences have been confirmed for most of the measurements. (orig.)

  8. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    International Nuclear Information System (INIS)

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  9. The geometry of the bone structure associated with total hip arthroplasty.

    Directory of Open Access Journals (Sweden)

    Zhang Yang

    Full Text Available Close adaptation of the prosthesis to the bone is the key to achieving optimal stability and fixation for total hip arthroplasty (THA. However, there have been no adequate studies of bone morphology, especially in different races. The aim of this study was to analyze the geometry of the acetabulum and proximal femur of people from South China, based on three-dimensional reconstruction, and to detect differences between different population subsets. CT scans were performed on 80 healthy volunteers (160 hips from South China, comprising 40 males (80 hips and 40 females (80 hips. The images were imported into Mimics 10.01 to perform 3D reconstruction. THA-associated anatomical parameters were measured and compared with other published data. In comparison with published data, it seemed that people from South China have smaller acetabular abduction angle, larger acetabular supro-inferior diameter, larger neck-shaft angle, smaller offset, thinner femoral shaft and more proximal isthmus, which needed to be further confirmed. There were significant differences between the genders in most parameters. As significant differences in canal flare index (CFI and distal canal flare index (DCFI were found between genders, it was concluded the most significant differences lay in the isthmus of the femur. Among the femora, according to Noble's classification we identified more normal types and fewer stovepipe and champagne-flute types than expected from the literature, indicating that uncemented prostheses would be suitable for most people from South China. Our findings reveal that simply choosing the smallest of a series of prostheses would not necessarily provide a good fit, due to the different trends from the proximal to the distal part of the femur. Significant variation exists in THA-associated anatomy between genders and population subsets. It is therefore imperative that each patient receives individual consideration rather than assuming all patients have

  10. Radiographic measurements of hip dysplasia at skeletal maturity - new reference intervals based on 2,038 19-year-old Norwegians

    International Nuclear Information System (INIS)

    Normative references for radiographic measurements commonly used in the diagnosis of developmental dysplasia of the hip at skeletal maturity are incomplete. The present study therefore aimed to establish new gender-specific standards for measurements reflecting the acetabular morphology, namely Sharp's angle, the acetabular roof angle of Toennis (AA) and the acetabular depth-width ratio (ADR), and measurements reflecting the position of the femoral head related to the acetabulum, namely the center-edge (CE) angle of Wiberg, the refined CE angle of Ogata, and the femoral head extrusion index (FHEI). The joint space width (JSW) is also reported. The population-based 1989 Bergen Birth Cohort (n = 3,935) was invited at age 19 years to a follow-up during 2007-09, of which 2,038 (52 %) attended. A standardized antero-posterior radiograph was assessed. The normative references are presented as mean ± standard deviation (SD) and 2.5-97.5 percentiles with 95 % confidence intervals. A total of 2,011 (841 males, 1,170 females, mean age 18.6 (SD 0.6)) radiographs were analyzed. Sharp's angle was 38.8 ± 3.5 in males and 40.7 ± 3.5 in females, with 97.5 percentiles of 46 and 47 , respectively. The CE angle was 32.1 ± 6.1 in males and 31.0 ± 6.1 in females, with 2.5 percentiles of 21 and 20 , respectively. The FHEI was 86.0 % ± 6.3 % in males and 85.6 % ± 6.6 % in females, with 2.5 percentiles of 74 and 73 , respectively. Updated gender-specific reference ranges for radiographic measurements commonly used for hip dysplasia at skeletal maturity are reported, similar to or slightly wider than those described in the literature. Statistically significant gender differences have been confirmed for most of the measurements. (orig.)

  11. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

    Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship

  12. 加强髋关节撞击征的临床与基础研究%Emphasis on clinical and basic research of femoroacetabular impingement

    Institute of Scientific and Technical Information of China (English)

    黄公怡

    2014-01-01

    The concept of femoroacetabular impingement ( FAI ) was ifrst proposed by Ganz, which had been more and more concerned in recent 10 years. FAI refers to abnormal impact or entrapment in the femoral head and neck border and in the margin of the acetabulum and the related clinical symptoms in the hip movement process caused by dysplasia of the hip joint, injuries, operation and so on. Muscular tissues around the hip joint act as the powerplant. The coordination and antagonism among muscles promote the completion of movement and the avoidance of impact in the joint, when the structures and functions of the innervation and muscles are perfect. Even in the patients with developmental or acquired abnormal anatomy, the occurrence of impact or FAI is not inevitable. Due to developmental or acquired abnormal anatomy, the imbalance of motivation functions of muscles or both abnormal structures and abnormal motivation functions, the occurrence of FAI becomes possible. The long-term, frequent and repeating impact makes the articular cartilage be further involved by injures, degeneration and stripping of the glenoid labrum, and it is hard to avoid the occurrence and development of osteoarthritis. Due to the impact in the joint, the rhythm in the corresponding direction will be certainly changed. Therefore, it is supposed that the understanding of the occurrence, development course and discipline of impact is helpful for the investigation and research of early prevention and compensation training. A long-term longitudinal survey is performed in the adolescents majoring in sports, in which some persuasive evidences may be found. Individualized diagnosis and treatment will always be the basic principle of thinking and practice in the clinical work. The etiology, pathological mechanism and prognosis of FAI should be further explored and more evidences on the basis of the evidence-based medicine should be accumulated clinically, so as to improve the understanding and prevention

  13. Brief communication: Lumbar lordosis in extinct hominins: implications of the pelvic incidence.

    Science.gov (United States)

    Been, Ella; Gómez-Olivencia, Asier; Kramer, Patricia A

    2014-06-01

    Recently, interest has peaked regarding the posture of extinct hominins. Here, we present a new method of reconstructing lordosis angles of extinct hominin specimens based on pelvic morphology, more specifically the orientation of the sacrum in relation to the acetabulum (pelvic incidence). Two regression models based on the correlation between pelvic incidence and lordosis angle in living hominoids have been developed. The mean values of the calculated lordosis angles based on these models are 36°-45° for australopithecines, 45°-47° for Homo erectus, 27°-34° for the Neandertals and the Sima de los Huesos hominins, and 49°-51° for fossil H. sapiens. The newly calculated lordosis values are consistent with previously published values of extinct hominins (Been et al.: Am J Phys Anthropol 147 (2012) 64-77). If the mean values of the present nonhuman hominoids are representative of the pelvic and lumbar morphology of the last common ancestor between humans and nonhuman hominoids, then both pelvic incidence and lordosis angle dramatically increased during hominin evolution from 27° ± 5 to 22° ± 3 (respectively) in nonhuman hominoids to 54° ± 10 and 51° ± 11 in modern humans. This change to a more human-like configuration appeared early in the hominin evolution as the pelvis and spines of both australopithecines and H. erectus show a higher pelvic incidence and lordosis angle than nonhuman hominoids. The Sima de los Huesos hominins and Neandertals show a derived configuration with a low pelvic incidence and lordosis angle. PMID:24615397

  14. Ability of lower teardrop edge to restore anatomical hip center height in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Lu Yufeng; Cheng Liming; Guo Wanshou; Yu Qingsheng; Gao Fuqiang; Zhang Qidong; Liu Zhaohui

    2014-01-01

    Background The acetabular teardrop is often used to guide acetabular component placement in total hip arthroplasty (THA).Placing the lower acetabular component aspect at the same level as the lower teardrop edge was assumed to restore the hip center of rotation.Here we radiographically analyzed the relationship between cup center and normal contralateral acetabulum center height on unilateral THA using this placement method.Methods A total of 106 unilateral THA cases with normal contralateral acetabula were reviewed and the vertical and horizontal distances in relation to the lower acetabular teardrop edge from both hip joint centers,cup inclination,and anteversion were measured radiographically.The paired t-test was used to compare left and right hip center heights.Scatter plots and Pearson's correlation coefficients were used to evaluate differences in hip center heights,cup anteversion,inclination angles,and medialized cup center distance compared to the contralateral hip joint.Results Cup center height was significantly greater (P <0.01) than contralateral hip joint center height (93.4% in the 0-5 mm range,6.6% >5 mm).There was a weak correlation between hip center height difference and inclination (r=0.376,P <0.01) and between difference and anteversion (r=0.310,P <0.01) but no correlation between difference and outer cup diameter (r=0.184,P=0.058) or difference and medialized cup center distance (r=-0.098,P=0.318).Conclusions Although this method did not exactly replicate anatomic hip center height,the clinical significance of cup center height and anatomic hip center height differences is negligible.This acetabular component placement method has high simplicity,reliability,and stability.

  15. THR Simulator – the software for generating radiographs of THR prosthesis

    Directory of Open Access Journals (Sweden)

    Hou Sheng-Mou

    2009-01-01

    Full Text Available Abstract Background Measuring the orientation of acetabular cup after total hip arthroplasty is important for prognosis. The verification of these measurement methods will be easier and more feasible if we can synthesize prosthesis radiographs in each simulated condition. One reported method used an expensive mechanical device with an indeterminable precision. We thus develop a program, THR Simulator, to directly synthesize digital radiographs of prostheses for further analysis. Under Windows platform and using Borland C++ Builder programming tool, we developed the THR Simulator. We first built a mathematical model of acetabulum and femoral head. The data of the real dimension of prosthesis was adopted to generate the radiograph of hip prosthesis. Then with the ray tracing algorithm, we calculated the thickness each X-ray beam passed, and then transformed to grey scale by mapping function which was derived by fitting the exponential function from the phantom image. Finally we could generate a simulated radiograph for further analysis. Results Using THR Simulator, the users can incorporate many parameters together for radiograph synthesis. These parameters include thickness, film size, tube distance, film distance, anteversion, abduction, upper wear, medial wear, and posterior wear. These parameters are adequate for any radiographic measurement research. This THR Simulator has been used in two studies, and the errors are within 2° for anteversion and 0.2 mm for wearing measurement. Conclusion We design a program, THR Simulator that can synthesize prosthesis radiographs. Such a program can be applied in future studies for further analysis and validation of measurement of various parameters of pelvis after total hip arthroplasty.

  16. Intrapopulational body size variation and cranial capacity variation in Middle Pleistocene humans: the Sima de los Huesos sample (Sierra de Atapuerca, Spain).

    Science.gov (United States)

    Lorenzo, C; Carretero, J M; Arsuaga, J L; Gracia, A; Martínez, I

    1998-05-01

    A sexual dimorphism more marked than in living humans has been claimed for European Middle Pleistocene humans, Neandertals and prehistoric modern humans. In this paper, body size and cranial capacity variation are studied in the Sima de los Huesos Middle Pleistocene sample. This is the largest sample of non-modern humans found to date from one single site, and with all skeletal elements represented. Since the techniques available to estimate the degree of sexual dimorphism in small palaeontological samples are all unsatisfactory, we have used the bootstraping method to asses the magnitude of the variation in the Sima de los Huesos sample compared to modern human intrapopulational variation. We analyze size variation without attempting to sex the specimens a priori. Anatomical regions investigated are scapular glenoid fossa; acetabulum; humeral proximal and distal epiphyses; ulnar proximal epiphysis; radial neck; proximal femur; humeral, femoral, ulnar and tibial shaft; lumbosacral joint; patella; calcaneum; and talar trochlea. In the Sima de los Huesos sample only the humeral midshaft perimeter shows an unusual high variation (only when it is expressed by the maximum ratio, not by the coefficient of variation). In spite of that the cranial capacity range at Sima de los Huesos almost spans the rest of the European and African Middle Pleistocene range. The maximum ratio is in the central part of the distribution of modern human samples. Thus, the hypothesis of a greater sexual dimorphism in Middle Pleistocene populations than in modern populations is not supported by either cranial or postcranial evidence from Sima de los Huesos. PMID:9590522

  17. Ocorrência de displasia coxo-femural em cães na região de Londrina no período de 1977 a 1981 Occurrence of hip dysplasia in dogs in the region of Londrina in the period 1977-1981

    Directory of Open Access Journals (Sweden)

    Nilva Maria Freres

    1982-11-01

    Full Text Available No período de janeiro de 1977 a dezembro de 1981, foram diagnosticados 58 casos de displasia coxo-femural no Ambulatório do Hospital Veterinário - UEL, em animais com sinais de claudicação, sensibilidade dos membros posteriores e da bacia. Esses animais foram encaminhados para exame radiológico detalhado, procurando-se obter incidências ventro-dorsais da região pélvica com os membros posteriores tracionados para trás. As displasias foram classificadas quanto ao grau de alterações observadas no acetábulo e cabeça do fémur, distribuindo-se de acordo com a raça, sexo e faixa etária. Tendo sido observado uma maior ocorrência nos animais da raça Pastor Alemão, com até um ano de idade e do sexo masculino.From January 1977 to December 1981, 58 cases of hip dysplasia were diagnosed in the Clinical Ambulatory of Veterinary Hospital, coming from animals with signs of lameness, and posterior members or pelvis sensibility. These animals were submitted to an accurate radiologic examination in order to obtain incident ventro-dorsal of pelvis region, with the both legs tracetioned for back. The dysplasia vases were classified according to the grade of alteration observed an acetabulum and femur head and distributed according to breed, sex and age. The major incidence was observed in male German Shepherd dogs, whith less than one year old.

  18. The effect of hip replacement in the treatment of elderly patients with dysplasia of hip joint combined with bone arthritis%髋关节置换术对老年髋关节发育不良继发骨关节炎的应用效果

    Institute of Scientific and Technical Information of China (English)

    郭军

    2016-01-01

    Objective:To explore the effect of hip replacement in the treatment of elderly patients with dysplasia of hip joint combined with bone arthritis.Methods:108 elderly patients with dysplasia of hip joint combined with bone arthritis were selected. They were treated with total hip replacement.We observed the clinical efficacy and postoperative complications.Results:After treatment,patients with limb activity ability were significantly improved;the Harris function score was significantly higher than before treatment;no patient had serious complications.Conclusion:Total hip replacement in the treatment of elderly patients with dysplasia of hip joint combined with bone arthritis can effectively reconstruct the acetabulum and prosthesis,protect the normal limbs activities,and improve the quality of life.%目的:探讨全髋关节置换术在老年髋关节发育不良继发骨关节炎中的应用效果。方法:收治老年髋关节发育不良继发骨关节炎患者108例,采用全髋关节置换术治疗,观察临床疗效及术后并发症。结果:治疗后,患者肢体活动能力均明显提升,Harris功能评分明显高于治疗前,所有患者无严重并发症发生。结论:全髋关节置换术治疗老年髋关节发育不良继发骨关节炎,能有效重建髋臼和假体,保障正常的四肢活动,提高生活质量。

  19. A Comparison of the Contact Force Distributions on the Acetabular Surface Due to Orthopedic Treatments for Developmental Hip Dysplasia.

    Science.gov (United States)

    Márquez-Flórez, Kalenia M; Silva, Octavio; Narváez-Tovar, Carlos A; Garzón-Alvarado, Diego A

    2016-07-01

    We used a three-dimensional rigid body spring model (RBSM) to compare the contact force distributions on the acetabular surface of the infant hip joint that are produced by three orthopedic treatments for developmental dysplasia of the hip (DDH). We analyzed treatments using a Pavlik harness, a generic rigid splint, and a spica cast. The joint geometry was modeled from tomography images of a 1-year-old female. The articular cartilage was modeled as linear springs connecting the surfaces of the acetabulum and the femoral head, whereas the femur and the hip bone were considered as rigid bodies. The hip muscles were modeled as tensile-only preloaded springs. The treatments with the Pavlik harness and the generic rigid splint were modeled for an infant in supine position with a hip flexion angle of 90 deg. Also, since rigid splints are often recommended when children are initiating their gait phase, we modeled the treatment with the infant in standing position. For the spica cast, we only considered the infant in standing position with a flexion angle of 0 deg, and the fixation bar at two heights: at the ankle and at the knee. In order to analyze the effect of the hip abduction angle over the contact force distribution, different abduction angles were used for all the treatments modeled. We have found that the treatments with the infant in supine position, with a flexion angle of 90 deg and abduction angles between 60 deg and 80 deg, produce a more homogenous contact force distribution compared to those obtained for the treatments with the infant in standing position. PMID:27150210

  20. 全髋关节置换术治疗成人髋臼发育不良继发骨性关节炎疗效分析%Analysis Curative Effect of Total Hip Arthroplasty in Treatment of Adult Acetabular Dysplasia With Bad Osteoarthritis Secondary

    Institute of Scientific and Technical Information of China (English)

    时梦猇

    2015-01-01

    Objective To observe curative effect of total hip arthroplasty in treatment of adult acetabular dysplasia with bad osteoarthritis secondary. Methods Retrospective analyzed the clinical data of total hip arthroplasty of adult acetabular dysplasia with bad osteoarthritis secondary. Results The symptoms of pain disappeared, and the body was short and the case was correct. The acetabular angle was located at 35 to 40 angle, and the CE angle of the prosthesis was more than 20 angle. No prosthesis loosening, fracture of acetabulum, handle, neurovascular injury and so on. The excellent and good rate of postoperative Harris hip score was 94.6%. Conclusion The effect of total hip arthroplasty on adult acetabular dysplasia with bad osteoarthritis secondary os obvious.%目的 观察全髋关节置换术治疗成人髋臼发育不良继发骨性关节炎疗效.方法 回顾性分析在我院接受全髋关节置换术治疗的成人髋臼发育不良继发骨性关节炎患者临床资料.结果 疼痛症状基本消失,肢体短缩情况矫正良好.髋臼角位于35°~40°,假体CE角>20°,无假体臼、柄松动、骨折、神经血管损伤等发生.患者术后Harris髋关节功能评分优良率94.6%.结论 全髋关节置换术治疗成人髋臼发育不良继发骨性关节炎疗效明显.

