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Sample records for anterior hip dislocation

  1. Traumatic Anterior Dislocation of Hip in a Child- Case Report

    Directory of Open Access Journals (Sweden)

    S Ahmad

    2015-03-01

    Full Text Available Traumatic hip dislocation in children is relatively rare accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type but the much rarer anterior and anterior-inferior (obturator types have also been described. We present the case of an eight years old girl with an obturator type of hip dislocation following trivial trauma. She was treated with closed reduction and immobilisation in skin traction for three weeks. She was followed up closely for one year and did not develop any complications during that period.

  2. Traumatic anterior hip dislocation in a 12-year-old child

    Institute of Scientific and Technical Information of China (English)

    Vinay Gupta; Maneet Kaur; Zile Singh Kundu; Aseem Kaplia; Deepinderjit Singh

    2013-01-01

    Hip dislocation in children can occur congenitally in isolation or in conjunction with other congenital abnormalities.Traumatic hip dislocations in children are relatively uncommon and anterior dislocation of hip joint is even rarer.We report such a case following unusual mode of injury in a 12-year-old child.The patient underwent successful emergent closed reduction of left hip.The clinical course and follow-up assessment of the patient was otherwise uneventful.At 2 years' follow-up there was no evidence of osteoarthritis,coxa magna,heterotrophic calcification,in congruency of the joints or avascular necrosis of the head of femur.

  3. 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.

  4. Dislocation following revision total hip arthroplasty.

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    Gioe, Terence J

    2002-04-01

    Dislocation is a relatively common complication following revision total hip arthroplasty. Risk factors include surgical approach, gender, underlying diagnosis, comorbidities, surgical experience, and previous surgery; for later dislocations, risk factors include wear/deformation of polyethylene, trauma, and decreased muscle strength. Prevention and precaution are the watchwords for dislocations following revision total hip arthroplasty. For dislocations that do occur, treatment rests first on identifying the source of instability. Most dislocations can be managed by closed reduction. Constrained components may increase success rates, but only for appropriate indications. Prevention and treatment of dislocations following revision total hip arthroplasty are discussed in this article.

  5. CT findings of traumatic posterior hip dislocation after reduction

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    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.

  6. 21 CFR 890.3665 - Congenital hip dislocation abduction splint.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Congenital hip dislocation abduction splint. 890....3665 Congenital hip dislocation abduction splint. (a) Identification. A congenital hip dislocation abduction splint is a device intended for medical purposes to stabilize the hips of a young child...

  7. Femoral head fracture without hip dislocation

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    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  8. Total hip arthroplasty in paralytic dislocation from poliomyelitis.

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    Laguna, Rafael; Barrientos, Jesús

    2008-02-01

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

  9. Surgical hip dislocation for treatment of cam femoroacetabular impingement

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    Milind M Chaudhary

    2015-01-01

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

  10. Unusual combination of posterior femoral head dislocation with anterior and posterior wall fractures in the ipsilateral acetabulum.

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    Chen, Wei; Su, Yanling; Zhang, Yingze; Zhang, Qi; Zheng, Zhanle; Pan, Jinshe

    2010-06-09

    Although hip dislocation combined with acetabular fracture is not an uncommon injury, anterior acetabular wall fractures rarely occur in patients who have posterior fracture-dislocations of the hip. This article presents a unique case of anterior and posterior wall fractures of the ipsilateral acetabulum in a patient who sustained traumatic posterior hip dislocation that resulted from a high-speed motor vehicle accident. The initial imaging evaluation, which did not include the obturator oblique view, revealed no concomitant anterior acetabular wall fracture. Repeated manipulative reductions were unsuccessful in reducing the displaced hip joint. Pelvic computed tomography (CT) scans revealed the initially missed anterior acetabular wall fracture fragments incarcerated in the left hip joint in addition to the hip dislocation and the posterior acetabular wall fracture. The incarcerated bone fragments lay between the anterior wall and the femoral head, and between the posterior wall and the femoral head, which appeared to derive from both anterior and posterior acetabular walls, respectively. Open reduction and internal fixation was performed to manage the posterior dislocation and associated acetabular fractures. Intraoperatively, the major anterior wall fragment was used to reconstruct the defected posterior wall. This case highlights the necessity of suspicion and pre- and postoperative monitoring of the obturator oblique view and CT scans to detect the potentially existing anterior acetabular wall fracture. Early surgical intervention is important to guarantee satisfactory outcomes of such complex fracture-dislocation injuries.

  11. Congenital dislocation of the hip. A review.

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    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.

  12. Traumatic bilateral knee dislocations, unilateral hip dislocation, and contralateral humeral amputation: a case report.

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    Voos, James E; Heyworth, Benton E; Piasecki, Dana P; Henn, R Frank; MacGillivray, John D

    2009-02-01

    Bilateral traumatic knee dislocations are a rarity. We report a case of bilateral traumatic knee dislocations with concomitant right hip dislocation and complete traumatic amputation of the left, nondominant upper extremity at the level of the proximal one-third of the humerus. Angiograms revealed no evidence of popliteal artery injury. Orthopedic treatment consisted of immediate reduction of the dislocations and urgent revision amputation of the upper extremity. Staged, bilateral knee ligamentous reconstructions were performed on hospital days 24 and 29, respectively. Despite this constellation of devastating injuries, the patient had a satisfactory outcome. In patients with high-energy hip or knee dislocations, the bilateral hips and knees should be carefully examined to check for associated fractures and/or dislocations.

  13. Traumatic bilateral hip dislocation with bilateral sciatic nerve palsy

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Amarjit Singh Sidhu; Arun Pal Singh

    2010-01-01

    Bilateral hip dislocation rarely occurs.In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic acci-dent is reported.Both hips were emergently reduced under general anaesthesia.Acetabular reconstruction was done bilaterally due to the unstable hips.The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty.The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was aug-mented by tendon transfer.Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time.To the best of our knowledge, this kind of injury has not been reported in the English .language literature.

  14. Differentiating subluxation from developmental dislocation of the hip.

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    Tavares, Joao O

    2012-01-02

    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.

  15. An Unexpected Complication of Hip Arthroplasty: Knee Dislocation

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    Serdar Yilmaz

    2015-01-01

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

  16. Acetabular cup position and risk of dislocation in primary total hip arthroplasty

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    Seagrave, Kurt G; Troelsen, Anders; Malchau, Henrik;

    2016-01-01

    Background and purpose - Hip dislocation is one of the most common complications following total hip arthroplasty (THA). Several factors that affect dislocation have been identified, including acetabular cup positioning. Optimal values for cup inclination and anteversion are debatable. We perform...

  17. Role of the limbus in femoral-head deformation in developmental dislocation of the hip: findings of two-directional hip arthrography.

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    Hara S; Akazawa H; Mitani S; Oda K; Inoue H

    2002-01-01

    Two-directional arthrographic findings made during conservative treatment of developmental dislocation of the hip were compared with the femoral-head configurations and radiological results obtained from long-term follow-up examinations in this retrospective study. Sixty hips were followed until at least age 14. Arthrography was carried out according to Terazawa's method. The shape of the superior, anterior, and posterior limbus was evaluated based on a modified Fujii's classification. The fe...

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

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    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.

  19. Differentiating subluxation from developmental dislocation of the hip

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    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.

  20. Resection arthroplasty of the hip in paralytic dislocations.

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    Kalen, V; Gamble, J G

    1984-06-01

    The chronically dislocated paralytic hip causes postural difficulties, nursing and hygiene problems, and pain. Therapeutic options are limited. This study reviews the results of resection arthroplasty on 18 hips of 15 such patients. This procedure has many complications, including hip ankylosis, heterotopic ossification, abduction contracture and bony overgrowth. Despite this, all of the nursing goals were achieved and most patients had relief of pain. The operation is most successful in the skeletally mature patients, and it relies on soft-tissue interposition between the bony fragments and postoperative positioning to ensure optimum posture.

  1. Increasing preoperative dislocations and total time of dislocation affect surgical management of anterior shoulder instability

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    Denard, Patrick J.; Dai, Xuesong; Burkhart, Stephen S.

    2015-01-01

    Purpose: Our purpose was to determine the relationship between number of preoperative shoulder dislocations and total dislocation time and the need to perform bone deficiency procedures at the time of primary anterior instability surgery. Our hypothesis was that need for bone deficiency procedures would increase with the total number and hours of dislocation. Materials and Methods: A retrospective review was performed of primary instability surgeries performed by a single surgeon. Patients with 25% glenoid bone loss were treated with Latarjet reconstruction. Number of dislocations and total dislocation time were examined for their relationship with the treatment method. Results: Ten arthroscopic Bankart repairs, 13 arthroscopic Bankart plus remplissage procedures, and 9 Latarjet reconstructions were available for review. Total dislocations (P = 0.012) and total hours of dislocation (P = 0.019) increased from the Bankart, to the remplissage, to the Latarjet groups. Patients with a total dislocation time of 5 h or more were more likely to require a Latarjet reconstruction (P = 0.039). Patients with only 1 preoperative dislocation were treated with an isolated Bankart repair in 64% (7 of 11) of cases, whereas those with 2 or more dislocations required a bone loss procedure in 86% (18 of 21) of cases (P = 0.013). Conclusion: Increasing number of dislocations and total dislocation time are associated with the development of glenoid and humeral head bony lesions that alter surgical management of anterior shoulder instability. The necessity for the addition of a remplissage to an arthroscopic Bankart repair or the use of a Latarjet reconstruction increases with only 1 recurrent dislocation. Level of evidence: Level III, retrospective comparative study. PMID:25709237

  2. Hip Arthroscopy for Incarcerated Acetabular Labrum following Reduction of Traumatic Hip Dislocation: Three Case Reports

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    Hwang, Jung-Mo; Lee, Woo-Yong; Noh, Chang-Kyun; Zheng, Long

    2016-01-01

    Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation. PMID:27777919

  3. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

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    Deepak

    2015-06-01

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

  4. Anticoagulant-induced hemarthrosis presenting as anterior shoulder dislocation.

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    Davis, Christine B; Nowak, Richard M

    2014-12-01

    This is a case of nontraumatic shoulder pain initially diagnosed on x-ray as an anterior dislocation. The patient was on anticoagulants and, in actuality, had severe hemarthrosis that caused the subluxation. Attempts to reduce the dislocation in this situation might have resulted in worsening of the intra-articular bleed. There has been only 1 similar reported case in the European Journal of Emergency Medicine in 2013 of a 53-year-old woman who was thought to have a nontraumatic anterior shoulder dislocation, and attempts were unsuccessful at reduction. Definitive therapy involved hemarthrosis aspiration. Others have reported spontaneous hemarthrosis due to anticoagulants; however, only 1 has reported an initial mistaken joint dislocation diagnosis. Nontraumatic hemarthrosis do occur in patients on anticoagulant therapy, and it is important to recognize that this can be misdiagnosed as a joint dislocation requiring reduction. In a patient who is on anticoagulants presenting with nontraumatic joint pain and anterior shoulder or possibly other dislocations on plain radiographs, it is pertinent to consider hemarthrosis.

  5. ASYMMETRICAL BILATERAL HIP DISLOCATION WITH SEGMENTAL FRACTURE FEMUR: AN UNUSUAL CASE REPORT AND LITERATURE REVIEW

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    Ramesh

    2015-01-01

    Full Text Available Bilateral traumatic hip dislocation is rarely seen. A unique case is presented, consisting of asymmetric bilateral hip dislocation with associated segmental fracture femur, resulting from fall from bus. This case represents an unusual, severe combination of injuries resulting from the fall from bus under influence of alcohol. Traumatic hip dislocation represents a true orthopaedic emergency . Given the severity of associated complications, every effort should be made to ensure pr ompt diagnosis and immediate therapy. We report our experience in the management of this complex injury pattern and review the pertinent literature on this subject. Keywords: Bilateral hip dislocation , Asymmetric hip dislocation , Segmental femur fracture , Closed reduction , Fall from bus .

  6. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

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    Yashavantha Kumar C

    2013-01-01

    Full Text Available Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.Case Report: A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted . There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks.Conclusion: Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored.

  7. Simple self-reduction method for anterior shoulder dislocation

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    Reiner Wirbel; Martin Ruppert; Elmar Schwarz; Bernhard Zapp

    2014-01-01

    Objective:To demonstrate and evaluate a modified simple method about self-reduction of anterior shoulder dislocation for significance in the emergency room. Methods:TheBoss-Holzach-Matter method for self-reduction of anterior shoulder disloaction is described.Patients with an anterior shoulder dislocation were retrospectively analysed concerning age, gender, type of anterior shoulder dislocation, occurrence of associated fractures, time between injury and reduction, reduction time, and method of reduction with its respective success rate. Results:Eighty-six patients(52 men,34 women, mean age49 years) were treated fromJanuary 2010 toJune2014.The reduction time ranged between20 seconds and6 min(mean1.5 min). Subcoracoid type of shoulder dislocation was seen in72 cases(84%), subglenoid type in14 cases(16%).Associated factures were seen in20 cases, proportionally more often in subgleboid dislocations,12 at the greater tuberosity,6 at the inferior rim of the glenoid fossa and2 at both localizations.TheBoss-Holzach-Matter method was used in35 cases with a success rate of 71.5%; dieKocher method and traction/countertraction method with premedication were used in 14 cases and17 cases with success rates of64% and70%, respectively.All other cases and the failed primary attempts required hyponotic medication.All patients older than70(n=16) were not able to perform the self reducing procedure. Conclusion:The presentedBoss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial.The successful rate is comparable with other established methods.

  8. Results of hip arthroplasty using Paavilainen technique in patients with congenitally dislocated hip

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    R. M. Tikhilov

    2014-01-01

    Full Text Available The purpose of the study was to analyze the medium- and long-term results of hip arthroplasty using Paavilainen technique in patients with the congenitally dislocated hip. Methods: From 2001 to 2012 180 operations were carried out were using the Paavilainen technique in 140 patients with high dislocation of the hip (Crowe IV. All patients were clinically evaluated using the Harris Hip Score (HHS, VAS and radiography. Statistical analysis was performed using the Pearson correlation coefficients, multiple regression analysis and classification trees analysis. Results: The average Harris score improved from preoperative 41.6 (40,3-43,5 to 79.3 (77,9-82,7 at final follow-up, and the difference was significant. Early complications were 9% (the most frequent were fractures of the proximal femur, later - 16.7% (pseudoarthrosis of the greater trochanter, 13.9%; disclocations-1,1%, aseptic loosening of the components - 1.7%, reoperation performed in 8.3% of cases. Such factors as age and limb length has statistically significant effect on functional outcomes. Established predictive model allows to get the best possible functional outcome in such patients with severe dysplasia. Conclusions: Total Hip arthroplasty using the Paavilainen technique is an effective method of surgical treatment in patients with the congenitally dislocated hip, but it is technically difficult operation with a high incidence of complications in comparison with standard primary total hip replacement.

  9. Central dislocation of the hip secondary to insufficiency fracture

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    Moe Thaya

    2010-03-01

    Full Text Available We present a case report of a 45-year old man who sustained a central dislocation of the hip secondary to an insufficiency fracture of the acetabulum. At the time of presentation he was on alendronate therapy for osteoporosis which had been previously investigated. CT scanning of the pelvis was useful for pre-operative planning which confirmed collapse of the femoral head but no discontinuity of the pelvis. The femoral head was morcellized and used as bone graft for the acetabular defect and an uncemented total hip replacement was performed.

  10. Asymmetric traumatic bilateral dislocation of hip. Case report

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    Pedro Gonzalo González González

    2009-05-01

    Full Text Available A male (26 years suffered an asymmetric bilateral dislocation of hip as a result of a car accident. The patient was treated with closed reduction and bone traction for six weeks. We present this report since the reviewed literature only include six cases with this kind of lesion and because this is a medical emergency resulting from high impact trauma, being the aseptic osteonecrosis the most significant and serious complication.

  11. Three-dimensional computerized selection of hip prostheses in patients with congenital dislocated hips.

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    Gelalis, L D; Xenakis, T A; Hantes, M; Vartziotis, K; Soucacos, P N

    2001-11-01

    This study assessed the effectiveness of the combined use of computed tomography (CT) and computer-aided design (CAD) in the preoperative evaluation and implant selection in 20 patients (20 hips) with congenital dislocation of the hip who were scheduled to undergo total hip arthroplasty. Computerized selection of the femoral implant with optimum fit and fill was made after a three-dimensional reconstruction of the femoral canal using CT data and CAD. Implantation of all sizes of 5 noncemented and 2 cemented femoral implants was simulated using CATIA software (IBM, Kingstone, NY). When patients underwent surgery, 18 of 20 preselected prostheses agreed by type and size with the prostheses implanted. The remaining 2 preselected implants agreed by type only. In patients with dislocated and dysplastic hips, combined use of CT and CAD allows effective preoperative planning by providing the surgeon with vital information about the proximal femoral canal geometry and the possible femoral implant with optimum fit and fill to be used.

  12. Imaging of traumatic dislocation of the hip in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Vialle, Raphael; Pannier, Stephanie; Odent, Thierry; Glorion, Christophe [Necker Enfants-Malades Hospital, Department of Paediatric Orthopaedics, Paris Cedex 15 (France); Schmit, Pierre [Necker Enfants-Malades Hospital, Department of Paediatric Radiology, Paris (France); Pauthier, Francois [CHI Poissy Saint Germain en Laye, Department of Orthopaedic Surgery, Poissy (France)

    2004-12-01

    Traumatic hip dislocation in childhood is a rare consequence of violent trauma. After reduction, outcome is usually favourable although epiphyseal necrosis can occur. Reduction must be carried out as soon as possible and is achieved easily, although if the labrum is involved, surgery may be required to achieve complete reduction. To analyze a retrospective series of traumatic hip dislocations in children, describing the therapeutic and imaging strategy. A total of 42 patients were studied. Their mean age was 10 years 3 months. All relevant radiographic, CT, MRI and radionuclide bone scan examinations were reviewed. Special attention was paid to associated lesions. In 22 patients the dislocation was caused by low-energy trauma. Road traffic accidents accounted for 17 dislocations. An acetabular fracture was present in six patients and the femoral head was fractured in three. Reduction was easily achieved in 31 patients. In 11 patients the postreduction radiograph and CT showed joint space asymmetry secondary to labral entrapment. Only two patients developed epiphyseal necrosis. It has been difficult to define and evaluate accurate principles for a medical imaging strategy in this group of patients. Analysis of plain radiographs is essential before and after reduction of the joint, and it is important to perform postreduction CT in every patient whose joint space remains widened. A radionuclide bone scan should be performed between the second and third weeks after injury to assess epiphyseal vascularity. With the use of specific sequences, MRI may be an alternative modality to assess epiphyseal vitality. (orig.)

  13. Misdiagnosis induced intraocular lens dislocation in anterior megalophthalmos

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-wei; XU Wen; ZHU Ya-nan; LI Jin-yu; ZHANG Li; YAO Ke

    2012-01-01

    Anterior megalophthalmos (AM) is an uncommon developmental anomaly of the anterior segment of the eye with a constellation of findings that includes enlarged cornea,deep anterior chamber,posterior positioning of the iris and lens,iris stroma atrophy,hypoplasia of iris dilator,pupil displacement,large capsular bag,lens subluxation,prematurely cataract and the tendency to retinal detachment.AM,especially when symptoms are mild,is not an easy disease to diagnose.We present 3 AM cases that were misdiagnosed as congenital cataract with weak zonule and megalocornea.Intraocular lenses (IOLs) dislocated after standard cataract surgeries and subsequent surgery (replacing the dislocated IOLs with iris-claw intraocular lenses) achieved satisfactory outcome.Although rare,AM should be included in the differential diagnosis of enlarged cornea and we recommend implanting Artisan lens in AM patients.

  14. Vibration arthrometry in congenital dislocation of the hip.

    Science.gov (United States)

    Kernohan, W G; Cowie, G H; Mollan, R A

    1991-11-01

    Three hundred six neonates referred to a research clinic for vibration arthrometry were studied to determine whether the application of objective methods could enhance the accuracy of hip examinations. A total of 629 vibration episodes (hip "clicks" and "clunks") were detected using miniature accelerometers and recorded during testing for congenital dislocation of the hip. Five categories of congenital dislocations of the hip (CDH) were defined: normal (53 cases), safe click (201 cases), click associated with later CDH (16 cases), unstable (14 cases), and late CDH (22 cases). Follow-up examinations were performed over a four-year period. Detailed measurement of vibration signals was possible and resulted in the resolution of eight variables for each episode. Two variables, pulse area and peak frequency, were selected for their power to discriminate between the five clinical groups. The pulse area values were higher for the late and unstable groups. In addition, the vibrations were examined using Fourier analysis, and the safe click group demonstrated higher frequency components than any other group. Vibration arthrometry is proposed as a possible adjunct in screening for CDH, as it may pick up cases that would be missed by an average examiner and it could monitor clicks, thus avoiding nonessential splintage.

  15. Anterior shoulder dislocation with axillary artery and nerve injury.

    Science.gov (United States)

    Razif, M A Mohamed; Rajasingam, V

    2002-12-01

    We report a rare case of left axillary artery injury associated with anterior dislocation of the left shoulder in a 25 yrs old male as a result of a road traffic accident. The shoulder dislocation was reduced. A left upper limb angiogram showed an obstructed left axillary artery. The obstructed segment was surgically reconstructed with a Dacron graft. Six months post operation in follow up, he was found to have good left shoulder function and no neurovascular deficit. This is an injury that could have been easily missed without a simple clinical examination.

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

    Directory of Open Access Journals (Sweden)

    K Karthik

    2011-01-01

    Conclusions: Intra-articular loose bodies were identified by nonconcentric reduction in 12 out of 117 patients with simple hip dislocation. Careful evaluation by fluoroscopy and good quality radiographs are indicated following reduction of hip dislocations.

  17. Anterior Hip Subluxation due to Lumbar Degenerative Kyphosis and Posterior Pelvic Tilt

    Directory of Open Access Journals (Sweden)

    Hiroyuki Tsuchie

    2014-01-01

    Full Text Available Nontraumatic anterior subluxation and dislocation of the hip joint are extremely rare. A 58-year-old woman presented to our outpatient clinic with left hip pain with a duration of 15 years. There was no history of trauma or other diseases. Her hip pain usually occurred only on walking and not at rest. Physical examinations demonstrated no tenderness in the hip joint. The range of motion of both hip joints was almost normal. Laxity of other joints was not observed. The bone mineral density of the lumbar spine and proximal femur confirmed a diagnosis of osteoporosis. A plain radiograph showed osteoarthritic changes of the hip joints, severe posterior pelvic tilt, and superior displacement of both femoral heads, especially in a standing position. Three-dimensional computed tomography (3DCT revealed anterior subluxation of both femoral heads. Seven years after the initial visit, both hip joints showed progression to severe osteoarthritis. Although the exact cause remains unclear, lumbar kyphosis, posterior pelvic tilt, and a decrease in acetabular coverage may have influenced the current case. We should be aware of these factors when we examine patients with hip osteoarthritis.

  18. BILATERAL ANTERIOR DISLOCATION OF SHOULDER WITH GREATER TUBEROSITY FRACTURE DUE TO HYPONATREMIA : A RARE PRESENTATION

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    Sivananda

    2015-01-01

    Full Text Available We here report a rare presentation of bilateral anterior dislocation of shoulder with associated fracture of greater tuberosity in a 38 year old male due to minor trauma which he sustained secondary to hyponatremia induced irritability. There was no associ ated rotator cuff tear which is often associated with BADS which makes this presentation unique. Unilateral dislocation of shoulder is a common condition which is frequently encountered in emergency trauma department. Anterior dislocation is more common th an posterior dislocation. However, simultaneous bilateral shoulder dislocations are usually posterior. Bilateral anterior dislocations with fractures of the greater tuberosity are even rarer and are usually associated with trauma or seizures

  19. Proximal femoral epiphysiolysis during reduction of hip dislocation in adolescents.

    Science.gov (United States)

    Herrera-Soto, Jose Antonio; Price, Charles T; Reuss, Bryan L; Riley, Patrick; Kasser, James R; Beaty, James H

    2006-01-01

    Traumatic hip dislocation is an uncommon injury in children. The urgency of closed reduction to prevent possible osteonecrosis may present some pitfalls. Adolescents with open proximal femoral physis may have sustained trauma to the physis at the time of dislocation that can lead to displacement of the epiphysis during the reduction maneuver. The purpose of this study is to report 5 cases with this complication and discuss potential etiology and management. All of the 5 patients were between 12 and 16 years old and underwent closed reduction under conscious sedation. Epiphysiolysis of the femoral head was diagnosed after reduction in all 5 patients. Every patient underwent emergent open reduction and internal fixation of the femur and open hip reduction. Avascular necrosis was identified in all 5 patients within 3 to 15 months postinjury. If there is any suspicion of associated physeal injury or if there is any physeal instability noted under fluoroscopy, an open reduction is recommended in the operating room under radiograph guidance to prevent displacement.

  20. Anterior dislocation of shoulder in eclampsia:a case report

    Institute of Scientific and Technical Information of China (English)

    Seema Rawat; Sanjay Meena; Shreesh Kumar Gangari; Lalit Kumar Lohia

    2012-01-01

    This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia.This is an unusual mechanism of injury,but similar to other uncontrolled muscular contractions caused by electroconvulsive therapy,etc.To the best of our knowledge only one such case has been reported in the English literature.Closed reduction under general anaesthesia was successfully achieved.High suspicion in patients complaining of pain over shoulder joint is necessary for early diagnosis of this condition.

  1. THA following deformities due to congenital dislocation of the hip joint.

    Science.gov (United States)

    Macheras, George A; Koutsostathis, Stefanos D; Lepetsos, Panagiotis; Anastasopoulos, Panagiotis P; Galanakos, Spyridon; Papadakis, Stamatios A

    2014-10-02

    Total hip replacement is the treatment of choice for the patient suffering from end-stage hip osteoarthritis. Excellent long-term results have been published. In the presence of deformities due to congenital hip dislocation, total hip replacement is, in most of the cases, a difficult task, since the technique of performing such an operation is demanding and the results could vary. This paper presents our experience and preferred strategies focusing on challenges and surgical techniques associated with reconstructing the dysplastic hip.

  2. Anterior dislocation of an empty capsular bag in a pseudophakic eye: A rare case report

    Directory of Open Access Journals (Sweden)

    Hyung Bin Hwang

    2015-01-01

    Full Text Available Spontaneous intraocular lens (IOL dislocation is uncommon in the absence of any ocular areas with zonular weakness or trauma. There have been no reports of spontaneous capsular bag dislocation into the anterior chamber without an IOL. We report a rare, interesting case of spontaneous capsular bag anterior dislocation, without an IOL, into the anterior chamber with no history of genetic disease, ocular trauma, or pseudoexfoliation that might predispose to a zonular abnormality.

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

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2012-09-01

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

  4. Arthroscopic removal of intraarticular fragments following fracture dislocation of the hip

    Directory of Open Access Journals (Sweden)

    Bagaria Vaibhav

    2008-01-01

    Full Text Available We report here a case of posterior dislocation of hip with fracture of posterior lip of acetabulum, with retained fracture fragments after a successful closed reduction. The fractured fragments were removed by arthroscopy of the hip. The technique of hip arthroscopy used in removing the fragments is discussed.

  5. 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.

  6. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tamara Alexandrov

    2014-01-01

    consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%, femur fracture (2%, greater trochanteric fracture (12%, postoperative periprosthetic intertrochanteric fracture (2%, femoral nerve palsy (5%, hematoma (2%, and postoperative iliopsoas avulsion (2%. Radiographic analysis revealed average cup anteversion of 19.6°±6.6, average cup abduction angle of 48.4°±7, stem varus of 0.9°±2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.

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

    Directory of Open Access Journals (Sweden)

    Venkateswarlu

    2015-11-01

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

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

    LENUS (Irish Health Repository)

    Forde, James C

    2012-02-01

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

  9. Surgical hip dislocation according to Ganz for excision of osteochondromas in patients with multiple hereditary exostoses

    NARCIS (Netherlands)

    Sorel, J. C.; Façee Schaeffer, M.; Homan, A. S.; Scholtes, V. A B; Kempen, D. H R; Ham, S. J.

    2016-01-01

    Aims We report a prospective cohort study of the midterm results of surgical dislocation of the hip (according to Ganz) to perform resection of osteochondromas involving the femoral neck in patients with multiple hereditary exostoses (MHE). Methods Hip range of movement (ROM) was assessed pre-and po

  10. Role of the limbus in femoral-head deformation in developmental dislocation of the hip: findings of two-directional hip arthrography.