  1. Research Advances of the Normal Hip Joint Development%髋关节正常生长发育的研究进展

    Institute of Scientific and Technical Information of China (English)

    邱旭升

    2011-01-01

    The normal hip development is the result of a complicated halance of acetabulum , proximal femur, ligaments, vasculature , nerves ,and muscles. 'rhe program of hip development is controlled by complicated celluar events which are influenced by environmental and biologic factors. The systemic review is to show the following aspects of the normal hip development, the prenatal development , postnatal development , the arterial supply and innervation of the hip, and the cell signaling in intrauterine hip joint development. Understanding the sequential steps of the hip's development is critical to elucidate the pathobiologic mechanisms of hip disease and deformity,such as hip dysplasia.%髋关节的正常生长发育需要髋臼、股骨近端、关节周围韧带、血管、神经以及肌肉的协调生长共同完成.它由复杂的基因网络调控,同时受环境、生物因素的影响.现从出生前髋关节发育、出生后髋关节发育、髋关节的血管神经支配以及髋关节形成的分子机制等方面对髋关节的正常生长发育进行全面系统的回顾,为临床研究髋关节疾病,如发育性髋关节发育不良等提供理论基础.

  2. Combined Microwave Ablation and Cementoplasty in Patients with Painful Bone Metastases at High Risk of Fracture

    Energy Technology Data Exchange (ETDEWEB)

    Pusceddu, Claudio, E-mail: clapusceddu@gmail.com [Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital “A. Businco” (Italy); Sotgia, Barbara, E-mail: barbara.sotgia@gmail.com; Fele, Rosa Maria, E-mail: rosellafele@tiscali.it [Regional Referral Center for Oncological Diseases, Department of Oncological Radiology, Oncological Hospital “A. Businco” (Italy); Ballicu, Nicola, E-mail: nicolaballicu77@gmail.com [Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital “A. Businco” (Italy); Melis, Luca, E-mail: doclucamelis@tiscali.it [Regional Referral Center for Oncological Diseases, Department of Oncological Radiology, Oncological Hospital “A. Businco” (Italy)

    2016-01-15

    PurposeTo retrospectively evaluate the effectiveness of computed tomography-guided percutaneous microwave ablation (MWA) and cementoplasty in patients with painful bone metastases at high risk of fracture.Materials and MethodsThirty-five patients with 37 metastatic bone lesions underwent computed tomography-guided MWA combined with cementoplasty (polymethylmethacrylate injection). Vertebrae, femur, and acetabulum were the intervention sites and the primary end point was pain relief. Pain severity was estimated by visual analog scale (VAS) before treatment; 1 week post-treatment; and 1, 6, and 12 months post-treatment. Functional outcome was assessed by improved patient walking ability. Radiological evaluation was performed at baseline and 3 and 12 months post-procedure.ResultsIn all patients, pain reduction occurred from the first week after treatment. The mean reduction in the VAS score was 84, 90, 90 % at week 1, month 1, and month 6, respectively. Improved walking ability occurred in 100 and 98 % of cases at the 1- and 6-month functional outcome evaluations, respectively. At the 1-year evaluation, 25 patients were alive, and 10 patients (28 %) had died because of widespread disease. The mean reduction in the VAS score and improvement in surviving patients’ walking ability were 90 and 100 %, respectively. No patients showed evidence of local tumor recurrence or progression and pathological fracture in the treated sites.ConclusionOur results suggest that MWA combined with osteoplasty is safe and effective when treating painful bone metastases at high risk of fracture. The number of surviving patients at the 1-year evaluation confirms the need for an effective and long-lasting treatment.

  3. The outcome of surgically treated traumatic unstable pelvic fractures by open reduction and internal fixation

    Directory of Open Access Journals (Sweden)

    Keykhosro Mardanpour

    2013-07-01

    Full Text Available BACKGROUND: This study was performed to evaluate functional and radiological results of pelvic ring fractures treatment by open reduction and internal fixation. METHOD: Thirty eight patients with unstable pelvic fractures, treated from 2002 to 2008 were retrospectively reviewed. The mean patients’ age was 37 years (range 20 to 67. Twenty six patients were men (4patients with type B and 22 patients with type C fracture and 12 women (7 patients with type B and 5 patients with type C fracture. The commonest cause was a road traffic accident (N=37, about 97%. Internal fixation was done by plaque with ilioinguinal and kocher-langenbeek approaches for anterior, posterior pelvic wall and acetabulum fracture respectively. Quality of reduction was graded according to Majeed score system. RESULTS: There were 11 type-C and 27 type-B pelvic fractures according to Tile’s classification. Thirty six patients sustained additional injuries. the commonest additional injury was lower extremity fracture. The mean follow-up was 45.6 months (range 16 to 84 months.The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients with type B pelvic fractures and functional outcome was excellent in 46%, good in 27%, fair in 27% and poor in 0% of the patients with type C pelvic fractures. There were four postoperative infections. No sexual functional problem was reported. Neurologic problem like Lateral cutaneous nerve of thigh injury recovered completely in 2 patients and partially in 2 patients. There was no significant relation between functional outcome and the site of fracture (P greater than 0.005. CONCLUSION: Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization. It must be carried out as soon as the general condition of the patient permits, and even up to two weeks

  4. Phantom validation for ultrasound to statistical shape model registration of human pelvis

    Science.gov (United States)

    Ghanavati, Sahar; Mousavi, Parvin; Fichtinger, Gabor; Abolmaesumi, Purang

    2011-03-01

    Total Hip Replacement (THR) has become a common surgical procedure in recent years, as a result of increasing aging population with osteoarthritis of the hip joint. Localization of the pelvic anatomical coordinate system (PaCS) is a critical step in accurate placement of the femur prosthesis in the acetabulum in THR. Intra-operative ultrasound (US) imaging can provide a radiation-free navigation system for localization of the PaCS. However, US images are noisy and cannot provide any anatomical information beneath the bone surface due to the total reflection of US beam at the bone-soft tissue interface. A solution to this problem is to fuse intra-operative US with pre-operative imaging or a statistical shape model (SSM) of the pelvis. Here, we propose a multi-slice to volume intensity-based registration of the pelvic SSM to a sparse set of 2D US images in order to localize the PaCS in the US. In this registration technique, a set of 2D slices are extracted from a pelvic SSM using the approximate location and orientation of their corresponding 2D US images. During the registration, the comparison between the SSM slices and the US images is made using an ultrasound simulation technique and a correlation-based similarity metric. We demonstrate the feasibility of our proposed approach in localizing the PaCS on five patient-based phantoms. These results indicate the necessity of including pubic symphysis landmarks in the 2D US slices in order to have a precise estimation of the PaCS.

  5. An observer study for direct comparison of clinical efficacy of electronic to film portal images

    International Nuclear Information System (INIS)

    Purpose: To directly compare clinical efficacy of electronic to film portal images. Methods and Materials: An observer study was designed to compare clinical efficacy of electronic to film portal images acquired using a liquid matrix ion-chamber electronic portal imaging device and a conventional metal screen/film system. Both images were acquired simultaneously for each treatment port and the electronic portal images were printed on gray-level thermal paper. Four radiation oncologists served as observers and evaluated a total of 44 sets of images for four different treatment sites: lung, pelvis, brain, and head/neck. Each set of images included a simulation image, a double-exposure portal film, and video paper prints of electronic portal images. Eight to nine anatomical landmarks were selected from each treatment site. Each observer was asked to rate each landmark in terms of its clinical visibility and to rate the ease of making the pertinent verification decision in the corresponding electronic and film portal images with the aid of the simulation image. Results: Ratings for the visibility of landmarks and for the verification decision of treatment ports were similar for electronic and film images for most landmarks. However, vertebral bodies and several landmarks in the pelvis such as the acetabulum and pubic symphysis were more visible in the portal film images than in the electronic portal images. Conclusion: The visibility of landmarks in electronic portal images is comparable to that in film portal images. Verification of treatment ports based only on electronic portal images acquired using an electronic portal imaging device is generally achievable

  6. Inspiration, simulation and design for smart robot manipulators from the sucker actuation mechanism of cephalopods.

    Science.gov (United States)

    Grasso, Frank W; Setlur, Pradeep

    2007-12-01

    Octopus arms house 200-300 independently controlled suckers that can alternately afford an octopus fine manipulation of small objects and produce high adhesion forces on virtually any non-porous surface. Octopuses use their suckers to grasp, rotate and reposition soft objects (e.g., octopus eggs) without damaging them and to provide strong, reversible adhesion forces to anchor the octopus to hard substrates (e.g., rock) during wave surge. The biological 'design' of the sucker system is understood to be divided anatomically into three functional groups: the infundibulum that produces a surface seal that conforms to arbitrary surface geometry; the acetabulum that generates negative pressures for adhesion; and the extrinsic muscles that allow adhered surfaces to be rotated relative to the arm. The effector underlying these abilities is the muscular hydrostat. Guided by sensory input, the thousands of muscle fibers within the muscular hydrostats of the sucker act in coordination to provide stiffness or force when and where needed. The mechanical malleability of octopus suckers, the interdigitated arrangement of their muscle fibers and the flexible interconnections of its parts make direct studies of their control challenging. We developed a dynamic simulator (ABSAMS) that models the general functioning of muscular hydrostat systems built from assemblies of biologically constrained muscular hydrostat models. We report here on simulation studies of octopus-inspired and artificial suckers implemented in this system. These simulations reproduce aspects of octopus sucker performance and squid tentacle extension. Simulations run with these models using parameters from man-made actuators and materials can serve as tools for designing soft robotic implementations of man-made artificial suckers and soft manipulators. PMID:18037726

  7. Cytochemical demonstration of cholinergic, serotoninergic and peptidergic nerve elements in Gorgoderina vitelliloba (Trematoda: Digenea).

    Science.gov (United States)

    McKay, D M; Halton, D W; Johnston, C F; Fairweather, I; Shaw, C

    1991-02-01

    Standard enzyme cytochemical and indirect immunocytochemical techniques have been used in conjunction with light and confocal scanning laser microscopy (CSLM) to visualize cholinergic, serotoninergic and peptidergic nerve elements in whole-mount preparations of the amphibian urinary-bladder fluke, Gorgoderina vitelliloba. Cholinesterase (ChE) activity was localized in paired anterior ganglia, a connecting dorsal commissure and in the origins of the ventral nerve cords. Cholinergic ganglia were also evident in shelled embryos in the uterus. Serotonin-immunoreactivity (IR) was more extensive than ChE activity and was identified in both the central and peripheral nervous systems. Serotoninergic nerve fibres were associated with the somatic musculature and female reproductive ducts. Antisera to nine mammalian peptides and one invertebrate (FMRFamide) peptide have been used to investigate the peptidergic nervous system in the parasite. Immunoreactivity was obtained to five peptides, namely pancreatic polypeptide (PP), peptide YY (PYY), neuropeptide Y (NPY), substance P (SP) and FMRFamide. Peptidergic nerve fibres were found to be more abundant than demonstrable cholinergic or serotoninergic nerve fibres. NPY-IR was identified only in the main components of the central nervous system. However, PP- and PYY-IR occurred in the anterior ganglia, dorsal commissure, main nerve cords and in numerous small varicose fibres that ramified throughout the worm. Additionally, PP-immunoreactive nerve fibres were found to innervate the musculature of the female reproductive tracts. Six sites of IR were found in the acetabulum, using antisera directed towards the C-terminal end of PP and PYY, and these matched with the distribution of six non-ciliated rosette-like papillae observed by scanning electron microscopy. SP- and FMRFamide-IR were identified in the CNS, and FMRFamide-immunopositive nerve fibres were also evident in association with the gonopore cirrus region and with the

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

    Science.gov (United States)

    Kiebzak, Wojciech; Żurawski, Arkadiusz; Dwornik, Michał

    2016-01-01

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

  9. A Comparison of the Effectiveness of Surgical and Nonsurgical Treatment of Legg-Calve-Perthes Disease: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Karimi

    2012-01-01

    Full Text Available Legg-Calve-Perthes disease (LCPD is a degenerative condition of the hip joint characterised by idiopathic avascular necrosis of the femoral head. Loss of bone mass causes a degree of collapse of the joint and may result in deformity of the ball of the femur and the surface of the hip socket. A reduction in hip joint range of motion, alternation in growth of femoral head, and associated pain are most important problems associated with this disease. Various treatment methods are currently in use and aim to increase containment of the femoral head within the acetabulum, redistribute loading patterns applied to the femoral head, and to decrease the final deformities associated with this condition. These treatments depend on a variety of underlying factors and the aim of this paper was to determine appropriate pathways for treatment and the evidence of treatment method success. A review of the relevant literature was carried out in a variety of data bases including PubMed and ISI Web of Knowledge, and Gale between 1950 and 2011. Research results were categorised depending on the identified treatment method. The success of each treatment pathway was assessed and reasons for the pathway selected were grouped by the age of disease onset, follow-up period, and the final outcome. Evidence relating to the effectiveness of the treatment method used was conflicting. Different methods of screening and follow-up periods were employed in each study which used subjects of varying ages. Minimal evidence of sufficient quality exists in the literature to determine the most appropriate treatment of Legg-Calve-Perthes disease. Research provides some evidence to suggest that nontreatment may be as effective as orthotic or surgical intervention. More research is required to determine the effectiveness of orthotic and surgical treatment.

  10. Zweymuller系统全髋关节置换术治疗髋臼发育不良的中期疗效分析%Metaphase outcome of total hip arthroplasty with Zweymuller system in treating developmental dysplasia of the hip(DDH)

    Institute of Scientific and Technical Information of China (English)

    翁文杰; 邱旭升; 张海林; 袁涛; 陈东阳; 徐志宏; 蒋青

    2011-01-01

    目的:评价Zweymuller螺旋臼结合髋臼加深技术治疗髋臼发育不良的中期疗效.方法:自1998年1月至2004年12月,采用Zweymuller系统进行全髋关节置换术治疗髋臼发育不良继发髋关节骨性关节炎患者56例62髋,男14例(15髋),女42例(47髋);平均年龄48.6岁(30~67岁).术前所有患者均有髋关节疼痛和功能障碍.观察项目包括术后并发症、影像学及功能恢复情况.髋关节功能采用Harris评分标准进行评定.结果:56例获得随访,时间5~11年,平均6.5年.X线检查显示髋臼假体位于真臼住置,与周围骨床结合紧密.髋臼假体外展角35°~50°,股骨假体内、外翻3°以内,术后患肢短缩平均(0.5±0.2)cm.术后近期发生深静脉血栓20例,予溶栓治疗后好转.近期脱位1例,复位、制动3周后下地行走.4髋发生异位骨化、均为BrookⅡ型.无感染、神经损伤病例发生.术后Harris评分(87.4±3.5)分,与术前(43.2±6.7)分比较,差异有统计学意义(P<0.01).结论:Zweymuller螺旋臼结合髋臼加深技术治疗髋臼发育不良继发髋关节骨性关节炎中期疗效优良.%Objective :To analyze the metaphase outcome of total hip arthroplasty with Zweymuller system and deepening acetabulum technique in treating DDH. Methods:From Jan. 1998 to Dec.2004,56 patients (62 hips) with DDH (secondary osteoarthritis) were treated with total hip arthroplasty with Zweymuller system. There were 14 males ( 15 hips ) and 42 females (47 hips) with an average age of 48.6 years,ranged from 30 to 67 years. All patients had pain of hip joint and functional disturbance before operation. Observation items included postoperative complications,imaging and function of hip joint. The function of hip joint was analyzed according to Harris scoring. Results:All patients were followed up from 5 to 11 years with an average of 6.5 years. X-rays showed that the acetabular cup was in the position of true acetabulum,which combined tightly with the

  11. 基于激光快速成型技术正常步态下骨盆应力分布的三维光弹分析%Three-dimensional photoelastic analysis on the stress distribution of the pelvis under normal gait based on laser rapid prototyping technology

    Institute of Scientific and Technical Information of China (English)

    孙剑伟; 尹望平; 张春才; 任可; 支晓丞; 高振巢; 朱行飞

    2012-01-01

    BACKGROUND: Finite element technology is a digital simulation of the real stress situation; however, photoelastic technology can truly display the overall stress distribution of the test model.OBJECTIVE: To make the pelvis photoelastic model by laser rapid prototyping technology, and then to investigate the stress distributions of the pelvis under normal gait loading conditions by three-dimensional photoelastic analysis and to compare the result with that gained by the finite element method.METHODS: The pelvic potoelastic model was made by laser rapid prototyping technology, including the fifth lumbar vertebrae and bilateral proximal femur. Mass loading was imposed on the femur. Four groups of muscles forces were imposed through steel wire fixed on iliac wing, anterior superior iliac spine, posterior superior iliac spine and inferior ramus of pubis. The femur was assumed to adduct for 15° and moved from flexed 22° to extend 12° during four gait phases. After stress froze, slices were cut along the arcuate line. Isochromatic lines and isoclinic lines were observed in the field of polarized light.RESULTS AND CONCLUSION: ①Stress was concentrated on the center of ilium posterior superior roof of acetabulum, iliopubic eminence and cacroiliac joint, and the maximum stress was on the posterior superior roof of acetabulum. ② The main stress was transferred from posterior superior roof of acetabular to the cacroiliac joint and superior ramus of pubis partly. The area from roof to tubercle of the iliac crest loaded more stress with the femur extending. ③The stress on the acetabular area was mainly from the acetabular contact forces produced by mass loading, and the role of the muscle contraction force was limited. The three-dimensional photoelastic analysis could reflect distribution of stress on acetabulum. The result was in accordance with the data of finite element method.%背景:三维有限元技术是对应力真实情况的数字模拟,光弹技术可以真

  12. 髋关节假体聚乙烯磨损及其影响因素的相关性分析%Correlations between polyethylene wear direction and other influencing factors in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    兰天; 肖军; 史占军

    2014-01-01

    目的 探讨磨损与假体植入参数的相关性.方法 1997年4月至2006年3月对南方医科大学附属南方医院关节与骨病外科58髋Zweymuller双锥面非骨水泥螺旋臼假体进行临床和影像学检查,以计算机辅助测量方法测量髋关节假体聚乙烯内衬的线性磨损,平均随访时间为7.3年.利用股骨头假体中心相对于髋臼杯开口平面轴线的矢量位移,来决定线性磨损的大小和方向.分析髋臼外展角、股骨偏心距、髋臼前倾角对线性磨损方向和大小的影响.结果 平均线性磨损率为(0.17 ±0.08) mm/年,平均线性磨损方向与髋臼杯轴线的夹角为(34.2±29.3)°.线性磨损方向与外展角存在正相关性(r =0.480,P=0.000),与术后Harris评分存在负相关性(r=-0.314,P=0.016).外展角>45°组的线性磨损方向较外展角< 45°组更加偏离髋臼轴心(P =0.001).术中股骨偏心距得到重建组的线性磨损率小于未得到重建组(P =0.043).结论 该计算机辅助测量方法适用于各种髋臼杯假体聚乙烯内衬的二维磨损测量.人工全髋关节置换术中合理的髋臼杯外展角和恢复正常偏心距可以减少聚乙烯内衬线性磨损率,增加髋关节假体的稳定性,改善远期效果.%Objective To explore the correlations between polyethylene wear direction and implanted parameters of prosthesis in total hip arthroplasty (THA) by computer-assisted measurement techniques.Methods Retrospective analyses were performed for 58 uncemented THAs from April 1997 to March 2006.The sagittal displacement of femoral head to axis of acetabulum opening plane was examined to determine the direction and degree of linear polyethylene wear.Radiographs were assessed for femoral offset,acetabular abduction,acetabular anteversion and conventional polyethylene wear.The linear polyethylene wear directions were compared between different parameter groups.Results The average linear wear rate was 0.17 ± 0.08 mm/year and the

  13. Experimental study on the pathogenesis of deep venous thrombosis in lower limbs following artificial total hip replacement%人工全髋关节置换术后下肢深静脉血栓形成原因的实验观察

    Institute of Scientific and Technical Information of China (English)

    杨景武; 史晓林

    2005-01-01

    不良事件及副反应:3例出血达1 000 mL.为充分暴露手术视野,用拉钩阻挡肌肉等组织,即造成血管的长期积压,血流迟缓.结论:人工全髋置换术易损伤髋臼血管内壁,从而导致血流减慢和血小板聚集,最终促使血栓形成.同时术中失血多,使血液黏稠导致血栓形成.根据易损伤区及安全区模式图可知,下肢深静脉血栓是可以减少的.%BACKGROUND:Deep venous thrombosis has already been recognized as an important serious postoperative complication because it can cause fatal pulmonary embolism and long-term deep venous dysfunction. With the constant development of artificial joint operation and the popularization of such surgery, much attention has been paid to the formation of deep venous thrombosis following artificial joint replacement.OBJECTIVE: To observe the anatomical property of acetabular surrounding arteries and veins, as well as their injury during total hip replacement,so as to explore the cause of deep venous thrombosis in lower limbs following artificial total hip replacement.DESIGN: Single sample observation and before-after self-control.SETTING: Gross anatomy was carried out in the anatomical laboratory of the Medical School of Huzhou Teachers' College; total hip replacement was carried out in the Orthopedic Department, Xinhua Hospital of Zhejiang Traditional Chinese Medicine College.PARTICIPANTS: Pelvic samples were collected from 60 normal adult corpuses (30 from men and 30 from women); meanwhile, 30 patients (18 males and 12 females) received total hip replacement in the Orthopedic Department of Xinhua Hospital, Zhejiang Traditional Chinese Medicine College, between March 2002 and August 2003.METHODS: Gross anatomy was carried out at the anatomical laboratory in the Medical School of Huzhou Teachers' College between March and May 2003. The running course of bilateral external iliac artery and vein, as well as the relationship between the branches of femoral artery and vein and acetabulum were

  14. Measurements of the posterior acetabular surface and design of a new anatomical locking plate for acetabular fractures%髋臼后表面解剖形态测量及新型解剖锁定钢板的设计

    Institute of Scientific and Technical Information of China (English)

    张里程; 张立海; 许猛; 尹鹏; 赵喆; 吕厚辰; 尹鹏滨; 唐佩福

    2014-01-01

    Objective To design a new type of anatomical locking plate which fits better the shape of posterior acetabular surface in Chinese population and presets reasonable directions of locking screws according to the measurements of the posterior acetabular surface in three dimensional (3D) reconstruction models of normal Chinese acetabulum.Methods Included in this study were CT scan data of the normal pelvis of 171 patients,100 males and 71 females with a mean of age 45.9 years (range,from 18 to 60 years).The imaging data at the.dicom format were imported into the Materiaise' s interactive medical image control system (Mimics,version 10.0) for 3D reconstruction and editing before they were saved as the STL files.Next the STL files were imported into the IMAGEWARE software (Imageware V12.1,US EDS Corporation) to set up standard points and surface of the posterior acetabular surfac e.Based on the database,we designed a new type of anatomical locking plate which could fit the shape of bone surface and preset directions of lock screws.Finally,the data were entered into a computerized numerical control digital milling machine to manufacture a real plate and screws.Results The mean acetabular diameters were 57.6 ± 2.9 mm and 52.6 ± 2.6 mm and the mean widths of the posterior acetabular wall were 40.7 ± 2.9 mm and 38.4 ± 2.4 mm for men and women,respectively,with significant differences between men and women (P < 0.05).After one-tenth of the diameter (d) of the acetabulum (d/10) was chosen as the measurement unit of the new coordinate system,the mean widths of the acetabular wall were 7.10 ±0.52 d/10 and 7.16 ±0.47 d/10 for men and women,respectively,with no significant difference between men and women (P > 0.05).The IMAGEWARE software showed that the anatomic shape of our self-designed new type of locking plate was in complete agreement of that of the posterior acetabular surface.The mean deviation of the plate from the bone surface was 3.2 ± 1.0 mm.The locking

  15. 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

  16. An observer study for direct comparison of clinical efficacy of electronic to film portal images and their incorporation in a network; Apport de l'imagerie de haute energie dans un service de radiotherapie et incorporation de celle-ci dans un systeme en reseau

    Energy Technology Data Exchange (ETDEWEB)

    Pradier, O.; Hille, A.; Schmidberger, H.; Hess, C.F. [Gottingen Universitat, Klinik und Poliklinik fur Trahlentherapie und Radioonkologie (Germany)

    2001-06-01

    An observer study for direct comparison of clinical efficacy of electronic to film portal images and their incorporation in a network. To directly compare the clinical efficacy of electronic to film portal images and the advantages of comparing directly on the monitor the simulation image and the portal image. Material and methods. - This study was designed to compare clinical efficacy of electronic to film portal images acquired using a liquid matrix ion-chamber electronic portal imaging device (EPID) and a conventional film system. Two radiation oncologists served as observers and evaluated a total of 30 sets of images for three different treatment sites: lung, pelvis, and head/neck. Each set of images included a simulation image, a portal film, a video paper print of electronic portal images, and a video prints of electronic portal images. Four to six anatomical landmarks were selected from each treatment site. Each observer was asked to rate each landmark in terms of its clinical visibility and to rate the ease of making the pertinent verification decision in the corresponding electronic and film portal images with the aid of the simulation image. The time needed to obtain and analyse a conventional portal image and an EPID would be analysed for the radiotherapist and the medical technicians. Results- Ratings for the visibility of landmarks and for the verification decision of treatment ports were similar for electronic and film images for most landmarks. However, vertebral bodies and several landmarks in the pelvis such as the acetabulum and pubic symphysis were more visible in the electronic portal images than in the portal film images. For the medical technicians, the EPID is more comfortable, and they do not need to develop any images. Conclusion. -The visibility of landmarks in electronic portal images is comparable to that in film portal images. Verification of treatment ports based only on electronic portal images acquired using an electronic portal

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

    Directory of Open Access Journals (Sweden)

    Kiebzak W

    2016-08-01

    Full Text Available Wojciech Kiebzak,1,2 Arkadiusz Żurawski,2 Michał Dwornik3 1Center for Pediatrics, Regional Hospital in Kielce, Kielce, Poland; 2Department of Physiotherapy, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland; 3Department of Osteopathic Medicine and Physiotherapy, Medical College of Podkowa Lesna, Podkowa Lesna, Poland Background: Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and structural disorders. Such cases particularly demand optimizing therapeutic effects and maximally reducing the duration of therapy. Purpose: The aim of this case report is to present the therapeutic process in a child with developmental hip dysplasia. Case report: This is a case report of a female child with a birth weight of 2,800 g and an Apgar score of 9 points born to a gravida 3 para 3 mother at 37 weeks. The child was delivered by cesarean section, and the pregnancy was complicated by oligohydramnios. Subluxation of the left hip joint was diagnosed by an orthopedist in the third month of life. The treatment followed was the Vojta method (the first phase of reflex turning and reflex crawling. Results: During the 6 weeks of the Vojta treatment, the left half of the femoral head was centralized, and the process of formation of the hip joint acetabulum was influenced effectively enough to change the acetabulum’s Graff type from the baseline D to IIb after 41 days of treatment. Conclusion: The diagnostic work-up of congenital hip joint dysplasia should involve a physiotherapist who will investigate the child’s neuro­muscular coordination, in addition to a neonatologist and a pediatrician. The therapy for a disorder of hip joint development of neuromotor origin should involve the application of global patterns according to Vojta. Children with congenital dysplasia of the hip joint should commence rehabilitation as early as possible. Keywords: global pattern

  18. MR imaging findings in transient osteoporosis of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Malizos, Konstantinos N. E-mail: kmalizos@otenet.gr; Zibis, Aristidis H.; Dailiana, Zoe; Hantes, Michael; Karahalios, Theophilos; Karantanas, Apostolos H

    2004-06-01

    Purpose: The authors sought to describe the magnetic resonance (MR) imaging findings including perfusion imaging, in association with the course of acute bone marrow oedema syndrome (aBMEs), in a group of patients with acute hip pain and a final diagnosis of transient osteoporosis of the hip (TOH). Materials and methods: From 217 patients referred with a probable diagnosis of avascular necrosis (AVN) of the femoral head, we identified 42 patients who had clinical and radiographic findings not relevant to AVN. MR imaging examinations were performed on a 1.0T scanner. Perfusion imaging was performed in 20 patients. The bone marrow oedema (BME) was classified in four stages. In addition, the presence or absence of oedema in the subchondral area and the presence of other subchondral lesions were recorded. Acetabular bone marrow was also assessed for the presence of oedema. The quantitative measurements included: maximum size of the effusion, percentage of enhancement (PE) and time of peak enhancement of abnormal marrow compared to the first pass, on the perfusion images. Results: Osteopenia was present on plain radiographs in 87% of cases. The most common pattern of BME was extending to the femoral head and neck. Acetabulum was involved in 16.6%. In 22.6% the BME spared the subchondral region of the femoral head. There were two cases (4.7%) with subchondral changes. A joint effusion was noted in 33 of the 42 patients. On perfusion imaging, a delayed peak enhancement was noted in 20 patients between 40 and 65 s after the first pass of contrast. No patient had any evidence of femoral head collapse or change in sphericity on follow-up MRI. None of the patients developed avascular necrosis in a time frame of 18 months from the onset of the acute hip pain. Conclusion: The aBMEs MR imaging pattern varies and is most commonly appearing on X-rays as osteopenia. Absence of subcondral lesions, delayed peak enhancement of the abnormal marrow on perfusion images, and sparing of

  19. Orthopedic and interventional applications at low field MRI with horizontally open configuration

    Energy Technology Data Exchange (ETDEWEB)

    Koskinen, S.K.; Parkkola, R.K.; Karhu, J.; Komu, M.E.S.; Kormano, M.J. [Diagnostic Radiology, Turku Univ. Hospital (Finland)

    1997-10-01

    The recently introduced horizontally open configuration imagers allow imaging of knee, hip or shoulder during whole range of motion, which is not possible in conventional MR imagers. Special joint motion devices can be used to provide accurate and reproducible studies. In cervical spine, functional MR imaging may be useful in evaluating alarligament stability in patients with late sequelae of a whiplash injury, and in patients with rheumatoid arthritis who are clinically suspected of having a cervical myelopathy or superior migration of the odontoid process. In shoulder, full range of motion abduction study may be helpful in assessing the supraspinatus tendon impingement. To evaluate patellofemoral malalignment, quadriceps loading is recommended since associated contracting muscles and related soft tissue structures can be evaluated. The position of the femoral head relative to the acetabulum during different positions can be assessed. Open-configuration scanners provide an access to patients during scanning procedure, and therefore permit interventional procedures to be monitored with MRI. Such interventions include aspiration cytology/biopsy and different drainage procedures. (orig.) [Deutsch] Die kuerzlich eingefuehrten bildgebenden Systeme mit horizontal offener Konfiguration ermoeglichen die Darstellung von Knie, Huefte oder Schulter ueber den gesamten Bewegungsbereich, war bisher mit konventionellen MR-Systemen nicht moeglich. Fuer genauere und reproduzierbare Untersuchungen koennen spezielle Gelenkbewegungsgeraete verwendet werden. Bei der Halswirbelsaeule kann die funktionelle NMR-Darstellung im Hinblick auf die Beurteilung der Stabilitaet der Ligamenta alaria bei Patienten mit Spaetfolgen eines Schleudertraumas und bei Patienten mit rheumatoider Arthritis von Nutzen sein, wenn klinisch eine zervikale Myelopathie oder superiore migration des Dens axis vermutet wird. Bei der Schulter kann eine Abduktionsstudie des vollen Bewegungsbereichs bei der Beurteilung

  20. Efficient radiologic diagnosis of pelvic and acetabular trauma; Rationelle bildgebende Diagnostik von Becken- und Azetabulumverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Rommens, P.M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Unfallchirurgie

    2000-01-01

    In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.) [German] Bei der Klaerung einer Verletzung des Beckens oder des Azetabulums stellen konventionelle Uebersichtsaufnahmen weiterhin die Basis der bildgebenden Diagnostik dar. Art und Umfang werden bestimmt von lokalen Gegebenheiten (z.B. Verfuegbarkeit von CT-Geraeten) sowie vom klinischen Zustand des Patienten. Aufgrund der diagnostischen Ungenauigkeit der konventionellen Roentgendiagnostik gerade im Bereich des stabilitaetsbedeutsamen dorsalen Beckenringes und des Azetabulums schliesst sich beim klinisch stabilen

  1. Evaluation of usefulness of portal image using Electronic Portal Imaging Device (EPID) in the patients who received pelvic radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo Chul; Kim, Heon Jong; Park, Seong Young; Cho, Young Kap; Loh, John J. K. [College of Medicine, Inha Univ., Pusan (Korea, Republic of); Park, Won; Suh, Chang Ok; Kim, Gwi Eon [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    1998-12-01