    Directory of Open Access Journals (Sweden)

    Hara S

    2002-04-01

    Full Text Available Two-directional arthrographic findings made during conservative treatment of developmental dislocation of the hip were compared with the femoral-head configurations and radiological results obtained from long-term follow-up examinations in this retrospective study. Sixty hips were followed until at least age 14. Arthrography was carried out according to Terazawa's method. The shape of the superior, anterior, and posterior limbus was evaluated based on a modified Fujii's classification. The femoral-head configuration was classified into 4 groups, and the radiological results were evaluated using Severin's classification at the final observation. There was a statistically significant relationship between the shape of the anterior limbus, the number of portions of deformed limbus (superior, anterior, posterior, and the femoral-head configuration. Also, a statistically significant relationship between the shape of the limbus and Severin's classification was observed. These results suggest that the deformed limbus seems to play an important role in triggering femoral-head deformities, possibly via mechanical compression, and negatively affects development of the hip joint.

  11. Role of the limbus in femoral-head deformation in developmental dislocation of the hip: findings of two-directional hip arthrography.

    Science.gov (United States)

    Hara, Seinosuke; Akazawa, Hirofumi; Mitani, Shigeru; Oda, Ko; Inoue, Hajime

    2002-04-01

    Two-directional arthrographic findings made during conservative treatment of developmental dislocation of the hip were compared with the femoral-head configurations and radiological results obtained from long-term follow-up examinations in this retrospective study. Sixty hips were followed until at least age 14. Arthrography was carried out according to Terazawa's method. The shape of the superior, anterior, and posterior limbus was evaluated based on a modified Fujii's classification. The femoral-head configuration was classified into 4 groups, and the radiological results were evaluated using Severin's classification at the final observation. There was a statistically significant relationship between the shape of the anterior limbus, the number of portions of deformed limbus (superior, anterior, posterior), and the femoral-head configuration. Also, a statistically significant relationship between the shape of the limbus and Severin's classification was observed. These results suggest that the deformed limbus seems to play an important role in triggering femoral-head deformities, possibly via mechanical compression, and negatively affects development of the hip joint.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Aggarwal Sameer

    2012-11-01

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

  14. Simultaneous Bilateral Anterior Shoulder Dislocation Occurred During Sleepwalking

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    fevzi yilmaz

    2013-10-01

    A 17-years-old male presented to our emergency department with a complaint of bilateral shoulder pain and motion restriction. His past medical history was unremarkable for epilepsy or major trauma. His family members said that he was a sleepwalker since he was 5 or 6 years old and sometimes he was going to another place from his bed and when they saw him there were abrasions especially on his face and extremities. It was learned that he left the drugs given by the doctors for his complaint after using a short time. On his physical examination in the emergency department he appeared to be good, he was concious, cooperative and oriented to person, time and place. His vital signs and neurological examination were normal. His extremity examination revealed that his arms were slightly in abduction and external rotation. There was epaulet sign bilateral on his shoulders and his peripheral neurological examination was otherwise normal. The radiological evaluation revealed bilateral subchorocoidal anterior dislocation without signs of fracture (Figure 1.

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

    Directory of Open Access Journals (Sweden)

    Lidder Surjit

    2009-08-01

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

  16. Cementless total hip arthroplasty with modified oblique femoral shortening osteotomy in Crowe type IV congenital hip dislocation.

    Science.gov (United States)

    Kiliçoğlu, Onder İ; Türker, Mehmet; Akgül, Turgut; Yazicioğlu, Onder

    2013-01-01

    Midterm results of cementless total hip arthroplasty in patients with Crowe type IV congenital dislocation of the hip were evaluated. A modified oblique subtrochanteric shortening osteotomy was used in all patients. A cylindrical femoral stem was used in all patients to stabilize the osteotomy. Mean follow-up was 82 months in 20 hips of 16 patients. Mean Merle D'Aubigné pain score increased from 2.52 to 5.65 points, function score improved from 4.0 to 5.3 points, and mobility score improved from 3.95 to 5.35. Mean greater trochanter height relative to the estimated hip center was 6.8 ± 2.0 cm preoperatively and -1 ± 0.2 cm postoperatively. Complications were dislocations in 3 patients, which were successfully managed without redislocation and fracture of greater trochanter in 3 patients, which healed uneventfully in 2 but with residual Trendelenburg gait in one. Total hip arthroplasty with modified oblique subtrochanteric shortening osteotomy is an effective technique for the treatment for Crowe type IV hip dislocation.

  17. Radial head button holing: a cause of irreducible anterior radial head dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Bae, Kee Jeong [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Orthopedic Surgery, Seoul (Korea, Republic of)

    2016-10-15

    ''Buttonholing'' of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. (orig.)

  18. Primary and revision anterior supine total hip arthroplasty: an analysis of complications and reoperations.

    Science.gov (United States)

    Berend, Keith R; Kavolus, Joseph J; Morris, Michael J; Lombardi, Adolph V

    2013-01-01

    Anterior total hip arthroplasty (THA) has been touted by some as a muscle-sparing, less invasive procedure. Reports have focused on the high intraoperative and postoperative complication rates, the increased transfusion risk, and its questionable clinical benefits. The senior author's experience regarding complications and reoperations that occurred after primary and revision THA using an anterior supine intermuscular approach has been generally favorable. An electronic database was used to identify 906 patients treated with 1,035 consecutive anterior supine intermuscular THAs performed by a single surgeon between January 2007 and December 2010, which included 986 primary THAs, 2 resurfacings, 2 conversions of failed open reduction and internal fixation for fracture, and 45 revision THAs. The surgical technique used an anterior approach with a modified Smith-Petersen interval and was performed with the patient supine on a standard operating table without traction. The transfusion rate was 5%. There were three intraoperative calcar cracks and one canal perforation, which was treated with cerclage cables. Four wound complications required débridement, four hips had substantial lateral femoral cutaneous nerve paresthesias that had not resolved by the 12-month follow-up, and one femoral nerve palsy was reported. At up to 40 month's follow-up, there have been 25 revisions (2.4%), including 9 periprosthetic femoral fractures; 1 stem subsidence; 4 hips with aseptic loosening; 5 metal-on-metal bearing complications; 1 cup malpositioning, which was corrected the same day; 4 dislocations; and 1 infection. This 4-year experience with primary and revision anterior THAs has showed acceptable rates of perioperative transfusion, complications, and revisions.

  19. Effect of prolonged bed rest on the anterior hip muscles.

    Science.gov (United States)

    Dilani Mendis, M; Hides, Julie A; Wilson, Stephen J; Grimaldi, Alison; Belavý, Daniel L; Stanton, Warren; Felsenberg, Dieter; Rittweger, Joern; Richardson, Carolyn

    2009-11-01

    Prolonged bed rest and inactivity is known to cause muscular atrophy with previous research indicating that muscles involved in joint stabilisation are more susceptible. The anterior hip muscles are important for hip joint function and stability but little is known about the effects of prolonged inactivity on their function. This study investigated the effect of prolonged bed rest on the size of the anterior hip muscles and their pattern of recovery. The effect of resistive vibration exercise (RVE) as a countermeasure to muscle atrophy was also investigated. 12 male participants, randomly assigned to either a control or an exercise group, underwent 8 weeks of bed rest with 6 months follow-up. Changes in muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius and rectus femoris muscles were measured by magnetic resonance imaging at regular intervals during bed rest and recovery phases. CSAs of iliopsoas and sartorius decreased at the hip joint (piliacus, psoas, and rectus femoris CSAs were unchanged (p>0.05). No significant difference was found between the two groups for all muscles (all p>0.1), suggesting inefficacy of the countermeasure in this sample. These findings suggest that prolonged bed rest can result in the atrophy of specific muscles across the hip joint which may affect its stability and function.

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

    Directory of Open Access Journals (Sweden)

    Plate Johannes F

    2012-10-01

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

  1. Joystick reduction and percutaneous pinning for an acutely anteriorly dislocated coccyx: a case report.

    Science.gov (United States)

    Kim, Weon-Yoo; Han, Chang-Whan; Kim, Yong-Hwan

    2004-07-01

    A sacrococcygeal dislocation is a rare occurrence, and the treatment options vary. Initial treatment is nonoperative, consisting of a manual reduction with a gloved finger and local rest. Acute operative treatment of a failed closed reduction is unusual. We report a case of an acute irreducible anteriorly dislocated coccyx successfully treated with a minimally invasive technique: joystick reduction and Steinman pin fixation.

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

    Directory of Open Access Journals (Sweden)

    Wang Chen-Ti

    2008-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-05-15

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

  4. SUBLUXATION AND DISLOCATION OF THE HIP IN CHILDREN WITH SPINA BIFIDA (REVIEW

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    A. G. Baindurashvili

    2013-01-01

    Full Text Available Subluxation or dislocation of the hip joint develops in 30-50% children with spina bifida during the first 2-3 years of life. These problems results from force disbalance between muscle group and other structural changes of the hip and pelvis components of the joint. The goal of treatment subluxation and dislocation of the hip joint in children with spina bifida is to make comfortable daily functions, eliminate the pain, provide the mobility and social independent. Management of subluxation and dislocation in children with spina bifida had changed in the last years because of the analysis long-term results. Indications for surgical treatment were determined more clearly, what made the results of treatment better.

  5. DUAL MOBILITY ACETABULAR COMPONENT AS A WAY TO PREVENT HEAD DISLOCATION OF THE HIP

    Directory of Open Access Journals (Sweden)

    V. A. Shilnikov

    2016-01-01

    Full Text Available Prevention of femoral head dislocation is becoming one of the most important tasks in view of increased number of total hip replacement procedures throughout the world. The purpose of the present work is to acquaint the surgeons with possibilities and the first experience of dual mobility acetabular component application as the most up-to-date solution to prevent dislocation of the femoral head in primary or revision arthroplasties. The paper is based on the literature data and presents a critical analysis of the causes of femoral head dislocation during hip replacement. The authors considered historical aspects and the first outcomes of dual mobility use in the European and Western countries, as well as own positive clinical experience with dual mobility system during a study of 36 patients with an increased risk of femoral head dislocation.

  6. Anterior fracture dislocation of sacroiliac joint: A rare type of crescent fracture

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    Vivek Trikha

    2015-01-01

    Full Text Available Crescent fractures of the pelvis are usually described as posterior sacro iliac fracture dislocations. Rarely anterior displacement of the fractured iliac fragment along with dislocation has been reported in crescent fractures. Four cases of anterior fracture dislocation of the sacro iliac joint managed in the last two years by a single surgeon are presented. The injury mechanism, radiological diagnosis, management protocol along with functional outcomes of all the four patients have been discussed. CT scan is essential in the diagnosis and preoperative planning of this injury pattern. Early fixation along with proper reduction leads to excellent functional outcome in this subset of lateral compression injuries of the pelvis.

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

    Directory of Open Access Journals (Sweden)

    Mladenović Marko

    2015-01-01

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

  8. Uncemented Total Hip Replacement After Two Years of Neglected Hip Dislocation With Fracture of Posterior Column and Wall of the Acetabulum

    Directory of Open Access Journals (Sweden)

    DC

    2016-07-01

    Full Text Available Introduction Posterior hip dislocation of the hip with acetabular fracture is a challenging problem to treat. Such dislocations are associated with avascular necrosis of the femoral head if neglected. Managing such conditions with total hip replacement (THR is very difficult because of associated altered anatomy. Case Presentation We hereby report a two-year neglected hip dislocation with associated acetabular fracture successfully treated with uncemented THR. The patient was successfully treated with uncemented THR and experienced significant improvement in his functional status, with a Harris hip score of 82 at the two-year follow up. Radiologically, there were no radiolucent areas or osteolysis, with good consolidation of the bone graft. Conclusions A neglected hip dislocation with acetabular fracture can be managed satisfactorily with uncemented THR. Bone reconstruction using chunk grafts and use of cementless components ensures long-term survival and also preserves adequate bone stock for revision, especially in young patients.

  9. Can posterior hip fracture-dislocation occur in indoor football (futsal)? A report of two cases.

    Science.gov (United States)

    Yasin, Faissal Nor; Singh, Vivek Ajit

    2009-01-01

    Hip fracture-dislocation is extremely rare in sports and is most frequently seen after road traffic accidents. This injury is associated with considerable long-term disability and rapidly progressive joint degeneration. This case report illustrates two cases of hip fracture dislocation that occurred while playing recreational indoor football (futsal). Futsal is a fast-emerging recreational sport in Malaysia and we are now beginning to see high-impact injuries rarely encountered in recreational sports. Therefore, futsal cannot be taken lightly and it is important to take adequate precautions to prevent serious injuries when participating in such sports.

  10. Treatment of Hip Dislocations and Associated Injuries: Current State of Care.

    Science.gov (United States)

    Beebe, Michael J; Bauer, Jennifer M; Mir, Hassan R

    2016-07-01

    Hip dislocations, most often caused by motor vehicle accidents or similar high-energy trauma, traverse a large subset of distinct injury patterns. Understanding these patterns and their associated injuries allows surgeons to provide optimal care for these patients both in the early and late postinjury periods. Nonoperative care requires surgeons to understand the indications. Surgical care requires the surgeon to understand the benefits and limitations of several surgical approaches. This article presents the current understanding of hip dislocation treatment, focusing on anatomy, injury classifications, nonoperative and operative management, and postinjury care.

  11. Habitual dislocation of the hip in children: report of eight additional cases and literature review.

    Science.gov (United States)

    Song, Kwang Soon; Choi, In Ho; Sohn, Young Jin; Shin, Hyun Dae; Leem, Ho Seung

    2003-01-01

    The purpose of this study was to report eight additional cases of habitual dislocation of the hip (HDH) and to combine the authors' data with a compilation of the cases from the literature. The authors attempted to investigate the various causative factors, outcomes, and indications for conservative and operative treatments. The results suggest that an unusual ability to dislocate the hip voluntarily at a young age constitutes a specific pediatric entity, and no single factor can be determined to be the definite cause of HDH. Multiple triggering factors (generalized ligamentous laxity, excessive anteversion of the femur and acetabulum, osteocartilaginous defect of acetabulum, coxa valga, psychiatric immaturity) appear to be associated with HDH. Treatment should be conservative in the first instance; it includes simple observation with or without psychiatric counseling and immobilization with cast or brace. Hip stabilization by surgical means is selectively indicated when the episodes of hip dislocation do not fade away in due time despite conservative treatment and when primary or secondary capsular laxity or osteocartilaginous deformation or defect of the hip is severe enough to cause repeated dislocation or residual subluxation, which may cause persistent pain or discomfort.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  13. OPEN REDUCTION OF HIP DISLOCATION IN PATIENTS WITH ARTHROGRYPOSIS MULTIPLEX CONGENITA – AN ANTEROMEDIAL APPROACH

    Science.gov (United States)

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

    2015-01-01

    To evaluate the results from surgical treatment of hip dislocation through the anteromedial approach, in patients with arthrogryposis multiplex congenita (AMC). Methods: The medical files and radiographs of seven children with AMC who presented hip dislocation (total of 10 dislocated hips) were retrospectively reviewed. Pre and postoperative joint mobility was evaluated by summing the joint range of motion in flexion and abduction. The acetabular angle and height of the femoral neck before the operation, and the continuity of the Shenton arc, Sharp angle and center-edge (CE) angle after the operation, were evaluated radiographically. When avascular necrosis was identified, it was classified in accordance with Ogden and Bucholz. Results: The mean age of the children at the time of the surgery was 5.5 months (range: 3 to 11 months). The mean duration of follow-up for the patients was 9.5 years (range: 2 to 13 years). The mean amplitude of the sum of the joint range of motion in flexion and abduction in the preoperative examination was 108° (range: 70° to 155°) and postoperatively, it was 125° (range: 75° to 175°). In the last evaluation, eight hips were found to be centered and two were subluxated. Two hips had been subjected to Salter iliac osteotomy. Two hips (20%) had presented significant signs of Ogden type IV avascular necrosis. Eight hips had good results while two were fair. Conclusion: We consider that the anteromedial approach is a good option for treating hip dislocation in very young patients with arthrogryposis multiplex congenita. PMID:27022586

  14. 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

  15. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

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    Tripathy Sujit Kumar

    2012-02-01

    Full Text Available 【Abstract】Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had sa-tisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment. An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature. Key words: Shoulder dislocation; Epilepsy; Accidents, traffic

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

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    Navin

    2015-03-01

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

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

    LENUS (Irish Health Repository)

    Galbraith, John G

    2011-01-01

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

  18. Anterior Inferior Iliac Spine (AIIS) and Subspine Hip Impingement

    Science.gov (United States)

    Carton, Patrick; Filan, David

    2016-01-01

    Summary Background Abnormal morphology of the anterior inferior iliac spine (AIIS) and the subspine region of the acetabular rim are increasingly being recognised as a source of symptomatic extra-articular hip impingement. This review article aims to highlight important differences in the pathogenesis, clinical presentation and management of extra-articular hip impingement from both the AIIS and subspine bony regions, and the outcome following surgical intervention. Methods A literature review was undertaken to examine the supporting evidence for AIIS and subspine hip impingement. A narrative account of the Author’s professional experience in this area, including operative technique for arthroscopic correction, is also presented. Results Abnormal morphology of the AIIS and subspine region has been classified using cadaveric, radiological and arthroscopic means; the clinical presentation and operative treatment has been documented in several case series studies. Dual pathology is often present - recognition and treatment of both intra- and extra-articular components are necessary for good postoperative outcome. Conclusions AIIS and sub-spine hip impingement should be considered as distinct pathological entities, which may also co-exist. Symptom relief can be expected following arthroscopic deformity correction with the treatment of concomitant intra-articular pathology. Failure to recognise and treat the extra-articular component may affect postoperative outcome. Level of evidence V. PMID:28066737

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

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    Mukesh Tiwari

    2013-04-01

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

  20. Hip dislocation in cerebral palsy: evolution of the contralateral side after reconstructive surgery

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    João Caetano Munhoz Abdo

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the progression of the contralateral hip after unilateral reconstruction of hip dislocation in patients classified as GMFCS IV-V; and to identify potential prognostic factors for their evolution. METHODS: This was a retrospective study on 17 patients with spastic cerebral palsy, who were classified on the GMFCS scale (Gross Motor Functional Classification System as degrees IV and V, and who underwent unilateral reconstruction surgery to treat hip dislocation (adductor release, femoral varus osteotomy and acetabuloplasty. The minimum postoperative follow-up was 30 months. The clinical parameters evaluated were sex, age at time of surgery, length of follow-up after surgery and range of abduction. The treatment parameters were use/nonuse of femoral shortening, application of botulinum toxin and any previous muscle releases. The radiographic parameters were Reimer's extrusion index (REI, acetabular angle (AA and the continuity of Shenton's line. RESULTS: Among the 17 patients evaluated, eight presented dislocation (group I and nine did not (group II. Group I comprised three males and five females; group II comprised one male and eight females. The mean age at the time of surgery among the group I patients was 62 months and the mean follow-up was 62 months. In group II, these were 98 and 83 months, respectively. There was a trend in which patients of greater age did not evolve with contralateral dislocation. Among the nine patients with the combination of REI < 30% and AA < 25°, only one presented dislocation during the follow-up. Contralateral subluxation occurred within the first two years after the surgery. CONCLUSION: Hips presenting REI < 30° and AA < 25° do not tend to evolve to subluxation and can be kept under observation. Preoperative clinical and radiographic measurements alone are not useful for indicating the natural evolution of non- operated hips. The critical period for subluxation is the first two

  1. 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.)

  2. [Anterior dislocation of the fibula resulting from surgical malreduction: a case report].

    Science.gov (United States)

    Wang, Z Y; Wu, X B

    2016-04-18

    Ankle joint fracture is one of the most common types of fracture. There are many researches on the injury mechanism, treatment principles and surgical techniques. A type of injury which combines posterior dislocation of fibula, known as the Bosworth injury, is relatively rare. In 1947, Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture dislocation of the distal part of the fibula. In this type of fracture, the proximal fibular shaft fragment locks behind the tibialis posterior tubercle. This rare ankle fracture variant is often not recognized in initial radiographs and requires a computed tomographic (CT) scan for verification. But there are already many reports, discussing the injury mechanism, treatment principles and surgical techniques. However, there are few reports of anterior dislocation of the fibula, caused by either injury or surgery. The mechanism of the injury is still not clear. This article reports a case of anterior dislocation of the fibula. We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage III, Gustilo IIIA). Open reduction and internal fixation was done in the initial surgery, but ended up with poor reduction, resulting in fibula anterior dislocation, anterior dislocation of talus and tibia fibular dislocation. The fibula was dislocated anteriorly of the tibia, which rarely happened. The patient suffered severe ankle joint dysfunction. The second operation took out the original internal fixation, reduced the fracture, and reset the internal fixation. The function of ankle joint was improved obviously after operation. But because of the initial injury and the two operations, the soft tissue around the fracture was greatly damaged. 6 months after the second operation, and the fracture still not healed, so the bone graft was carried out in the third surgery. Two months after the third surgery, the function of the ankle was significantly

  3. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Sujit Kumar Tripathy; Ramesh Kumar Sen; Sameer Aggarwal; Sarvdeep Singh Dhatt; Naveen Tahasildar

    2011-01-01

    Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment.An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.

  4. 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

  5. Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Tirman, P.F.J. [San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Feller, J.F. [Department of Veterans Affairs, David Grant USAF Medical Center, Travis Air Force Base, CA (United States); Stauffer, A.E. [Radiologic Imaging Associates, Mission Viejo, CA (United States)

    1996-11-01

    Objective. To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. Design and patients. We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. Results. MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). Conclusions. Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality. (orig.). With 4 figs.

  6. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure☆

    Science.gov (United States)

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-01-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.1,2 We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation. PMID:26566343

  7. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure.

    Science.gov (United States)

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-12-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.(1) (,2) We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation.

  8. Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    Vivek Trikha; Tarun Goyal; Ram K.Jha

    2011-01-01

    Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.

  9. Congenital dislocation of the hip. Incidence, and treatment of a local population group.

    Science.gov (United States)

    Chaitow, J; Lillystone, D

    1984-04-28

    For a period of three months, the incidence of hip abnormality was determined in 450 consecutive deliveries at the Hornsby and Ku-ring-gai Hospital newborn nursery. Three children were found to have dislocatable hips, and received treatment with a von Rosen splint. In 60 babies, soft tissue clicks could be elicited but the joints were stable. These babies received no treatment, but were reassessed one and six weeks later. No hip abnormality was detected in any of them at the follow-up examination. A retrospective analysis of the records of the previous 450 newborn babies showed that nine had received treatment with double nappies; von Rosen splints had not been used. At the six-month follow-up examination, one of these nine babies had a dislocated hip. "Double nappies" as a treatment modality is still widely practised in Sydney, though neither the literature nor the results of our retrospective analysis support its efficacy.

  10. Axillary artery transection and bilateral pulmonary embolism after anterior shoulder dislocation: case report

    Directory of Open Access Journals (Sweden)

    Leclerc Betty

    2017-01-01

    Full Text Available Introduction: Anterior shoulder dislocation can be associated with vascular and neurological complications. However, axillary artery injury associated with shoulder dislocation is rare and extremely rare without bone fracture. An early diagnosis of these complications allows predicting long-term functional outcomes. Methods: This article reports the case of a 66-year-old patient who presented an anterior shoulder dislocation after a ski fall without any neurological dysfunction or pulse deficit. Results: The first reduction attempts were unsuccessful and during the new attempt, we observed a hematoma. A CT scan showed a disruption of the axillary artery and a bilateral pulmonary embolism. Conclusion: Neurovascular injury must be systematically sought before and after reduction, and a multidisciplinary approach is always necessary.

  11. Conservative treatment of an anterior-lateral ankle dislocation without an associated fracture in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2012-06-01

    Full Text Available Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patient's visit 12 months after the initial injury, he was asymptomatic with full range of motion of the ankle joint. To our knowledge, we could not identify this type of an injury in a diabetic patient that was treated successfully with conservative treatment in the existing literature.

  12. Luxação glenoumeral anterior bilateral: caso clínico Bilateral anterior glenohumeral dislocation: clinical case

    Directory of Open Access Journals (Sweden)

    Luís Pires Silva

    2011-01-01

    Full Text Available A luxação glenoumeral anterior bilateral é uma ocorrência rara. Apresentamos um caso de luxação glenoumeral anterior bilateral com origem após uma queda da própria altura. O interesse desta publicação reside no fato de se tratar de uma raridade clínica com poucos casos descritos na literatura. Paciente do sexo feminino com 89 anos recorre ao serviço de urgência (SU após queda referindo dor intensa e incapacidade de mobilização de ambos os ombros. Ao exame objetivo apresentava sinais clínicos suspeitos de luxação glenoumeral anterior bilateral confirmados por radiografia. Ambas as luxações foram reduzidas no SU pela técnica de Milch modificada, com sucesso. Quando existe uma força simétrica e síncrona sobre os ombros e estes se apresentarem dolorosos e com limite funcional significativo, a suspeita de luxação glenoumeral bilateral, embora rara, é um diagnóstico diferencial a ter em conta.Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare.

  13. Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy

    OpenAIRE

    Carvalho Filho, Guaracy; Chueire, Alceu Gomes; Ignácio,Helencar; Carneiro,Márcio de Oliveira; Francese Neto,João; Canesin,Augusto César

    2003-01-01

    The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter). In this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months...

  14. OUTCOMES OF PALLIATIVE ORTHOPEDIC SURGERY FOR HIP DISLOCATION IN PATIENTS WITH CEREBRAL PALSY

    OpenAIRE

    R. R. Bidyamshin; S. O. Ryabykh; G. M. Chibirov; D. A. Popkov

    2016-01-01

    Introduction. Hip dislocation is the key problem in patients with severe cerebral palsy (GMFCS IV, V) older than 10 years that affects life quality and limits functional capabilities. In the present study the authors evaluated the efficiency of the proximal femoral resection arthroplasty (pfra) and valgus proximal osteotomy of the femur (VPOF) associated with femoral head resection for pain control, improvement of postural management, hygiene and verticalization with total weight-bearing and ...

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  16. TRAUMATIC POSTERIOR DISLOCATION OF THE HIP IN CHILDREN:REPORT ON FIVE CASES

    Science.gov (United States)

    Brandão, Gilberto Francisco; Américo, Luiz Renato Drumond; Soares, Cláudio Beling Gonçalves; Faria, Rodrigo Galinari Costa; Teixeira, Luiz Eduardo Moreira

    2015-01-01

    Objective: To evaluate a series of cases of traumatic posterior dislocations in children, with the treatment and results, and to review issues relating to the epidemiology, clinical and radiographic diagnosis, treatment, complications and prognosis of such cases. Methods: Five patients with traumatic hip dislocation, with a mean age of 4.6 ± 0.9 years and a follow-up period of 19.8 ± 7.0 months, were evaluated retrospectively. The time elapsed between dislocation and reduction, the type of treatment, the associated injuries and the subsequent complications were evaluated. Results: The initial treatment was closed reduction, which was performed on average 5.2 ± 3.6 hours after the initial trauma. All the patients underwent the reduction under anesthesia. The complementary treatment included plaster cast immobilization and traction. No need for additional surgery was observed and there were no long-term side effects. Conclusion: Traumatic dislocation of the hip should be treated quickly by means of closed reduction, with appropriate control over the reduction and rigorous observation in order to diagnose and treat late complications. PMID:27022542

  17. MRI morphometric hip comparison analysis of anterior acetabular labral tears

    Energy Technology Data Exchange (ETDEWEB)

    Aly, Abdel Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Saskatoon City Hospital, Saskatoon, SK (Canada); Rajasekaran, Sathish [HealthPointe, Pain, Spine and Sport Medicine, Alberta (Canada); Obaid, Haron [Royal University Hospital, University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

    2013-09-15

    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  18. Computer modeling of the pathomechanics of spastic hip dislocation in children.

    Science.gov (United States)

    Miller, F; Slomczykowski, M; Cope, R; Lipton, G E

    1999-01-01

    Spastic muscles about the hip cause subluxation, dislocation, and lead to acetabular dysplasia. Spastic hip disease occurs when the muscles about the hip exert forces that are too high or in the wrong direction or both. To determine the role of the hip forces in the progression of spastic hip disease and the effect of both muscle-lengthening and bony reconstructive surgeries, a computerized mathematical model of a spastic hip joint was created. The magnitude and direction of the forces of spastic hips undergoing surgery were analyzed preoperatively and postoperatively to determine which procedure is best suited for the treatment of spastic hip disease. The muscle-lengthening procedures included (a) the adductor longus, (b) the psoas, iliacus, gracilis, adductor brevis, and adductor longus, and (3) the psoas, iliacus, gracilis, adductor brevis, adductor longus, semimembranosus, and semitendinosus. The bony reconstructive and muscle-lengthening procedures included (a) lengthening the psoas, iliacus, gracilis, adductor brevis, adductor longus, semimembranosus, and semitendinosus combined with changing femoral neck anteversion from 45 to 10 degrees , (b) lengthening of the psoas, iliacus, gracilis, adductor brevis, adductor longus, semimembranosus, and semitendinosus combined with changing neck-shaft angle from 165 to 135 degrees , and (c) lengthening of the psoas, iliacus, gracilis, adductor brevis, adductor longus, semimembranosus, and semitendinosus combined with changing femoral neck anteversion from 45 to 10 degrees and neck-shaft angle from 165 to 135 degrees . Results show that a child with spastic hip disease has a hip-force magnitude 3 times that of the a child with a normal hip in the normal physiologic position. Based on this mathematical model the best to normalize the magnitude of the hip-joint reaction force, the muscles to be lengthened should include the psoas, iliacus, gracilis, adductor brevis, and the adductor longus. To normalize the direction of

  19. Surgical versus nonsurgical treatment in first traumatic anterior dislocation of the shoulder in athletes

    Directory of Open Access Journals (Sweden)

    Gustavo Gonçalves Arliani

    2011-03-01

    Full Text Available Gustavo Gonçalves Arliani, Diego da Costa Astur, Carina Cohen, Benno Ejnisman, Carlos Vicente Andreoli, Alberto Castro Pochini, Moises CohenCentro de Traumatologia do Esporte (CETE, Departamento de Ortopedia e Traumatologia da Universidade Federal de São Paulo, São Paulo, BrazilAbstract: Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first episode of shoulder dislocation, a combination of lesions can lead to chronic instability. The management in treatment of young athletes after the first acute anterior shoulder dislocation is controversial. The available literature supports early surgical treatment for young male athletes engaged in highly demanding physical activities after the first episode of traumatic dislocation of the shoulder. This is because of the best functional results and lower recurrence rates obtained with this treatment in this population. However, further clinical trials of good quality comparing surgical versus nonsurgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence.Keywords: athlete, conservative treatment, surgical treatment, immobilization, stabilization, primary treatment, shoulder dislocation

  20. Neurovascular complications due to the Hippocrates method for reducing anterior shoulder dislocations.

    Science.gov (United States)

    Regauer, Markus; Polzer, Hans; Mutschler, Wolf

    2014-01-18

    In spite of the fact that the Hippocrates method hardly has been evaluated in a scientific manner and numerous associated iatrogenic complications have been reported, this method remains to be one of the most common techniques for reducing anterior shoulder dislocations. We report the case of a 69-year-old farmer under coumarin anticoagulant therapy who sustained acute first time anterior dislocation of his dominant right shoulder. By using the Hippocrates method with the patient under general anaesthesia, the brachial vein was injured and an increasing hematoma subsequently caused brachial plexus paresis by pressure. After surgery for decompression and vascular suturing, symptoms declined rapidly, but brachial plexus paresis still was not fully reversible after 3 mo of follow-up. The hazardousness of using the Hippocrates method can be explained by traction on the outstretched arm with force of the operator's body weight, direct trauma to the axillary region by the physician's heel, and the topographic relations of neurovascular structures and the dislocated humeral head. As there is a variety of alternative reduction techniques which have been evaluated scientifically and proofed to be safe, we strongly caution against the use of the Hippocrates method as a first line technique for reducing anterior shoulder dislocations, especially in elder patients with fragile vessels or under anticoagulant therapy, and recommend the scapular manipulation technique or the Milch technique, for example, as a first choice.

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

    Directory of Open Access Journals (Sweden)

    Eyup Cagatay Zengin

    2014-03-01

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

  2. Treatment of recurrent anterior dislocations of shoulder by Laterjet-Bristow operation: an experience.

    Science.gov (United States)

    Bajracharya, A R; Anjum, M P

    2007-01-01

    Shoulder dislocation is common problem in orthopaedics. Management of recurrent shoulder dislocation is painstaking with different surgical procedures having varying outcomes. Laterjet-Bristow procedure provides stability and good functional outcome in Rowe scale and long term patient satisfaction. This is an observational prospective study carried out at two different tertiary care centers at Nepal and Pakistan using the same protocol. Habitual and pathological recurrent dislocations were excluded and all the recurrent dislocation of shoulder following initial traumatic anterior dislocation was included in this study. Standard Laterjet-Bristow operation was done and followed up for average of 27 months. Functional evaluation was done using Rowe score and graded as excellent, good, fair and poor. There were 12 men and 9 women with the mean ages of 23.4 years. At 12 months, 11 patients had fair result and seven patients had good result. At two years only three had fair result, 15 had good result and three patients had excellent result. Only three patients had poor result at one year while none had poor result at two year. The mean loss of external rotation in operated shoulder at one year was 24.33 degrees which decreased to 21.2 degrees at the end of second year. There was no restriction of external rotation in three patients at both yearly follow-ups while 18 patients had restriction in the range 10-30 degrees. Laterjet-Bristow can be the procedure of choice for surgical treatment of recurrent traumatic anterior dislocation and also as a salvage surgery for failed cases from other types of procedures. The only shortcoming of this procedure was some limitation in external rotation and minor loss in muscle power of that shoulder.

  3. Posterior dislocation of hip with ipsilateral intertrochanteric fracture: A report of two cases

    Directory of Open Access Journals (Sweden)

    Rehan Ul Haq

    2016-01-01

    Full Text Available Posterior dislocations of the hip are known to be associated with fractures of the femoral head, neck, shaft, or posterior acetabular wall. However, its association with ipsilateral intertrochanteric fracture has only been anecdotally described in the English literature. We report two such cases managed by open reduction (OR of the hip and internal fixation (IF of the intertrochanteric fracture. The first case was a 26-year-old male who was managed by OR of the hip with IF of the intertrochanteric fracture with a dynamic hip screw and had a good functional result at 1-year followup. The second case was a 36-year-old female who was also managed by OR of the hip with IF of the head fragments with Herbert screw and IF of the intertrochanteric fracture with a dynamic condylar screw. The patient had a fair, functional result at 1-year followup. With the increase in high energy trauma, these fracture patterns have become more common, and there is an urgent need to review the existing classifications so that these fractures are better categorized, and treatment guidelines defined.

  4. Posterior dislocation of hip with ipsilateral intertrochanteric fracture: A report of two cases

    Science.gov (United States)

    Ul Haq, Rehan; Kumar, Jaswant; Dhammi, IK; Jain, Anil K

    2016-01-01

    Posterior dislocations of the hip are known to be associated with fractures of the femoral head, neck, shaft, or posterior acetabular wall. However, its association with ipsilateral intertrochanteric fracture has only been anecdotally described in the English literature. We report two such cases managed by open reduction (OR) of the hip and internal fixation (IF) of the intertrochanteric fracture. The first case was a 26-year-old male who was managed by OR of the hip with IF of the intertrochanteric fracture with a dynamic hip screw and had a good functional result at 1-year followup. The second case was a 36-year-old female who was also managed by OR of the hip with IF of the head fragments with Herbert screw and IF of the intertrochanteric fracture with a dynamic condylar screw. The patient had a fair, functional result at 1-year followup. With the increase in high energy trauma, these fracture patterns have become more common, and there is an urgent need to review the existing classifications so that these fractures are better categorized, and treatment guidelines defined. PMID:27746503

  5. Fibular allograft and anterior plating for dislocations/fractures of the cervical spine

    Directory of Open Access Journals (Sweden)

    Ramnarain A

    2008-01-01

    Full Text Available Background: Subaxial cervical spine dislocations are common and often present with neurological deficit. Posterior spinal fusion has been the gold standard in the past. Pain and neck stiffness are often the presenting features and may be due to failure of fixation and extension of fusion mass. Anterior spinal fusion which is relatively atraumatic is thus favored using autogenous grafts and cages with anterior plate fixation. We evaluated fresh frozen fibular allografts and anterior plate fixation for anterior fusion in cervical trauma. Materials and Methods: Sixty consecutive patients with single-level dislocations or fracture dislocations of the subaxial cervical spine were recruited in this prospective study following a motor vehicle accident. There were 38 males and 22 females. The mean age at presentation was 34 years (range 19-67 years. The levels involved were C5/6 ( n = 36, C4/5 ( n = 15, C6/7 ( n = 7 and C3/4 ( n = 2. There were 38 unifacet dislocations with nine posterior element fractures and 22 were bifacet dislocations. Twenty-two patients had neurological deficit. Co-morbidities included hypertension ( n = 6, non-insulin-dependent diabetes mellitus ( n = 2 and asthma ( n = 1. All patients were initially managed on skull traction. Following reduction further imaging included Computerized Tomography and Magnetic Resonance Imaging. Patients underwent anterior surgery (discectomy, fibular allograft and plating. All patients were immobilized in a Philadelphia collar for eight weeks (range 7-12 weeks. Eight patients were lost to follow-up within a year. Follow-up clinical and radiological examinations were performed six-weekly for three months and subsequently at three-monthly intervals for 12 months. Pain was analyzed using the visual analogue scale (VAS. The mean follow-up was 19 months (range 14-39 months. Results: Eight lost to followup, hence 52 patients were considered for final evaluation. The neurological recovery was 1.1 Frankel

  6. Intraarticular lidocaine versus intravenous analgesic for reduction of acute anterior shoulder dislocations. A prospective randomized study.

    Science.gov (United States)

    Matthews, D E; Roberts, T

    1995-01-01

    We performed a prospective, randomized study to evaluate the use of injected lidocaine as an anesthetic for closed reduction of acute anterior shoulder dislocations. Thirty consecutive patients who presented at the emergency department with acute anterior shoulder dislocations were randomly placed in one of two groups. One group received an intraarticular injection of 20 ml of 1% lidocaine and the other group, intravenous injections of morphine sulfate and midazolam. The groups were compared regarding time of reduction maneuver, difficulty of reduction, subjective pain, complications, and total time spent in the emergency department. The lidocaine provided adequate anesthesia and secondary relief of muscle spasm in 15 of 15 (100%) patients. When compared with the intravenous sedation group, the lidocaine group showed no statistically significant difference in time for reduction maneuver, difficulty of reduction, or subjective pain. The lidocaine group had no complications and had a statistically significant shorter emergency department visit when compared with the intravenous sedation group (mean, 78 minutes versus 186 minutes; P = 0.004). Lidocaine provides excellent anesthesia for patients with uncomplicated anterior shoulder dislocations and can be very beneficial when sedation is contraindicated. Lidocaine injections also proved to be cost effective in our institution, reducing total costs by as much as 62%.

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

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer C; Kjaersgaard-Andersen, Per; Solgaard, Søren

    2014-01-01

    characteristics from six Danish arthroplasty departments with similar fast-track approaches were cross-referenced with the Danish National Patient Registry for complete 90-day follow-up on readmissions, including emergency-room contacts. Complete patient files and postoperative radiographs were reviewed in case.......31-3.40)] but not hospital stay of fast-track total hip...

  8. Anterior dislocation of the sacroiliac joint with complex fractures of the pelvis and femur in children: a case report.

    Science.gov (United States)

    Zhang, Hua; Jin, Libin; Li, Wanli; Li, Hang

    2013-09-01

    Pediatric sacroiliac joint injuries are uncommon lesions, especially when combined with anterior sacroiliac dislocation. Here, we present a rare case of anterior dislocation of the sacroiliac joint associated with ipsilateral acetabulum, subtrochanteric, and pubic rami fractures combined with a contralateral sacral fracture. This appears to be the first such case reported in the literature. At the 6-month follow-up, a favorable clinical outcome was achieved, with radiological healing of the lesion.

  9. Arthroplasty combined with cup-plastics in the surgical treatment of congenital dislocation of the hip.

    Science.gov (United States)

    Udvarhelyi, I; Riskó, T; Kremsier, K; Böröcz, T

    1985-01-01

    The authors review the arthroplasty combined with cup-plastics in the treatment of congenital dislocation of the hip. The indications and surgical exploration are discussed in detail. Good results are reported. The complications and their solutions are also described. In the recent five years, 100 patients were operated by them. Based on their experiences, they suggest this intervention at an earlier age, too (i.e. 30 to 40 years). Moreover, they believe it to be an important possibility to provide an adequate rehabilitation for patients being still of working age.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Jonathan E. dela Cruz

    2014-02-01

    Full Text Available Introduction: Various types of sedation can be used for the reduction of a dislocated total hip arthroplasty. Traditionally, an Opiate/Benzodiazepine combination has been employed. The use of other pharmacologic agents, such as Etomidate and Propofol, has more recently gained popularity. Currently no studies directly comparing these sedation agents have been carried out. The purpose of this study is to compare differences in reduction and sedation outcomes including recovery times of these three different sedation agents. Methods: A retrospective chart review was performed examining 198 patient’s charts who presented with dislocated total hip arthroplasty at two academic affiliated medical centers. The patients were organized into groups according to the type of sedation agent used during their reduction. The percentages of reduction and sedation complications were calculated along with overall recovery times. Reduction complications included fracture, skin or neurovascular injury, and failure of reduction requiring general anesthesia. Sedation complications included use of bag-valve mask and artificial airway, intubation, prolonged recovery, use of a reversal agent, and inability to achieve sedation. The data were then compared for each sedation agent. Results: The reduction complications rates found were 8.7% in the Propofol group, 24.68% in the Etomidate, and 28.85% in the Opiate/Benzodiazepine groups. The reduction complication rate in the Propofol group was significantly different than those of the other two agents (p≤0.01. Sedation complications were found to happen 7.25% of the time in the Propofol group, 11.69% in the Etomidate group, and 21.25% in the Opiate/ Benzodiazepine group with Propofol having complication rates significantly different than that of the Opiate/Benzodiazepine group (p=0.02. Average lengths of recovery were 25.17 minutes for Propofol, 30.83 minutes for Etomidate, and 44.35 minutes for Opiate/ Benzodiazepine with

  12. Relative trochanteric overgrowth after ischemic necrosis in congenital dislocation of the hip.

    Science.gov (United States)

    Iwersen, L J; Kalen, V; Eberle, C

    1989-01-01

    To determine the relative trochanteric overgrowth after ischemic necrosis of the femoral head during treatment of congenital dislocation of the hip (CDH), we reviewed radiographs of patients with ischemic necrosis and no femoral side surgery. The articulotrochanteric distance (ATD) was recorded after physeal closure. Ischemic necrosis was classified with the systems proposed by Salter et al. and Kalamchi and MacEwen. The resultant overgrowth was correlated with these systems. The articulotrochanteric distance in 29 patients with a Trendelenburg gait was also measured. The Kalamchi classification is more useful for predicting relative trochanteric overgrowth. Children with an ATD of less than or equal to 0 mm are likely to have a Trendelenburg gait.

  13. Extreme femoral shortening: an approach to the chronically dislocated hip in the nonambulatory pediatric population.

    Science.gov (United States)

    Kalawadia, Jay V; Patel, Ronak M; Jensen, Layne; Sarwark, John

    2014-09-01

    There are many surgical techniques for treating the chronically dislocated, painful hip in patients with neuromuscular spasticity, but each has significant complication rates. We conducted a study to examine the outcomes of a novel technique, an extreme varus femoral shortening osteotomy, used in nonambulatory patients with neuromuscular spasticity. Patients who underwent the procedure were identified retrospectively by surgical codes. Medical records were reviewed for range of motion, pain and functional assessment, surgical indications, complications, and results. In addition, preoperative and postoperative radiographs were assessed, and caretaker questionnaires reviewed. Between 2001 and 2010, 1 surgeon performed 6 femoral shortening osteotomies in 5 nonambulatory patients with neuromuscular spasticity. In all 5 cases, there were improvements in pain, sitting tolerance, ease of hygiene, and ease of transfers at a minimum follow-up of 2 years (mean, 3.4 years). Postoperative complications included asymptomatic heterotopic ossification and recurrent subluxation. Extreme femoral shortening is a reproducible surgical technique that alleviates pain and makes hygiene easier in nonambulatory children with symptomatic hip dislocations caused by neuromuscular spasticity. Our complication rate was comparable to that of other procedures.

  14. Reduction of acute anterior shoulder dislocations using the Milch technique: a study of ski injuries.

    Science.gov (United States)

    Russell, J A; Holmes, E M; Keller, D J; Vargas, J H

    1981-09-01

    During the 1977-78, 1978-79, and 1979-80 ski seasons, 76 acute anterior shoulder dislocations were treated by one of three Orthopedic Surgeons at the Rutland Vermont Hospital Emergency Room: 68 (89.4%) were reduced on first attempt using the Milch technique of abduction and external rotation. Four (5.2%) required general anesthesia and four were reduced using meperidine hydrochloride (Demerol, Winthrop) and diazepam (Valium, Roche) and a traction-countertraction technique. Of the 68 shoulders reduced with the Milch technique, 47 (69.1%) required no analgesics or muscle relaxants. There were no complications attributable to the technique itself. Males were injured more frequently than females in a 4.4:1 ratio. Left shoulder injuries were as common as right. Recurrent dislocations occurred more frequently in younger individuals. Fractures of the greater tuberosity were associated injuries in five (6.6%) of all dislocations. These all occurred in individuals older than age 39 years and were coincident with primary dislocations.

  15. A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, R.W.; Naeem, R.; Srinivas, K.; Shyamalan, G. [Birmingham Heartlands Hospital, Birmingham (United Kingdom)

    2015-05-01

    The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations. A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries. Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83-0.95) and 0.94 (CI 0.9-0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44-0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14-0.86). The overall positive predictive value was 0.88 (CI 0.76-0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07-0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05-0.7). Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor. (orig.)

  16. Anterior decompression, structural bone grafting, and Caspar plate stabilization for unstable cervical spine fractures and/or dislocations.

    Science.gov (United States)

    Garvey, T A; Eismont, F J; Roberti, L J

    1992-10-01

    Fourteen patients who sustained acute cervical spine fractures and/or dislocations with associated posterior ligamentous disruption had anterior decompressions, structural bone grafting, and anterior Caspar plate stabilization. With an average 30-month follow-up, no patient has had loss of fixation. Despite criticism raised from biomechanical testing, the Caspar anterior plate system (Aesculape, Tuttlingen, Germany) may be added to structural bone grafting of unstable cervical fractures and/or dislocations, yielding an in vivo solid construct, which obviates the need for simultaneous posterior stabilization.

  17. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation

    Science.gov (United States)

    D’Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido; Taverna, Ettore

    2015-01-01

    This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process. PMID:26288539

  18. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation.

    Science.gov (United States)

    D'Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido; Taverna, Ettore

    2015-01-01

    This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process.

  19. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation

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    Riccardo D′Ambrosi

    2015-01-01

    Full Text Available This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process.

  20. S-ROM modular arthroplasty combined with transverse subtrochanteric shortening for Crowe type IV congenital dislocation of hip

    Institute of Scientific and Technical Information of China (English)

    ZHONG Cheng; CAI Xun-zi; YAN Shi-gui; HE Rong-xin

    2011-01-01

    Background This work was carried out to evaluate the clinical efficacy and the complications of S-ROM modular hip arthroplasty combined with transverse subtrochanteric shortening for Crowe type IV congenital dislocation of the hip (CDH).Methods A totoal of 28 consecutive patients with Crowe type IV CDH received treatment using this surgical technique from June 2003 to June 2010.The follow-up was conducted at 3 days,1,6,and 12 months after the operation and later annually at the outpatient of our hospital.Sequential pelvic plain film and normotopia film of the affected hip joint were taken.The limp and the Trendelenburg sign were also assessed,the ischiadic nerve injury was also evaluated by electromyogram,and Harris hip scores were recorded.Results After operation,both the alignment and the position of the transverse osteotomies were good.None of the patients had presented complications of joint infection,prosthesis loosening,joint dislocation,or nerve injury.Conclusions S-ROM modular hip arthroplasty combined with transverse subtrochanteric shortening was a satisfactory and safe technique for the Crowe type IV congenital hip dislocation within a mean follow up of 53 months.Transverse subtrochanteric shortening could effectively prevent the distraction injury of sciatic nerve.

  1. Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    Chengwei JING; Qin FU; Xiaojun XU

    2009-01-01

    This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, t = 2.800, P0.05). Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

  2. Fate of the psoas muscle after open reduction for developmental dislocation of the hip (DDH).

    Science.gov (United States)

    Bassett, G S; Engsberg, J R; McAlister, W H; Gordon, J E; Schoenecker, P L

    1999-01-01

    We evaluated the anatomic and functional consequences of psoas lengthening during operative intervention for developmental dislocation of the hip (DDH). Possible anatomic changes were assessed by magnetic resonance imaging (MRI), and functional assessment included strength determination by an isokinetic dynamometer and gait analysis. Six girls and one boy, ranging in age from 15 to 20 months, had operative reduction of a unilateral DDH. One closed and six open reductions (three anteromedial and three anterolateral approaches) were performed. Follow-up ranged from 4 years 0 months to 9 years 2 months. The cross-sectional area determined by MRI of the lengthened psoas muscles was markedly reduced for all of the six open-reduction patients (three moderate and three severe). Atrophy of the iliacus muscle also was apparent by MRI in five of the six open-reduction patients. Maximum flexion torque, as determined by the isokinetic dynamometer, was diminished on the DDH side for the three patients whose hips were reduced open through the anteromedial approach. Average hip-flexion torque over the entire range of motion was decreased for both anteromedial and anterolateral groups on the operated-on side. Lengthening of the psoas tendon during open reduction of a DDH is associated with considerable atrophy of the psoas muscle.

  3. 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.

  4. Total hip arthroplasty in young females with congenital dislocation of the hip, radically improves their long-term quality of life.

    Science.gov (United States)

    Roidis, Nikolaos T; Pollalis, Athanasios P; Hartofilakidis, George C

    2013-08-01

    Eighty-two female patients with low dislocation (67 hips) or high dislocation (48 hips) were assessed using clinical scores and EQ-5D quality of life (QoL) questionnaire. Assessment was performed at the first to secondyear postoperatively and at the final follow-up, after a minimum of 12 years (12-37). Patients reported with a high EQ-5D health state VAS scale, VAS index and TTO index at 1 to 2 years follow-up (94,21/0,907/0,931) that remained considerably high despite the long-term follow-up (73,8/0,721/0,746). The scores for pain and range of motion presented with a statistically significant improvement at 1 to 2 years postoperatively and at the time of final follow-up. Function scores have declined with age. Total hip arthroplasty in CHD patients radically improves QoL for a long period of time.

  5. Remifentanil versus Fentanyl/Midazolam in Painless Reduction of Anterior Shoulder Dislocation; a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohammad Gharavifard

    2016-04-01

    Full Text Available Introduction: Performance of painful diagnostic and therapeutic procedures is common in emergency department(ED, and procedural sedation and analgesia (PSA is a fundamental skill for every emergency physician.This studywas aim to compare the efficacy of remifentanil with fentanyl/midazolam in painless reduction of anteriorshoulder dislocation. Methods: In this randomized, double blind, clinical trial the procedural characteristics,patients satisfaction as well as adverse events were compared between fentanyl/midazolamand remifentanilfor PSA of 18–64 years old patients, which were presented to ED following anterior shoulder dislocation.Results: 96 cases were randomly allocated to two groups (86.5% male. There were no significant difference betweengroups regarding baseline characteristics. Remifentanil group had lower duration of procedure (2.5§1.6versus 4.6§1.8 minutes, p Ç 0.001, higher pain reduction (53.7§13.3 versus 33.5§19.6, p Ç 0.001, lower failurerate (1 (2.1% versus 15 (31.3%, p Ç 0.001, higher satisfaction (p Æ 0.005. Adverse events were seen in 12 (25%patients in midazolam/fentanyl and 8 (16.7% cases in remifentanil group (p Æ 0.122. Conclusion: It seemsthat use of remifentanil resulted in lower procedural time, lower failure rate, and lower pain during procedureas well as higher patient satisfaction in comparison with midazolam/fentanyl combination in anterior shoulderdislocation.

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

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    Shuichi Miyamoto

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

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    Sven Herrmann

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

  9. Reduction of Anterior Shoulder Dislocation in Emergency Department; Is Entonox® Effective?

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    Babak Mahshidfar

    2011-12-01

    Full Text Available Introduction: An appropriate procedural sedation and analgesia (PSA is crucial to reduce a dislocated shoulder successfully in emergency department. This study compares sedative effect of inhalational Entonox® (En to intra-venous (IV Midazolam plus Fentanyl (F+M. Methods: 120 patients with recurrent anterior shoulder dislocation were randomly assigned into two groups. 60 patients (group F+M received 0.1 mg/kg IV Midazolam plus 3µg/kg IV Fentanyl and 60 patients (group En received Entonox® with self administration face mask on an on-demand basis. Traction/counter-traction method was used to reduce the dislocated shoulder joint in both groups. Results: 48 out of 60 (80% patients in group F+M and 6 out of 60 (10% patients in group En had successful reduction (p < 0.0001. The mean pain score reduction was 6.3 ± 1.2 for group F+M and 3 ± 0.9 for group En (p < 0.0001. There was a statistically significant difference in mean patient satisfaction (assessed with Likert score between two groups (4.45 ± 0.6 for group F+M and 2.3 ± 1 for group En; p < 0.0001. Duration of entire procedure (since the beginning of PSA up to the end of successful or unsuccessful reduction was shorter in Group F+M, but successful reductions occurred earlier in group En. No major side effect such as airway compromise, retracted respiratory depression, or circulatory failure was occurred in any group. Conclusion: Entonox® may not be an appropriate agent to help reducing a dislocated shoulder.

  10. Propensity for hip dislocation in normal gait loading versus sit-to-stand maneuvers in posterior wall acetabular fractures.

    Science.gov (United States)

    Marmor, Meir; McDonald, Erik; Buckley, Jenni M; Matityahu, Amir

    2013-09-01

    Treatment of posterior wall (PW) fractures of the acetabulum is guided by the size of the broken wall fragment and by hip instability. Biomechanical testing of hip instability typically is done by simulating the single-leg-stance (SLS) phase of gait, but this does not represent daily activities, such as sit-to-stand (STS) motion. We conducted a study to examine and compare hip instability after PW fractures in SLS and STS loading. We hypothesized that wall fragment size and distance from the dome (DFD) of the acetabulum to the simulated fracture would correlate with hip instability and, in the presence of a PW fracture, the hip would be more unstable during STS loading than during SLS loading. Incremental PW osteotomies were made in 6 cadaveric acetabula. After each osteotomy, a 1200-N load was applied to the acetabulum to simulate SLS and STS loading until dislocation occurred. All hip joints in the cadaveric models were more unstable in STS loading than in SLS loading. PW fragments at time of dislocation were larger (Pfracture size of 33% or more and a DFD of 20 mm or less.

  11. OUTCOMES OF PALLIATIVE ORTHOPEDIC SURGERY FOR HIP DISLOCATION IN PATIENTS WITH CEREBRAL PALSY

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    R. R. Bidyamshin

    2016-01-01

    Full Text Available Introduction. Hip dislocation is the key problem in patients with severe cerebral palsy (GMFCS IV, V older than 10 years that affects life quality and limits functional capabilities. In the present study the authors evaluated the efficiency of the proximal femoral resection arthroplasty (pfra and valgus proximal osteotomy of the femur (VPOF associated with femoral head resection for pain control, improvement of postural management, hygiene and verticalization with total weight-bearing and correction of accompanying orthopaedic deformities. Material and мethods. A retrospective study compared two groups of patients where PFRA (7 cases, 13 hips or VPOF (14 patients, 23 hips were performed. Level V of GMFCS was reported in 10 patients, and level IV of GMFCS – in 11 patients. The mean age at time of surgery was 15.3±3.9 y.o. PFRA was performed in 7 cases (13 joints and VPOF – in 14 patients (23 joints. Results. The authors did not observe any difference between the methods in respect of pain control, postural management, comfortable sitting position and hygiene. The verticalization with total weight-bearing and life quality improvement was achieved only after PVOF with femoral head resection associated with simultaneous knee and foot deformity correction performed according to the principles of Single-Event Multilevel Orthopedic Surgery. Conclusion. Both palliative methods allow to control pain syndrome, to achieve satisfactory postural management, comfortable sitting position and hygiene. But only VPOF with simultaneous knee and foot deformity correction provides possibility to verticalize the patient with weight-bearing using different orthopedic devices.

  12. Endothelial keratoplasty for corneal decompensation leaded by a dexamethasone implant dislocation in anterior chamber

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    Fernanda Pacella

    2016-06-01

    Full Text Available Background: Dexamethasone intravitreal implant (DEX largely showed his safety and efficacy for the treatment of cases of macular edema. Even if uncommon, delivery dislocation in anterior chamber has been described in Literaure as complication of the injection procedure, leading to irreversible endothelial cell loss in the majority of cases. We report a case of a 66-year-old man with pain and vision loss in his left eye. The anamnesis revealed a recent intravitreal injection of DEX implant for a persistent cystoid macular edema related to central retinal vein occlusion. Anterior segment examination showed corneal edema and the rod implant adherent to corneal endothelium. A large peripheral iridectomy was evident with retroillumination and IOL appeared good centered in the bag. The implant was removed but corneal decompensation was irreversible. One month later, an endothelial keratoplasty was successfully performed restoring corneal transparency. DEX intravitreal implant can migrate from vitreous cavity to anterior chamber and lead to irreversible corneal decompensation by mechanical and chemical toxicity on corneal endothelium. Removeal of the implant is necessary to avoid total endothelial decompensation. Despite this, in some cases endothelial keratoplasty had to be performed.