    To evaluate the usefulness of electronic portal imaging device through objective compare of the images acquired using an EPID and a conventional port film. From Apr. to Oct. 1997, a total of 150 sets of images from 20 patients who received radiation therapy in the pelvis area were evaluated in the Inha University Hospital and Severance Hospital. A dual image recording technique was devised to obtain both electronic portal images and port film images simultaneously with one treatment course. We did not perform double exposure. Five to ten images were acquired from each patient. All images were acquired from posteroanterior (PA) view except images from two patients. A dose rate of 100-300 MU/min and a 10-MV X-ray beam were used and 2-10 MUs were required to produce a verification image during treatment. Kodak diagnostic film with metal/film imaging cassette which was located on the top of the EPID detector was used for the port film. The source to detector distance was 140 cm. Eight anatomical landmarks (pelvic brim, sacrum, acetabulum, iliopectineal line, symphysis, ischium, obturator foramen, sacroiliac joint) were assessed. Four radiation oncologist joined to evaluate each image. The individual landmarks in the port film or in the EPID were rated-very clear (1), clear (2), visible (3), notclear (4), not visible (5). Using an video camera based EPID system, there was no difference of image quality between no enhanced EPID images and port film images. However, when we provided some change with window level for the portal image, the visibility of the sacrum and obturator foramen was improved in the portal images than in the port film images. All anatomical landmarks were more visible in the portal images than in the port film when we applied the CLAHE mode enhancement. The images acquired using an matrix ion chamber type EPID were also improved image quality after window level adjustment. The quality of image acquired using an electronic portal imaging device was

  2. Trans trochanteric approach with coronal osteotomy of the great trochanter

    Directory of Open Access Journals (Sweden)

    Steffann Francois

    2015-01-01

    Full Text Available Several surgical approaches could be used in hip arthroplasty or trauma surgery: anterior, anterolateral, lateral, posterior (with or without trochanterotomy, using or not an orthopedic reduction table. Subtrochanteric and extra-capsular trochanteric fractures (ECTF are usually treated by internal fixation with mandatory restrictions on weight bearing. Specific complications have been widely described. Mechanical failures are particularly high in unstable fractures. Hip fractures are a major public health issue with a mortality rate of 12%–23% at 1 year. An alternative option is to treat ECTF by total hip arthroplasty (THA to prevent decubitus complications, to help rapid recovery, and to permit immediate weight bearing as well as quick rehabilitation. However, specific risks of THA have to be considered such as dislocation or cardiovascular failure. The classical approach (anterior or posterior requires the opening of the joint and capsule, weakening hip stability and the repair of the great trochanter is sometimes hazardous. For 15 years, we have been treating unstable ECTF by THA with cementless stem, dual mobility cup (DMC, greater trochanter (GT reattachment, and a new surgical approach preserving capsule, going through the fracture and avoiding joint dislocation. Bombaci first described a similar approach in 2008; our trans fractural digastric approach (medial gluteus and lateral vastus is different. A coronal GT osteotomy is performed when there is no coronal fracture line. It allows easy access to the femoral neck and acetabulum. The THA is implanted without femoral internal rotation to avoid extra bone fragment displacement. With pre-operative planning, cup implantation is easy and stem positioning is adjusted referring to the top of the GT after trial reduction and preoperative planning. The longitudinal osteotomy and trochanteric fracture are repaired with wires and the digastric incision is closed. This variant of Bombaci

  3. Gain and loss of polyadenylation signals during evolution of green algae

    Directory of Open Access Journals (Sweden)

    Glöckner Gernot

    2007-04-01

    Full Text Available Abstract Background The Viridiplantae (green algae and land plants consist of two monophyletic lineages: the Chlorophyta and the Streptophyta. Most green algae belong to the Chlorophyta, while the Streptophyta include all land plants and a small group of freshwater algae known as Charophyceae. Eukaryotes attach a poly-A tail to the 3' ends of most nuclear-encoded mRNAs. In embryophytes, animals and fungi, the signal for polyadenylation contains an A-rich sequence (often AAUAAA or related sequence 13 to 30 nucleotides upstream from the cleavage site, which is commonly referred to as the near upstream element (NUE. However, it has been reported that the pentanucleotide UGUAA is used as polyadenylation signal for some genes in volvocalean algae. Results We set out to investigate polyadenylation signal differences between streptophytes and chlorophytes that may have emerged shortly after the evolutionary split between Streptophyta and Chlorophyta. We therefore analyzed expressed genes (ESTs from three streptophyte algae, Mesostigma viride, Klebsormidium subtile and Coleochaete scutata, and from two early-branching chlorophytes, Pyramimonas parkeae and Scherffelia dubia. In addition, to extend the database, our analyses included ESTs from six other chlorophytes (Acetabularia acetabulum, Chlamydomonas reinhardtii, Helicosporidium sp. ex Simulium jonesii, Prototheca wickerhamii, Scenedesmus obliquus and Ulva linza and one streptophyte (Closterium peracerosum. Our results indicate that polyadenylation signals in green algae vary widely. The UGUAA motif is confined to late-branching Chlorophyta. Most streptophyte algae do not have an A-rich sequence motif like that in embryophytes, animals and fungi. We observed polyadenylation signals similar to those of Arabidopsis and other land plants only in Mesostigma. Conclusion Polyadenylation signals in green algae show considerable variation. A new NUE (UGUAA was invented in derived chlorophytes and replaced

  4. Evaluation of Constant Thickness Cartilage Models vs. Patient Specific Cartilage Models for an Optimized Computer-Assisted Planning of Periacetabular Osteotomy.

    Directory of Open Access Journals (Sweden)

    Li Liu

    Full Text Available Modern computerized planning tools for periacetabular osteotomy (PAO use either morphology-based or biomechanics-based methods. The latter relies on estimation of peak contact pressures and contact areas using either patient specific or constant thickness cartilage models. We performed a finite element analysis investigating the optimal reorientation of the acetabulum in PAO surgery based on simulated joint contact pressures and contact areas using patient specific cartilage model. Furthermore we investigated the influences of using patient specific cartilage model or constant thickness cartilage model on the biomechanical simulation results. Ten specimens with hip dysplasia were used in this study. Image data were available from CT arthrography studies. Bone models were reconstructed. Mesh models for the patient specific cartilage were defined and subsequently loaded under previously reported boundary and loading conditions. Peak contact pressures and contact areas were estimated in the original position. Afterwards we used a validated preoperative planning software to change the acetabular inclination by an increment of 5° and measured the lateral center edge angle (LCE at each reorientation position. The position with the largest contact area and the lowest peak contact pressure was defined as the optimal position. In order to investigate the influence of using patient specific cartilage model or constant thickness cartilage model on the biomechanical simulation results, the same procedure was repeated with the same bone models but with a cartilage mesh of constant thickness. Comparison of the peak contact pressures and the contact areas between these two different cartilage models showed that good correlation between these two cartilage models for peak contact pressures (r = 0.634 ∈ [0.6, 0.8], p 0.8, p < 0.001. For both cartilage models, the largest contact areas and the lowest peak pressures were found at the same position. Our study is

  5. 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

  6. Sutures versus staples for wound closure in orthopaedic surgery: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Shantz Jesse A

    2012-06-01

    Full Text Available Abstract Background A recently published meta-analysis comparing metallic staples to sutures in orthopaedic procedures revealed three fold increase in risk for infection in stapled wounds. The studies included in the meta-analysis are at risk of bias due to experimental design limitations. A large randomized controlled trial is proposed to direct orthopaedic surgeons in their choice of wound closure material. Methods/Design A parallel group randomized controlled trial with institutional review board approval will be conducted. Patients will be randomized intraoperatively to have skin wounds closed with sutures or staples. Dressings will be used to maintain blinding outcome assessors. The primary outcome measure will be a composite all-cause wound complication outcome measure composed of: infection, wound drainage, wound necrosis, blistering, dehiscence, suture abscess and material sensitivity reaction. An independent review board blinded to treatment assignment will adjudicate suspected complications based on clinical data. All deceased patients will also be reviewed. An interim analysis of complications will take place after half of the patients have been recruited. All data will be analyzed by a blinded statistician. Dichotomous primary and secondary outcome measures will be analyzed using the Chi-squared statistic. Continuous outcome measures will be analyzed using Student's t-test. Subgroup analysis will compare infection rates using sutures versus staples in each anatomic area (upper extremity, pelvis/acetabulum, hip/femur, knee, ankle. A further subgroup analysis will be conducted comparing trauma patients to elective surgery patients. Non-infected revision surgery will also be compared to primary surgery. Discussion Wound closure material is an afterthought for many orthopaedic surgeons. The combined results of several comparative trials suggests that the choice of wound closure materials may have an impact on the rate of surgical site

  7. Anthelmintic activity in vitro and in vivo of Baccharis trimera (Less) DC against immature and adult worms of Schistosoma mansoni.

    Science.gov (United States)

    de Oliveira, Rosimeire Nunes; Rehder, Vera Lúcia Garcia; Oliveira, Adriana Silva Santos; Jeraldo, Veronica de Lourdes Sierpe; Linhares, Arício Xavier; Allegretti, Silmara Marques

    2014-04-01

    Although its efficiency against all Schistosoma species, praziquantel (PZQ) shows low efficacy against schistosomula and juvenile stages. The potential for development of resistance to PZQ has justified the search for new alternative chemotherapies. In this scenario, studies to new formulations, more comprehensive and without adverse effects, are being conducted. One viable and promising treatment is the study of medicinal plants as a new approach to the experimental treatment for Schistosomiasis. Amongst all the variety of the medicinal species studied, we can highlight Baccharis trimera (Less) DC, known as "Carqueja-amarga". This paper not only describes the effect of crude dichloromethane extract (DE) and aqueous fraction (AF) obtained from B. trimera, in vitro but also is the first one that investigates the in vivo efficacy of B. trimera against schistosomula, juvenile and adult worms of Schistosoma mansoni BH strain. In the experiment, mice were treated with DE, AF and PZQ (40 and 200mg/kg) over the period of larval development (3 and 30 post-infection; pi), and adult worms (60days post-infection; pi). The in vitro results show that the DE and AF effects are dose-dependents, being the 130μg/mL the most effective one in a shorter period of incubation. The exposure of the in vitro samples over adult parasites were able to inhibit 100% of the oviposition in females. Likewise caused the mortality of the parasites with morphological alterations on the tegument, on the suckers, oral and acetabulum, in both males and females after 6-72h of exposure. Additionally, the in vivo treatments against juvenile and adult infection were more effective compared to the control group untreated. Administrations of AF and DE in day 30pi (juvenile worms) show female worm total burden reductions of 75% and 68% respectively. At the same period of infection reductions of respectively 98% and 97% egg/g in the faeces were seen. In relation to the different egg developmental stages

  8. Magnetic resonance imaging evaluation of acetabular orientation in normal Chinese children.

    Science.gov (United States)

    Li, YiQiang; Liu, YuanZhong; Zhou, QingHe; Chen, WeiDong; Li, JingChun; Yu, LingJia; Xu, HongWen; Xie, DengHui

    2016-09-01

    There are no data regarding the acetabular orientation on magnetic resonance imaging (MRI); this study investigates the changes of acetabular orientation with age in normal Chinese children.We retrospectively analyzed the medical records of children who underwent hip MRI examination at our hospital from January 2009 to December 2015. A total of 180 patients with normal MRI reading of the hip joints were included and were divided into 14 groups according to age: from 6 months of age and then for each year from 1 to 16 years. The bony and cartilage acetabular anteversion angle (AAA), acetabular inclination angle (AIA), and acetabular index (AI) were measured. Total bony and cartilage femoral head coverage angles were measured on axial section total femoral head coverage angle (a-TCA) and coronal section total femoral head coverage angle (c-TCA).The mean bony AAA and AIA were 12.2 ± 2.5° and 50.9 ± 2.5°, respectively; both of them stayed constant from the age of 6 months to 16 years. Similar results were found in cartilage AAA (12.1 ± 2.5°) and AIA (41.2 ± 3.0°). There was no difference between bony and cartilage AAA, but bony AIA was significantly larger than cartilage AIA. Bony AI was 24.1 ± 2.4° at the age of 6 months, decreasing to 12.5 ± 2.3° by 12 to 13 years of age; cartilage AI (5.9 ± 1.7°) maintained a steady value with age. The mean bony a-TCA and c-TCA at 6 months were 117.0 ± 5.8° and 127.5 ± 5.1°, increasing to 144.5 ± 4.6° and 140.7 ± 2.5° at the age of 16 years. However, the cartilage a-TCA (145.2 ± 7.2°) and c-TCA (154.1 ± 5.7°) did not change significantly with age.Both bony and cartilage AAA and AIA remain constant up to the age of 16 years in normal Chinese pediatric population. Although the cartilage coverage of femoral head by the acetabulum remains unchanged with age, the bony coverage of femoral head increases. PMID:27631258

  9. Porous surface replacement of the hip with chamfered-cylinder component.

    Science.gov (United States)

    Amstutz, H; Kilgus, D; Kabo, M; Dorey, F

    1988-01-01

    One hundred porous surface replacements (PSR) were performed in 92 patients (63 men and 29 women) with a mean age of 53 (range 17-76). Follow-up times range from 1 to 4 years, with 48 patients having a follow-up of at least 2 years. Preoperative diagnoses were osteoarthritis (OA) 63, osteonecrosis (ON) 13, dysplasia 9, rheumatoid-ankylosing spondylitis 6, and other 9. Seventeen hips had metal-backed acrylic-fixed THARIES acetabular sockets, nine hips had a porous cobalt chrome hemispheric beaded acetabular component with adjuvant fixation screws and externally protruding screw hubs, and 74 hips had a porous chamfered cylinder-design acetabulum. Pain relief had been immediate and more complete than with acrylic-fixed or biologic-ingrowth stem-type replacement with comparable walking and function improvements. There have been no major systemic complications, sepsis, or loosening. There have been two transient peroneal nerve palsies and three trochanteric fibrous unions. There have been three reoperations, one for subluxation, one for "metalosis" due to mesh pad loosening, and one femoral neck fracture. Examination of one removed femoral surface component which has been histologically sectioned revealed excellent (90%) bone in-growth. Circumferential progressive radiolucencies developed at the bone-cement interface by 1 year in all of the 17 acrylic-fixed acetabular components. Reaming or seating defects were noted in 25% of the ingrowth components on postoperative radiographs. Radiographic analysis of immediate postoperative films of the chamfered cylinder design acetabular components frequently demonstrated bone-component interface radiolucencies which represented component seating defects. These initial interface radiolucencies became progressively more narrow over the first six months postoperatively suggesting "healing" of the reamed bone-component interface with trabecular bone around the chamfered cylinder acetabular components. Partial healing of initial

  10. Imaging Findings of Hip Joint Tuberculosis of Children%小儿髋关节结核的影像学表现

    Institute of Scientific and Technical Information of China (English)

    陈久尊; 何家维; 郭安娜; 严志汉; 陈伟

    2012-01-01

    目的 探讨小儿髋关节结核的影像学表现.方法 回顾性分析24例小儿髋关节结核病例的X线、CT、MRI影像资料.结果 病变多累及单侧关节,男孩多见,早期主要表现关节囊和周围软组织肿胀,关节腔积液,病变进展到中后期,主要表现骨质巯松,髋臼及股骨头骨骺破坏,冷脓肿形成并呈流注样扩散,肉芽组织形成,晚期表现为股骨头坏死,关节畸形、脱位及强直等.结论 MRI对于髋关节早期软组织病变,关节积液、脓肿,以及软骨破坏等敏感,X线片对于整体观察骨质疏松、骨质破坏,及关节脱位等有价值,CT能发现细微的骨破坏病灶及死骨等,3种检查方法合理选择,有助于病变早期诊断和长期随访观察.%Objective To study the imaging findings of hip joint tuberculosis of children. Methods Imaging data of X - ray, CT and MRI of 24 cases with hip joint tuberculosis of children were analyzed retrospectively. Results Lesions involeved more than a single, more in boys. Early main manifestations were the swelling of the joint capsule and the soft tissue around and the articular cavity effusion. When disease progressing to later period, the main manife stations were osteoporosis, the destruction of acetabulum and osteoepiphysis of caput femoris, the formation of cold abscess spreading like flow column samples and the formation of granulation tissue. The late manifestations were the necrosis of caput femoris, the joint deformities, dislocation and stiffness and so on. Conclusion MRI is a sensitive examination in the early soft tissue lesions, the joint effusion, abscess and the destruction of cartilage. X - ray is an valuable examination in osteoporosis, bone destruction and dislocation of joint. CT can discover the tiny lesions of bone destruction, sequestrum and so on. A reasonable choice of these three examinations is in favor of the early diagnosis of lesions and long - term follow - up.

  11. A new sensor for measurement of dynamic contact stress in the hip.

    Science.gov (United States)

    Rudert, M J; Ellis, B J; Henak, C R; Stroud, N J; Pederson, D R; Weiss, J A; Brown, T D

    2014-03-01

    Various techniques exist for quantifying articular contact stress distributions, an important class of measurements in the field of orthopaedic biomechanics. In situations where the need for dynamic recording has been paramount, the approach of preference has involved thin-sheet multiplexed grid-array transducers. To date, these sensors have been used to study contact stresses in the knee, shoulder, ankle, wrist, and spinal facet joints. Until now, however, no such sensor had been available for the human hip joint due to difficulties posed by the deep, bi-curvilinear geometry of the acetabulum. We report here the design and development of a novel sensor capable of measuring dynamic contact stress in human cadaveric hip joints (maximum contact stress of 20 MPa and maximum sampling rate 100 readings/s). Particular emphasis is placed on issues concerning calibration, and on the effect of joint curvature on the sensor's performance. The active pressure-sensing regions of the sensors have the shape of a segment of an annulus with a 150-deg circumferential span, and employ a polar/circumferential "ring-and-spoke" sensel grid layout. There are two sensor sizes, having outside radii of 44 and 48 mm, respectively. The new design was evaluated in human cadaver hip joints using two methods. The stress magnitudes and spatial distribution measured by the sensor were compared to contact stresses measured by pressure sensitive film during static loading conditions that simulated heel strike during walking and stair climbing. Additionally, the forces obtained by spatial integration of the sensor contact stresses were compared to the forces measured by load cells during the static simulations and for loading applied by a dynamic hip simulator. Stress magnitudes and spatial distribution patterns obtained from the sensor versus from pressure sensitive film exhibited good agreement. The joint forces obtained during both static and dynamic loading were within ±10% and ±26

  12. Acetabular deepening in the treatment of severe canine hip dysplasia Aprofundamento do acetábulo no tratamento de displasia coxofemoral grave em cães

    Directory of Open Access Journals (Sweden)

    Paulo Iamaguti

    2009-02-01

    Full Text Available A technique to restore acetabular anatomy by deepening the acetabular cavity and reconstructing the femoral head ligament and the joint capsule was tested on nine large breed dogs with severe hip dysplasia and acute subdislocation or dislocation. The technique consisted of two phases. First, all dogs were submitted to bilateral pectinotomy. In a second surgical intervention on the same dogs the acetabulum was approached and deepened, and the femoral head ligament and the joint capsule were reconstructed. In general, within 30 days of the surgery dogs could stand on the operated member to walk. Except for two dogs, all the others recovered pelvic member locomotive ability within 60-90 days after surgery. It is concluded that acetabuloplasty is a good alternative for treatment of severe canine hip dysplasia.Uma técnica para restituir a anatomia acetabular com aprofundamento da cavidade acetabular e reconstrução do ligamento da cabeça do fêmur e da cápsula articular, foi testada em nove cães, de raças de grande porte, portadores de displasia coxofemoral grave com subluxação acentuada ou luxação. O procedimento cirúrgico foi constituído de duas fases. Inicialmente, foi realizada a pectineotomia bilateral em todos os cães. A segunda intervenção nos mesmos cães incluiu abordagem e aprofundamento do acetábulo, reconstrução do ligamento da cabeça do fêmur e da cápsula. Em geral, 30 dias após a cirurgia, os cães apoiavam o membro operado para se locomover. Com exceção de dois cães, todos os outros recuperaram a função locomotora do membro pélvico dentro de 60-90 dias. É concluído que a técnica de acetabuloplastia é uma boa alternativa para o tratamento da displasia coxofemoral grave.

  13. Aumento acetabular pela técnica de Stahelli modificada Acetabular increase with modified Stahelli technique

    Directory of Open Access Journals (Sweden)

    Sílvio Pereira Coelho

    2000-09-01

    Full Text Available Os autores apresentam neste trabalho um estudo retrospectivo realizado em 18 pacientes submetidos a tratamento cirúrgico de insuficiência acetabular pela osteotomia da pelve seguindo a técnica descrita por Lynn T. Staheli. Enfatizam a modificação da técnica deste autor, com a introdução do enxerto ósseo, retirado da tábua externa do ilíaco, numa fenda aprofundada até cerca da cortical interna do ilíaco. Os pacientes foram acompanhados através de consultas ambulatoriais previamente a cirurgia e pós-operatoriamente com seguimento que variou de 2 meses a 4 anos no serviço de ortopedia infantil do Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. O objetivo do trabalho foi avaliar o quadril acometido pré e pós-operatoriamente, demonstrando a evolução e vantagens da variação da técnica de Staheli desenvolvida neste serviço. Observou-se que a cirurgia, se realizada sob técnica adequada e em mãos experientes, torna-se uma fonte válida de tratamento para aquelas patologias que levam a uma insuficiente cobertura da cabeça femoral.The authors present in this paper a retrospective study of eighteen patients treated surgically for insufficiency of the acetabular coverage with the shelf procedure according to Lynn T. Staheli. This study was done at the Service of Pediatric Orthopedics of Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. They call attention to the modification of the surgical technique in that the bone graft taken from outer cortex of the iliac bone, is deepened in the slot in the superior rim of the acetabulum. The follow-up ranged from two months to four years. The aim of this paper was to evaluate the affected hip pre and postoperatively showing the results and the advantages of the modified shelf technique. They observed that if the surgery is performed according to the correct technique and by an experienced surgeon, it is a very good alternative to the treatment of those

  14. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  16. Modeling and finite element analysis of a new acetabular revision component with three wings%三翼髋臼假体有限元模型的建立及其力学分析

    Institute of Scientific and Technical Information of China (English)

    马文辉; 张学敏; 王继芳; 时述山

    2010-01-01

    Objective To analyze and evaluate a new acetabular revision component with three wings. Methods The finite-element models of a new acetabular component and acetabulum with bone loss were established to calculate the interface stresses during a normal gait cycle with use of the finite-element formulations. Results The finite-element analysis demonstrated that stress and strain at the interfaces of bone-shell and metal-polyethylene liner had the same direction of change but no remarkable difference between them. In the study, the result indicated increased contact stresses with an increased joint load and orientation. The peak stress was tested at the second stage of gait cycle. The stress of wings increased gradually from rim to root. Its peak stress that was significantly lower than yield force of the Co-Cr alloy was at the joint between the wing and the shell. The stress of graft had the same change rule as the joint force. The part of graft near to acetabular component was subjected to higher stress conditions. Conclusion The hip forces can transfer from acetabular component and implant to acetabulum. The result of the finite-element analysis underlined the importance of wings of the new acetabular component. The wing can help to improve the antitorsion ability of acetabular component and to minimize its aseptic loosening rate. Therefore, based on results of this study and clinical application, the acetabular component with wings is known a viable means for acetabular revision in the presence of bone loss. But further research is needed as to this acetabular component.%目的 对于一种临床上用于髋臼骨缺损的新型三翼髋臼翻修假体的设计进行有限元分析及力学评价.方法 建立三翼翻修假体及缺损髋臼的有限元模型,应用有限元分析公式计算在髋臼骨缺损翻修后,翻修假体在正常步态周期内的应力变化规律.结果 研究证实在正常步态周期内,三翼髋臼假体金属壳两侧界面的

  17. 骨盆并髋臼骨折内固定材料的生物相容性%Materials biocompatibility in the internal fixation of pelvic fracture combined with acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    高明杰; 陶杰; 周孜辉; 杜琳

    2015-01-01

    背景:骨盆骨折合并髋臼骨折多由高能量暴力伤所致,常伴严重并发症,往往需要外科内固定治疗。目的:探讨骨盆骨折合并髋臼骨折内固定治疗以及材料的生物相容性。方法:以“骨盆骨折,髋臼骨折,内固定,材料;pelvis fracture,acetabulum fracture,internal fixators, materials”为关键词,应用计算机检索2005至2014年万方数据库、清华知网数据库和PubMed数据库,选取有关骨盆骨折合并髋臼骨折内固定治疗以及材料生物相容性研究的文献,同一领域文献选择权威杂志或发表时间为近期的文章,依据纳入排除标准选取29篇文献进行归纳分析。结果与结论:对于骨盆骨折合并髋臼骨折临床多采用重建钢板或拉力螺钉内固定,常用于内固定的重建钢板材料是钛板,弹性模量接近骨的弹性模量,生物相容性好,可在置入前预先弯曲塑形,使之与骨折部位骨面相匹配。可吸收螺钉具有良好的组织相容性,无毒副反应,避免金属螺钉的电解与腐蚀,在内固定早期保持一定的强度,随着时间的推移骨折逐渐愈合,材料强度也缓慢降低,材料最终降解为水和二氧化碳,治疗效果满意。以三维重建技术定制钢板固定和微创内固定是目前骨折治疗的重大进展,临床应用前景广阔。%BACKGROUND:Pelvic fractures combined with acetabular fractures are mostly caused by high-energy violence, often accompanied by severe complications and high mortality, and surgical fixation is preferred in most cases. OBJECTIVE:To investigate the internal fixation of pelvic fracture combined with acetabular fracture and to analyze the material biocompatibility. METHODS:A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles related to the internal fixation of pelvic fracture combined with acetabular fracture and material biocompatibility published

  18. One stage total hip arthroplasty for acetabular fractures%Ⅰ期全髋关节置换治疗髋臼骨折

    Institute of Scientific and Technical Information of China (English)

    王子明; 孙红振; 王爱民; 杜全印; 吴思宇; 赵玉峰; 唐颖

    2008-01-01

    目的 探讨髋臼骨折后Ⅰ期全髋关节置换(total hip arthroplasty,THA)的手术适应证和手术方法,观察其临床疗效.方法 对11例髋臼骨折患者行Ⅰ期THA.其中前柱骨折3例,后壁骨折1例,后柱骨折2例,后柱合并后壁骨折2例,横形骨折1例,横形合并后壁骨折1例,两柱骨折1例.伤后8~37 d(平均24 d)接受THA.对新鲜髋臼骨折患者,先用重建钢板或螺钉固定骨折以恢复髋臼肇的形态,将切下的股骨头制成颗粒状或块状植于髋臼内后安置臼杯.陈旧性髋臼骨折有节段性髋臼骨缺损者,将切下的股骨头制成大块状进行髋臼内结构性植骨后再安置臼杯.结果 术后3个月完全负重,无人工关节脱位.随访时间6~45个月,平均28个月.Harris评分平均78分.髋关节屈伸平均活动度为95°.X线片示1例出现髋臼松动及骨溶解征象.结论 髋臼骨折移位明显,关节软骨面损伤严重,错过了手术复位时机,可以Ⅰ期行THA.如能创造稳定的髋臼杯结构,近期临床效果满意.%Objective To explore operative indications,methods and effect of one stage total hip arthroplasty(THA)in treatment of acetabular fractures.Methods One stage total hip arthroplasty (THA)was carried out in 11 patients with acetabular fractures including 10 males and one female(at mean age of 42.4 years)8-37 days(mean24 days)after injury.There were anterior column fractures in three patients,posterior wall fracture in one,posterior column fracture in two,posterior column fracture combined with posterior wall fracture in two,transverse fracture in one,transverse fracture combined with posterior wall fracture in one and two-column fracture in one.Fresh acetabular fractures were first fixed with reconstruction plate or screws to restore shape of acestbular wall;then,granule or bulk of resected femoral head were implanted into acetabulum posterior to placement of acetabular cup prosthesis.While for old acetabular fractures,the resected

  19. Progress in diagnosis and care of fractures of the femoral head%股骨头骨折的诊治进展

    Institute of Scientific and Technical Information of China (English)

    高悠水; 孙玉强; 张长青

    2016-01-01

    dysfunction,the typical signs include flexion,adduction and internal rotation of the hip and shortening of involved limb.CT and MRI get their popularity as diagnostic methods for FFH.An emergency open reduction should be indicated in the scenario of failed closed reduction in FFH with posterior dislocation,of FFH with femoral neck fractures,of unmatched head and acetabulum following closed reduction and of deteriorating sciatic nerve damage.Pipkin as well as Brumback classification is still the most popularly used methods,which have great significance for establishment of surgical strategy and prediction of prognosis.More and more clinical evidences show conservative care of FFH should only be indicated for non-displaced fractures or displacement less than 2 mm.These cases must meet the following criteria simultaneously,including stable hip joint,concentric head and acetabulum,no free fractured fragments in the joint space and no labrum entrapment.Operative care is naturally the treatment of choice.Surgical approaches for FFH are hot topics in recent years.In previous control studies to compare Kocher-Langenbeck (K-L) and Smith-Peterson (S-P) approach,it is revealed less operative time,less blood loss and better operative field you can get in S-P approach,however,the incidence of ectopic ossification is higher.Ganz approach,which is characterized by osteotomy of great trochanter,hip capsulotomy and surgical dislocation of the hip,is a novel pattern for operative care of FFH.Ganz approach can show the entire femoral head,while can not damage medial femoral circumflex artery (MFCA) and induce iatrogenic osteonecrosis of the femoral head (ONFH).Various screws are the main implants for the fixation of fractured femoral head.Osteoarthritis and ONFH are two principal complications following FFH,which not only closely associate with severity and mechanism of primary injury,but also correlate with reduction quality and iatrogenic factors.Artificial hip joint replacement is a rational

  20. Abordagem cirúrgica inédita para denervação acetabular em cães A new surgical approach to acetabular denervation in dogs

    Directory of Open Access Journals (Sweden)

    Cássio R.A. Ferrigno

    2007-02-01

    greater trocanter of the femur, in direction of the ileum body. After dorsal opening of the middle gluteal muscle, the insertion of the deep gluteal muscle is inserted for the access to the mentioned regions. With the help of a curette, the periosteum of the cranial and dorso-lateral acetabular margin was removed until the bone cortex was exposed, in all patients. In all animals, the approach was possible, both in the cranial as well as in the caudal faces for the access and curettage of the acetabulum, with the technique described, with a skin incision of about 3.2cm. The curettage of the cranial portion of the acetabulum was, in all cases, realized without the visualization of the bone, but of easy achievement and without intercurrences of nervous or muscular injuries. In all the approaches, it was possible to visualize the articular capsule of the coxo-femoral joint, and in none of the animals, this structure was incised for a technique mistake. The surgical approach described in the present study is feasible for this kind of surgical procedure in dogs, promoting adequate access, with minimal invasion and with no complications of any nature.

  1. Descripción de una especie de Cotylophoron (Digenea: Paramphistomidae en bovinos del Meta y Guaviare, Colombia

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    Velásquez Trujillo Luz Elena

    2012-08-01

    del Guaviare.

    Palabras clave: Bos indicus, Cotylophoron panamensis, Trematodo, Paramfistomosis.

    SUMMARY

    The family Paramphistomidae (Trematoda: Digenea is compose by several species that parasitize the rumen and cause severe enteritis of clinical with a milk and meat decrease production of ruminants. The paramphistomosis cattle has been recorded in the eastern plains nationals four times over the past two decades. However in these documents has not disclosed the description of the parasites to support the specific taxonomic status assigned. The discovery of digenea in the rumen of cattle slaughtered in the slaughterhouse of Guamal, Meta, in 2006, 2007 and 2008 was an opportunity to describe and identify the species. This removed 715 adult flukes in the rumen of 32 cattle from Meta and Guaviare departments. The digenea were processed individually and according to the morphological characteristics were determined as Cotylophoron panamensis. The adult has the following characteristics: the family Paramphistomidae, Laurers canal crossing excretory vesicle disease opening posteriorly to excretory pore; genus Cotylophoron acetabulum small and genital sucker present; C. panamensis pharynx the Calicophoron type, acetabulum of the Cotylophoron type, absence of

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

    Institute of Scientific and Technical Information of China (English)

    韦宜山; 刘万林; 丁良甲; 王炳海; 白锐; 李岱鹤; 赵振群

    2012-01-01

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

  3. Computer aided technology assesses adult acetabular dysplasia after total hip arthroplasty:biological performance%计算机辅助技术评价成人髋臼发育不良全髋关节置换生物性能分析

    Institute of Scientific and Technical Information of China (English)

    邵正海; 徐卫东

    2016-01-01

    Bone and Joint Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA from January 2015 to August 2015 were selected and analyzed. Al the enrol ed patients underwent total hip arthroplasty. Al the patients were randomly divided into control and computer-aided technology groups. CT scanning was conducted in these two groups before replacement. Three-dimensional reconstruction measuring and surgical rehearsal on the acetabular site were conducted using M3D visualization software in the computer-aided technology group. The effects and biological properties of total hip arthroplasty were compared between these two groups. RESULTS AND CONCLUSION: Patients in these two groups primarily healed after replacement. The excel ent and good rate, Harris score after treatment, acetabular component, valgus angle and anteversion in the computer-aided technology group were significantly higher than those in the control group (P < 0.05). The acetabular cup abduction angle offset degrees, acetabular cup anteversion offset degrees, and the incidences of complications after replacement were significantly decreased compared with those in the control group (P < 0.05). These results suggest that the effect of computer-aided evaluation in adult acetabular dysplasia after total hip arthroplasty is ideal, and can accurately grasp the true acetabular anatomical characteristics and the corresponding relationship with the prosthesis, so as to help patients to choose the proper acetabulum and acetabular prosthesis and reconstruction ways and improve the biological performance of acetabulum after replacement, with a high clinical value.

  4. Anterolateral muscle sparing approach total hip arthroplasty: an anatomic and clinical study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xian-long; SHEN Hao; QIN Xiao-long; WANG Qi

    2008-01-01

    patients. During the operations, anterior border injury in deep layers of the gluteus medius was found in 9 patients. Posteromedial perforation of the prosthesis stem on the femoral side was found in 2 patients, which were revised immediately. No positive Trenderlenburg sign was found during the 12 months of follow-up.Conclusions The incision of the anterolateral muscle sparing approach should be directed from the anterior tubercle of the greater trochanter toward 6 cm posterior to the anterior superior lilac spine. The proximal part of the incision should be within 6 cm from the anterior tubercle of the greater trochanter, and it is safe to be extended distally. The anterolateral muscle sparing approach is a minimally invasive approach for total hip arthroplasty, through which the surgeon can operate on the acetabulum and femoral sides in a single incision without muscle detachment, and fluoroscopy assistance is not needed. The surgeon should pay more attention to protecting the gluteus medius from injury by distraction before femoral neck cutting and during the preparation of the femoral side.