  13. Prevalence of hip dislocation among children with cerebral palsy in regions with and without a surveillance programme: a cross sectional study in Sweden and Norway

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    Elkamil Areej I

    2011-12-01

    Full Text Available Abstract Background Hip dislocation is a serious complication among children with cerebral palsy (CP. The aim of this study was to compare the prevalence of hip dislocation among children with CP in an area providing regular care with an area providing hip surveillance services. Methods This is a cross-sectional study in seven Norwegian counties providing regular care and one Swedish healthcare region where a hip surveillance programme was introduced in 1994. Data were provided by the Norwegian Cerebral Palsy Register and the CP Register in Southern Sweden. Children born 1996 - 2003 with moderate to severe CP, defined as Gross Motor Classification System (GMFCS levels III - V, were included. In all, 119 Norwegian and 136 Swedish children fulfilled the criteria. In Norway, data on hip operations and radiographs of the hips were collected from medical records, while these data are collected routinely in the Swedish register. The hip migration percentage was measured on the recent radiographs. Hip dislocation was defined as a migration percent of 100%. Results The proportion of children at GMFCS levels III - V was 34% in the Norwegian and 38% in the Swedish population. In the Norwegian population, hip dislocation was diagnosed in 18 children (15.1%; CI: 9.8 - 22.6 compared with only one child (0.7%; 95% CI: 0.01 - 4.0 in Southern Sweden (p = Conclusions The surveillance programme reduced the number of hip dislocations and the proportion of children undergoing hip surgery was lower. However, with the surveillance programme the first operation was performed at a younger age. Our results strongly support the effectiveness of a specifically designed follow-up programme for the prevention of hip dislocation in children with CP.

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

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    Shirin Mardookhpour

    2012-06-01

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

  15. The surgical treatment of the recurrent dislocation on the shoulder joint with minimum invasion anterior approach

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    Ninković Srđan

    2008-01-01

    Full Text Available Shoulder joint is one of the spherical joints and one of the most movable but also the most unstable joint of locomotive apparatus. The aims of this work are to review and analyze the results of medical treatment of frontal recurrent dislocations on the shoulder with open surgery technique on the Clinic for Orthopaedic Surgery and Traumatology in Novi Sad in the period from 2002 to 2005. Twenty one patients with anterior recurrent dislocations of the shoulder were operated on, 19 men and 2 women. The average age of those patients was 24.8 (15-40 year-olds. Ten patients had an injury of the left and 11 patients the injury of the right shoulder. There were eight handball players, four fighting skills players; two of them played volleyball and one was a basketball player. Six of them were not sportsmen. The preoperational and post operational mean value of the modified Rowe scale showed a statistically significant difference (P<0.001. Observing the patients after the operation in the period of 2 years, according to Neer scale, 3 patients (14.28% had great results (grade over 90, 16 patients (76.19% had a good result, (75-89, and only two patients (9.52% had results less than 75. The measuring of the volume of movements after physical treatment in 12 patients (57.14% has shown the decrease of the outside rotation. Open surgery treatment of the front unstable shoulder joint is reliable and time tested and it gives good clinical results in young sportsmen with undirected unstable, bigger number of dislocations and associated osseous defects. .

  16. Which technique is better for reduction of anterior shoulder dislocation? External rotation or Milch method. A review of literature

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    Niaz Mohammad Jafari Chokan

    2016-11-01

    Full Text Available Anterior shoulder dislocation is the most common joint dislocation in human body. Many methods are traditionally described for reduction of shoulder dislocation. Most of these techniques are painful to patients and may be associated with further injury. An ideal method should be easy, effective, and less painful, not associated with iatrogenic complications and should be easy to teach and learn. Among different methods of reduction, external rotation and Milch methods are more popular. Both methods are found to be atraumatic, relatively painless and can be performed without anesthesia. In this article, we aimed to review the literatures regarding these two methods of reduction and comparing their success rate and outcome. We reviewed the literature to find articles related to reduction of anterior shoulder dislocations applying one of two techniques described above. We searched PubMed and Google Scholar. In total, 46 articles were found, of them 17 articles -which mainly focused on anterior shoulder dislocation reduction by means of two above methods-were included in this review. The results showed that both techniques were effective, safe, relatively painless, and were well tolerated with no complications, but the external rotation method was superior.

  17. Delayed surgical treatment for a traumatic bilateral cervical facet joint dislocation using a posterior-anterior approach: a case report

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    Shimada Takashi

    2013-01-01

    Full Text Available Abstract Introduction There have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more. We report the case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation. Case presentation A 76-year-old Asian man was involved in a road traffic accident. He presented with neck pain and arm pain on his right side, but motor weakness and paralysis were not observed. He was treated conservatively; however, instability and spondylolisthesis at the C5 to C6 joint increased eight weeks after the injury. We performed a posterior-anterior reduction and fixation. After surgery, bony union was achieved, and his neck pain and arm pain disappeared. Conclusion We recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine.

  18. Primary total hip arthroplasty: a comparison of the lateral Hardinge approach to an anterior mini-invasive approach

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    Nathan Wayne

    2009-11-01

    Full Text Available The anterior mini-invasive (MI approach to performing total hip arthroplasty (THA is associated with less soft tissue damage and shorter postoperative recovery than other methods. Our hospital recently abandoned the traditional lateral Hardinge (LH approach in favour of this new method. We compared the first 100 patients operated after the changeover to the new method (MI group to the last 100 patients operated using the traditional method (LH group. Clinical and radiological parameters and complications were recorded pre- and postoperatively and the collected data of the two groups were statistically compared. There were no statistically significant differences between either group with regard to patient demographics or procedural data, placement of the femur component, postoperative leg discrepancy, prosthesis dislocation, blood transfusion, or postoperative dislocation of the components. The MI group had a significantly longer operating time, more bleeding, higher rate of nerve damage, and a higher percentage of acetabular component malposition whilst having a significantly shorter hospital stay and significantly fewer infections of the operative site in comparison to the LH group. Additionally, and perhaps most worrying was the clinically significant increase in intraoperative femur fractures in the MI group. The changeover to the anterior mini-invasive approach, which was the surgeons' initial experience with the MI technique, resulted in a drastic increase in the number of overall complications accompanied by less soft tissue damage and a shorter period of rehabilitation. Our results suggest that further analysis of this surgical MI technique will be needed before it can be recommended for widespread adoption.

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

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    Skand Sinha

    2013-10-01

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

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

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    Pozdniakova О.N.

    2011-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Sen Ramesh Kumar

    2011-06-01

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

  2. Intra-articular lignocaine as a means of analgesia during manual reduction of acute anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Manoj Kadel

    2016-11-01

    Full Text Available Background & Objectives: Acute anterior shoulder dislocation needs prompt reduction of the dislocation. The ideal reduction method should be simple, fast, effective and non- traumatic, with minimal pain, and should not cause further injury to the affected shoulder. Intra-articular local lignocaine injection is a means of achieving analgesia with less complication, and allowing prompt patient discharge of patient after reduction. The study was conducted with objective to evaluate the effectiveness of intra-articular lignocaine for reduction of acute anterior shoulder dislocation.Materials & Methods: Twenty- one cases of acute anterior shoulder dislocation were reduced using intra-articular local lignocaine injection as a method of analgesia by modified Hippocrates method.Results: The mean age was 44.71 years ± SD 20.14 while 11 cases were reduced with one to six hours of injury. Pain assessed through application of a visual analogue scale during the maneuver revealed scores ranging from two to eight with mean score of 4.29 ± SD 1.55.Conclusion: This method is not only safe and effective but also reduces hospital stay and has negligible adverse effects making it a popular choice for most orthopedists.

  3. EXPERIENCE OF THE LATARJET PROCEDURE FOR RECURRENT ANTERIOR SHOULDER DISLOCATION TREATMENT

    Directory of Open Access Journals (Sweden)

    E. A. Belyak

    2014-01-01

    Full Text Available We have the experience of open Latarjet procedures which were perfomed to 18 patients since 2011 to 2014 in the orthopaedic department Moscow city hospital № 12, among them 14 male (77,8% and 4 female (22,2% with anterior shoulder instability. Mean age of the group was 24,3 years. The mean follow-up was 16±4 months (from 6 to 26 months. Mean range of motion increased after 1 year post-op: flexion 178°±2° (from 170° to 180, increased at 2.4°. There was no post-op recurrent dislocation. The patients felt no subluxation or disturbance in operated shoulder. For functional scores, WOSI pre-op was 49,8, one year post-op decreased to 30,3. DASH-score pre-op was 16,5, post-op - 5,2. The results were defined as excellent in 12 patients, good in 6 patients, we had no bad or moderate results. All patients returned to normal life and sport activity.

  4. Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit.

    Science.gov (United States)

    Chung, Hoejeong; Yoon, Yeo-Seung; Shin, Ji-Soo; Shin, John Junghun; Kim, Doosup

    2016-09-01

    Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  6. 人工全髋置换联合髋臼造盖治疗先天性髋关节脱位★%Artificial total hip arthroplasty and hip-self procedure in the treatment of congenital dislocation of hip

    Institute of Scientific and Technical Information of China (English)

    刘燚; 严建军; 崔志明

    2013-01-01

      背景:以往采用单纯的人工关节置换、截骨重建等治疗成人 CrownⅣ型先天性髋关节脱位的效果都不是很满意。目的:探讨人工全髋置换联合髋臼造盖重建治疗成人CrownⅣ型先天性髋关节脱位的疗效。方法:回顾性分析采用人工全髋置换联合髋臼造盖重建治疗23例成人CrownⅣ型先天性髋关节脱位的患者,其中男2例,女21例,年龄20-35岁,平均(24.26±3.56)岁。重建治疗后按Harrris髋关节功能标准评定术后疗效并进行统计学分析。结果与结论:23例患者均获得随访,随访时间为12-60个月,平均(26.60±13.16)个月。采用SPSS19.0进行统计学比较后发现,手术前后髋关节功能Harrris评分差异有显著性意义(P <0.01)。人工全髋置换联合髋臼造盖能重建髋关节正常结构,缓解疼痛,增加髋关节稳定性,是治疗成人 Crown Ⅳ型先天性髋关节脱位的理想方法。%BACKGROUND:The effects of artificial joint replacement, osteotomy and reconstruction in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult are not very satisfied. OBJECTIVE:To evaluate the effect of artificial total hip arthroplasty and hip-self procedure in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult patients. METHODS:Twenty-three adult patients with Crown Ⅳ-type congenital dislocation of hip were treated with artificial total hip arthroplasty and hip-self procedure. There were 2 males and 21 females with an average age of (24.26±3.56) years ranging 20 to 35 years. The effect was evaluated according to the Harrris evaluation standard, and the statistical analysis was performed. RESULTS AND CONCLUSION:Al of the patients were fol owed-up for 12-60 months, averaged of (26.60±13.16) months. Statistical comparison with the SPSS 19.0 system showed there was significant difference of the Harrris scores between preoperation and postoperation period (P<0.05). The

  7. Proximal coracobrachialis tendon rupture, subscapularis tendon rupture, and medial dislocation of the long head of the biceps tendon in an adult after traumatic anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Bryan M Saltzman

    2015-01-01

    Full Text Available Rupture of the coracobrachialis is a rare entity, in isolation or in combination with other muscular or tendinous structures. When described, it is often a result of direct trauma to the anatomic area resulting in rupture of the muscle belly. The authors present a case of a 57-year-old female who suffered a proximal coracobrachialis tendon rupture from its origin at the coracoid process, with concomitant subscapularis tear and medial dislocation of the long head of biceps tendon after first time traumatic anterior shoulder dislocation. Two weeks after injury, magnetic resonance imaging suggested the diagnosis, which was confirmed during combined arthroscopic and open technique. Soft-tissue tenodesis of coracobrachialis to the intact short head of the biceps, tenodesis of the long head of biceps to the intertubercular groove, and double-row anatomic repair of the subscapularis were performed. The patient did well postoperatively, and ultimately at 6 months follow-up, she was without pain, and obtained 160΀ of active forward elevation, 45΀ of external rotation, internal rotation to T8, 5/5 subscapularis and biceps strength. Scoring scales had improved from the following preoperative to final follow-up: American Shoulder and Elbow Surgeons, 53.33-98.33; constant, 10-100; visual analogue scale-pain, 4-0. DASH score was 5.

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

    Science.gov (United States)

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

    2010-03-01

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

  9. Evaluation of the results and complications of the Latarjet procedure for recurrent anterior dislocation of the shoulder

    Directory of Open Access Journals (Sweden)

    Luciana Andrade da Silva

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: Evaluate the results and complications of Latarjet procedure in patients with anterior recurrent dislocation of the shoulder. METHODS: Fifty-one patients (52 shoulders with anterior recurrent dislocation, surgically treated by Latarjet procedure, were analyzed retrospectively. The average follow-up time was 22 months, range 12-66 months; The age range was 15-59 years with a mean of 31; regarding sex, 42 (82.4% patients were male and nine (17.6% were female. The dominant side was affected in 29 (55.8% shoulders. Regarding the etiology, 48 (92.3% reported trauma and four (7.6% had the first episode after a convulsion. RESULTS: The average elevation, lateral rotation and medial rotation of the operated shoulder were, respectively, 146° (60-80°, 59° (0-85° and T8 (T5 gluteus, with statistical significance for decreased range of motion in all planes, compared with the other side. The scores of Rowe and UCLA were 90.6 and 31.4, respectively, in the postoperative period. Eleven shoulders (21.2% had poor results: signs of instability (13.4%, non-union (11.5% and early loosening of the synthesis material (1.9%. There was a correlation between poor results and convulsive patients ( p = 0.026. CONCLUSION: We conclude that the Latarjet procedure for correction of anterior recurrent dislocation leads to good and excellent results in 82.7% of cases. Complications are related to errors in technique.

  10. 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.

  11. “Table-less” and “Assistant-less” Direct Anterior Approach to Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Daniel C Allison

    2015-10-01

    Full Text Available In recent years, specialized, non-sterile, traction table systems have facilitated Direct Anterior Approach (DAA hip arthroplasty. To combat the potential downsides of these traction systems, a sterile, intra-operative retractor option has emerged as a means to access the surgical site more easily, minimize soft-tissue trauma, and reduce the degree of required human assistance. This chapter describes the setup, surgical approach, and early results of a retractor system (the Phantom MIS Anterior Hip Retractor system [TeDan Surgical Innovations, Inc. {TSI}, Houston, Texas, US Patent # 8,808,176 B2], which uses a standard operating table, allows preparation of both lower extremities free in the surgical field, is compatible with fluoroscopy, and aids in both acetabular and femoral exposure, preparation, and implantation. Early outcome data indicates that this system significantly minimizes the need for surgical assistance, while allowing for safe and effective DAA performance, facilitating the procedure for high-volume surgeons and shortening the learning curve for surgeons new to the procedure.

  12. Open reduction for congenital dislocation of the hip: comparison of the long-term results of the wide exposure method and Ludloff's method.

    Science.gov (United States)

    Matsushita, T; Miyake, Y; Akazawa, H; Eguchi, S; Takahashi, Y

    1999-01-01

    We compared the long-term clinical and radiographic results of two methods of open reduction for congenital dislocation of the hip; a wide exposure method (360-degree circumferential capsulotomy) versus Ludloff's method (limited capsulotomy via the medial approach). Thirty-one hips in 24 patients assigned to group A received the wide exposure method and 32 hips in 27 patients assigned to group B had the Ludloff reduction. All patients were surgically reduced at less than 3 years of age. The follow-up averaged 16 years. None of the hips in group A required additional operations; however, 34.4% of the hips in group B did. At the latest review, 26 (83.9%) of the hips in group A were rated as Severin class I or II. Except for one patient, none had pain or a limp. Of the hips in group B, 18 (56.3%) were rated as Severin class I or II. Three patients had pain or Trendelenburg gait. Avascular necrosis occurred in 3.2% of hips in group A and in 21.9% of hips in group B. The wide exposure method is capable of completely releasing the posterosuperior tightness resulting from capsular adhesion to the ilium and the contracted short external rotators. Releasing the posterosuperior tightness from these structures seemed to provide a better chance of achieving an anatomically and functionally satisfactory hip.

  13. Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Frich, Lars Henrik; Hougaard, K.;

    1995-01-01

    The purpose of our study was to evaluate the use of static magnetic resonance imaging (MRI) as a preoperative diagnostic tool in young patients with a traumatic primary anterior shoulder dislocation. Twenty-five patients who had acute primary traumatic anterior shoulder dislocation were examined...... with MRI and arthroscopy. The patients (18 male and 7 female) were between 16 and 39 years old (mean age, 27 years). They had no previous shoulder dislocations. The dislocations were confirmed radiographically. Examination with MRI and arthroscopy was performed within 10 days after the trauma. The MRI...... evaluation was performed before the arthroscopic examination, and the images were interpreted by an experienced magnetic resonance radiologist. No information from the MRI examination was available to the orthopedic surgeons before arthroscopy. The standard of reference for comparison was arthroscopy...

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

    DEFF Research Database (Denmark)

    Jakobsen, Thomas; Kappel, Andreas; Hansen, Flemming;

    2014-01-01

    with a Saturne dual mobility cup (Amplitude, Neyron, France). The mean follow-up period was 44 months (SD 30, range 0.1-119). RESULTS: One patient (1.8%) experienced a re-dislocation. Three patients (5.3%) had to be revised. One due to disintegration between the femoral head and inner shell, one due to loosening...

  15. Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

    Directory of Open Access Journals (Sweden)

    Yasuhiro Homma

    2014-01-01

    Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

  16. Scleral Fixation of Posteriorly Dislocated Intraocular Lenses by 23-Gauge Vitrectomy without Anterior Segment Approach

    Directory of Open Access Journals (Sweden)

    Jeroni Nadal

    2015-01-01

    Full Text Available Background. To evaluate visual outcomes, corneal changes, intraocular lens (IOL stability, and complications after repositioning posteriorly dislocated IOLs and sulcus fixation with polyester sutures. Design. Prospective consecutive case series. Setting. Institut Universitari Barraquer. Participants. 25 eyes of 25 patients with posteriorly dislocated IOL. Methods. The patients underwent 23-gauge vitrectomy via the sulcus to rescue dislocated IOLs and fix them to the scleral wall with a previously looped nonabsorbable polyester suture. Main Outcome Measures. Best corrected visual acuity (BCVA LogMAR, corneal astigmatism, endothelial cell count, IOL stability, and postoperative complications. Results. Mean follow-up time was 18.8 ± 10.9 months. Mean surgery time was 33 ± 2 minutes. Mean BCVA improved from 0.30 ± 0.48 before surgery to 0.18 ± 0.60 (p=0.015 at 1 month, which persisted to 12 months (0.18 ± 0.60. Neither corneal astigmatism nor endothelial cell count showed alterations 1 year after surgery. Complications included IOL subluxation in 1 eye (4%, vitreous hemorrhage in 2 eyes (8%, transient hypotony in 2 eyes (8%, and cystic macular edema in 1 eye (4%. No patients presented retinal detachment. Conclusion. This surgical technique proved successful in the management of dislocated IOL. Functional results were good and the complications were easily resolved.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    谢喜波

    2015-01-01

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

  19. High Complication Rate With Anterior Total Hip Arthroplasties on a Fracture Table

    Science.gov (United States)

    Collis, Dennis K.

    2010-01-01

    Background Recent attention in THA has focused on minimally invasive techniques and their short-term outcomes. Despite much debate over the outcomes and complications of the two-incision and the mini-lateral and mini-posterior approaches, complications arising from use of the anterior THA on a fracture table are not well documented. Questions/purposes We determined the intraoperative and postoperative complications with the anterior approach to THA through an extended single-surgeon patient series. Methods We reviewed 800 primary THAs performed anteriorly with the aid of a fracture table over 5 years and recorded all intraoperative and postoperative complications up to latest followup (average, 1.8 years; range, 0–5 years). Patients with severe acetabular deformity or severe flexion contractures were excluded and those surgeries were performed with a lateral approach during the time period of this study. Results Intraoperative complications included 19 trochanteric fractures, three femoral perforations, one femoral fracture, one acetabular fracture, one bleeding complication, and one case of cardiovascular collapse. There were no ankle fractures. Postoperative complications included seven patients with dislocations; seven with deep infections; one with delayed femur fracture; 37 with wound complications, among which 13 had reoperation for local débridement; 14 with deep venous thrombosis; and two with pulmonary embolism; and 31 other nonfatal medical complications. Conclusions The main intraoperative complications of trochanteric fractures and perforations occurred mostly early in the series, while the main postoperative complications related to wound healing were prevalent throughout the entire series. Despite potential advantages of use of a fracture table, surgeons should be aware of the potential complications of trochanteric fractures, perforations, and wound-healing problems associated with this technique. Level of Evidence Level IV, therapeutic study

  20. Hip and knee joint kinematics during a diagonal jump landing in anterior cruciate ligament reconstructed females.

    Science.gov (United States)

    Delahunt, Eamonn; Prendiville, Anna; Sweeney, Lauren; Chawke, Mark; Kelleher, Judy; Patterson, Matt; Murphy, Katie

    2012-08-01

    Anterior cruciate ligament (ACL) injury is a common injury encountered by sport medicine clinicians. Surgical reconstruction is the recommended treatment of choice for those athletes wishing to return to full-contact sports participation and for sports requiring multi-directional movement patterns. The aim of ACL reconstruction is to restore knee joint mechanical stability such that the athlete can return to sporting participation. However, knowledge regarding the extent to which lower limb kinematic profiles are restored following ACL reconstruction is limited. In the present study the hip and knee joint kinematic profiles of 13 ACL reconstructed (ACL-R) and 16 non-injured control subjects were investigated during the performance of a diagonal jump landing task. The ACL-R group exhibited significantly less peak knee joint flexion (P=0.01). Significant between group differences were noted for time averaged hip joint sagittal plane (Pjoint frontal plane (Phip and knee joint kinematic profiles are present following ACL reconstruction, which could influence future injury risk.

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

    Energy Technology Data Exchange (ETDEWEB)

    Tins, Bernhard, E-mail: Bernhard.Tins@rjah.nhs.uk [Department of Radiology, RJAH Orthopaedic Hospital, Oswestry, Shropshire, SY 107 AG (United Kingdom)

    2011-07-15

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

  2. Incidence of selective ultrasound screening in congenital hip dislocation diagnosis. Incidencia del screening ecografico selectivo en el diagnostico de la luxacion de cadera

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Llorente, J.; Alonso Roca, S.; Garcia Urbon, M.; Malillos Perez, E.

    1994-01-01

    For the purpose of reducing the number of cases of late-diagnosed congenital hip dislocations, of the 1149 infants born in the province of Segovia during 1992, ultrasound exploration of the hip was performed in 297 who presented risk factors or abnormalities detected at physical examination. Of these, 16(1.4%) presented femoral head instability (13 subluxated or dislocated, and 3 susceptible to subluxation). Among this group, only 3 infants, versus a mean of 8 cases in preceding years, in whom radiolography was performed as a complementary study, were over four months old at the time of the exploration. Thus, it can be concluded that the use of ultrasound as a selective screening method significantly reduces the age at which diagnosis is feasible.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

  4. Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Desai Pingal; Timothy Marqueen; Karanvir Prakash

    2016-01-01

    Apophyseal injuries of the pelvis have increased recently with increased participation of teenagers in contact sports.Apophyseal fractures of the pelvis should be ruled out from apophysitis,os acetabuli and bony tumors.We report a case of fracture of anterior-inferior iliac spine following indirect injury to the hip in a young football player.The patient failed to get better with nonoperative management and continued to have pain in the left hip and signs and symptoms of impingement.He improved following surgical excision of the heterotopic bone and did not have any evidence of recurrence at 2 years followup.

  5. 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

  6. Congenital dislocation of hip in children: a review of patients treated in the Institute of Orthopaedics and Traumatology, General Hospital, Kuala Lumpur, 1975-1988.

    Science.gov (United States)

    Chai, A L; Sivanantham, M

    1990-06-01

    A retrospective review of patients with congenital dislocation of the hip (CDH) seen in the Institute of Orthopaedics, Kuala Lumpur General Hospital from 1975 to 1988 is presented. There was a female predominance of 17 to five. The average follow-up was 43 months and the average age at final assessment was 63 months. The results were assessed clinically and radiographically using Severin criteria. Eighty eight percent of the hips had excellent or good clinical results at final review compared with 40% of the hips which had excellent or good radiological grading (Severin I and II). Initial acetabular angle before treatment and types of treatment appeared to have a correlation with the final result. The incidence of avascular necrosis was 16%.

  7. Outcome of modified Bristow-Laterjet procedure in post-traumatic recurrent anterior shoulder dislocation in young population.

    Science.gov (United States)

    Sakeb, N; Islam, M A; Jannat, S N

    2015-01-01

    Anterior shoulder dislocation (ASD) is a common injury of young population which may progress to recurrent episodes. The treatment is initially conservative but surgery is indicated when it fails. Out of more than 150 techniques, modified Bristow-Latarjet procedure has become most favorable even to arthroscopic techniques. We have intended to retrospectively assess the outcome of it in post-traumatic recurrent ASD of young non-athletes, performed at our different private settings between January 2007 and July 2012; which included 15 male patients of 20-39 years with minimum 2 years follow up. Clinical, functional, radiological and overall outcome status were evaluated. There was significant improvement of shoulder stability (p<0.05, chi-square test) despite significant deterioration (p<0.05, paired t-test) of external rotation (21.67°±00.61° loss). The patient self assessed pain and instability had highly significant (p<0.001, paired t-test) and all components of activities of daily living (except above shoulder weight carrying and overhead throwing) had significant improvement (p<0.05, paired t-test). Despite of intra-operative difficulties, radiological transplant errors (33.33%) and post-operative complications (06.67%), overall satisfactory outcome (86.67%) had been significant (p<0.05, chi-square test).

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

    Institute of Scientific and Technical Information of China (English)

    鲁纯新; 金鸣苍

    1984-01-01

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

  9. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  11. Using evidence-based algorithms to improve clinical decision making: the case of a first-time anterior shoulder dislocation.

    Science.gov (United States)

    Federer, Andrew E; Taylor, Dean C; Mather, Richard C

    2013-09-01

    Decision making in health care has evolved substantially over the last century. Up until the late 1970s, medical decision making was predominantly intuitive and anecdotal. It was based on trial and error and involved high levels of problem solving. The 1980s gave way to empirical medicine, which was evidence based probabilistic, and involved pattern recognition and less problem solving. Although this represented a major advance in the quality of medical decision making, limitations existed. The advantages of the gold standard of the randomized controlled clinical trial (RCT) are well-known and this technique is irreplaceable in its ability to answer critical clinical questions. However, the RCT does have drawbacks. RCTs are expensive and can only capture a snapshot in time. As treatments change and new technologies emerge, new expensive clinical trials must be undertaken to reevaluate them. Furthermore, in order to best evaluate a single intervention, other factors must be controlled. In addition, the study population may not match that of another organization or provider. Although evidence-based medicine has provided powerful data for clinicians, effectively and efficiently tailoring it to the individual has not yet evolved. We are now in a period of transition from this evidence-based era to one dominated by the personalization and customization of care. It will be fueled by policy decisions to shift financial responsibility to the patient, creating a powerful and sophisticated consumer, unlike any patient we have known before. The challenge will be to apply medical evidence and personal preferences to medical decisions and deliver it efficiently in the increasingly busy clinical setting. In this article, we provide a robust review of the concepts of customized care and some of techniques to deliver it. We will illustrate this through a personalized decision model for the treatment decision after a first-time anterior shoulder dislocation.

  12. Catarata polar anterior piramidal deslocada para a câmara anterior causando edema de córnea: relato de caso Corneal edema caused by a pyramidal anterior polar cataract dislocated to the anterior chamber: case report

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

    Full Text Available Cataratas polares anteriores piramidais são opacidades cônicas que se projetam para a câmara anterior a partir da cápsula anterior do cristalino. Na grande maioria dos pacientes a opacidade permanece aderida e estável durante toda a vida. O objetivo deste trabalho é documentar uma manifestação incomum desse tipo de catarata: a deiscência espontânea das pirâmides para a câmara anterior causando descompensação endotelial e edema corneal bilateral. Relatamos o caso de uma paciente feminina, de 66 anos, branca, que apresentava edema corneal localizado inferiormente no olho direito associado à lesão nodular branco-esclerótica compatível com a pirâmide anterior da catarata polar. O olho esquerdo apresentava edema corneal difuso intenso e presença de uma catarata polar anterior com a região piramidal deslocada para a câmara anterior. Sabe-se que a pirâmide anterior pode permanecer inabsorvida na câmara anterior por longo período, pois é composta de tecido colágeno denso. Isto causa perda endotelial progressiva e edema corneal e deve ser considerada indicação de remoção cirúrgica da catarata polar anterior e de seu fragmento. Ressalta-se, também, a importância do bom senso no julgamento das cataratas polares anteriores, considerando-se tamanho da opacidade, simetria das opacidades e componente cortical associado, na tentativa de se evitar ambliopia.Pyramidal anterior polar cataracts are conical opacities that project into the anterior chamber from the anterior capsule of the lens. In the vast majority of patients the opacity remains bound and stable throughout life. We report an unusual complication of this type of cataract: spontaneous dehiscence of the pyramids to the anterior chamber causing bilateral endothelial damage and corneal edema. 66-year-old white woman presented with inferior corneal edema in the right eye and diffuse corneal edema in the left eye. A white nodular lesion was observed in the inferior angle

  13. Intra-articular lignocaine versus intravenous analgesia with or without sedation for manual reduction of acute anterior shoulder dislocation in adults.