  5. Nonunion of the femoral neck: Possibilities and limitations of the various treatment modalities

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    Raaymakers Ernst

    2008-01-01

    replacement if necessary because of avascular necrosis or osteoarthritis is considerably postponed; and better milieu for hip replacement can be achieved by the development of sclerotic bone in the subchondral areas of the acetabulum and femoral head. Between 65 and 80 years of age, a total hip replacement is probably the best option for fit patients. We treat fresh femoral neck fractures with a hemiarthroplasty in patients over the biological age of 80 years. Logically the same choice will be made for patients with a nonunion. During the period 1973-1995 we performed hemiarthroplasty ( n = 34 in patient with low general condition. Their mean age was 79 years. The average survival in these patients was less than three years and that explains probably the low late complication rate: in this group. Total hip replacement was performed in 37 younger patients with a mean age of 69 years. They were not considered for a valgization osteotomy because of age being over 70 years, severe osteoporosis or a total collapse of the femoral head. In this group, we observed one aseptic cup revision and two extractions of the prosthesis because of a deep infection.

  6. Notable seasonal variation observed in the morphology of the reindeer rumen fluke (Paramphistomum leydeni in Finland

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    Sven Nikander

    2009-01-01

    Full Text Available Although numerous Paramphistomum species have been described from the rumen and reticulum of domestic and wild ruminants, information about rumen flukes in reindeer is sparse and their nomenclature is somewhat conflicting. Rumen fluke of reindeer is usually referred to as P. cervi, but P. leydeni and Cotylophoron skriabini are also mentioned in the literature. Here, the surface structures and internal anatomy of rumen flukes from reindeer, as seen by scanning electron microscopy (SEM and in histological sections under light microscopy, are presented. The aim of the study was to find morphological information to enable identification of rumen flukes in reindeer to species level. In addition, the morphology of rumen flukes collected in winter (winter flukes was compared with that of flukes collected in summer (summer flukes. Key morphological findings were as follows: the acetabulum of the rumen flukes was of paramphistomum type, the pharynx of liorchis type, and the genital atrium of leydeni type. Both winter and summer flukes shared these morphological features. Based on these findings, it was concluded that rumen flukes of reindeer in Finland belonged to the species P. leydeni. Significant morphological variation was observed when winter and summer flukes were compared. The winter fluke was smaller in size, possessed immature gonads (testes, ovary, uterus, and immature accessory genital glands (Mehlis’ gland, vitelline follicles, and had barely discernible tegumental papillae. These data indicate that winter rumen flukes represent an immature stage of P. leydeni and summer flukes the mature stage of the same species. Further, these findings suggest that the rumen flukes of reindeer during wintertime in Finland have a slowed or inhibited lifecycle.Abstract in Finnish / Yhteenveto:Poron pötsimadon (Paramphistomum leydeni morfologiassa esiintyy selvää vuodenaikaisvaihtelua Pötsimatoja (Paramphistomum spp. löytyy monien villien ja kotiel

  7. MR-arthrography of the acetabular labrum - radiologic-pathologic correlation in 20 cadaveric hip joints; MR-Arthrographie des Labrum acetabulare - Radiologisch-anatomische Korrelation an 20 Leichenhueften

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    Brossmann, J.; Steffens, J.C.; Heller, M. [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie; Ploetz, G.M.J.; Hassenpflug, J. [Kiel Univ. (Germany). Klinik fuer Orthopadie

    1999-08-01

    Purpose: To investigate frequency of acetabular labral lesions in elderly hip joints, and to determine sensitivity and specificity of MR arthrography (MRa) for the detection of these abnormalities. Materials and Methods: Twenty cadaveric hip joints were examined by MRa. For MRa, 15 ml of a solution of iodinated contrast solution (Solutrast 300) and Gd-DTPA (100:1) were injected under fluoroscopic guidance. MR imaging was performed on a 1.5 TM scanner (Vision, Siemens; FOV 16 cm, matrix 256x256, fat-suppressed 3D-FLASH). Multiplanar image reconstructions were done perpendicular to the acetabulum in the oblique-coronal, oblique-axial, and radial planes. The labral specimens were examined macroscopically. Results: In 12/20 hips (60%), a labral lesion was found on pathologic examination. In 7 specimens, the labrum was partially or completely detached in the weight-bearing superior region. One flap-like variant of the labrum was seen; in 4 hip joints, the labrum was degenerated (one cystic degeneration). Pathologic findings were confirmed by MRa in 8/12 specimens (sensitivity 67%). All degenerated labra were correctly diagnosed on MRa. Three small labral detachments and the flap-like variant were misinterpreted as being normal. There were no false positive findings (specificity 100%). The accuracy was 80%. Labral lesions were seen in 6/8 and in 6/12 of hips with and without osteoarthritis, respectively. Conclusion: MRa is well suited to delineate the acetabular labrum and to diagnose labral abnormalities. Detection of small labral detachments and anatomic variants is difficult and requires some experience. Labral lesions are correlated to osteoarthritis of the hip, but may be frequently seen in the elderly without underlying osteoarthritis. (orig.) [German] Ziel: Feststellung der Haeufigkeit von Laesionen des Labrum acetabulare bei aelteren Hueftgelenkspraeparaten und Untersuchung der Sensitivitaet und Spezifitaet der MR-Arthrographie (MRa) fuer die Darstellung dieser

  8. Analysis of {sup 18} F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

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    Cremerius, U.; Niethard, F.U. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Mumme, T.; Reinartz, P.; Wirtz, D. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Orthopaedische Klinik; Buell, U.

    2003-12-01

    -Fluordeoxyglukose ({sup 18}F-FDG) zur Erkennung von aseptischer Pfannen- und Schaft- sowie septischer Prothesenlockerung. Methoden: 18 Patienten mit Schmerzen nach Hueftgelenkersatz wurden praeoperativ mit 200-300 MBq {sup 18}F-FDG in einem dedizierten Vollring-PET-Scanner untersucht. Die Grenzflaeche zwischen Prothese und umgebendem Weichteil-/Knochengewebe in koronarer Schichtfuehrung wurde entsprechend den Klassifikationen von Delee und Gruen in 12 Segmente unterteilt. Fuer jedes Segment wurde durch zwei unabhaengige Untersucher ein visueller Uptake-Score (0-3) erhoben. Als Goldstandard dienten intraoperativ erhobene Befunde. Ergebnisse: Intraoperativ fanden sich 14 Pfannen- bzw. 9 Schaftlockerungen und 7 Protheseninfekte. In der PET korrelierte die Pfannenlockerung mit einem erhoehten Uptake im mittleren Acetabulum, die Schaftlockerung mit erhoehtem Uptake entlang des proximalen bis mittleren lateralen Schaftes sowie des proximalen medialen Schaftes, Protheseninfekte mit erhoehtem Uptake entlang des mittleren lateralen Schaftes. 6 der 7 infizierten Prothesen wiesen auch Pfannen- und Schaftlockerungen auf. Nimmt man zusaetzlich zu den genannten Befundmustern eine Speicherintensitaet entsprechend Grad 3 im Schaftbereich als Kriterium fuer einen Infekt, so ergibt sich eine Treffsicherheit der PET in der Detektion von aseptischer Pfannenlockerung, aseptischer Schaftlockerung und septischer Lockerung von 72, 78 und 89%. Schlussfolgerungen: Die Pilotstudie zeigt, dass {sup 18}F-FDG-PET eine vielversprechende Methode in der Diagnostik schmerzhafter Totalendoprothesen des Hueftgelenkes darstellt. Ihre Wertigkeit sollte an groesseren Patientenkollektiven ueberprueft werden. (orig.)

  9. Magnetic resonance imaging and magnetic resonance arthography of the acetabular labrum: Comparison with surgical findings; Magnetresonanztomographie und Magnetresonanzarthrographie des Labrum acetabulare: Vergleich mit operativen Ergebnissen

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    Czerny, C. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Kramer, J. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Institut fuer bildgebende Diagnostik am Schillerpark, Linz (Austria); Neuhold, A. [Krankenhaus Rudolfinerhaus, Vienna (Austria). Inst. fuer bildgebende Diagnostik; Urban, M. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Tschauner, C. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria); Hofmann, S. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)

    2001-08-01

    Aim of the study: To evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrography in detecting acetabular labral lesions in correlation to surgical findings. Patients and methods: Forty patients (40 hips) with chronic hip pain and a strong clinical suspicion of labral lesions were examined with MRI in the coronal and axial plane by obtaining T{sub 1} weighted and proton density-weighted spin echo sequences. Additionally, MR arthrography of the high joint in the coronal oblique and sagittal oblique plane was performed by obtaining T{sub 1}-weighted three-dimensional gradient echo sequences after the intraarticular injection of gadopentate dimeglumine. The labra were prospectively evaluated on the basis of morphology, signal intensity, the presence or absence of a tear, and their attachment to the acetabulum. All patients underwent surgery, and the MRI findings and MR arthrography findings were compared with the surgical results. Results: Surgically, 34 labral lesions, and 6 normal labra were detected. MRI correctly depicted labral lesions in 24 patients and two normal labra, and MR arthrography correctly depicted labral lesions in 30 patients and 5 normal labra compared with the surgical results. The sensitivity of MRI was 80%, the accuracy of MRI was 65%, the sensitivity of MR arthrography was 95%, and the accuracy of MR arthgrography was 88%. Conclusions: MR arthrography enables considerably more accurate detection of acetabular labral lesions than MRI. MR arthrography should be the method of choice for the diagnosis of the presence or absence of acetabular labral lesions in patients with chronic hip pain and a strong clinical suspicion of labral lesions. (orig.) [German] Ziel: Die Bestimmung der Wertigkeit der konventionellen Magnetresonanztomographie (MRT) und der Magnetresonanzarthrographie (MR-Arthrographie) in der Abklaerung von Laesionen des Labrum acetabulare im Vergleich mit Operationsbefunden (Goldstandard). Methode

  10. Estudo do tratamento das fraturas da cabeça do fêmur Study of the treatment of femoral head fractures

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    Rodrigo Pereira Guimarães

    2010-01-01

    , resulting in two excellent and one regular result. Two Pipkin 3 patients had primary arthroplasty. Among Two Pipkin 4 patients, one was treated with open reduction and internal fixation of the acetabulum, without addressing the head fragment that had reduced significantly, resulting in early arthrosis, and the other patient was treated with primary total hip replacement. CONCLUSION: Upon comparing the literature review and our patients' treatment results, we concluded that the femoral head fracture treatment must be surgical and that the choice surgical access depends on the type of fracture.

  11. Radiological diagnosis of femoroacetabular impingement; Radiologische Diagnose des femoroazetabulaeren Impingements

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    Mamisch, T.C. [Inselspital, Abt. Orthopaedische Chirurgie, Bern (Switzerland); Klinik Sonnenhof, Abt. Radiologie, Bern (Switzerland); Werlen, S.; Trattnig, S. [Klinik Sonnenhof, Abt. Radiologie, Bern (Switzerland); Zilkens, C. [Universitaetsklinikum Duesseldorf, Orthopaedische Klinik, Duesseldorf (Germany); Kim, Y.J. [Harvard Medical School, Childrens Hospital, Boston, MA (United States); Siebenrock, K.A.; Bittersohl, B. [Inselspital, Abt. Orthopaedische Chirurgie, Bern (Switzerland)

    2009-05-15

    Femoroacetabular impingements (FAI) are due to an anatomical disproportion between the proximal femur and the acetabulum which causes premature wear of the joint surfaces. An operation is often necessary in order to relieve symptoms such as limited movement and pain as well as to prevent or slow down the degenerative process. The result is dependent on the preoperative status of the joint with poor results for advanced arthritis of the hip joint. This explains the necessity for an accurate diagnosis in order to recognize early stages of damage to the joint. The diagnosis of FAI includes clinical examination, X-ray examination and magnetic resonance imaging (MRI). The standard X-radiological examination for FAI is carried out using two X-ray images, an anterior-posterior view of the pelvis and a lateral view of the proximal femur, such as the cross-table lateral or Lauenstein projections. It is necessary that positioning criteria are adhered to in order to avoid distortion artifacts. MRI permits an examination of the pelvis on three levels and should also include radial planned sequences for improved representation of peripheral structures, such as the labrum and peripheral cartilage. The use of contrast medium for a direct MR arthrogram has proved to be advantageous particularly for representation of labrum damage. The data with respect to cartilage imaging are still unclear. Further developments in technology, such as biochemical-sensitive MRI applications, will be able to improve the diagnosis of the pelvis in the near future. (orig.) [German] Beim femoroazetabulaeren Impingement (FAI) bewirkt ein anatomisches Missverhaeltnis zwischen proximalem Femur und Azetabulum eine fruehzeitige Abnuetzung der Gelenkflaechen. Um Symptome wie eingeschraenkte Beweglichkeit und Schmerzen zu beheben, aber auch um dem degenerativen Prozess vorzubeugen oder ihn zu verlangsamen, ist haeufig eine Operation notwendig. Dabei haengt das Resultat vom praeoperativen Gelenkstatus ab - mit

  12. Achados em ressonância magnética artrográfica de indivíduos com lesão do labrum acetabular Magnetic resonance arthrographic findings in subjects with acetabular labral tears

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    André Luiz Almeida Pizzolatti

    2011-01-01

    Full Text Available OBJETIVO: Descrever os achados em artro RM de sujeitos com suspeita de lesão do labrum acetabular. MÉTODO: Foram analisadas 108 artro RM de quadris em 2007/2008. Dois radiologistas independentemente analisaram as imagens e foi considerada a resposta comum entre eles. Com base em seus pareceres observou-se o local e estadiamento das lesões labrais e condrais, as alterações anatômicas, e a presença de tendinite e bursite trocantérica. RESULTADO: As lesões labrais grau I ocorreram em 41% dos casos, grau II em 31%, e grau III em 29%. O IFA tipo cam foi frequente em 36% dos casos, tipo pincer em 11%, e IFA misto em 13%, nestes casos 57% apresentaram lesão labral grau III, A lesão condral grau I foi observada em 51% acetábulos, as de grau II em 13%, e grau III em 18%. CONCLUSÃO: As alterações morfológicas que provocam IFA do tipo cam foram as mais prevalentes. Em relação ao grau de lesão labral e condral foram predominantes as lesões grau I independente da presença ou do tipo de IFA, exceto em IFAs mistos onde houve predomínio de lesão labral grau III. Não foi observada uma relação entre o grau de lesão labral e condral.OBJECTIVE: To describe the MR arthrographic findings in subjects with suspected acetabular labral tears of the hip. METHOD: 108 hip MRa results were analyzed in 2007-2008. Two radiologists independently interpreted the images, and the consensual answers between them were considered for analysis. Based on their opinions, information was obtained on the location, staging of the chondral and labral lesions, anatomic alterations, and the presence of trochanteric bursitis and tendonitis. RESULTS: 1st degree labral lesions occurred in 41% of cases, 2nd degree in 31%, and 3rd degree in 29%. The cam type FAI was common in 36% of cases, pincer FAI in 11%, and mixed cam-pincer FAI in 13%; in these cases 57% had grade III labral lesions. 1st degree chondral lesions were observed in 51% of acetabulum, 2nd degree in 13

  13. Patagifer lamothei n. sp. (Digenea: Echinostomatidae: Nephrostominae from the white ibis Eudocimus albus (Threskiornithidae from Texas, USA Patagifer lamothei n. sp. (Digenea: Echinostomatidae: Nephrostominae del ibis blanco Eudocimus albus (Threkiornithidae de Texas, EUA

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    Norman O. Dronen

    2008-08-01

    Full Text Available During a study of the endohelminths of wading birds from the Texas Gulf coast, 12 specimens of an undescribed species of Patagifer Dietz, 1909 (Echinostomatidae: Nephrostominae were collected from 2 of 8 white ibis, Eudocimus albus (Linnaeus (Threskiornithidae, from the Galveston and Brazos County areas of Texas, USA. Patagifer lamothei n. sp. can be distinguished from P. bilobus (Rudolphi, 1819, P. brygooi Richard, 1964, P. consimilis Dietz, 1909, and P. fraternus Johnston, 1917, where the testes are close together (contiguous to nearly contiguous, the ovary is close to the anterior testis (a distance that is less than the length of the ovary, and the posttesticular space is less extensive, by having the testes separated from each other by a distance approximately equal to or greater than the length of the ovary, the ovary positioned about the length or longer of the ovary from the anterior testis, and by having a more extensive posttesticular space. In addition, the ovary of the new species is located just ahead of midbody rather than being at midbody, as is seen in P. bilobus, P. fraternus, and P. vioscai Lumsden, 1962, or below midbody, as is the case in P. brygooi and P. consimilis. The new species is most like P. simarai Nigam, 1944 in the similar distance between testes, position of the ovary, and the posttesticular space (30-36% of the body length. The new species differs from P. simarai by having a smaller body size, a smaller oral sucker and pharynx, a smaller acetabulum, ovary, testes, cirrus sac, and smaller spines on the margin of the collar, but larger corner spines, and the ovary of the new species is located immediately anterior to the midbody, while in P. simarai it is located well ahead of the midbody.En un estudio de endohelmintos de aves de los humedales de la costa de Texas, se recolectaron 12 ejemplares de una especie no descrita de Patagifer Dietz, 1909 (Echinostomatidae: Nephrostominae en 2 ibis blancos de 8 examinados

  14. Self-made pygal cloth sting for the treatment of congenital dislocation of hip in infants%自制臀兜治疗婴儿先天性髋关节脱位

    Institute of Scientific and Technical Information of China (English)

    王国勤; 杨荣建; 康秀宣; 温应辉; 袁和森

    2011-01-01

    Objective: To investigate the early clinical detection and new method for the treatment of congenital dislocation of hip in infants. Methods: From 2006 to 2010,95 infants with congenital dislocation of hip were treated with self-made pygal cloth sling,including 25 males and 70 females,with an average age of 3.2 months old ranging from 0 to 6 months. Some patients were detected incidentally for the symptoms like asymmetric muscle strength or lower limbs range of motion,and all the patients got diagnosed with dislocation. Results: After the treatment, all of the patients received outpatient view once a month and taken X-ray examination bimonthly. Pygal cloth sling was removed after 2 months. According to the assessment criteria made by LIU Yuan-zhong,90 patients got an excellent result,2 good,2 fair and 1 poor. Conclusion;Treatment of congenital dislocation of hip in infants with self-made pygal cloth sling promotes the development of acetabulum and femoral head,and worthy further clinical applications.%目的:探讨要儿先天性髋关节脱位的早期发现和新的治疗方案,了解先天性髋关节脱位早期的临床表现,早期诊断.方法:2006年至2010年应用自制臀兜治疗婴儿先天性髋关节脱位95例,男25例,女70例;年龄0~6个月,平均3.2个月.有因换尿布时发现臀部或双下肤臀纹不对称或双下肢肌力活动度不同,来院检查,进一步拍X线片证实为充天性髌关节脱位,并及时给予自制臀兜治疗.结果:患儿及时佩戴自制臀兜治疗,固定期间每月门诊复查1次,每2个月拍片1次至患儿月龄加2个月解除固定.根据刘远忠等疗效评定标准,本组优90例,良2例,可2例,差1例.结论:臀兜穿裁舒适,固定可靠,双下肢能在一定的范围内活动,符合中医正骨动静结合原则,使头臼产生一定的生理刺激,促进髋臼及股骨头的发育.