    LENUS (Irish Health Repository)

    Wakai, Abel

    2012-01-31

    BACKGROUND: There is conflicting evidence regarding the use of intra-articular lignocaine injection for the closed manual reduction of acute anterior shoulder dislocations. A systematic review may help cohere the conflicting evidence. OBJECTIVES: To compare the clinical efficacy and safety of intra-articular lignocaine and intravenous analgesia (with or without sedation) for reduction of acute anterior shoulder dislocation. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 1), MEDLINE (1950 to March 2010), and EMBASE (1980 to March 2010). We searched Current Controlled Trials metaRegister of Clinical Trials (compiled by Current Science) (March 2010). We imposed no language restriction. SELECTION CRITERIA: Randomized controlled trials comparing intra-articular lignocaine (IAL) with intravenous analgesia with or without sedation (IVAS) in adults aged 18 years and over for reduction of acute anterior shoulder dislocation. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. Where possible, data were pooled and relative risks (RR) and mean differences (MD), each with 95% confidence intervals (CI), were computed using the Cochrane Review Manager statistical package (RevMan). MAIN RESULTS: Of 1041 publications obtained from the search strategy, we examined nine studies. Four studies were excluded, and five studies with 211 participants were eligible for inclusion. There was no difference in the immediate success rate of IAL when compared with IVAS in the closed manual reduction of acute anterior shoulder dislocation (RR 0.95; 95% CI 0.83 to 1.10). There were significantly fewer adverse effects associated with IAL compared with IVAS (RR 0.16; 95% CI 0.06 to 0.43). The mean time spent in the emergency department was significantly less with IAL compared with IVAS (MD 109.46 minutes; 95% CI 84.60 to 134.32). One trial reported significantly less time for

  14. Manipulative reduction of shoulder lift for the treatment of posterior dislocation of hip joint%肩顶复位法治疗髋关节后脱位

    Institute of Scientific and Technical Information of China (English)

    孙权; 唐孝富

    2012-01-01

    目的:观察肩顶复位法治疗髋关节后脱位的临床疗效.方法:2001年7月至2010年6月,14例髋关节后脱位,男12例,女2例;年龄18-57岁,平均34.6岁;病程2 h-3d,平均1.1d.采用肩顶复位法整复,复位后配以牵引、练功及中药等治疗.根据Harris功能评分系统评价疗效.结果:14例均一次复位成功并获随访,时间8-24个月,平均16个月.Harris功能总分为(97.14±4.90)分,其中髋部疼痛、关节活动度、日常功能活动、畸形分别为(42.86±1.88)、(4.71±0.47)、(45.57±9.26)、(4.00-±0.00)分;优12例,良2例.均未出现股骨头缺血性坏死等并发症.结论:肩顶复位法可单人操作,有效整复髋关节后脱位,为患髋康复奠定良好基础.%Objective: To observe the effects of shoulder lift reduction for treatment of posterior dislocation of hip joint. Methods:From July 2001 to June 2010,14 cases of posterior dislocation of hip joint were treated with shoulder lift reduction involving 12 males and 2 females with an average age of 34.6 years ranging from 18 to 57 years. After recduction,all patients were assisted with the traction,exercise and traditional Chinese medicine. The mean duration between injured and treatment was 1.1 days (2 hours to 3 days). According to Harris scoring system the hip joint function were evaluated. Results: All patients were followed-up for 8 to 24 months (means 16 months). Fourteen cases were reset well in first without any complication. The Harris score was (97.14±4.90) in total, involving hip pain (42.86±1.88),articular activity (4.71 ±0.47), daily activity (45.57±9.26) .deformity (4.00±0.00) ,the clinical outcome was excellent in 12 cases,good in 2. There were not complications such as avascular necrosis of the femoral head, and so on. Conclusion: The shoulder lift reduction can be used by one person, and the treatment of posterior dislocation of hip joint is effective. It established a good foundation for the rehabilitation of

  15. Descriptive anatomy of the femoral portion of the iliopsoas muscle. Anatomical basis of anterior snapping of the hip.

    Science.gov (United States)

    Tatu, L; Parratte, B; Vuillier, F; Diop, M; Monnier, G

    2001-01-01

    Anterior hip snapping is a rare clinical observation. The physiopathological hypothesis currently held is a sudden slip of the iliopsoas tendon over the iliopectineal eminence. For symptomatic cases, a surgical technique is proposed. The aim of this work is to describe the anatomy of the femoral portion of the iliopsoas, which is the target of surgery. We have studied, through dissection of embalmed cadavers, the different components of the musculotendinous complex forming the femoral portion of the muscle and the gliding apparatus associated with it. The psoas major tendon exhibited a characteristic rotation. The iliacus tendon, more lateral, received the most medial iliacus muscular fibers, then fused with the main tendon. The most lateral fibers, starting in particular from the ventral portion of the iliac crest, ended up without any tendon on the anterior surface of the lesser trochanter and in the infratrochanteric region. The most inferior muscular fibers of the iliacus, starting from the arcuate line, joined the principal tendon of the psoas major passing around it by its ventromedial surface. An ilio-infratrochanteric muscular bundle was observed, in a deeper position, under the iliopsoas tendon; it arose from the interspinous incisure and on the anterior inferior iliac spine, ran along the anterolateral edge of the iliacus and inserted without any tendon onto the anterior surface of the lesser trochanter of the femur and in the infratrochanteric area. The iliopectineal bursa was studied on horizontal cross sections of a frozen pelvis and on 5 of the non-frozen preparations after dividing the iliopsoas tendon. The iliopectineal bursa had the shape of a 5 to 6-cm high and 3-cm wide cavity; in its upper part, it was divided into 2 compartments: a medial compartment for the main tendon and a lateral compartment for the accessory tendon.

  16. 双侧发育性髋关节脱位一期Salter骨盆截骨术%Bilateral Salter osteotomies for developmental dislocation of hip in children

    Institute of Scientific and Technical Information of China (English)

    孙庆增; 史迎春; 秦海辉; 张凤飞

    2012-01-01

    目的 探讨双侧发育性髋关节脱位一期Salter骨盆截骨术的安全性和近期疗效.方法 双侧同时行Salter骨盆截骨术的发育性双侧髋关节脱位患儿48例(96髋),为观察组,取同期单侧分次Salter骨盆截骨术患儿66例(76髋),为对照组.比较两组术后关节功能、髋臼的X线表现、并发症发生率等.结果 随访2年至5年6个月,按Mckay髋关节功能评价标准,观察组术后优良率为96.88%,对照组为98.68%;按Severin标准评定X线表现,病例组术后优良率为94.79%,对照组为97.37%;股骨头无菌性坏死率观察组为4.17%,对照组为3.95%;髋关节功能不良的发生率在观察组及对照组分别为3.13%和1.32%.两组各项指标比较均无统计学意义.结论 双侧同时行Salter骨盆截骨与单侧Salter骨盆截骨疗效相似,双侧Salter骨盆截骨治疗发育性双侧髋关节脱位安全有效.远期疗效有待迸一步观察.%Objective To evaluate the safety and short-term efficacy of bilateral Salter osteotomies for developmental dislocation of bilateral hips. Methods 48 cases (96 hips , study cases) with developmental dislocation of bilateral hips were observed and analyzed,who were treated with bilateral Salter ostotomies, another 66 patients(76 hips) underwent unilateral Salter osteotomy were served as controls. Clinical data including mobility of hip joint , radiological findings, and operation complications were analyzed and compared with the control group. Statistical analysis of the results was performed using Pearson Chi-Square test. Results The mean follow-up was 3.5(2-5.5)years. According to the modified McKay clinical criteria,Severin radiographic classification and Salter AVN diagnostic criteria,the excellent to good rate for Severin classification and modified McKay criteria were94. 79% ,96. 88% respectively in study cases, while 98. 68% ,97. 37% in control group. The incidence of avascular necrosis of the femoral head were 4

  17. 手术复位不良导致的腓骨前脱位1例%Anterior dislocation of the fibula resulting from surgical malreduction:a case report

    Institute of Scientific and Technical Information of China (English)

    王子昀; 吴新宝

    2016-01-01

    SUMMARY Anklejointfractureisoneofthemostcommontypesoffracture.Therearemanyresearches on the injury mechanism,treatment principles and surgical techniques.A type of injury which combines posterior dislocation of fibula,known as the Bosworth injury,is relatively rare.In 1947,Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture disloca-tion of the distal part of the fibula.In this type of fracture,the proximal fibular shaft fragment locks be-hind the tibialis posterior tubercle.This rare ankle fracture variant is often not recognized in initial radio-graphs and requires a computed tomographic (CT)scan for verification.But there are already many re-ports,discussing the injury mechanism,treatment principles and surgical techniques.However,there are few reports of anterior dislocation of the fibula,caused by either injury or surgery.The mechanism of the injury is still not clear.This article reports a case of anterior dislocation of the fibula.We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage Ⅲ,Gustilo ⅢA).Open reduction and internal fixation was done in the initial surgery,but ended up with poor reduction,resulting in fibula anterior dislocation,anterior dislocation of talus and tibia fibular dislocation.The fibula was dis-located anteriorly of the tibia,which rarely happened.The patient suffered severe ankle joint dysfunc-tion.The second operation took out the original internal fixation,reduced the fracture,and reset the in-ternal fixation.The function of ankle joint was improved obviously after operation.But because of the ini-tial injury and the two operations,the soft tissue around the fracture was greatly damaged.6 months after the second operation,and the fracture still not healed,so the bone graft was carried out in the third sur-gery.Two months after the third surgery,the function of the ankle was significantly better than before, but the fracture

  18. Anterior cervical fusion and osteosynthetic stabilization according to Caspar: a prospective study of 41 patients with fractures and/or dislocations of the cervical spine.

    Science.gov (United States)

    Goffin, J; Plets, C; Van den Bergh, R

    1989-12-01

    Between June 1984 and April 1988, 41 patients with severe posttraumatic lesions of the cervical spine between the C2-C3 and the C7-T1 level seen consecutively were treated by an anterior cervical fusion and osteosynthetic stabilization according to Caspar. These patients were prospectively studied. Seven patients had a bilateral facet dislocation, 5 a unilateral facet dislocation, 9 an anterior subluxation, 9 an anterior compression fracture, 5 a hangman's fracture, and 6 a hyperextension injury at a lower cervical level. From a neurological point of view, there were 12 patients with an initial complete transverse lesion and 14 with an incomplete transverse lesion, and the remaining 15 patients did not have any deficit initially. Four patients died during the first 3 months after the operation. In 38 patients good anatomical position was obtained, generally by the intraoperative use of the vertebral distractor of Caspar. In all patients excellent immediate postoperative stability of the spine was obtained, although in 2 patients a second operation was necessary a few days after the first one. Postoperatively all patients were "immobilized" by a soft collar for 3 months. Four patients with an initial complete transverse lesion showed some neurological recovery in the postoperative period, and all patients with an incomplete transverse lesion improved. There were no postoperative neurological disturbances in the group of patients who were neurologically normal from the beginning. The mean postoperative hospitalization time was 13.6 days. These results were compared to the results from the literature, concerning other conservative and operative treatments for posttraumatic lesions of the cervical spine.

  19. Does anterior knee pain severity and function relate to the frontal plane projection angle and trunk and hip strength in women with patellofemoral pain?

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; Carvalho E Silva, Ana Paula de Moura Campos; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2015-07-01

    The aim of the present study was to determine the relationship between knee pain severity and function with the frontal plane projection angle (FPPA) and trunk and hip peak torque (PT) in women with patellofemoral pain (PFPS). Twenty-two women with PFPS were assessed. Knee pain severity (KPS) was assessed with an 11-point visual analog scale and function with an Anterior Knee Pain Scale. The FPPA was recorded with a digital camera. PT of extensors, abductors, and the lateral rotators of hip and lateral core stability were measured with a handheld dynamometer. FPPA was the only predictor for the KPS. Regarding predictors of function, PT of lateral core stability and the extensor and abductor of the hip explained 41.4% of the function. Increase in FPPA was associated with greater KPS, and the lowest PT of lateral core stability, hip abductors, and extensors was associated with lower function in women with PFPS.

  20. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    Science.gov (United States)

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  1. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

    Science.gov (United States)

    Godinho, Glaydson Gomes; Freitas, José Márcio Alves; de Oliveira França, Flávio; Santos, Flávio Márcio Lago; de Simoni, Leandro Furtado; Godinho, Pedro Couto

    2016-01-01

    Objective To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. Methods Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A) or greater than or equal to 3.0 cm (group B). All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles) score and strength measurements. Results The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743). Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416). Conclusion The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation. PMID:27069884

  2. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

    Directory of Open Access Journals (Sweden)

    Glaydson Gomes Godinho

    2016-04-01

    Full Text Available OBJECTIVE: To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. METHODS: Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A or greater than or equal to 3.0 cm (group B. All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles score and strength measurements. RESULTS: The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743. Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416. CONCLUSION: The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation.

  3. Surgical hip dislocation approach for treatment of Pipkin type Ⅳ fractures%髋关节外科脱位入路治疗Pipkin Ⅳ型骨折

    Institute of Scientific and Technical Information of China (English)

    刘世学; 杨晓东; 夏广; 谷城; 王宏波; 李涛; 黄伟奇; 麦奇光; 樊仕才

    2016-01-01

    ) and type Ⅱ (3 ones).According to Letournel-Judet classification,the acetabular fractures were one posterior wall fracture,2 posterior column and posterior wall fractures,and 2 posterior wall and hemitransverse fractures.All patients received reduction and supracondylar bone traction within 8 hours after injury,and surgery 5 to 12 days after injury.The Ganz approach was made.The trochanteric fragment was displaced anteriorly.After a Z-shaped capsulotomy,the visualized hip joint was dislocated.The acetabulum was fixated after the femoral head was reduced and fixated.Postoperative traction continued for 4 weeks.The outcomes were evaluated in terms of avascular necrosis of the femoral head,heterotopic ossification and Thompson-Epstein scores.Results All patients obtained fine radiographic reduction and union of the fractures of femoral head and acetabulum.The patients were followed up for an average of 18 months (from 6 to 36 months).Necrosis of the femoral head of stage Ⅰb-Ⅱb (by International Bone Circulation Society Scale) without obvious symptoms occurred in one case.Necrosis of the femoral head of stage Ⅲ b 1 occurred in another who was treated by total hip replacement.Heterotopic ossification occurred in one case.No infection,implant failure,or nonunion of fracture of femoral head or acetabulum happened.By the Thompson-Epstein score,3 patients were excellent,one good and one fair.Conclusion The surgical hip dislocation approach (Ganz approach) is fine for the treatment of Pipkin type Ⅳ fracture,because it can not only protect the remaining vessels of the femoral head but also fully reveal the acetabulum and the femoral head.

  4. Comparison of direct anterior approach and posterolateral approach in total hip arthroplasty%直接前入路与后外侧入路全髋关节置换术的对比研究

    Institute of Scientific and Technical Information of China (English)

    桑伟林; 朱力波; 陆海明; 王聪; 马金忠

    2015-01-01

    .Methods From September 2008 to March 2011, total hip arthroplasties were performed on 160 patients (160 hips) in orthopedic department of Shanghai General Hospital of Shanghai Jiaotong University.DAA was used in 78 patients and posterolateral approach was used in 82 patients.All the cases were primary unilateral hip joint replacement.Crow Ⅳdevelopmental dysplasia of the hip ( DDH) , ankylosing hip arthritis and those needing special prosthesis were not included.The age, body mass index, operation time, blood loss, and diameter of the artificial femoral head were recorded and analyzed.Acetabular abduction angles, anteversion angles and femoral prosthesis lines were measured six months after the operation.The incidences of dislocation and other complications between the two groups were compared.Harris scores were also compared at the last follow-up visit.All the cases were followed up for at least two years.Results The average age of the patients was (53.0 ±11.2)years in DAA group and (54.0 ±13.2)years in posteolateral group.The mean body mass index was ( 24.2 ±2.7 ) in DAA group and ( 24.1 ±3.3 ) in posteolateral group, which showed no significant difference between the two groups.The average operation time of the DAA group [ ( 72.0 ± 10.1) min] was longer than the posteolateral group [(55.0 ±11.5) min] (P0.05] at the last follow-up.No dislocation was observed in the DAA group;one case of periprosthetic fracture with hip revision and two cases of dislocation were observed in the posterolateral group.One case of deep hematoma and one case of delayed infection were observed in the DAA group and in the posterolateral group respectively.Conclusion Direct anterior approach total hip arthroplasty can preserve hip muscles and achieve faster recovery and better stability.

  5. 髋脱位莎氏术后影像学与功能评价的相关性%Correlation between radiological manifestations and functional outcomes of hips after surgery for developmental dislocation of the hip in children

    Institute of Scientific and Technical Information of China (English)

    刘坚林; 赵黎; 胡玲珑; 赵大航; 沈品泉; 王晓林; 陆美玲; 陈瑾瑛; 赵艳君

    2015-01-01

    Objective To explore the relationship between residual dysplasia of hip and functional outcomes after surgery for developmental dislocation of hip in children.Methods From January 1994 to December 2000,17 children (26 hips) were diagnosed as developmental dislocation of the hip and underwent modified Zahradnicek procedure at our hospital.The involved hip joints were bilateral (n =9),right-sided (n =4) and left-sided (n =4).The average follow-up period was 15.6 (12-20) years.The values of Sharp angle,acetabular depth and center-edge angle were measured while the integrity of Shenton line and radiological manifestations of osteoarthritis were assessed by pelvic radiograph.The functional outcomes of hip were assessed by the Harris questionnaire.The relationships between residual dysplasia of hip joint deformity and osteoarthritis,residual dysplasia of hip joint deformity and Harris score and osteoarthritis and Harris score were assessed by Spearman's test respectively.Results No correlation existed between residual dysplasia of hip joint deformity and osteoarthritis (R=0.360 0,P=0.155 8) or Harris score (R =-0.066 5,P =0.799 9).However,there was correlation between osteoarthritis and Harris score (R =-0.612 1,P =0.009 0).Conclusions Based on the results of mid-term follow-ups,severity of hip residual dysplasia is not a decisive factor for its function.Some other causes may contribute to poor function of involved hip.If osteoarthritis is detected on pelvic radiograph,joint function shall be affected.Proper treatment is selected according to radiological findings and comprehensive evaluations.%目的 通过评价儿童髋关节脱位莎氏手术复位后影像学改变与临床功能评价的相关性,探索髋关节发育不良术后后遗发育不良的表现和关节功能之间的联系,对患儿日常生活的影响,以及什么样的髋关节后遗表现才需要进一步治疗的问题.方法 收集1994年1月至2000年12月间,因髋关节脱位在我院行开

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

    Institute of Scientific and Technical Information of China (English)

    李军; 梅玉峰; 王海鹏; 陈祝峰; 胡运生; 周程沛; 王波

    2016-01-01

    目的:观察髋关节外科脱位( surgical hip dislocation,SHD )技术在髋关节手术中的应用效果,探讨与临床意义有关的影响因素。方法回顾分析2008年2月至2013年8月,29例患者应用 SHD 技术进行手术,得到全程随访19例,随访时间11~46个月,平均28个月。术前诊断髋关节撞击综合征8例,股骨头坏死继发髋关节撞击征3例,髋关节良性肿瘤5例,扁平髋畸形( Perthe’s 病后遗畸形)3例,所有病例术前有明显的关节疼痛,关节活动障碍等症状,影像学提示关节畸形。本组年龄16~55岁,平均31.2岁。末次随访时行髋关节 X 线摄片评估股骨头缺血坏死情况及 YHS 评分( Non-Arthritic Young Hip 评分)评价髋关节功能变化,比较手术前后结果,并进行统计学分析。结果平均手术脱位时间32.6 min,术中失血353.43 ml。所有病例髋关节疼痛均有不同程度减轻和关节活动度的提高,髋关节功能平均 YHS 术前评分(49.42±7.73)分,术后(83.52±10.19)分。改良 YHS 评分满意度评价优5例(26.3%),良12例(63.2%),可1例(5.3%),差1例(5.3%)。大粗隆截骨部位均愈合良好,无股骨头坏死及股骨粗隆间骨折并发症。结论SHD 技术可全方位显露髋关节包括髋臼和股骨侧的所有关节和非关节头颈交界区,不影响股骨头主要血液供应,是全面进入髋关节内部进行髋关节手术的良好方法。%Objective To analyze the clinical and radiographic results of surgical hip dislocation ( SHD ) in the treatment of various hip surgeries, and to evaluate the influence factors of the clinical outcomes. Methods From February 2008 to August 2013, 29 SHD surgeries were performed. Nineteen patients were followed up with the average of 28 months ( range: 11 - 46 months ). Primary diagnoses of the hip abnormalities: femoracetabular impingement ( FAI ) in 8 cases, FAI and avascular necrosis of the hip ( AVN ) in 3 cases

  7. MRI study of the infantile developmental dislocation of the hip%婴幼儿发育性髋关节脱位MR I评价

    Institute of Scientific and Technical Information of China (English)

    王亮; 盛茂; 郭万亮; 王琪; 任彦; 甄允方; 杨毅; 沈钧康

    2014-01-01

    目的:探讨 MRI在婴幼儿发育性髋关节脱位(DDH)诊断中的应用价值。方法回顾性分析45例经手术证实为 DDH患儿(病例组)的术前 MRI和40例正常髋关节儿童的(对照组)MRI 资料。根据 Dunn标准将 DDH 分为3型(Ⅰ型、Ⅱ型、Ⅲ型)。在 MRI冠状位测量骨性髋臼指数(BAI)、软骨性髋臼指数(CAI),并与正常髋关节相应的测量值作对照;同时观察影响 DDH 复位的因素(关节软骨、盂唇、圆韧带、髂腰肌)。结果对照组髋关节80个,病例组髋关节73个,其中Ⅰ型30个、Ⅱ型20个、Ⅲ型23个。对照组与病例组BAI分别为(26.13±2.19)°、(35.87±4.42)°,CAI 分别为(13.84±1.07)°、(21.92±4.70)°。各型(Ⅰ型、Ⅱ型、Ⅲ型)脱位髋关节BAI分别为(31.80±1.74)°、(37.80±3.40)°和(39.17±4.11)°;CAI分别为(17.20±2.68)°、(20.91±2.02)°和(27.50±2.78)°。BAI 和 CAI 在对照组与病例组间的差异均具有显著统计学意义(t值分别为-11.048和-9.188,P 值均为0.000)。BAI和CAI在病例组各型(Ⅰ型、Ⅱ型和Ⅲ型)脱位髋关节间的差异均具有显著统计学意义(F值分别为22.159和47.241, P值均为0.000)。病例组、对照组及各型(Ⅰ型、Ⅱ型、Ⅲ型)髋脱位BAI与CAI二者间均呈线性正相关(r值分别为0.964、0.844、0.953、0.931和0.870,P值均为0.000)。Ⅱ型和Ⅲ型脱位髋关节中观察到盂唇内翻、圆韧带粗大、髂腰肌挛缩、关节软骨增生、关节积液、脂肪增生等病理变化。结论 MRI不仅可测量BAI和CAI值,比较二者在对照组、病例组及各型间的线性相关关系,而且清晰显示影响DD H 复位的因素,为诊断与治疗提供重要的参考依据。%Objective To investigate the diagnostic value of MRI in the infantile developmental dislocation of the hip.Methods Forty-five cases of preoperative hip MRI data of DDH (patient group)and 40 cases of normal hip (control group)MRI data were retrospectively analyzed.Three types

  8. Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy Tratamento cirúrgico da luxação congênita do quadril pós marcha: redução aberta e osteotomia de Salter

    OpenAIRE

    Guaracy Carvalho Filho; Alceu Gomes Chueire; Helencar Ignácio; Márcio de Oliveira Carneiro; João Francese Neto; Augusto César Canesin

    2003-01-01

    The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter). In this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months...

  9. Proptosis and Anterior Dislocation as a Late Noninflammatory Complication of Failure of Tissue Integration in the Alphasphere Implant.

    Science.gov (United States)

    Neimkin, Michael G; Reggie, Sara; Holds, John B

    2016-01-04

    A 57-year-old healthy female underwent enucleation for choroidal melanoma with primary implantation of a 2-hydroxyethyl methacrylate sphere (AlphaSphere, Addition Technology, Des Plaines, IL). Her course was uneventful, with successful prosthetic fitting 6 weeks postoperatively. She returned 2 years later, with anterior displacement of the implant, poor implant movement, and poor prosthetic fit. There was no defect in the conjunctiva, Tenon's layer or evidence of inflammation. Successful orbital implant exchange was performed, replacing the AlphaSphere with an eyebank-scleral wrapped acrylic implant. Intraoperative findings revealed dissolution of the scaffolding aspect of the anterior implant, with loss of extraocular muscle attachments and no fibrovascular ingrowth. This case demonstrates late AlphaSphere failure in an otherwise unremarkable course; further review of similar cases or a larger study is warranted to examine the efficacy of this relatively new implant.

  10. Resultados do procedimento artroscópico de "remplissage" na luxação anterior recidivante do ombro Results from filling "remplissage" arthroscopic technique for recurrent anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Mauro Emilio Conforto Gracitelli

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o resultado clínico da técnica de "remplissage" associada ao reparo da lesão de Bankart (BK para o tratamento da luxação anterior recidivante do ombro. MÉTODOS: Nove pacientes (10 ombros, com seguimento médio de 13,7 meses, apresentaram luxação traumática anterior recidivante do ombro. Todos tinham lesão de BK associada à lesão de Hill e Sachs (HS, com sinal do "encaixe". O defeito das lesões de HS foi medido e apresentava em média 17,3% (7,7% a 26,7% de perda óssea em relação ao diâmetro da cabeça do úmero. Todos foram submetidos ao reparo artroscópico da lesão de BK associado ao preenchimento ("remplissage" da lesão de HS pela tenodese do infraespinal. RESULTADOS: O escore de Rowe variou de 22,5 (10 a 45 no período pré-operatório para 80,5 (5 a 100 no período pós operatório (p OBJECTIVE: To evaluate the clinical result from the filling ("remplissage" technique in association with Bankart lesion repair for treating recurrent anterior shoulder dislocation. METHODS: Nine patients (10 shoulders, with a mean follow-up of 13.7 months, presented traumatic recurrent anterior shoulder dislocation. All of them had a Bankart lesion, associated with a Hill-Sachs lesion showing the "engaging" sign. The Hill-Sachs lesion defect was measured and showed an average bone loss of 17.3% (7.7% to 26.7% in relation to the diameter of the humeral head. All the cases underwent arthroscopic repair of the Bankart lesion, together with filling of the Hill-Sachs lesion by means of tenodesis of the infraspinatus. RESULTS: The Rowe score ranged from 22.5 (10 to 45 before the operation to 80.5 (5 to 100 after the operation (p < 0.001. The UCLA score ranged from 18.0 (8 to 29 to 31.1 (21 to 31 (p < 0.001. The measurements of external and internal rotation at abduction of 90º after the operation were 63.5º (45º to 90º and 73º (50º to 92º respectively. Two patients presented recurrence (one with dislocation and the other

  11. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    Directory of Open Access Journals (Sweden)

    Andrew D. Vigotsky

    2015-09-01

    Full Text Available Background. Foam rolling has been shown to acutely increase range of motion (ROM during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated.Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61; z(22 = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72 was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75; t(22 = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29 or rectus femoris length (change = −0.005 (−0.013, +0.003; t(22 = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16 were not due to chance alone.Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  12. Do Muscle Strength Deficits of the Uninvolved Hip and Knee Exist in Young Athletes Before Anterior Cruciate Ligament Reconstruction?

    Science.gov (United States)

    Hannon, Joseph; Wang-Price, Sharon; Goto, Shiho; Garrison, J. Craig; Bothwell, James M.

    2017-01-01

    Background: Muscle strength of the involved limb is known to be decreased after injury. Comparison with the uninvolved limb has become standard of practice to measure progress and for calculation of limb symmetry indices (LSIs) to determine readiness to return to sport. However, some literature suggests strength changes in the uninvolved limb also are present after lower extremity injury. Purpose: To examine the uninvolved limb strength in a population of adolescent athletes after an anterior cruciate ligament (ACL) injury and compare strength values with those of the dominant limb in a healthy control group. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 64 athletes were enrolled in this study, including 31with injured ACLs (mean age, 15.6 ± 1.4 years) and 33 healthy controls (mean age, 14.9 ± 1.9 years). The median time from injury to testing was 23 days for the ACL-injured group. Participants underwent Biodex isokinetic strength testing at 60 deg/s to assess quadriceps and hamstring strength. Isometric hip strength (abduction, extension, external rotation) was measured using a handheld dynamometer. The muscle strength of the uninvolved limb of the ACL-injured group was compared with that of the dominant limb of the healthy control group. Results: The results showed a significant difference in quadriceps muscle strength between the 2 study groups (P ACL group was significantly decreased by 25.5% (P ACL injury as compared with healthy controls. Consideration should be taken when using the uninvolved limb for comparison when assessing quadriceps strength in a population with an ACL injury. PMID:28203600

  13. Efficacy of Total Hip Arthroplasty of Adults with Congenital Dislocation of the Hip%人工全髋关节置换术对成人先天性髋脱位的疗效观察

    Institute of Scientific and Technical Information of China (English)

    钱宏

    2012-01-01

      Objective To analyze and evaluate adult patients with congenital dislocation of the hip patients to the clinical efficacy of the implementation of total hip arthroplasty. Implementation of a total hip arthroplasty: 18 cases of Crowe,  Ⅳ congenital dislocation of the hip patients, preoperative administration of skeletal traction for 2 weeks of treatment, intraoperative lysis and reconstruction of the hip center of rotation and hip abduction postoperatively Limb Lengthening the assessment of hip function. Results  The average time of the surgery the patient was 100.5 ± 9.5min, hand bleeding volume average is (490.4±31.5)mL; joint center of rotation of all patients with reconstruction of the normal anatomical position. Followed up for 15 months after surgery the patient, and did not find the cup and the femoral prosthesis loosening, the Harris hip score was average (90.4±3.1); follow-up was not found during the dislocation, fracture, and periprosthetic tissue infections. Conclusion  The Crowe, Ⅳ congenital dislocation of the hip in patients with tibial traction before surgery, the release of the hip center of rotation and re-establish a reasonable choice of the prosthesis, the effective protection of the nerves and blood vessels and other measures, the use of artificial hip arthroplasty surgery can still achieve a better therapeutic effect.%  目的 分析并评价成人先天性髋关节脱位患者实施人工全髋关节置换术的临床疗效.方法 对18例 Crowe Ⅳ型先天性髋关节脱位患者实施人工全髋关节置换术,术前给予骨牵引治疗2周,术中松解与重建髋关节旋转中心以及髋关节外展功能,术后对肢体延长情况与髋关

  14. 先天性髋脱位治疗后股骨头缺血性坏死的后遗畸形%Residual Deformities of Avascular Necrosis of Femoral Head following Treatment of Congenital Dislocation of Hip

    Institute of Scientific and Technical Information of China (English)

    吉士俊; 周永德; 刘卫东; 纪树荣

    1985-01-01

    238 Cases of congenital dislocation of the hip were treated in the past 20 years.40 cases(52 hips)complicated with avascular necrosis of the femoral head were followed up for more than 3 years,(average 6.2 years)This paper gives an analysis of the residual deformities of the avascular necrosis of the femoral head,which can be divided into 3 types:(1)deformities of the femoral head including enlargement flattening, deformation and disappearance(28 hips 53.7%);(2)shortening and widening of the femoral neck in 34 hips(65.4%),coxa valga(8 hips,15.4%)and coxa vara(15 hips,28.8%)and relative high position of the greater trochanter(28 hips,53.8%);(3)degenerative arthritis(19 hips,36.5%).Also discussed is the difference between residual deformities of the femoral head necrosis and Legg-Perthes disease, as well as their mechanism,pathological development after avascular necrosis,and the characters of the residual deformities in the 4 types of avascular necrosis of the femoral head.Several surgical procedures to improve the residual deformities are also described.%@@ 近年来随着治疗先天性髋脱位的日益增加,股骨头缺血性坏死(以下简称头坏死)的并发症也不断增多,确认和处理其后遗畸形已成为临床研究的重要课题.

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

    OpenAIRE

    Balaji Saibaba; Ramesh Kumar Sen; Manish Sharma; Uma Nahar

    2016-01-01

    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 ...

  16. Atraumatic Bilateral Neglected Anterior Shoulder Dislocation: Case Report of a Jehovah’s Witness 28-Year-Old Male Affected by Iron-Deficiency Anemia and Treated with Bilateral Latarjet Procedure

    Science.gov (United States)

    Poggetti, Andrea; Castellini, Iacopo; Neri, Elisabetta; Marchettil, Stefano; Lisanti, Michele

    2015-01-01

    Introduction: Neglected bilateral anterior shoulder dislocation is a very rare condition, often related to seizures or major trauma. Open reduction is recommended whenever Hill-Sachs lesion is >25% of the joint and the dislocation is elder than 3 weeks. Case Report: We describe a case report of a 28-year-old man left handed Jehovah’s Witness laborer assessed 12 weeks after bilateral anterior shoulder dislocation. The patient was evaluated with clinical examination, and it was observed an asymptomatic intrarotation of both shoulders with a mild left circumflex nerve deficit. He was able to perform flexion and abduction of both arms up to 60° and 10° of extrarotation. Pre-operative constant scores were 49 in left and 55 in right shoulder, pre-operative disabilities of the arm, shoulder, and hand (DASH) scores were 57 in left and 53 in right shoulder, and visual analogue scales (VAS) was 2. Radiological examination were bilateral anteroposterior shoulder X-rays and computer tomography scan. The surgeon treated both shoulder (not simultaneously) by open reduction and Bristow-Latarjet coracoids transfer procedure. A 1 year after operations, left flexion was 180° while right was 160, bilateral abduction was 180. He was able to return to his pre-injury activities, the constant score was 89 left and 83 right, DASH score was 17 left and 13 right and VAS was 0. Conclusion: Atraumatic bilateral neglected anterior shoulder dislocation can be treated with open Bristow-Latarjet procedure to provide a stable glenohumeral joint in laborer patient and permit a return to the pre-injury activities, to create a greater extension of the glenoid arc and to avoid future dislocation. PMID:27299079

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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

  19. 后前入路治疗下颈椎骨折脱位伴双侧关节突绞锁%Decompression via posterior-anterior approach and anterior fixation in treatment of fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation

    Institute of Scientific and Technical Information of China (English)

    李鹏; 雪原; 王沛; 马信龙; 赵华健; 赵晓涛; 卢旭亚

    2011-01-01

    Objective To evaluate the surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation. Methods This study retrospectively reviewed 37 cases of lower cervical spine fracture with bilateral joints dislocation. There were 21 males and 16 females with an average age of 42 years (19-58). Distraction-flexion stage 3(DFS 3) were found in 24 cases and DFS 4 in 13 cases. All the cases were diagnosed by X-ray, CT and MRI and confirmed during the surgery. Decompression via posterior-anterior approach and anterior fixation had been adapted as the surgical strategy. The NASCIS and IMSOP standard were applied to definite the level of cervical spinal cord injury. The ASIA grading was used for evaluation the spinal cord function and the recovery rate. The X-ray and CT were used to observe reduction and bone fusion. Results The mean operative time was (4.5:±0.5) h, and the mean amount of blood loss was 360 ml (200-500 ml). All the incision healed. The two segments fixation was used in 23 cases, 3 segments fixation in 13 cases, and 4 segments fixation in 1 case. The mean follow-up period was 32 months (16-45 months).Postoperative X-ray and CT showed that bone fusion was achieved in all patients within 4-8 months, without graft displacement, or failure of implants. Spinal cord function did not aggravate, and sensory recovery ranged from 7 to 20 levels (averaged, 12.7). The ASIA grade were improved with an average of one grade. Conclusion To treat fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation, the posterlor-anterior approach and anterior fixation/fusion was benefit to preservation the cervical spinal cord function and reconstruction biomechanical stability of the cervical spine.%目的 探讨后前路减压、前路固定治疗下颈椎骨折脱位伴双侧关节突绞锁的可行性及临床效果.方法 2000

  20. 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%.

  1. ACETABULAR RECONSTRUCTION SURGERY IN TREATMENT OF PATHOLOGICAL DISLOCATION OF HIP JOINT IN CHILDREN%髋臼重建手术在儿童髋关节病理性脱位的应用

    Institute of Scientific and Technical Information of China (English)

    蒋欣; 唐学阳; 王道喜; 陈小亮; 刘芳; 谢晓丽; 刘利君; 彭明惺

    2012-01-01

    目的 总结髋臼重建手术在儿童髋关节病理性脱位中的应用及临床疗效.方法 2006年1月-2011年1月,共收治59例(59髋)儿童髋关节病理性脱位,采用髋关节切开复位联合髋臼重建手术治疗.男22例,女37例;年龄1~15岁,平均4.9岁.化脓性髋关节炎后遗病理性脱位33例,髋关节结核26例;病程1个月~10年.髋关节半脱位9例,髋关节全脱位50例.术前Harris髋关节功能评分为43~78分,平均61分.14例髋臼指数基本正常,32例轻度增大,13例明显增大.合并髋臼破坏28例;股骨头缺血性坏死25例,股骨头部分缺失12例,股骨头完全缺失6例,股骨头颈同时缺失3例;前倾角增大25例;髋内翻畸形9例.结果 术后即刻摄X线片示所有髋关节均达中心性复位.55例切口 Ⅰ期愈合,4例切口延期愈合.53例获随访,随访时间2~5年,平均3年.随访期间无髋关节再脱位.38例髋臼指数基本正常,15例轻度增大.前倾角15~25°,平均20°;颈干角110~140°,平均125°,头颈解剖关系基本恢复正常.术后2年髋关节活动度完全恢复正常18例,屈曲及旋转轻度受限30例,纤维强直5例;Harris髋关节功能评分为62~95分,平均87分.结论 儿童髋关节病理性脱位常合并严重的髋臼及股骨头颈部骨质破坏及后遗畸形,治疗上应严格遵循个体化原则,根据患髋主要病理改变选择适当的髋臼重建术式,并结合股骨头颈重建处理,可获得满意疗效.%Objective To investigate the effectiveness of the acetabular reconstruction surgery in children pathological dislocation of the hip joint. Methods Between January 2006 and January 2011, 59 patients (59 hips) with pathological dislocation were treated by open reduction combined with acetabular reconstruction surgery. There were 22 boys and 37 girls, aged from 1 to 15 years (mean, 4.9 years). There were 9 cases of hip subluxation and 50 cases of hip joint dislocation, which were caused by suppurative

  2. 儿童创伤性髋关节脱位26例疗效分析%Treatment of traumatic hip dislocation in children-A report of 26 cases

    Institute of Scientific and Technical Information of China (English)

    沈品泉; 徐卫东; 赵黎

    2015-01-01

    Objetive To analyze retrospectively a series of traumatic hip dislocations in children,de-scribing the therapeutic strategy. Methods Consecutively collect 26 children with traumatic hip dislocation who underwent close reduction or open reduction.The patients were grouped according to different treatments and different age,and the results were assessed according to Harris hip scores.Results The dislocation of 12 patients who underwent closed reduction in the emergency department was caused by low-energy trauma.In 10 inpatients,5 patients underwent close reduction and the other 5 patients underwent open reduction.After at least 2 years follow-up,the hip scores of emergency department patients and inpatients were 98.5 and 87.8 re-spectively.The hip scores of patients elder than 8 years and younger than 8 years were 86.6 and 99.1 respec-tively.Conclusions Urgent close reduction of acute cases must be done in the traumatic hip dislocation in children,sometimes open reduction must be done.The hips had more excellent functional outcome in young age group with low-energy trauma.%目的:回顾性分析儿童创伤性髋关节脱位的治疗情况,探讨其治疗策略。方法收集26例创伤性髋关节脱位患儿临床资料,采用手法复位或切开复位治疗,对治疗结果进行 Harris 髋关节评分,根据治疗方法和年龄大小分组评估疗效。结果得到随访的22例患儿中,12例于急诊室早期复位成功,均为低能量创伤;入院治疗10例中,5例在麻醉下行髋关节闭合复位获成功,5例行髋关节切开复位。急诊室早期复位和入院复位治疗两组病例2年后髋关节评分分别为98.5和87.8,>8岁与<8岁两组病例2年后髋关节评分分别为86.6和99.1。急诊室早期复位和<8岁病例的治疗效果优于入院治疗和年龄>8岁组。结论儿童创伤性髋关节脱位治疗要早,需尽早进行关节复位,必要时行切开复位治疗,低年龄、低

  3. The Treatment of Cervical Fracture Dislocation by Titanium Rete and Orion Anterior Cervical Plate System%钛网并Orion颈椎接骨板在颈椎骨折脱位中的应用

    Institute of Scientific and Technical Information of China (English)

    郑建平; 郭萍; 廉凯

    2011-01-01

    目的 探讨钛质外科网并Orion颈椎接骨板在颈椎骨折脱位手术治疗中的应用价值.方法 对32例前路减压术的临床资料进行回顾性分析,判断融合效果.结果 随访10 ~24个月,32例颈椎脱位完全复位,颈椎生理曲度保护良好,植骨全部融合,椎间高度维持良好,脊髓功能获得不同程度改善.结论 钛质外科网合并Orion颈椎接骨板治疗颈椎骨折脱位效果肯定.%Objective To investigate the value of titanium rete and the Orion anterior cervical plate system in the cervical fracture or dislocation. Methods The clinical data of 32 cases of anterior cervical surgeries were reviewed. The effects of surgery were evaluated. Results All patients were followed up for 10 to 24 months( mean, 18months ). The intervertebral space was totally restored and cervical iordosis were well protected in 32 cases,the bone graft fused well. No implants breakage and loosening was found. Conclusion It is an ideal way to apply the titanium rete and the Orion anterior cervical plate system in the cervical fracture or dislocation.

  4. Imaging of hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  5. Biomechanical Study on Pediatric Congenital Dislocation of Hip Joint%小儿先天性髋关节脱位的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    师宜健; 韩慧; 邢晖; 李秀兰; 王志彬; 叶金铎

    2001-01-01

    Objective To study the biomechanical change of congenital dislocation of hip (CDH) intra-operative in vivo tests.Methods Pediatric patients with CDH were tested in multi-point in multi-body of postion.Biomechanical electronic methods with special pressure sensores were used in operation and the data were compared with the same test at the ipsilateral side after the operation and then the data were statistically analyzed suing ANSYS 5.4.Results There is a high strass area in the cop and 30° around the corona of head of femur.Limited analysis revealed that within 30° around corona and inside of neck of femur had the largest load and deformity.Conclusion The pediatric CDH is interrelated to load in neck of femur.The treatment with cloth harness in frog fixation in early stage is able to reduce contyloid load normally and relevantly.Salter and Chiari osteotomy in later stage may increase load in 30°around corona of head of femur,reduce load at the medial side of the neck of femur.%目的通过先天性髋关节脱位患儿在术中的活体测试,对先天性髋关节脱位的生物力学改变进行研究。方法本研究采用生物力学电测法,并利用特种压力传感器,对先天性髋关节脱位患儿在术中进行髋关节多点多体位测定,同时进行术后等同测定进行比较性研究。测试结果使用ANSYS5.4有限元软件进行处理。结果先天性髋关节脱位股骨头顶部及冠状面内30°为高应力分布区。有限元分析股骨头冠状面30°及内侧股骨颈载荷变形较大。结论小儿先天性髋关节脱位发展过程与股骨头颈载荷改变具有明显改变,早期的连衣挽具及蛙式支架治疗,可部分消除股骨头顶部及冠状面的内30°病理性高应力区,使股骨头及臼部得到相对正常的载荷。晚期的Salter及Chiari截骨术可增加股骨头冠状面的外30°载荷,减少股骨颈内侧载荷。

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

    Institute of Scientific and Technical Information of China (English)

    齐秀玉(综述); 李志奇(审校)

    2016-01-01

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

  7. 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.

  8. Unstable total hip arthroplasty: detailed overview.

    Science.gov (United States)

    Berry, D J

    2001-01-01

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

  9. [The mechanism of the development of residual deformation and complications after the reduction of congenital hip dislocation in children and their conservative treatment].

    Science.gov (United States)

    Rogova, A A

    1991-01-01

    There is described the mechanism of development of hip joint instability of different types and associated secondary complications. Conservative biomechanical approach of treatment of residual instability and its complications: enchondral growth and ossification, delay, pathologic restructuring and coxarthrosis, is proposed.

  10. A report of bilateral hip dislocations (left rear, right front) caused by trauma combined with unilateral fracture of the femoral head in 1 case%双侧髋关节创伤性左后右前脱位并单侧股骨头骨折一例

    Institute of Scientific and Technical Information of China (English)

    刘丙立; 张宏斌; 张立峰

    2012-01-01

    @@ 髋关节脱位在所有关节脱位中所占比例较低,外伤性髋关节脱位约占所有关节脱位的2%~5%[1-2], 双侧髋关节同时脱位约占所有髋关节脱位的1%﹪~2%﹪,其中一前一后脱位约占40%[3].%Objective To analyze the mechanism and treatment of asymmetric bilateral dislocations of the hip. Methods I male patient of asymmetry bilateral hip dislocations caused by crushing injury from the agricultural vehicle was accompanied with the fractures of left acetabulum and femoral head. The dislocations were treated with manipulative reduction, and the fracture of the left femoral head was treated with open reduction and internal fixation. Results The function of bilateral hip recovered to the normal in the 2 years' follow-up. HARR.1S score: left 95, right 100. Conclusions Asymmetric hip dislocations are rare to see, careful check and proper treatment can insure a satisfactory effect.

  11. 先天性髋脱位治疗前后股骨上端静脉造影的观察%Intraosseous Venography of Proximal Femur before and after Treatment of Congenital Dislocation of the Hip

    Institute of Scientific and Technical Information of China (English)

    吉士俊; 陈丽英; 纪树荣; 刘卫东; 周永德

    1986-01-01

    In order to observe the change in the blood flow of proximal femur before and after treatment of congenital dislocation of the hip and disturbance in circulation in avascular necrotic femoral head,29 cases (56 hips) were examined by intraosseous venography,including:normal (8 hips),untreated islocation(29 hips),treated and without avascular necrosis (10 hips) and treated but with avascular necrosis (9 hips).The result showed that (1) In the normal group the visualization frequency of epiphyses medial veins (EMV) was 75%,epiphyses lateral vein (ELV) was 25%,and ligmentum teres veins (LTV) was 37%.(2) Between the untreated and normal groups the venograms displayed no obvious difference.(3) In postoperative group ELV and EMV were present in 30% and 50% of the cases respectively,and newly growing vein appeared in 6 cases.(4) In patients with avascular necrosis the visualization frequencies of ELV and EMV were decreased,1 case had no vein visualized,2 cases had opaque in femoral head and 3 cases had delayed opaque discharge. We also found that the visualization frequency of the veins varied with the patient's age in normal and untreated groups. Causes of avascular necrosis and the characteristics of circulatory disturbance in femoral head are also discussed.%@@ 为了观察先天性髋脱位治疗前后股骨上端血运变化,进一步探讨治疗后股骨头缺血性坏死的血运分布特点和发生因素,我院自1983年9月至1985年1月对29例先天性髋脱位患儿做了股骨上端静脉造影检查,现将结果报告如下. 方法与结果 造影方法:患儿仰卧位、全麻下于两侧股骨大粗隆下2cm处,分别用骨髓穿刺针,向股骨头方向刺入,止于股骨颈基底部,经电视透视证实后,快速注入76%泛影葡胺各10ml,每间隔2秒拍摄骨盆正位片1张,共摄5张,当拍完后间隔3分钟,再摄最后1张,观察造影剂排空情况.

  12. A case report of the management and the outcome of a complete epiphyseal separation and dislocation with left anterior column fracture of the acetabulum

    Directory of Open Access Journals (Sweden)

    Jesús Palencia

    2016-01-01

    Conclusion: Epiphyseal fracture with dislocation of the femoral head is rare among children and adolescents, especially when associated with an acetabular fracture. AVN in such cases can develop, and it represents a challenge to orthopedic surgeons due to the poor prognosis and the future functional limitations of the joint.

  13. 外旋牵引指推法治疗老年人肩关节前脱位%Extorsion traction and pushing manipulation with fingers for the treatment of anterior shoulder dislocation in elder-ly

    Institute of Scientific and Technical Information of China (English)

    郗海涛; 黄海晶; 辛景义

    2014-01-01

    Objective:To investigate a manipulating therapy for treatment of anterior shoulder dislocation in elderly. Methods:From October 2011 to June 2012,27 elderly patients with anterior shoulder dislocation were treated by extorsion traction and pushing manipulation with fingers ,including 7 males and 20 females aged from 65 to 86 years old with an average of 77. The course of disease ranged from 1 h to 1 d. The shoulder manifested square deformity ,Dugus signs showed positive, and X ray displayed anterior shoulder dislocation. Dugus fixation was applied for and removed external fixation at 3 weeks after operation and carried out shoulder functional exercise. Functional evaluation standard on shoulder joint injuries was used for e-valuate clinical outcomes. Results:All patients were gained reduction for the first time ,and followed up at 3 months after oper-ation,no dislocation occurred. According to functional evaluation standard on shoulder joint injuries ,22 cases got an excellent result,2 cases good,and 1 case moderate. Conclusion:Extorsion traction and pushing manipulating therapy for treatment of anterior shoulder dislocation in elderly,which has advantages of simple,convenient,less painful,and can avoid iatrogenic in-jury,is feasible to widespread.%目的:探讨一种治疗老年人肩关节前脱位的复位方法。方法:自2011年10月至2012年6月,采用外旋牵引指推法治疗老年人肩关节前脱位27例,男7例,女20例;年龄65~86岁,平均77岁;病程1 h~1 d。患者呈方肩畸形,Dugus征阳性,X线片示肩关节前脱位。术后采用Dugus位固定,3周后去除外固定行患肩功能锻炼。按肩关节损伤的功能评定标准进行疗效评定。结果:患者均1次复位成功,25例获随访,时间为术后3个月,术后未出现再次脱位。按肩关节损伤的功能评定标准进行评定,优22例,良2例,中1例。结论:外旋牵引指推法治疗老年人肩关节前脱位具有简

  14. 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.

  15. 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.

  16. Hip joint pain in children with cerebral palsy and developmental dysplasia of the hip: why are the differences so huge?

    OpenAIRE

    2014-01-01

    Backgrounds Non-traumatic hip dislocation in children is most often observed in the course of developmental dysplasia of the hip (DDH) and infantile cerebral palsy. The risk of pain sensations from dislocated hip joint differentiates the discussed groups of patients. Will every painless hip joint in children with cerebral palsy painful in the future? Methods Material included 34 samples of joint capsule and 34 femoral head ligaments, collected during open hip joint reduction from 19 children ...

  17. Hip and Spine in Cerebral Palsy

    OpenAIRE

    Persson-Bunke, Måns

    2015-01-01

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

  18. 前侧入路在肥胖症患者全髋关节置换术中的应用价值%Application value of anterior approach for total hip arthroplasty in obese patients

    Institute of Scientific and Technical Information of China (English)

    刘俊波; 郑宁; 林涌生; 杨赞礼

    2016-01-01

    application value of anterior approach for total hip arthroplasty (THA) in obese patients.Methods Clinical data of 45 obese patients undergoing THA in the First People’s Hospital of Jieyang from March 2013 to June 2015 was retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. These patients were divided into the anterior approach group (group A) and the posterolateral approach group (group B) according to different surgical approaches. Among the 18 patients of group A, 6 were males and 12 were females with an average age of (61±6) years old. Among the 27 patients of group B, 8 were males and 19 were females with an average age of (63±6) years old. Indexes of gender, age, body mass index, operation time, intraoperative blood loss, ambulation time, Harris hip score, complication incidence, prosthesis position and angle were compared between the two groups. The comparisons of these clinical indexes were conducted usingt test andχ2 test.Results The operation time of group A was (75±11) min, which was significantly longer than (57±9) min of group B (t=6.457,P0.05); the average Harris score of group A was 83±16, which had no statistical differences with 85±17 of group B (t=1.137,P>0.05); the occurrence rates of hip dislocation, lower limb thrombosis, non-infective incision complication and infective incision complication in group A were 0.0% (0/18), 11.1% (2/18), 11.1% (2/18) and 5.5% (1/18) respectively, which had no statistical differences with 7.4% (2/27), 14.8% (4/27), 18.5% (5/27) and 7.4% (2/27) of group B respectively (χ2=2.105, 0.131, 0.467, 0.061,P>0.05).Conclusions Anterior approach for THA in obese patients can protect the surrounding soft tissue with little trauma, low complication incidence and good recovery of hip function, so it’s worthy to be used more widely.

  19. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three h...

  20. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Bret Contreras; Chris Beardsley; Bryan Chung; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three he...

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

    Directory of Open Access Journals (Sweden)

    Gilberto Francisco Brandão

    2010-01-01

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

  2. 发育性髋脱位联合去旋转截骨术后股骨颈前倾角塑形性的相关因素分析%Correlation of remodeling of femoral anteversion at axial plane after combined derotational osteotomy for unilateral developmental dislocation of the hip.

    Institute of Scientific and Technical Information of China (English)

    王彭; 杜智军; 吕洪海

    2012-01-01

    average age of final follow-up were 10. 8 ± 2. 82 yr ( range: 8. 2 ~ 18. 9 yr ). The average followed-up time was 4. 74 ± 0. 88 year ( range: 3.4 ~ 6. 4 year ). These individuals were all assessed with excellent and good according to the Mckay and Severin criteria of evaluation and included grade I avascular necrosis by criteria of Kalamachi-MacEwen. Meanwhile, femoral anteversion was checked out by Ogata chart according to standard anterior-posterior X-ray of pelvis and lateral X-ray of operated femur, in addition, neck-shaft angle, acetabular index and center-edge angle being obtained from anterior-posterior roentgenogram of pelvis. At final follow-up, internal and external rotation movement of bothsides were measured clinically. The non-operated side was set up as control group. SPSS 16. 0 software was ap-plied for further statistical analysis. Repeated measurement variance was used for changes of postoperative femoral ante version; meanwhile, Pearson correlation and multi linear regression were used for investigation related factors with remodeling of femoral anteversion. Besides that, paired-t test was chosen for analysis of rotational movements of both sides hip joints. P 0. 05 ) concomitant of neck-shaft after operation (β coefficient = 0. 039; P > 0. 05 ) and the remodeling ability of femoral anteversion. However, no obvious correlation was present between neck-epiphysis angle well as center-edge angle and remodeling of femoral anteversion. At final follow-up, no significant difference was present at the rotational movements of both sides ( P > 0. 05 for both internal and external rotation respectively ). Conclusion proximal femur has remodeling ability at axial plane after combined derotational osteotomy for developmental dislocation of the hip, and this remodeling is related to not only derotational degrees as well as neck-shaft angle, but also age at operation and postoperative acetabular index. And therefore, these related factors can provide significant

  3. Surgical management of hip instabilities in children with spina bifida

    OpenAIRE

    Erol, Bulent; Bezer, Murat; Kucukdurmaz, Fatih; Guven, Osman

    2004-01-01

    Objectives: We evaluated the results of surgical management of hip instability in children with spina bifida (SB). Methods: Twenty-eight hips of 26 patients (16 girls, 10 boys; mean age 4.5 years; range 3 to 6 years) were surgically managed for hip instability (subluxation/dislocation) associated with SB. Twenty-four patients (2 bilateral dislocations) had low-level lesions (L4-sacral) and a potential to walk, of which 16 patients presented with unilateral dislocation with functional probl...

  4. 关节镜下治疗创伤复发性Bankart损伤疗效分析%Clinical curative effect of the arthroscopic reconstruction for recurrent anterior dislocation of the shoulder

    Institute of Scientific and Technical Information of China (English)

    李彦林; 王国梁; 何川; 李建; 郑家礼; 陈广超; 李松; 余洋

    2014-01-01

    目的:探讨肩关节镜下Bankart损伤重建术治疗复发性肩关节前脱位的临床疗效。方法自2010年6月至2014年4月随访60例应用肩关节镜下Bankart损伤重建术治疗的复发性肩关节前脱位患者,随访10~38个月,平均26.6个月;年龄15~45岁,平均29岁。60例患者均为前方单方向性不稳定,术前平均脱位次数为6.5次(2~17次)。手术中采用缝合锚进行Bankart损伤重建术。随访时采用 ASES评分和Constant-Murley评分进行功能评估。结果60例患者手术前及终末随访时 ASES平均评分为(83.5±3.2)分与(97.1±2.1)分(t=4.79,P>0.01),肩关节平均前屈上举角度为(163.8±6.0)°与(185.4±3.9)°(t =4.87,P >0.01),外展角度为(90±1.1)°与(135.4±9.9)°(t=6.40,P>0.01),外旋角度为(57.6±4.3)°与(86.5±5.2)°(t=5.43,P >0.01);术前及终末随访时Constant-Murley平均评分为(77.6±3.5)分与(97.2±3.2)分(t=5.06,P >0.01)。终末随访时所有病例均未发生术后再脱位,术后残存恐惧试验阳性4例(6.7%)。所有患者均恢复术前工作,52例(8 6.7%)恢复到第一次脱位前的运动水平。结论肩关节镜下微创行 Bankart 损伤重建手术是治疗复发性肩关节前脱位的有效方法之一,术前病例选择、术中关节镜下操作技术及术后功能康复锻炼是手术成功的关键。%Background Recurrent dislocation of shoulder joint (or traumatic shoulder instability)initiates from the first shoulder dislocation,compromising the ligaments for stability of the shoulder.When the labrum is torn from the glenoid,the stable function of these ligaments is lost. The progression of traumatic shoulder instability and the type and degree of inj uries in glenoid labrum and surrounding ligaments are inextricably linked.Bankart injury is the most common cause of recurrent anterior shoulder dislocation,and the rehabilitation and reconstruction of stable structure in anterior shoulder is critical for the treatment of recurrent anterior

  5. 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.