  15. Ultrasonic and radiographic study of laxity in hip joints of young dogs Estudo ultra-sonográfico e radiográfico da frouxidão articular em cães jovens

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    B.D. Rocha

    2007-02-01

    Full Text Available In the present study, 22 hip joints of Whippet (four, Rottweiler (five and Labrador Retriever (two young dogs were evaluated with the aim of comparing the ultrasonic examination of coxofemoral joints with the radiographic evaluations, both distraction and conventional procedures, for the early diagnosis of passive laxity. The study was based on static ultrasonography, conventional radiography (CR and distraction radiography (DR methods. In order to quantify the relationship between the femur head and the acetabulum, the alpha (alpha and gamma (gamma angles were measured by ultrasonographic examination, the Norberg angle (NA was measured by CR, and the distraction index (DI was measured by DR. It was observed a negative correlation between angles alpha and gamma (r= -0,756; PAvaliaram-se 22 articulações coxofemorais de cães das raças Whippet (quatro cães, Rottweiler (cinco cães e Labrador Retriever (dois cães, com o objetivo de comparar o exame ultra-sonográfico da articulação coxofemoral de cães jovens com as avaliações radiográficas em distração e convencional, para a determinação precoce da frouxidão articular passiva. Utilizaram-se os métodos ultra-sonográfico estático, radiográfico convencional (MRC e radiográfico em distração (MRD. Para quantificar a relação entre a cabeça do fêmur e o acetábulo, foram medidos os ângulos alfa (alfa e gama (gama no exame ultra-sonográfico, o ângulo de Norberg (AN no MRC e o índice de distração (ID no MRD. Observou-se correlação negativa entre os ângulos alfa e gama (r= -0,756; P<0,001 e entre ID e AN (r= -0,474; P<0,026. Não se observou correlação entre os ângulos alfa e gama em relação ao ID e o AN (alfa e ID: r= -0,380; P<0,081; alfa e NA: r= 0,013; P<0,954; gama e ID: r= 0, 338; P<0,124; ângulo gama e AN: r= -0,192; P<0,391. O método ultra-sonográfico estático não se mostrou sensível para a detecção precoce da frouxidão passiva da articula

  16. Response of a Finite Element Model of the Pelvis to Different Side Impact Loads%骨盆有限元模型在承受侧面不同冲击力时的响应

    Institute of Scientific and Technical Information of China (English)

    阮世捷; 郑会景; 李海岩; 赵玮

    2013-01-01

    在汽车侧面碰撞中,骨盆是人体最容易受损伤的部位之一.研究侧面碰撞中骨盆的损伤机理,可以了解骨盆损伤的生物行为,从而用来设计汽车被动安全装置,提高乘员的安全性.本研究是用单独骨盆的有限元模型研究在不同侧面冲击条件下骨盆的动态反应.分别对有限元模型右侧髋臼关节表面施加1000、2000、3000、4000和5000 N的侧面冲击力,建立它的损伤阈值.结果表明:侧面冲击力越小,峰值应力和该方向的最大位移也越小.当侧面冲击力减小到大约3000 N时,峰值应力将不会超过皮质骨的平均屈服强度,从而得到失效阈值大约为3000N.因此合理的设计车门和臀部垫子,使车门对骨盆侧面冲击力降到大约3000 N,骨盆将不会损伤.%The pelvis is one of the most likely affected areas of the human body in case of side impact,especially while people suffer from motor vehicle crashes.With the investigation of pelvis injury on side impact,the injury biomechanical behavior of pelvis can be found,and the data can help design the vehicle security devices to keep the safety of the occupants.In this study,a finite element (FE) model of an isolated human pelvis was used to study the pelvic dynamic response under different side impact conditions.Fracture threshold was established by applying lateral loads of 1000,2000,3000,4000 and 5000 N,respectively,to the articular surface of the right acetabulum.It was observed that the smaller the lateral loads were,the smaller the von Mises stress and the displacement in the direction of impact were.It was also found that the failure threshold load was near 3 000 N,based on the fact that the peak stress would not exceed the average compressive strength of the cortical bone.It could well be concluded that with better design of car-door and hip-pad so that the side impact force was brought down to 3 000 N or lower,the pelvis would not be injured.

  17. Utilization of virtual reality technology in acetabular surgery%虚拟现实技术在髋臼手术中的应用

    Institute of Scientific and Technical Information of China (English)

    王玫; 张月东; 张兰华

    2011-01-01

    BACKGROUND: At present, abroad has carried out some research and practice on the medical virtual reality technology,especially in a virtual medical simulation training and other aspects of surgery, but it does not fully meet the needs of clinical orthopedic surgery. The acetabular fractures are difficult to treat because of its com plexity. Clinicians select appropriate treatment options and surgical approaches according to imaging studies, which are difficult to accurately determine the spatial three-dimensional relationship.OBJECTIVE: To review the application of virtual reality technology in acetabular surgery.METHODS: CNKI, PubMed, Wanfang and VIP databases were searched for papers addressing application of virtual reality in acetabular surgery using key words of "finite element model, acetabular fracture, and virtual surgery" both in English and Chinese.The repetitive studies or papers with blur parameter were removed.RESULTS AND CONCLUSION: Totally 115 documents were initial searched by computer, and 32 papers were included in this review. Acetabular virtual surgery system can analyze the complex of acetabulum and simulate the actual situation, thus, provides a 3-dimensional virtual procedure for clinical operations. A virtual platform can provide guidance for making preoperative plan,which has good prospect in medical surgery teaching and simulation training.%背景:目前国外已经对医学虚拟现实,尤其是在虚拟医学手术仿真训练等方面都进行了一定的研究和实践,但并不能完全适应骨科手术的临床需要.而髋臼骨折因其复杂性治疗困难,临床医师选择适当治疗方案和手术入路的主要依据来源于影像学检查,常难以准确判断空间立体关系.目的:综合分析虚拟现实技术在髋臼手术中的应用情况.方法:作者于2010-10通过互联网计算机检索了中国期刊全文数据库(CNKI)、PubMed数据库、万方数据库及维普数据库1980-01/2010-10以中文或英文

  18. Long-term effect of total hip arthroplasty on ankylosing spondylitis complicated with ankylosing hip%全髋关节置换术治疗强直性脊柱炎髋关节强直84例的长期效果观察

    Institute of Scientific and Technical Information of China (English)

    于鸿; 王秀利; 张弛; 王义生

    2016-01-01

    Objective To investigate the long-term effect of total hip arthroplasty on ankylosing spondylitis compli-cated with ankylosing hip. Methods From June 1992 to June 2006,84 cases(146 hips)of ankylosing spondylitis com-plicated with ankylosing hip were treated by total hip arthroplasty. Preoperative and postoperative outcomes with hip pain in-dex(0 - 10),Harris score,the improvement of hip joint activity and complications were observed to evaluate the curative effect. Results The mean follow-up was 12. 5 years(9 - 20 years). To the final follow-up,hip pain index,Harris score and hip joint activity were obviously improved,there were significant differences(P < 0. 05)between preoperative and final follow-up;the incidence of postoperative complications was 6. 2% ,among which 6 hips(4. 1% )with aseptic loosening and sinking,2 hips(1. 4% )with acetabulum loosening and shift,and heterotopic ossification in 1 case(0. 7% ),no nerve and vascular injury,prosthesis dislocation,or infection. Conclusions Total hip arthroplasty is an effective method for the treatment of ankylosing spondylitis complicated with ankylosing hip,with satisfying long-term effect.%目的:探讨全髋关节置换术治疗强直性脊柱炎髋关节强直的长期效果。方法1992年6月至2006年6月采用全髋关节置换术治疗强直性脊柱炎髋关节强直84例(146髋),术后对患者进行随访,观察手术前后髋关节疼痛指数、髋关节 Harris 评分、髋关节活动度的改善情况及术后并发症,评估疗效。结果术后平均随访12.5年(9~20年),至末次随访:患者髋关节疼痛指数、髋关节 Harris 评分、髋关节活动度均得到明显改善,术前与末次随访之间比较差异有统计学意义(P <0.05);术后并发症发生率为6.2%,其中股骨柄无菌性松动下沉者6髋(4.1%),髋臼松动移位2髋(1.4%),异位骨化1例(0.7%),未发现神经血管损伤、假体脱位、感染等并发

  19. Denervação capsular percutânea no tratamento da displasia coxofemoral canina Percutaneous hip denervation for the treatment of canine hip dysplasia

    Directory of Open Access Journals (Sweden)

    André Luis Selmi

    2009-04-01

    (MG and maximum degree of passive extension (PME and flexion (PMF of the hip were determined pre-operatively and at days 7, 15, 30, 180 and 360 post-operatively. Dogs were anesthetized and 4.5mm Steinman pin was used to percutaneously scrap the craniodorsal border of the acetabulum. LAM and PN were analyzed by means of ANOVA followed by a Friedman test, whereas MG, PME and PMF were analyzed by means of ANOVA followed by a Tukey test. There was a significant decrease in LAM and PN 15 days following surgery. PME presented a significant increase after 30 days of surgery. It is concluded that the percutaneous hip denervation is an effective method in restoring function in the dysplastic hip.

  20. Bernese periacetabular osteotomy for the treatment of severe hip dysplasia%伯尔尼髋臼周围截骨术对严重髋臼发育不良的治疗

    Institute of Scientific and Technical Information of China (English)

    黄野; 张洪; 刘庆; 蒋增辉; 窦勇

    2010-01-01

    Objective To analyze the mid-term clinical and radiographic results obtained with the Bernese periacetabular osteotomy for the treatment of severe hip dysplasia. Methods From October 1997 to December 2002 20 hips of 18 patients were classified as having severe acetabular dysplasia (Severin classification Grade Ⅳb). Preoperatively, all patients had hip pain, and sufficient hip joint congruency on functional radiographs. All 20 hips underwent Bernese periacetabular osteotomy. Postoperatively, the hips were assessed radiographically on center edge angle (CE), acetabular roof obliquity and the progression of osteoarthritis. Clinical results and hip function were measured with the Harris hip score at an average of 6.2 years follow-up. Results Comparison of preoperative and follow-up radiographs demonstrated significant improvements in the lateral CE angle, the anterior CE angle, and roof obliquity. The average Harris hip score improved from 78.5 points preoperatively to 91.1 points at the time of the latest follow-up. Fourteen of 18 patients were satisfied with the result of the surgery, and 16 of 20 hips had a good or excellent clinical result. Undercorrection occurred in 5 hips. Conclusions The Bernese periacetabular osteotomy is an effective procedure for surgical correction of the severe dysplastic hip. This osteotomy can predictably obtain major reorientation of the acetabulum in all planes. The clinical results in the mid-term follow-up are encouraging.%目的 研究和分析使用伯尔尼髋臼周围截骨术治疗严重髋臼发育不良的中期临床和影像学结果.方法 1997年10月至2002年12月对18例(20髋)严重髋臼发育不良(Severin分级Ⅳb级)的患者接受了伯尔尼髋臼周围截骨术.患者手术时平均年龄21岁,平均随访时间6.2年.本组患者术前患髋均已出现疼痛,术前功能位片显示关节面吻合.术后影像学评价畸形的矫正范围,截骨处的愈合情况及关节炎的进展.临床结果和髋关

  1. 计算机辅助截骨模板在Steel三相截骨治疗儿童先天性髋关节脱位中的应用%Application of computer-aided osteotomy template design in treatment of developmental dysplasia of the hip with steel osteotomy

    Institute of Scientific and Technical Information of China (English)

    佟矿; 张元智; 张晟; 余斌

    2013-01-01

    Objective To provide an accurate method for osteotomy in the treatment of developmental dysplasia of the hip with steel osteotomy by three-dimensional reconstruction and Reverse Engineering technique.Methods Between January 2011 and December 2012,13 children with developmental dysplasia of the hip underwent steel osteotomy.3D CT scan pelvic images were obtained and transferred via a DICOM network into a computer workstation to construct 3D models of the hip using Materialise Mimics 14.1 software in STL format.These models were imported into Imageware 12.0 software for steel osteotomy simulation until a stable hip was attained in the anatomical position for dislocation or subluxation of the hip in older children.The osteotomy navigational templates were designed according to the anatomical features after a stable hip was reconstructed.These navigational templates were manufactured using a rapid prototyping technique.Results The reconstruction hips in these children show good matching property and acetabulum cover.Conclusion The computer-aided design of osteotomy template provides personalized and accurate solutions in the treatment of developmental dysplasia of the hip with steel osteotomy in older children.%目的 利用计算机辅助设计为儿童先天性髋关节脱位采用Steel三相截骨矫正手术方案的制定和实施提供一种相对精确的截骨方案.方法 选择13例拟行Steel三相截骨手术治疗的单侧先天性髋关节脱位患儿,术前对患者骨盆行连续螺旋CT连续断层扫描,将原始Dicom格式数据导入Materialise Mimics 14.1软件,三维重建髋关节,以.stl格式保存,导入Imageware 12.0软件,通过镜像重建患髋矫形后位置,模拟Steel三相截骨,建立截骨模板,通过快速成型技术生成模板实体,指导手术.结果 通过术后X线片和术后1年随访,髋臼指数平均为19.1°±3.2°,头臼包容关系明显改善.X线评定优良率为92.31%.结论 计算机辅助截骨模板可以为

  2. 全髋关节置换术治疗27例髋关节发育不良合并骨性关节炎%Total Hip Arthroplasty for 27 Cases with Hip Dysplasia and Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    罗育润

    2014-01-01

    Objective To explore the clinical effect of total hip arthroplasty on 27 cases with hip dysplasia and osteoarthritis. Methods 27 patients (33 hips) with hip dysplasia and osteoarthritis admitted in our hospital including 9 patients with Crowe type IV (12 hips), 12 patients with Crowe type Ⅲ (15 hips), 6 patients with Crowe typeⅡ(6 hips), were given total hip arthroplasty. The surgery time, hip function and corrective recovery were counted and analyzed; all the patients were followed for 3 years. Results All the operations of the patients were conducted successfully. The operation time was 65~120min; the bilateral difference in leg length was 0.5~3cm after the operation; X-ray showed that artificial acetabulums were located in the true hip socket, no prosthesis loosening;the result of the last visit showed that Harris hip score was significantly higher than the preoperative score (preoperative score was 45.15 ± 8.81; the score at 36-month visit was 87.88 ± 6.33); the range of motion was improved to some extent and the patients were satisfied with the treatment effect. Conclusion Total hip arthroplasty is an effective way for treating hip dysplasia complicated by osteoarthritis, which can correct the joint deformities, improve the joint function, and is worthy of popularization and application.%目的:探讨全髋关节置换术对髋关节发育不良合并骨性关节炎的临床疗效。方法对该院27例(33髋)髋关节发育不良合并骨性关节炎的患者施行全髋关节置换术,其中Crowe IV型患者9例(12髋),Crowe Ⅲ型患者12例(15髋),CroweⅡ型患者6例(6髋),对手术时间、髋关节功能、矫正恢复情况进行统计分析,所有患者随访3年。结果患者全部顺利完成手术,手术时间在65~120 min,术后双侧下肢长度差在0.5~3 cm,X片示人工髋臼均位于真髋关节窝内,假体无松动移位,末次回访髋关节Harris评分明显高于术前评分[分别为术前评分(45.15±8.81);36

  3. Total hip arthroplasty for the treatment of the developmental dysplasia of the hip in adults%全髋关节置换术治疗成人发育性髋关节脱位

    Institute of Scientific and Technical Information of China (English)

    曹力; 阿斯卡尔; 张晓岗; 李国庆; 彭理斌

    2008-01-01

    目的 回顾性分析成人发育性髋关节脱位 (DDH) 患者的全髋关节置换手术 (THA) 方法及手术疗效.方法 对1999年5月至2007年5月接受THA的174例 (229髋) DDH患者进行随访.其中女128例,男46例,平均年龄32.6岁.分型采用Hartofilakidis分型:其中Ⅰ型(发育不良) 92例(123髋);Ⅱ型(低位脱位) 33例(49髋);Ⅲ型(高位脱位) 49例(57髋).Harris评分术前平均41.2分.手术入路采用后外侧入路,臼杯置于或接近于真臼水平.结果 平均随访47个月,术后Harris评分平均为87.5分,术后并发症为8例神经损伤,其中坐骨神经2例,股神经6例,术后1年随访均完全恢复.结论 成人DDH的THA难度较大,但对此类患者来说是一种较为理想的治疗方法,从很大程度上提高了患者的生活质量.%Objective To evaluate the operative technique and clinical outcome of total hip arthroplasty (THA) for the treatment of developmental dysplasia of the hip (DDH) in adults.Methods hundred and twenty-nine patients (229 hips) with DDH who received THA between 1999 and 2007 were followed up.In this group, 128 cases were female and 46 cases were male.The average age was 32.6 years (range from 17 to 57 years).According to the classification of Hartofilakidis′, 92 cases (123 hips) were type Ⅰ;33 cases (49 hips) were type Ⅱ and 49 cases (57 hips) were type Ⅲ.The average Harris hip score was 41.2 points before operation.All of patients were exposed through the posterolateral approach.The threaded cups were put in or near the level of the true acetabulum in all of cases.Full coating stems were used in femoral side.Results The average duration of follow-up was 47 months, the average Harris hip score was 87.5 points after operation.Eight patients who had postoperative nerve palsy (femoral nerve palsy happened in 6 cases and sciatic nerve palsy happened in 2 cases) were completely recovered 12 months after the operation.Conclusions THA is an optimal choice for the treatment of

  4. 强直性脊柱炎64例髋关节病变X线与MRI特点分析%Analysis of X-ray and MRI characteristic of hip-joint lesion in 64 patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    倪春五; 李志军

    2014-01-01

    目的 探讨强直性脊柱炎(AS)髋关节损害的x线与MRI表现特点,为AS的诊断、病情活动性判断、治疗反应、预后与鉴别诊断提供借鉴.方法 分析64例AS髋关节病变的X线片与MRI表现特点.结果 X线片示有髋关节囊变42例,髋关节骨质增生47例,髋关节间隙狭窄13例,髋关节骨质疏松11例.MRI发现:有滑膜炎症改变64例,软骨下骨髓水肿48例,关节软骨破坏、关节面下囊状骨改变42例,肌腱、韧带附着点炎24例,关节间隙改变13例.结论 AS髋关节病变X线片下通常只有髋关节囊性变、骨质增生及关节间隙狭窄等表现,通过MRI检查可以发现大多数AS患者有滑膜炎、软骨下骨髓水肿及关节软骨破坏、关节节面下囊状骨改变,提示病变活动;AS患者疑有髋关节病变者做MIR检查有利于病情活动性判断与治疗方案选择.%Objective To explore the X-ray and MRI manifestations of hip joint lesion in ankylosing spondylitis patients and give useful reference for diagnosis,assess of disease activity and therapeutic response and prognosis.Methods The X-ray manifestation and MRI manifestation of 64 cases of patients with ankylosing spondylitis were analyzed.Results In X-ray analyzed acetabulum joint changes 42,hip joint hyperostosis 47,hip joint interval narrow 13,hip joint osteoporosis 11,MRI analyzed synovial inflammatory change 64,subcartilaginous bone marrow edema 48,joint cartilage lesion and joint surface saccular change 42,tendon and ligament of enthesopathy 24,joint space change 13.Conclusion In patients with ankylosing spondylitis,X-ray manifestation of hip-joint lesion commonly included leacetabulum joint changes,hip joint hyperostosis and hip joint space narrowing while MRI manifestation included inflammation of synovium,edema of subcartilaginous bone marrow,and tendon of enthesopathy which suggested high disease activity.To suspicious hip-joint lesion in patients with ankylosing spondylitis

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

    Institute of Scientific and Technical Information of China (English)

    韦宜山; 刘万林; 丁良甲; 王炳海; 白锐; 李岱鹤; 赵振群

    2012-01-01

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

  6. 新型钩钢板在单足站立位下的生物力学研究%Biomechanical Study of New Type of Hook Plate in Single Foot Standing Posture

    Institute of Scientific and Technical Information of China (English)

    顾霄鹏; 陆欢; 张遂辉; 顾岳全; 董谢平

    2015-01-01

    目的:设计并研制针对髋臼方区骨折的钩钢板,与重建钢板对比进行单足站立位的生物力学实验。方法取成年防腐尸体5具。将同一骨盆的左右侧按随机数字表法分为实验组和对照组(每组5例),以期消除不同髋臼样本之间的外在影响因素。对标本造成相同的髋臼“T”型骨折,分别在同一标本两侧的髋臼四方区处给予髋臼方区钩钢板内固定(实验组)与重建钢板(3.5 mm)+后柱螺钉内固定(对照组),进行生物力学实验,比较两类钢板在相同类型骨折固定中的生物力学稳定性。结果在200、400、500 N 载荷下实验组骨折端的最大位移与对照组比较差异均无统计学意义(均 P >0.05)。结论髋臼方区钩钢板能满足髋臼方区骨折内固定的稳定性要求,其力学性能安全、优越、可靠。与普通的前柱重建钢板+后柱拉力螺钉结构相比,其坚固及稳定性无明显差异。%Objective To design and develop a hook plate for acetabular fractures,and to evalu-ate its biomechanical stability in single foot standing posture through comparison with reconstruc-tion plate.Methods The left and right sides of the pelvises of 5 adult corpses were randomly di-vided into experimental group(n=5)and control group(n=5)in order to eliminate the external factors among different samples of the acetabulum.The same acetabular T-type fractures were made in all samples.The hook plate internal fixation was performed in experimental group,and reconstruction plate(3.5 mm)plus posterior column screw internal fixation in control group.Bio-mechanical experiments were carried out in both groups to compare the biomechanical stability of the two types of steel plate.Results There were no significant differences in the maximum dis-placement of fractures under 200,400 and 500 N loads between the two groups(P >0.05).Con-clusion The acetabular hook plate can meet the requirement for

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

    Institute of Scientific and Technical Information of China (English)

    罗毅; 丁晓川; 侯伟光; 刘煊文; 张强

    2015-01-01

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

  8. 髂腹股沟入路手术相关急性医源性下肢深静脉血栓形成的临床诊治11例%Treatment of ilioinguinal approach surgery associated acute iatrogenic deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    孔凡国; 韩松辉; 李跃京; 刘锋卫

    2015-01-01

    目的 探讨髂腹股沟入路相关急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的病因、临床特点及诊疗经验.方法 回顾性分析河南省洛阳正骨医院2008年1月至2013年12月诊治的11例髂腹股沟手术入路相关急性医源性下肢DVT患者的临床特点及治疗措施.结果 11例复杂髋臼骨折病例,行髂腹股沟(ilioninguinal)入路手术7例,联合Kocher-Langenbeck入路4例,术后3d内并发患肢DVT,均经数字减影血管造影(digital subtraction angiography,DSA)证实了DVT与髂腹股沟入路手术关系密切,11例均在髂腹股沟段出现静脉狭窄,狭窄段远侧血栓形成9例,上下侧均有血栓形成2例,1例合并髂静脉广泛闭塞,1例合并股静脉广泛闭塞,均放置可回收型下腔静脉滤器,同期行经导管推注尿激酶接触溶栓治疗,溶栓治疗5~12d,平均(8.0±2.3)d,血栓完全溶解8例,少量残留3例,闭塞髂股静脉完全开通,随访6~18个月,平均(10±4)个月,无DVT复发及PTS发生.结论 髂腹股沟入路手术可对术区髂股静脉造成严重影响,是导致急性下肢深静脉血栓形成的重要原因,下腔静脉滤器保护下接触溶栓疗效确切.%Objective To evaluate the treatment of ilioinguinal approach surgery associated acute iatrogenic deep venous thrombosis (DVT).Methods The clinical data and treatment of 11 patients with ilioinguinal approach surgery associated acute iatrogenic DVT were analyzed.Results These 11 patients initially suffered from complicated acetabulum fracture,7 cases were treated by single ilioinguinal approach surgery and the other 4 cases were combined with Kocher-Langenbeck approach.In 3 days after surgery,DVTs were found by Doppler sonography,and all the DVTs were proved having closed relationships with ilioinguinal approach through digital subtraction angiography(DSA):iliac-femoral veins appeared stenosis at ilioinguinal segment in all the 11 cases,DVTs were found distal to the stenosis in 9

  9. 超高分子量聚乙烯/Al2O3人工关节副磨合期磨损颗粒的形态特征%Morphological characteristics of prosthetic wear particles generated in Al2O3-ultrahigh molecular weight polyethylene during running-in period

    Institute of Scientific and Technical Information of China (English)

    黄传辉; 杨根喜

    2008-01-01

    BACKGROUND: Wear particles factually serve as a medium carrying extensive information on the wear process involved in hip implants. Moreover, it has been demonstrated that wear particles contribute to the failure of Charnley total hip replacement.OBJECTIVE: To investigate the morphological characteristics of wear particles generated by couples of ultrahigh molecular weight polyethylene (UHMWPE) cups and Al2O3 femoral heads, mounted in a simulator in the presence of distilled water and explore the wear mechanism of UHMWPE cup.DESIGN: Wear tests were performed on a ball-in-socket hip simulator.SETTING: Department of Mechanical Engineering, Xuzhou Institute of Technology.MATERIALS: The molecular weight of UHMWPE selected as cup was 3 000 000. Its density was 0.935 g/cm3, hardness 30 HB, fracture strength 35 MPa, and water absorption 450 MPa, and tenacity 7 MPaM1/2.METHODS: The experiment was performed in the laboratory of tribology, China University of Mining and Technology from December 2003 to July 2005. Hip simulator was used to assess the tribological performance of Al2O3-UHMWPE at room temperature, 100 r/min, 784 N load for 1.5×106 cycles. Distilled water was used as the lubricant. Wear of UHMWPE acetabulum was measured every 3×105 cycles by taking out the acetabulum from simulator, cleaning in distilled water for 3 minutes in an ultrasonic bath, putting in an oven for 40 minutes at 80 ℃, and cooling off in a desiccator. A BT211D electronic balance (reciprocal sensibility, 0.01 mg) was used to measure the weight loss of UHMWPE acetabula according to the reference sample method to calculate the wear. A sample (20 mL) of distilled water lubricant used in test was obtained when the simulator was stopped for gravimetric analysis. Morphology of wear particles in samples and surface of worn UHMWPE acetabula were observed by using scanning electron microscope (SEM). The components of wear particles were determined by X-ray. Detailed measurements of the wear

  10. Internal fixation of the unstable pelvic fracture based on the anatomic features of the pelvis%骨盆的形态特点与不稳定型骨折内固定治疗评价

    Institute of Scientific and Technical Information of China (English)

    翁阳华; 吴显奎; 彭扬国; 欧耀芬

    2011-01-01

    under X-ray guide for 11 among 17 cases of sacral bone fracture or dislocation of sacroiliac joint, while, 4 cases treated with transiliac gudgeon fixation, 2 cases with tensile plates fixation between bilateral posterior iliac spine through posterior approach. For 9 cases of sacroiliac joint fracture and dislocation, 6 fixed with transdermal screw, and 3 with the plate. 8 cases combined with acetabulum fracture were fixed with the plate. Results According to the index of Matta score, which analyzed the greatest distance of the pelvic fracture displacement under X-ray evaluation, 56 cases (86.1%) were excellent, with the shorter displaced distance of the less of 4mm, 5 cases(7.7%) were fine, with the displaced distance of 4~10mm, 4 cases (6.2%) were better, with the displaced distance of 10~20mm, and no case was bad, with the greater displacement distance of 20 mm. Conclusions It is important to select reasonable internal fixation proposal for treating the unstable pelvic fracture, according to the different fracture types and anatomic features of pelvis.

  11. Combined approach to treatment of Tile type B and C old pelvis fracture%联合入路治疗陈旧性Tile B型和C型骨盆骨折的疗效

    Institute of Scientific and Technical Information of China (English)

    朱福良; 贾健; 郑道明; 张银光; 刘兆杰; 时宇博; 王云国; 李立军

    2016-01-01

    Objective To investigate the operative methods in treatment of Tile type B and C old pelvis fracture.Methods The study enrolled 19 cases (13 males and 6 females) with a mean age of 53.4 years (range,25-66 years) treated from July 2009 to July 2014.Injury resulted from traffic accidents in 14 cases,high falls in 3 cases and hit by heavy objects in 2 cases.Time from injury to operation was 1.5-10.3 months.According to the Tile classification,the type of fracture was 5 B2,5 B3,3 C1,4 C2 and 2 C3.Four cases of type B and two cases of type C were combined with acetabulum fracture.Type B fracture deformity was operated through the anterior letournel approach,during which the malunion had osteotomy and reconstruction plate fixation.When posterior wall or column acetabular fracture existed,additional posterior Kocher-Langenbeck incision was used to achieve fracture reduction and stabilization through bilateral fenestration in the floating position.Type C fracture undergone osteotomy through anterior letournel approach and posterior sacral osteotomy or ilio-lumbar fixation following sacroiliac osteotomy.With regard to the combined posterior wall or column acetabular fracture in type C fracture,the surgical method was the same as type B.Radiological and functional results were respectively evaluated using the Mears-Velyvis system and Majeed criteria.Results Mean duration of follow-up was 11.4 months (range,3-24 months).All fracture united in the one-stage,with mean union time of 5.2 months (range,3-7 months).According to the Mears and Velyvis system,10 cases obtained anatomical reduction,6 were satisfied,and 3 were unsatisfied.According to the Majeed criteria,the results were excellent in 6 cases,good in 10 and fair in 3.After operation,2 cases sustained poor control of urination caused by sacral nerve injury;l case still had hip pain caused by old acetabular fracture,but the symptom could be controlled by non-steroidal anti-inflammatory drugs;2 cases had sacroiliac joint

  12. 经皮微创锁定加压板固定治疗骨盆后环骨折%Percutaneous locking compression plate in the treatment of posterior pelvic ring fracture

    Institute of Scientific and Technical Information of China (English)

    王洪; 刘璠; 张亚峰; 刘雅克

    2011-01-01

    Objective To study the surgical indications of using locking compression plate (LCP) to fix the posterior pelvic ring fracture,and to explore its surgical techniques.Methods From September 2005 to February 2010,30 patients with posterior pelvic ring fracture were treated with LCP.Among them 21 were males,9 were females,with the average age of 38.7 years (ranged from 21 to 68 years).The injuries were caused by traffic accident in 14 cases,fall-down from high place in 10 cases,smash of heavy object in 6cases.According to Tile classification,4 patients were type B2,8 patients were type B3,12 patients were type C1,5 patients were type C2,and 1 patient was type C3.Concurrent injures including:3 cases with lung contusion; 3 cases with abdominal parenchymatous organs rupture,2 cases with intestinal rupture,5 cases with urethral injury,5 cases with traumatic brain injury,and 8 cases with fractures of limbs,spine and acetabulum.Results All the incisions of 30 patients were healed by first intention.No skin necrosis,fat liquefaction and infection.Thirty cases were followed up from 13 to 40 months,with the average time of 25.1months.According to Majeed functional score system,20 cases were excellent,7 cases were good and 3 cases were acceptable,the excellent and good rate was 90%.Twelve cases got bone healing 3 months after operation,10 cases got bone healing 4 months after operation,and 8 cases got bone healing 6 months after operation.All the cases had no reduction loss,no limb length discrepancy,no deep venous thrombosis,and had not accelerated the previous nerve symptom.Conclusion Using LCP to fix posterior pelvic ring fracture has many advantages,including wide indication,strong strength of fixation,well biomechanical properties,easy-to-use,and very go