  6. CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2008-06-01

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

  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. 医用骨水泥和人工韧带在犬髋关节脱位治疗中的应用%Application of Medical Bone Cement and Artificial Ligament in Treatment of Canine Hip Joint Dislocation

    Institute of Scientific and Technical Information of China (English)

    毛典荣; 刘汉文; 江颖; 李浓; 周庆国

    2014-01-01

    为了探索人工圆韧带植入术治疗犬髋关节脱位远期疗效降低的解决办法,选择体重6.5 kg~7.5 kg、年龄1岁左右的3只本地家犬,在使用外科丝线替代圆韧带植入髋关节后,使用医用骨水泥填充和封闭髋臼和股骨孔道,术后通过运动姿态观察、负重力测试、常规 X 线摄片、血清生化项目检测和病理剖检几个方面,分析评估人工圆韧带植入术使用医用骨水泥的效果。结果显示,随着犬肢运动状态逐渐改善,术肢负重力增加;但随着丝线断开或出现退行性关节病,术肢运动肢势改变和负重力降低;骨水泥填充、封闭人工圆韧带孔道效果可靠,关节滑液保持良好,血清重要生化指标均在参考范围。在动物试验基础上,选择医用人工韧带植入和将骨水泥用于犬髋关节脱位临床病例1例,经过9个月的动态观察,术肢运动状态、负重力和髋关节 X 线影像与健肢相比无任何异常。动物试验与临床疗效表明,联合使用医用骨水泥和人工韧带能够很好地重建髋关节结构和功能,维持人工圆韧带植入术治疗犬髋关节脱位的远期疗效。%To explore the solution for the lower long-term effects of the ligamentum teres implantation for canine hip joint dislocation,three hybrid dogs of about 1 year old,6.5 kg~7.5 kg body weight were select-ed.After surgical silk thread instead of the ligamentum teres was implanted into a hip joint,the acetabular and femoral holes were filled and closed with medical bone cement.Effect of the bone cement was analysed and evaluated by the observation of motion state,weight-bearing gravity test,conventional X-ray radio-graph,detection of serum biochemical items and pathological dissection.The results showed that the limb weight-bearing gravity increased with motion state gradually improved.But as the silk thread was discon-nected or degenerative joint disease appeared,the limb

  9. Dislocated Shoulder

    Science.gov (United States)

    ... bruising Intense pain Inability to move the joint Shoulder dislocation may also cause numbness, weakness or tingling near the injury, such as in your neck or down your arm. The muscles in your shoulder may spasm from the disruption, ...

  10. The efficacy of arthroscopic surgical treatment for infant with developmental dislocation of ;the hip%关节镜治疗婴幼儿发育性髋关节脱位

    Institute of Scientific and Technical Information of China (English)

    吉璐宏; 赵庭波; 许勇; 李皓桓

    2016-01-01

    目的:探讨关节镜治疗婴幼儿发育性髋关节脱位(DDH)的临床疗效。方法对13例DDH患儿(17髋)采用关节镜治疗。结果患儿均获得随访,时间3~7(5.3±2.1)年。至末次随访,患儿均获得正常步态及髋关节活动度,无一例患儿出现股骨头坏死。髋臼指数由术前32.9°~51.8°(39.4°±11.3°)改善至末次随访时的19.8°~33.1°(24.8°±6.5°)(P<0.001)。除1例(1髋)继发DDH外,其他患儿均获得股骨头与髋臼同心圆复位,恢复Shenton线连续性。结论采用关节镜治疗婴幼儿DDH临床疗效满意,具有创伤小、并发症发生率低等优点。%Objective To investigate clinical results of arthroscopic surgical treatment for developmental dislocation of the hip (DDH) in the infant. Methods Thirteen patients (17 hips) with DDH underwent arthroscopic surgical treatment. Results All of 13 patients were followed up for 3~7 (5. 3 ± 2. 1) years. At the final follow-up, all pa-tients had normal gait and full range of motion, without femoral head necrosis. The acetabular index improved from 32. 9°~51. 8° (39. 4 ± 11. 3)° preoperatively to 19. 8°~33. 1°(24. 8 ± 6. 5)° postoperatively(P<0. 001). Except for 1 hip secondary DDH,the other children got femoral head and acetabulum concentric circles reset,and restored Shenton′s line continuity. Conclusions The arthroscopic surgical treatment of infant with DDH can achieve satisfac-tory clinical outcomes, and has the advantage of less trauma and low rate of complication.

  11. Descrição de técnica de redução cirúrgica das luxações facetárias da coluna cervical baixa por via anterior Descripción de la técnica quirúrgica para reducción de las luxaciones facetarias de la columna cervical baja por acceso anterior Description of surgical technique for reduction of facet dislocations of the lower cervical spine by anterior approach

    Directory of Open Access Journals (Sweden)

    André Rafael Hübner

    2012-12-01

    Full Text Available O trabalho descreve uma técnica cirúrgica de redução anterior das luxações facetárias da coluna cervical e discute as indicações para cirurgia por via anterior para as luxações da coluna cervical baixa. A técnica descrita neste artigo oferece excelentes resultados, conforme revisão bibliográfica e dos resultados do Serviço, tendo sido aplicada em até 95% dos casos de fraturas-luxações. Não será abordada a apresentação de resultados neste trabalho, apenas a descrição e discussão da técnica aberta por via anterior. Observações de quarenta e um pacientes tratados nos últimos dez anos por esta técnica demonstram bons resultados quanto a pós-operatório menos doloroso, recuperação funcional extremamente rápida e complicações pouco frequentes.El artículo describe una técnica quirúrgica para las luxaciones facetarias de la columna cervical y discute las indicaciones para la cirugía de luxación de la columna cervical baja por lo acceso anterior. La técnica descrita en este artículo proporciona excelentes resultados según la revisión de la literatura y los resultados del Servicio, después de haber sido aplicado a 95% de los casos de fracturas-luxaciones. No serán abordados resultados, sino que únicamente la descripción y discusión de la técnica de reducción abierta por acceso vía anterior. Las observaciones en cuarenta y un pacientes operados en los últimos diez años por esta técnica muestran resultados sorprendentes con respecto a un pos operatorio menos doloroso, con recuperación funcional extremadamente rápida y complicaciones menos frecuentes.This paper describes a surgical technique for anterior reduction of the spinal facets dislocations and discusses its indications for surgery of lower cervical dislocations by anterior approach. The technique described in this article provides excellent results according to literature review and the results of the Service, having been applied to 95% of

  12. Atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    Vijendra K Jain

    2012-01-01

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

  13. 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.

  14. 前方经咽后入路治疗C2,3骨折脱位%Anterior retropharyngeal approach for treatment of C2/3 fracture and dislocation

    Institute of Scientific and Technical Information of China (English)

    董革辉; 韩建华; 夏本杰; 孙厚杰; 蔡小军

    2014-01-01

    Objective To investigate the surgical techniques and clinical effects of anterior retropharyngeal approach in treatment of C2/3 fracture and dislocation.Methods Twelve patients with C2/3 fracture and dislocation treated via anterior retropharyngeal approach between November 2011 and April 2013 were included in the study.There were 7 males and 5 females aged from 19 to 65 years (mean,35 years).Primary pathologies included 7 patients with traumatic C3 fracture,2 with Hangman fracture and 3 with fracture and dislocation of the anteroinferior margin of C2 vertebrae.C2-C4 vertebrae were exposed using anterior retropharyngeal approach,followed by C2/3 discectomy or C3 corpectomy,decompression,interbody cage fusion or titanium mesh cage fusion,and anterior internal fixation.Results Exposure of lesion was sufficient for all patients and all operations were completed under direct vision,with mean operation time of 140 minutes and mean blood loss of 120 ml.One patient with reduced tone after operation gradually recovered in a week; one with dysphagia after operation recovered in 3 months; one with skin necrosis 7 days after operation was recovered by changing dressing; for the rest,there were no complications of incision hematoma,infection,or asphyxia.Ten patients were followed up for mean 15 months,which showed bony fusion in mean 6 months.At final follow-up,no implant loosening or displacement occurred.Conclusion Anterior retropharyngeal approach to C2/3 fracture and dislocation provides sufficient exposure of lesions,minor trauma,and less bleedings and complications,but as the local anatomy is complicated,there indeed exists a learning curve of the approach.%目的 探讨前方经咽后入路治疗C2.3骨折脱位的手术技巧及临床疗效. 方法 选择2011年11月-2013年4月应用前方经咽后入路治疗的C2.3骨折患者12例,其中男7例,女5例;年龄19 ~65岁,平均35岁.骨折部位:C3骨折7例,Hangman骨折2例,C2椎体前下缘骨折3例.均采取

  15. 人工髋节治疗大龄先天性髋关节脱位股骨侧处理要点%Strategy of Implantation of Femoral Stem to Correct Deformity of Femur in Treatment of Congenital Hip Dislocation with Total Hip Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    张峡; 郝勇; 周跃; 任先军; 初同伟

    2011-01-01

    目的 分析大龄先天性髋关节脱位患者股骨侧病理变化特点,探讨置人股骨柄的难点,总结应用人工髓关节治疗大龄先天性髋关节脱时股骨柄置人应遵循的一般原则.方法 应用人工髋关节置换术治疗37例大龄先天性脆关节脱位,术前行影像学检查,评估患者股骨上段畸形的部位、类型及程度.术前及术后对患者髋关节功能行Hams评分,分析手术疗效.结果 术后随访3-38个月,平均19个月,股骨上段旋转畸形得到矫正,股骨假体无一侧松动及下沉,所有截骨处均获得骨性愈合,术后1例脱位,Hams评分由术前的(54±2.61)分增加至随访时的(87.24±5.62)分(P <0.01).结论 大龄先天性髋关节脱位患者股骨上段发育差,股骨及髓腔变小、变直,股骨上段于股骨小粗隆下方发生外旋,股骨柄与股骨髓腔达到牢固压配固定的同时,还要注意充分矫正股骨上段旋转畸形.如股骨颈前倾角大于25°,应行股骨小粗隆下方旋转截骨,必要时选用长柄增加固定有效性,促进截骨处骨折愈合.术前有手术史、脱位程度高及部分腰椎柔韧性较差的患者,需行股骨缩短术,以防术后出现难以矫正的肢体假长.%Objective To analyze the characteristics of the femoral deformity and the possible difficulties encountered in the implantation of femoral stem in the treatment of congenital hip dislocation patient with total hip arthroplasty. Methods Thirty seven patients with congenital hip dislocation were treated by total hip arthroplasty between February 2004 and April 2007. Femur deformities were fully evaluated before operations. Dysplastic femurs had shorter necks and smaller, straighter canals. The primary deformity of the dysplastic femur was rotation, which arised within the diaphysis between the lesser trochanter. Results All of the hips were followed up for 3~38 months.Osteotomy of the femur were all get united. There were no loosening of the femoral

  16. Crystal Dislocations

    Directory of Open Access Journals (Sweden)

    Ronald W. Armstrong

    2016-01-01

    Full Text Available Crystal dislocations were invisible until the mid-20th century although their presence had been inferred; the atomic and molecular scale dimensions had prevented earlier discovery. Now they are normally known to be just about everywhere, for example, in the softest molecularly-bonded crystals as well as within the hardest covalently-bonded diamonds. The advent of advanced techniques of atomic-scale probing has facilitated modern observations of dislocations in every crystal structure-type, particularly by X-ray diffraction topography and transmission electron microscopy. The present Special Issue provides a flavor of their ubiquitous presences, their characterizations and, especially, their influence on mechanical and electrical properties.

  17. 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.

  18. 治疗先天性髋脱位的强力造盖术及其应用的选择%The Application of Reinforced Shelf Operation on Congenital Hip Dislocation In Children

    Institute of Scientific and Technical Information of China (English)

    孙丹舟; 唐成林; 赵宝林; 季晓风; 孙冰

    1997-01-01

    Objective:To enhance the shelf supporting forces and intensity of resistence in shelf operation on congenital hip dislocation.Methods:The flat piece and fragments of bone were changed into three pieces of vertical triangle bone and added a vertical bone segment.The reinforced reversion shelf method should be adopted in acetabulum with enough width but a large acetabular index.If the false acetabulum was formed and narrowed the true acetabulum,the inserting shelf operation should be chosen to widen the true acetabulum.Results:The operation was adopted in 243 cases(315 hips),only one had fracture of the inserting shelf.Conclusions;The authors prefer the shelf operation to the used innominate osteotomy to treat the CDH.The problems of fracture and absorption of the shelf have been solved basically.%目的:为了增强治疗小儿先天性髋脱位造盖术造盖的支撑力及抗压强度.方法:将传统的翻转造盖术扁放骨片和碎骨块改为立放3枚三角形骨块,在传统插入造盖上方加1枚立式骨块,取名"强力造盖术".若真臼宽度够,只是髋臼指数大,应选用强力翻转造盖术;若假臼明显形成,将真臼顶挤压变窄,则应选用强力插入造盖术.结果:近5年来应用强力造盖术治疗小儿先天性髋脱位243例,315髋次,只发现1例1髋插入造盖折断.结论:基本上解决了造盖折断和吸收问题.因此,由原来多选用骨盆截骨术,改为现在多选用造盖术.

  19. Hip Ultrasound

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

    闫庆荣; 丁新友

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. 双截骨术治疗大龄儿童先天性髋关节脱位的术后训练%Postoperative rehabilitation exercise of old children underwent bilateral osteotomy of congenital dislocation of hip joint(CDS)

    Institute of Scientific and Technical Information of China (English)

    李平生; 阮雄星; 何向阳; 郭文荣

    2002-01-01

    @@ Determining appropriate treatment timing is very important for congenital dislocation of hip joint(CDS).Early treatment will produce distal effect.Management of CDS in children aged more than 6 years is very difficult,functional recovery is affected.From May to June 2001,23 children aged 6~ 12 years and suffered from CDS were adopted.Modified Salter Pelvis osteotomy and rotation osteotomy above femor in combination with postoperative rehabilitation exercise were carried out,and favorable effect was obtained.Here is reported.

  4. Clinical retrospective analysis of children for mixed dentition traumatic anterior teeth completely dislocation replantation%替牙期外伤性前牙完全脱位再植术的临床分析

    Institute of Scientific and Technical Information of China (English)

    赵然; 李凤和; 陈光

    2012-01-01

    目的:探讨替牙期完全脱位前牙再植术后的效果和相关影响因素.方法:对48例患儿58颗完全脱位前牙治疗方法和临床疗效进行分析.脱位前牙再植后复诊行牙髓测试、牙周检查,2周牙髓活力阴性的患牙行根尖诱导成形术,6个月~3年根尖孔完全形成后行根管永久充填治疗.结果:再植术后3年,5颗患牙活力存在,牙髓存活率达8.62%; 53颗患牙行根管治疗术后行X线检查,25颗患牙牙根牙周膜愈合,30颗患牙牙根部分牙周膜愈合和部分骨性愈合,3颗患牙不同程度牙根内外吸收,但无1例脱落.结论:早就诊且合理处理脱落牙、牙髓血管再生是牙再植术成功的关键,根尖诱导成形术可使替牙期牙根再度形成,牙骨质沉积于根端、封闭根尖孔,是替牙期脱位前牙治疗的重要手段,根管治疗可预防或减少脱位牙牙根的吸收.%Objective To explore the effects and related influential factors of replantation after complete dislocation of anterior teeth/tooth on mixed dentition patients experiencing tooth transitions. Methods Analysis of 48 patients with 58 traumatic anterior teeth were made based on treatments recieved and clinical observations.After the reimplantation for the traumatic anterior teeth, patients returned for dental pulp test and periodontal examination. 2 weeks later, apexification was performed after the dental pulp test had indicated a negative result.Six months to 3 years after apexification, permanent canal filling treatment was made once the apical had been fully formed. Results three years after the replantation,5 teeth exist vitality with a dental pulp survival rate of 8.62%; X-ray examination indicates that out of the 53 teeth have had apexification and canal filling treatment:25 teeth's tooth roots have periodontal ligament fully recovered (bined together or have been healed),30 teeth's teeth root have fully recovered iodontal ligaments and partial recover of the bone

  5. Distal femoral shortening in total hip arthroplasty for complex primary hip reconstruction. A new surgical technique.

    Science.gov (United States)

    Koulouvaris, Panagiotis; Stafylas, Kosmas; Sculco, Thomas; Xenakis, Theodore

    2008-10-01

    Successful total hip arthroplasty (THA) in congenital dislocated hips demands anatomical reduction in the normal center of rotation without overstretching the sciatic nerve and without excessive compression or abnormal forces across the joint. Proximal femoral and subtrochanteric shortening osteotomy has been described for THA for the treatment of dislocated hips. However, these osteotomies are demanding, associated with deformation of femoral canal and nonunion, and may increase the femoral stem stress. This study reports excellent results in 24 patients with a new surgical technique that combines THA with a distal femoral shortening in severely deformed hips using customized components.

  6. Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy Tratamento cirúrgico da luxação congênita do quadril pós marcha: redução aberta e osteotomia de Salter

    Directory of Open Access Journals (Sweden)

    Guaracy Carvalho Filho

    2003-01-01

    Full Text Available The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter. In this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months (age after march, mean age of 19 months. Fifteen were female and 3 were male, 4 patients had bilateral dislocation and in the remaining, 8 had their left hip dislocated and 6 had their right hip dislocated. The results were evaluated according to Dutoit et al.(3 clinical criteria and to Severin(12 radiological criteria, after a mean follow-up of 48 months. Eighteen percent of excellent clinical results (4; 54% of good results (12; 14% of regular results (3 and 14% of bad results(3 were obtained. As to the radiologic criteria, 36% of the hips were classified as excellent (8; 45% as good (10; 5% regular (1 and 14% bad (3. There were 3 cases of re-dislocation which were treated by a different surgical technique. No cases of infection, graft fracture and vascular or nervous injury were reported.A luxação congênita do quadril (LCQ, após a marcha, requer o tratamento cirúrgico, sendo uma das opções a redução aberta associada a osteotomia do osso inominado (tipo Salter. Neste estudo foram avaliados 18 pacientes, 22 quadris, que apresentavam LCQ tratados cirurgicamente, entre 1989 e 1995, utilizando a osteotomia do osso inominado, pela técnica de Salter, pós redução aberta. A idade dos pacientes, na época da cirurgia, variou de 12 a 30 meses, com média de 19 meses, sendo 15 do sexo feminino e 3 do masculino, 4 pacientes tinham acometimento bilateral, sendo que nos demais, 8 tinham o quadril esquerdo acometido e 6 o lado direito. Os resultados foram

  7. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

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

  8. Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty

    DEFF Research Database (Denmark)

    Gromov, Kirill; Greene, Meridith E; Huddleston, James I

    2016-01-01

    BACKGROUND: Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip arthrop...... should therefore take special care during placement of the acetabular component in patients with AD....

  9. Comparison of Gait in Patients Following a Computer-Navigated Minimally Invasive Anterior Approach and a Conventional Posterolateral Approach for Total Hip Arthroplasty : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Reininga, Inge H. F.; Stevens, Martin; Wagenmakers, Robert; Boerboom, Alexander L.; Groothoff, Johan W.; Bulstra, Sjoerd K.; Zijlstra, Wiebren

    2013-01-01

    Minimally invasive total hip arthroplasty (MIS THA) aims at minimizing damage to muscles and tendons to accelerate postoperative recovery. Computer navigation allows a precise prosthesis alignment without complete visualization of the bony landmarks during MIS THA. A randomized controlled trial (RCT

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

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Munhoz da Rocha

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento cirúrgico da luxação do quadril através do acesso anteromedial em pacientes com artrogripose múltipla congênita (AMC. MÉTODOS: Retrospectivamente foram revisados os prontuários e radiografias de sete crianças com AMC que apresentavam luxação do quadril, totalizando 10 quadris luxados. Foi avaliada a mobilidade articular pré e pós-operatória através da somatória do arco de mobilidade articular em flexão e abdução. Radiograficamente foram avaliados, no pré-operatório, o ângulo acetabular e a altura do colo do fêmur e, no pós-operatório, a continuidade do arco de Shenton, ângulo de Sharp e ângulo CE (centro borda. Quando foi identificada a necrose avascular, esta foi classificada segundo Ogden e Bucholz. RESULTADOS: A média de idade das crianças na ocasião da cirurgia era de 5,5 meses (três a 11 meses. O seguimento médio dos pacientes foi de 9,5 anos (dois a 13 anos. A média de amplitude de movimento da somatória do arco de mobilidade articular em flexão e abdução no exame pré-operatório foi de 108° (70 a 155° e no pós-operatório foi de 125° (75° a 175°. Na última avaliação, oito quadris estavam centrados e dois subluxados. Dois quadris foram submetidos a uma osteotomia de ilíaco do tipo Salter. Dois quadris apresentaram sinais significativos de necrose avascular Ogden tipo IV. Oito quadris foram considerados como bons resultados e dois como regulares. CONCLUSÃO: Consideramos a via anteromedial uma boa opção para tratamento da luxação de quadril em pacientes de baixa idade com artrogripose múltipla congênita.OBJECTIVE: To evaluate the results of the surgical treatment of hip dislocation through the anteromedial approach in patients with arthrogryposis multiplex congenita (AMC. METHODS: A retrospective review of the charts and radiographs of 7 children with AMC that presented dislocation of the hiprevised, totalling 10 dislocated hips. : Pre and

  11. A detailed review of hip reduction maneuvers: a focus on physician safety and introduction of the Waddell technique

    Directory of Open Access Journals (Sweden)

    Bradford S. Waddell

    2016-03-01

    Full Text Available Dislocation of the hip is a well-described event that occurs in conjunction with highenergy trauma or postoperatively after total hip arthroplasty. Bigelow first described closed treatment of a dislocated hip in 1870, and in the last decade many reduction techniques have been proposed. In this article, we review all described techniques for the reduction of hip dislocation while focusing on physician safety. Furthermore, we introduce a modified technique for the reduction of posterior hip dislocation that allows the physician to adhere to the back safety principles set for by the Occupational Safety and Health Administration.

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

    Institute of Scientific and Technical Information of China (English)

    巴晶晶; 雷伟; 颉强; 山世鹏; 严亚波; 马义善

    2013-01-01

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

  13. The long-term effects of developmental dislocation of hips by closed redution and limited immobilization after preliminary traction%牵引复位有限制动治疗发育性髋关节脱位的远期疗效

    Institute of Scientific and Technical Information of China (English)

    刘万林; 郭文通; 李文琪; 温树正; 韦宜山; 白锐; 李岱鹤

    2009-01-01

    目的 采用牵引复位、功能性装具有限制动治疗发育性髋关节脱位(DDH)患儿,评价其远期治疗结果.方法 选择1983年7月至2001年7月的86例(119髋)DDH患儿,初诊时平均年龄为19.5个月,经平均18 d牵引后配戴功能性装具.除6例(9髋)在全麻下复位外,其余80例(110髋)均在床旁成功复位,仅有1例(2髋)做了内收肌切断术.配戴功能性装具平均为10.4个月.结果 平均随访时间为10年2个月,21例随访至骨骼成熟Y型软骨骺闭合.随访时临床优良率为85.7%(102/119),放射学评估优良率为77.3%(92/119).8例(8髋)发生股骨头缺血性坏死(6.7%);8髋在复位后有部分或全部骨骺核出现不规则骨化.19例(26髋)由于残余畸形于保守治疗结束后3~8年施行了补充性手术.结论 牵引复位功能性装具有限制动是治疗DDH的一种确切、有效、并发症相对较低的方法;对DDH的保守治疗,要做长期随访.%Objective To evaluate the long-term effects for patients with developmental dislocation of hips (DDH) by closed reduction and limited immobilization.Methods From Jul 1983 to Jul 2001,86 patients with 119 dislocated hips were enrolled into this study.The matin age when the patients were diagnosed was 19.5 months.After traction for 18 days,the functional apparatus was applied on all the patients averagely for 10.4 months.One hundred and ten dislocated hips of 80 cases were repositioned at bedside,9 hips of 6 cases were repositioned under general anesthesia and only 2 hips of 1 case underwent the tenotomy of the adductors at both sides.Results The mean following up period was 10.2 years.Twenty-one patients were followed up until the epiphyses were closed.X-ray showed that the excellent and good rate was 77.3%.Mckays clinical evaluation showed that the excellent and good rate was 85.7%.Eight hips (6.7%) got avascular necrosis of the femoral head,8 hips got irregular ossification in all or part of the epiphyseal nucleus

  14. Revision of hip resurfacing arthroplasty.

    Science.gov (United States)

    Wera, Glenn D; Gillespie, Robert J; Petty, Carter; Petersilge, William J; Kraay, Matthew J; Goldberg, Victor M

    2010-08-01

    Metal-on-metal (MOM) hip resurfacing has become an increasingly popular treatment for young, active patients with degenerative disease of the hip, as bearing surfaces with better wear properties are now available. One proposed advantage of resurfacing is its ability to be successfully revised to total hip arthroplasty (THA). In addition, radiographic parameters that may predict failure in hip resurfacing have yet to be clearly defined. Seven MOM resurfacing arthroplasties were converted to conventional THAs because of aseptic failure. Using Harris Hip Scores (HHS) and Short Form 12 (SF-12) questionnaire scores, we compared the clinical outcomes of these patients with those of patients who underwent uncomplicated MOM hip resurfacing. In addition, all revisions were radiographically evaluated. Mean follow-up periods were 51 months (revision group) and 43 months (control group). There was no significant difference between the 2 groups' HHS or SF-12 scores. There was no dislocation or aseptic loosening after conversion of any resurfacing arthroplasty. Valgus neck-shaft angle (P hip resurfacing. Conversion of aseptic failure of hip resurfacing to conventional THA leads to clinical outcomes similar to those of patients who undergo uncomplicated hip resurfacing. The orientation of the femur and the components placed play a large role in implant survival in hip resurfacing. More work needs to be done to further elucidate these radiographic parameters.

  15. Trochanteric osteotomy in total hip replacement for congenital hip disease.

    Science.gov (United States)

    Hartofilakidis, G; Babis, G C; Georgiades, G; Kourlaba, G

    2011-05-01

    We studied the effect of trochanteric osteotomy in 192 total hip replacements in 140 patients with congenital hip disease. There was bony union in 158 hips (82%), fibrous union in 29 (15%) and nonunion in five (3%). The rate of union had a statistically significant relationship with the position of reattachment of the trochanter, which depended greatly on the pre-operative diagnosis. The pre-operative Trendelenburg gait substantially improved in all three disease types (dysplasia, low and high dislocation) and all four categories of reattachment position. A persistent Trendelenburg gait post-operatively was noticed mostly in patients with defective union (fibrous or nonunion). Acetabular and femoral loosening had a statistically significant relationship with defective union and the position of reattachment of the trochanter. These results suggest that the complications of trochanteric osteotomy in total hip replacement for patients with congenital hip disease are less important than the benefits of this surgical approach.

  16. Minimally invasive total hip replacement: the posterolateral approach.

    Science.gov (United States)

    Bottner, Friedrich; Delgado, Samuel; Sculco, Thomas P

    2006-05-01

    Our experience with the posterolateral mini-incision technique over the last 8 years has shown that total hip arthroplasty can be performed safely and effectively in properly selected patients through a much smaller incision than the one traditionally used. The main advantage of the posterolateral approach compared with other mini-incisions is its simplicity, with shortened operating time as a result. While the surgical time for a posterior approach is an average of 37 to 70 minutes throughout the literature, the 2-incision approach prolongs the surgery by a factor of 2 or 3. Compared with the anterior or 2-incision approach, the posterolateral and anterolateral approaches also have a much lower incidence of perioperative complications, with the rate being similar to rates seen with a standard incision. For the 2-incision technique and the anterior mini-incision approach, perioperative periprosthetic fracture rates of up to 8.7% and 8.4%, respectively, have been described. Surgeons who traditionally used an anterolateral standard approach might prefer an anterolateral mini-incision. The anterolateral mini-incision total hip arthroplasty has demonstrated excellent results; in the past it was suggested that the anterolateral approach has a higher incidence of heterotopic bone formation and impaired early abductor function, but more recent studies show no difference in abductor strength and limping between the anterolateral and posterior approaches. On the other hand, the posterior approach has been associated with an increased risk of postoperative dislocations. We did not encounter an increased incidence of postoperative dislocation at our institution. This might be related to the routine repair of the external rotators and the capsule in all patients. In summary, both the anterolateral and the posterior mini-incision approaches are reasonable alternatives, and surgeons should choose the approach that they feel most comfortable with. Statements in the press and by

  17. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

    YU Ze-sheng; James J.Yue; WEI Feng; LIU Zhong-jun; CHEN Zhong-qiang; DANG Geng-ting

    2007-01-01

    Background Lower cervical dislocation with locked facets is common in cervical injury. The locked facets include unilateral and bilateral types. Different successful closed reduction rates has been achieved between unilateral and bilateral types by using rapid skull traction, which was commonly used to reduce the cervical dislocation. It is important to investigate a suitable management specific to patients with different types of cervical locked facets.Methods A total of 38 patients with cervical dislocation with locked facet due to cervical injury treated by rapid skull traction and operation from 1988 to 2005 were reviewed. Rapid skull traction was used in all the patients. Successful closed reduction rate was 88.0% in patients with bilateral cervical locked facets and that was 15.4% in those with unilateral cervical locked facets. These data were then statistically compared by Chi-square test. Patients who were reduced successfully underwent anterior cervical discectomy and fusion at the injured level, and those who failed in closed reduction received posterior open reduction and fixation.Results In this series, there was statistically significant difference (P<0.05) in the rate of successful closed skull traction reduction between unilateral and bilateral locked facets dislocation. Unilateral cervical locked facets dislocation was not easily reduced by skull traction which was suitable for reduction of bilateral cervical locked facets dislocation. However,unilateral cervical locked facets dislocation can be reduced by posterior open reduction.Conclusions Unilateral cervical locked facets dislocation should be treated immediately with posterior open reduction and instrumentation. Bilateral cervical locked facets dislocation can be reduced by rapid skull traction firstly and anterior cervical discectomy and interbody fusion later.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  19. Comparison of two methods of early treatment in developmental dislocation of the hips%Pavlik吊带与牵引石膏早期治疗发育性髋脱位的疗效比较

    Institute of Scientific and Technical Information of China (English)

    付喆; 杨建平; 张中礼; 王侃; 邓书贞; 陈兆强; 解礼伟

    2016-01-01

    early treatment results of Pavlik harness and closed reduction plus spica cast⁃ing in treating developmental dislocation of the hips (DDH). Methods The patients with GrafⅢ/Ⅳtype DDH diagnosed by ul⁃trasound in our hospital were analyzed retrospectively from January 2009 to December 2013. The subjects with intact clinical and radiologic data and more than 2 years follow⁃up were included. The present study included 257 patients (298 hips), 31 male and 226 female, with the average age of 74.1±39.2 d (from 30 to 159 d). Pavlik harness underwent in 190, while 67 cases were treated with closed reduction plus spica casting. Acetabular index (AI), Wiberg OE angle (point O was the middle point of proximal me⁃taphyseal border) and Smith instability index (SI, SI⁃c:the lateral displacement index, SI⁃h:the vertical displacement index) on the pelvic X⁃ray film at 2-3 years of age after successful early treatment were recorded. Femoral head avascular necrosis (AVN) was diagnosed according to the Salter criteria. Results The success rate of reduction of closed reduction was significantly higher than Pavlik harness (97.5% vs. 69.9%, χ2=0.353, P=0.000). There was no significant difference in the incidence of AVN be⁃tween the closed reduction and Pavlik harness (6.6% vs. 4.6%, χ2=0.106, P=0.745). For GrafⅢ type DDH, the success rate of reduction of Pavlik harness and closed reduction were 80.7% and 98.4% respectively (χ2=11.248, P=0.001), while the Pavlik harness group had significantly worse results of AI, OE and SI⁃c at the age of 2-3 years (Pavlik harness: 22.9°±3.7°, 16.5°± 6.3° and 0.74 ± 0.06; closed reduction: 21.4° ± 3.4° , 18.9° ± 3.6° and 0.72 ± 0.03; P<0.05). For GrafⅣ type DDH, the success rate of reduction of Pavlik harness was much less than closed reduction (25.6% vs. 94.4%, χ2=24.231, P=0.001), with signifi⁃cantly worse results of OE at the age of 2-3 years (16.0°±4.1° vs. 18.6°±4.5°, t=-2.141, P=0.038). Conclusion

  20. Chronic bilateral dislocation of temporomandibular joint.

    Science.gov (United States)

    Shakya, S; Ongole, R; Sumanth, K N; Denny, C E

    2010-01-01

    Dislocation of the condyle of the mandible is a common condition that may occur in an acute or chronic form. It is characterised by inability to close the mouth with or without pain. Dislocation has to be differentiated from subluxation which is a self reducible condition. Dislocation can occur in any direction with anterior dislocation being the commonest one. Various predisposing factors have been associated with dislocation like muscle fatigue and spasm, the defect in the bony surface like shallow articular eminence, and laxity of the capsular ligament. People with defect in collagen synthesis like Ehler Danlos syndrome, Marfan syndrome are said to be genetically predisposed to this condition. Various treatment modalities have been used ranging from conservative techniques to surgical methods. Acute dislocations can be reduced manually or with conservative approach and recurrent and chronic cases can be reduced by surgical intervention. Though the dislocation in our case was 4 months a simple manual reduction proved to be successful. We believe that manual reduction can be attempted as first line of treatment prior to surgical intervention.

  1. 髋臼发育不良和股骨头坏死患者行髋关节表面置换术后血清金属离子水平比较%Comparison of serum metal ion levels after hip arthroplasty in patients with developmental dislocation of the hip and osteonecrosis of the femeral head

    Institute of Scientific and Technical Information of China (English)

    万彦林; 姜文学; 王鹏飞; 范猛

    2016-01-01

    [目的]探讨髋臼发育不良(developmental dislocation of the hip,DDH)与股骨头坏死(osteonecrosis of the femeral head,ONDH)患者行髋关节表面置换术(resurfacing arthroplasty of the hip,RSAH)后钴(Co)、铬(Cr)、钼(Mo)金属离子水平的差异.[方法] 2006年9月~2013年3月行RSAH的DDH患者14例19髋,平均年龄50.1岁,男4例,女10例,Crowe Ⅰ型9髋,Ⅱ型10髋,单侧9例,双侧5例,ONFH患者15例18髋,平均年龄47.0岁,男9例,女6例.ARCO Ⅱ期8例,Ⅲ期8例,Ⅳ期2例;单侧12例,双侧3例.使用电感耦合等离子体质谱仪检测术前和术后血清样本中Co、Cr、Mo离子的水平,并通过分析患者年龄、性别、术前术后Harris评分、侧别、使用不同假体、BMI、随访时间等信息以及术后髋臼外展角、前倾角等影像学指标分析造成DDH与ONFH患者术后金属离子水平差异的原因.[结果]随访26.1个月(3个月~7.6年),术后DDH组与ONFH组金属离子水平均较术前升高且DDH组金属离子水平升高幅度明显高于ONFH组,差异具有统计学意义.ONFH组髋臼外展角及外展肌力臂要大于DDH组,差异具有统计学意义.患者年龄、性别、术前术后Harris评分、侧别、使用不同假体、BMI、随访时间等差异均无统计学意义.[结论]术后随访未出现金属离子引起的不良反应,但术前合理选择病人,术中假体准确置入既是手术成功的关键也是降低术后金属离子水平的关键.

  2. 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.

  3. 护理干预在下颈椎骨折脱位前路复位减压植骨手术中的应用%Application of Nursing Intervention in Anterior Reduction and Decompression and Bone Graft Surgery in Lower Cervical Spine Fracture and Dislocation

    Institute of Scientific and Technical Information of China (English)

    李永岩

    2015-01-01

    目的:研究分析护理干预应用于下颈椎骨折脱位前路复位减压植骨手术的使用情况。方法根据我院2007年1月~2010年12月的35例下颈椎骨折脱位前路复位减压植骨手术治疗患者来进行研究分析。结果不完全性脊髓损伤的患者术后神经功能恢复Ⅰ级以上;完全性脊髓损伤的患者术后神经功能恢复无明显改善,患者疼痛缓解,肌力改善,没有肺部感染和泌尿系统症状存在。结论下颈椎骨折脱位前路复位减压植骨治疗手术需要提前做好准备,让患者的颈椎稳定,做好患者的生命体征以及并发症观察和预防,提升手术治疗效果,让患者的生活质量得到改善。%Objective To study and analyze the application of anterior reduction and decompression of the lower cervical spine fracture and dislocation of the lower cervical spine fracture and dislocation.MethodsAccording to our hospital from January 2007 to December 2010, 35 cases of lower cervical spine fracture and dislocation anterior reduction and bone graft surgery for patients to study and analysis.ResultsPatients with incomplete spinal cord injury recovered more than one grade. After surgery, patients with complete spinal cord injury had no obvious improvement in neurological function recovery. ConclusionAnterior reduction and decompression and bone grafting in the treatment of lower cervical spine fracture and dislocation need to be prepared in advance, so that patients with cervical stability, good life signs and complications observation and prevention, improve the surgical treatment effect, so that the quality of life of patients has been improved.

  4. The analysis of therapeutic effect of Halo-vest reduction combined with anterior decompression and internal fixation on lower cervical spine fracture-dislocation%Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效分析

    Institute of Scientific and Technical Information of China (English)

    姚关锋; 王新家; 罗滨; 王伟东; 曾机灿

    2013-01-01

    Objective:To investigate the efficacy of lower cervical spine fracture-dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation. Methods:A total of 17 patients with lower cervical spine fracture-dislocation were treated by operation from January 2009 to December 2011.The Halo-vest external fixation was performed under 1oca1 anesthesia in the first step, and then under reduction anterior decompression and internal fixation were carried out in the second step.Results: After surgery, al patients were fol owed up for more than 12 months.According to the X-ray films and CT scan,the fracture-dislocation was made in a complete reset,the natural arrangement of the cervical spine and physiological circular measure regained and the implanted bone was completely fused,without internal fixation breaking or loosening.According to the Frankel grading,the grade of 5 cases were remarkably reduced(2 levels),10 cases effectively reduced(1 leve1),and 2 cases were invalid.Conclusions: The treatment of lower cervical spine fracture-dislocation with Halo-vest reduction combined with anterior decompression and internal fixation is effective.%  目的探讨Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效。方法对2009年l月至2011年12月17例下颈椎骨折脱位患者,首先在局麻下行Halo-vest固定术,然后逐步撑开,在复位情况下,行前路减压内固定术。结果术后随访12~24个月,平均15.4个月。常规X光正侧位片显示骨折脱位均复位,恢复颈椎的正常序列及生理弧度,CT显示植骨融合,未发现内固定断裂及松动。按Frankel分级,显效(降低2级)5例,有效(降低1级)10例,无效2例。结论在Halo-vest复位的基础上行前路减压植骨融合内固定是治疗下颈椎骨折脱位的安全有效方法。

  5. Arthroscopic findings after shoulder dislocation

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    Medenica Ivica

    2009-01-01

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

  6. Management of developmental dysplasia of the hip in less than 24 months old children

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    Mehmet Bulut

    2013-01-01

    Full Text Available Background: There is no consensus on the treatment of developmental dysplasia of the hip in children less than 24 months of age. The aim of this study was to present the results of open reduction and concomitant primary soft-tissue intervention in patients with developmental dysplasia of the hip in children less than 24 months of age. Materials and Methods: Sixty hips of 50 patients (4 male, 46 female with mean age of 14.62 ± 5.88 (range 5-24 months months with a mean followup of 40.00 ± 6.22 (range 24-58 months months were included. Twenty five right and 35 left hips (10 bilaterally involved were operated. Open reduction was performed using the medial approach in patients aged < 20 months (with Tönnis type II-III and IV hip dysplasias and for those aged 20-24 months with Tönnis type II and III hip dysplasias ( n = 47. However for 13 patients aged 20-24 months with Tönnis type IV hip dysplasias, anterior bikini incision was used. Results: Mean acetabular index was 41.03 ± 3.78° (range 34°-50° in the preoperative period and 22.98 ± 3.01° (range 15°-32° at the final visits. Mean center-edge angle at the final visits was 22.85 ± 3.35° (18°-32°. Based on Severin radiological classification, 29 (48.3% were type I (very good, 25 (41.7% were type II (good and 6 (10% were type III (fair hips. According to the McKay clinical classification, postoperatively the hips were evaluated as excellent ( n = 42; 70%, good ( n = 14; 23.3% and fair ( n = 4; 6.7%. Reduction of all hip dislocations was achieved. Additional pelvic osteotomies were performed in 14 (23.3% hips for continued acetabular dysplasia and recurrent subluxation. (Salter [ n = 12]/Pemberton [ n = 2] osteotomy was performed. Avascular necrosis (AVN developed in 7 (11.7% hips. Conclusion: In DDH only soft-tissue procedures are not enough, because of the high rate of the secondary surgery and AVN for all cases aged less than 24 months. Bone procedures may be necessary in the walking

  7. 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)

  8. Manual treatment of dislocation of temporomandibular joint%颞下颌关节脱位的手法治疗

    Institute of Scientific and Technical Information of China (English)

    雷绍音; 陈永全

    2002-01-01

    Background: That the condylar process slides out of articular fossa and exceeds normal limit of articular motion and can not reduce automatically is called dislocation of temporomandibular joint. It is divided into unilateral and bilateral dislocation according to the part of dislocation. Or it is divided into acute, recurrent, and old dislocations according to the time of dislocation or into anterior, posterior, superior and lateral dislocations according the direction of dislocation of the condylar process. Manifestations of dislocation of temporomandibular joint include mandibular abnormal motion, opening of the mouth that can' t close with outflowing of the saliva, he mandible protrudes anteriorly, the cheeks become smooth, a pit can be palpated anterior to the antilobium.

  9. Delayed posterior dislocation of silicone plate-haptic lenses following anterior and posterior Nd:Yag laser capsulotomy%硅凝胶襻板式人工晶状体在YAG激光晶状体囊膜切开术后迟发性后脱位

    Institute of Scientific and Technical Information of China (English)

    KI Papageorgiou; A Ioannidis; AJ Sinha; PS Andreou

    2006-01-01

    · AIM: To observe the stability of silicone plate haptic intraocular lenses implanted following cataract surgery and analyse the reasons related to decentration and dislocation into the posterior segment.· METHODS- RESULTS: We report 3 cases of posterior dislocation of silicone plate-haptic lenses (Bausch and Lomb C11UB and Chiron C11UB) in patients who underwent uneventful phacoemulsification. One occurred 4 years following sectoral anterior capsulotomy for advanced anterior capsular contraction, the other in the early post-operative period following posterior capsulotomy and the third is a delayed ( 3months), dislocation following uneventful posterior capsulotomy. None of the cases were associated with a history of trauma or other precipitating event.· CONCLUSIONS: Silicone plate haptic IOLs seem to be prone to dislocation due to poor capsular adherence as they are only held in place by the fibrotic fusion of the haptics, If either the posterior or anterior capsules are disrupted, the forces created by capsular contraction may cause extension of radial tears, with subsequent posterior dislocation of the implant. Though the use of silicone plate-haptic lenses has been surpassed by other models, there are patients who had implantation of such lenses that may undergo YAG laser capsulotomy. It is important to inform them about the potential risk of posterior dislocation as an early or late complication following this procedure.%目的:观察白内障手术植入硅凝胶襻板式人工晶状体的稳定性,分析其偏心和后脱位的相关原因.方法-结果:我们报道了3例顺利行白内障超声乳化并硅凝胶襻板式人工晶状体植入手术的患者,在术后发生人工晶状体后脱位.1例出现在因高度前囊收缩行扇形晶状体前囊切开术后4 a,另2例分别出现在晶状体后囊切开术后早期和术后3 mo.3者均在顺利行晶状体后囊切开术后发生脱离.患者均无外伤病史或其他促发事件.结论:硅凝

  10. 关节镜辅助治疗婴幼儿难复性发育性髋关节脱位短期观察%Short-term effects on arthroscopic-assisted surgery for irreducible or unstable developmental dislocation of the hip in infants

    Institute of Scientific and Technical Information of China (English)

    丁仰坤; 李祁伟; 张立军; 李连永; 刘振江; 史立伟; 王恩波; 吉士俊; 赵群

    2016-01-01

    目的 探讨关节镜辅助治疗婴幼儿难复性发育性髋关节脱位(developmental dysplasia or dislocation of the hip,DDH)优缺点和短期临床效果.方法 2009年4月至2010年9月,应用关节镜辅助治疗难复性婴幼儿DDH患儿15例16髋,记录手术时间、出血量及术中阻碍髋关节复位的因素.采用改良McKay评分标准进行髋关节功能评估.应用髋臼指数(acetabular index,AI),臼头指数(acetabular head index,AHI),股骨头缺血性坏死(avascular necrosis,AVN),Severin方法分级等指标进行影像学评估.结果 手术时间平均123 min,出血平均4.8ml.妨碍髋关节复位的因素有:髋臼窝内增生的软组织、粗大的圆韧带,髋臼横韧带和内翻关节盂唇.所有患儿均获得成功复位.术后患儿均无切口感染、神经损伤等手术并发症.平均随访时间32个月(6~59个月).近期随访的6例患儿临床功能结果,优3髋,良1髋,可1髋,差1髋.近4岁以上的8髋,其中4髋(50%)为Severin分级为优良.16髋中有7髋(43.8%)出现AVN迹象,Kalamchi-MacEwenⅠ型6髋,Ⅱ型1髋.结论 关节镜辅助下治疗难复性婴幼儿DDH,手术安全创伤小,出血少,能够成功获得髋关节复位.但术后AVN可能与改良蛙式膏固定有关,关节液压力可能对股骨头血运产生影响,术后残余髋臼发育不良可能与未进行髋臼截骨有关.%Objective To explore the short-term effects on arthroscopic-assisted surgery for irreducible or unstable developmental dislocation of the hip (DDH) in infants.Methods From April 2009 to September 2010, 15 children (16 hip) with irreducible or unstable DDH undergoing arthroscopic-assisted surgery were followed up.The operative duration, blood loss and obstructions for hip reduction were recorded.Modified McKay grading was used for evaluating the hip joint functions.Acetabular index (AI), acetabular head index (AHI), avascular necrosis (AVN) and Severin's classification were used for evaluating the

  11. 髋关节外科脱位入路切开复位手术治疗中重度股骨头骨骺滑脱的临床疗效%Results of surgical treatment for moderate or severe slipped capital femoral epiphysis through the approach of surgical hip dislocation

    Institute of Scientific and Technical Information of China (English)

    杨璇; 蔡奇勋; 李海; 张自明; 陈珽; 赵黎

    2014-01-01

    Objective To evaluate the results of surgical treatment for moderate or severe slipped capital femoral epiphysis (SCFE) using modified Dunn procedure through the approach of surgical hip dislocation at the interval of minimum 12 months follow-up.Methods From November 2011 to June 2013,6 patients (7 hips) with SCFE were treated in department of pediatric orthopedics,Hospital Affiliated to Shanghai Jiaotong University School of Medicine,they all had trauma history.The patients were aged from 10-15 years,mean 13.6 years.The duration of symptoms ranged from 4 to 35 days,average 14.2 days.The degree of slip was averagely 45% (25%-55%).In 6 patients (except right side of 1 case was treated in situ with cannulated screws) were surgically treated using modified Dunn procedure through the approach of surgical hip dislocation.Postoperatively the brace was used for immobilizing the hip for 4 weeks,then 4 weeks of bed traction combined with rehabilitation program of hip joint activity.Eight weeks later,the gradual touchdown weight bearing was being allowed.Results The follow-up time ranged from 12 to 30 months,average 23.8 months.Six patients have been able to walk without crutches,no obvious limp.X-ray film showed femoral epiphysis line on the bit of good recovery,no appearance of avascular necrosis of the femoral head,joint space was normal.The Harris score of hip evaluation was 94.7 averagely,ranging 85 -100,at the time of last follow-up.Conclusions Application of surgical treatment for moderate or severe SCFE with open reduction through the approach of surgical hip dislocation is a valid alternative method.The femoral head epiphysis can be capable of restoring anatomy,at present no case occurred avascular necrosis,and patients are satisfied with the function of the hip joint.%目的 总结应用髋关节外科脱位入路行切开复位手术治疗青少年中、重度股骨头骨骺滑脱后至少12个月的随访效果.方法 2011年11月至2013年6月上海交通

  12. Latarjet两种术式治疗肩关节复发性前脱位伴重度骨缺损3~5年随访的比较研究%Comparison of two kinds of Latarjet procedures for recurrent anterior dislocation of the shoulder with severe glenoid bone defects:a 3-5 year follow-up study

    Institute of Scientific and Technical Information of China (English)

    向明; 杨国勇; 陈杭; 胡晓川; 唐浩琛

    2014-01-01

    Objective Shoulder dislocations,most of which are anterior dislocations,account for over 40% of joint dislocations.The main pathological mechanism is the dysfunction of the anteroinferior glenolabral articular ligamental complex,namely theBankart inj ury.Failure of the repair can cause the recurrent dislocation.Some cases are accompanied with the glenoidavulsion fracture or the bony defect,even with the inverted pear glenoid.Open or arthroscopic reconstruction can achieve excellent clinical results for the Bankart injury which bone defect is less than 25%.But if bony defect of glenoid is over 25%-30% or associtaed with Hill-Sachs injury,the re-dislocation rate is up to 67%after the simple Bankart reconstruction.The Latarj et procedure is able to reduce the recurrent dislocation significantly.This study is to retrospectively evaluate the three-to-five years'follow-up results of the Latarj et coracoid bone block procedure for the recurrent anterior dislocation of the shoulder associated with the severe bony defects.Methods Thirty-seven patients (23 men and 14 women)underwent the Latarjet procedure for the anterior glenohumeral instability between April 2006 and October 2009.All the shoulders had the severe osseous deficiency of the anterior glenoid rim, which was more than 25% of the glenoid width according to 3-dimensional CT scan and arthroscopic findings.The patients were associtated with Engaging Hill-Sachs lesion.21 patients were treated by the parallel coracoid transposition bone block from January 2008 to October 2009,and 16 patients were performed with the intorted coracoid transposition method from April 2006 to December 2007. Apprenhension sign was positive in all of the 37 patients before operation.And the mean time of their dislocations was 13.5 (ranged from 8 to 28 times).We evaluated the preoperative and postoperative pain,the daily living activities,the range of motion,stability of the shoulders,and function of the shoulder using the American Shoulder

  13. Latarjet 手术治疗癫痫患者复发性肩关节前脱位伴重度骨缺损的短期疗效分析%Curative effect analysis on Latarjet procedure in treatment of epileptic patients of recurrent anterior dislocation of shoulder with severe osseous deficiency with 3-5 years follow-up

    Institute of Scientific and Technical Information of China (English)

    杨国勇; 向明; 陈杭; 胡晓川; 唐浩琛

    2014-01-01

    after surgery,there was no evidence of fixation failure or graft resorption in the shoulders.No one underwent revision surgery.Overall,most of the patients had satisfactory pain relief and daily living activities postoperatively at the time of the latest follow-up.Conclusions The anterior dislocation of the shoulder in the epileptic patients is really uncommon.The treatment of the secondary recurrent anterior dislocations of the shoulder associated with severe osseous deficiency is quite difficult,due to the unacceptably high rate of re-dislocation after the open or arthroscopic reconstruction surgery of the Bankart lesion.Our study assessed the effects of Latarjet procedure on the radiological and clinical results in seven cases with severe glenoid osseous deficiency accompanied with epileptic seizure disorders and recurrent anterior dislocation of shoulder.The results suggested that when treating patients with an epileptic seizure disorder and recurrent anterior glenohumeral instability,effective control of the epileptic seizures is one of the most important methods to reduce the incidence of post-operative recurrent dislocation,because a compliant patient was very important for a successful clinical outcome.The Latarjet procedure can provide a satisfied reconstruction of shoulder stability,but the possibility of re-dislocation and osteoarthritis should be also noticed.We recommend a high index of suspicion when treating patients with a seizure disorder who have anterior shoulder instability,and we recommend making a preoperative CT scan,if there is a strong likelihood that a coracoid transfer will be used at surgery.This enables the diagnosis of a coracoid fracture nonunion to be made prior to surgery and helps to determine whether there is sufficient bone to allow a Latarjet procedure to be performed.However,it needs further investment to choose an appropriate surgery procedure for the untreated epileptic patients.

  14. Total hip arthroplasty following failed fixation of proximal hip fractures

    Directory of Open Access Journals (Sweden)

    Srivastav Shekhar

    2008-01-01

    Full Text Available Background: Most proximal femoral fractures are successfully treated with internal fixation but a failed surgery can be very distressing for the patient due to pain and disability. For the treating surgeon it can be a challenge to perform salvage operations. The purpose of this study was to evaluate the short-term functional outcome and complications of total hip arthroplasty (THA following failed fixation of proximal hip fracture. Materials and Methods: In a retrospective study, 21 hips in 20 patients (13 females and seven males with complications of operated hip fractures as indicated by either established nonunion or fracture collapse with hardware failure were analysed. Mean age of the patients was 62 years (range 38 years to 85 years. Nine patients were treated for femoral neck fracture, 10 for intertrochanteric (I/T fracture and two for subtrochanteric (S/T fracture of the hip. Uncemented THA was done in 11 cases, cemented THA in eight hip joints and hybrid THA in two patients. Results: The average duration of follow-up was four years (2-13 years. The mean duration of surgery was 125 min and blood loss was 1300 ml. There were three dislocations postoperatively. Two were managed conservatively and one was operated. There was one superficial infection and one deep infection. Only one patient required a walker while four required walking stick for ambulation. The mean Harris Hip score increased from 32 preoperatively to 79 postoperatively at one year interval. Conclusion: Total hip arthroplasty is an effective salvage procedure after failed osteosynthesis of hip fractures. Most patients have good pain relief and functional improvements inspite of technical difficulties and high complication rates than primary arthroplasty.

  15. 直接前方入路与后外侧入路在初次全髋关节置换术中的疗效分析%Efficacy of direct anterior approach and posterior lateral approach in primary total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    綦珂; 李甲; 李全; 张永进; 薛晨晨; 徐卫东

    2016-01-01

    THA were treated, among which 70 cases used posterior lateral approach (gourp A), and 66 cases used anterior lateral approach (group B).The follow-up period was five to 11 months, 7.2 months in average.The incision length, intraoperative blood loss, operation time, postoperative drainage volume, postoperative drainage time , hospital stay , postoperative Harris score , and postoperative complications of the two groups were observed and recorded .Software SPSS 13 was used to analyse and compare the data of the two groups .x2 test was performed in count data , and t test was used for measurement data .P0.05);the postoperative Harris score of group B was (91.6 ±4.4), while it was (89.4 ±5.8) in group A, (P>0.05).The postoperative complication was non in group B , while one case of postoperative hip dislocation and one case of nerve palsy were observed in group A , the difference was not statistically significant (P>0.05).During the operation, one case of greater trochanter fracture occurred in group B , while in group A , one case of the greater trochanter fracture and one case of the femoral fracture occurred . No deep vein thrombosis , prosthetic loosening or other complication was observed in the two groups . Conclusion The direct anterior approach of THA has obvious advantages in shortening the incision , less intraoperative and postoperative bleeding , reducing ambulation time and hospitalization , and decreasing the complication incidence;the recent curative effects are comfirmative , which is a safe surgical approach , and can benefit the rapid rehabilitation of patients .

  16. Total hip arthroplasty after previous fracture surgery.

    Science.gov (United States)

    Krause, Peter C; Braud, Jared L; Whatley, John M

    2015-04-01

    Total hip arthroplasty can be a very effective salvage treatment for both failed fracture surgery and hip arthritis that may occur after prior fracture surgery. The rate of complications is significantly increased including especially infection, dislocation, and loosening. Complications are more likely to occur after failed open reduction and internal fixation than after posttraumatic arthritis. Adequately ruling out infection before hip arthroplasty can be difficult. The best predictor of infection is a prior infection. Long-term outcomes can be comparable to outcomes in other conditions if complications are avoided.

  17. The ligamentum teres of the adult hip.

    Science.gov (United States)

    Bardakos, N V; Villar, R N

    2009-01-01

    Advances in hip arthroscopy have renewed interest in the ligamentum teres. Considered by many to be a developmental vestige, it is now recognised as a significant potential source of pain and mechanical symptoms arising from the hip joint. Despite improvements in imaging, arthroscopy remains the optimum method of diagnosing lesions of the ligamentum teres. Several biological or mechanical roles have been proposed for the ligament. Unless these are disproved, the use of surgical procedures that sacrifice the ligamentum teres, as in surgical dislocation of the hip, should be carefully considered. This paper provides an update on the development, structure and function of the ligamentum teres, and discusses associated clinical implications.

  18. The research of fascia perforating vessels in the anterior-lateral approach of the hip joint%筋膜穿支血管在髋关节 OCM 入路中解剖学定位的研究

    Institute of Scientific and Technical Information of China (English)

    黄宇; 孙晓彤; 尹东; 黄晓; 覃文杰

    2015-01-01

    Objectiv e To observe the relationship between fascia perforating vessels with muscle gap and neural interface in the anterior-lateral approach of the hip join .Methods 33 hips of dead bodies with formaldehyde solution embalmed , and without limb deformity and operation history were anatomised .The fascia vessel near point in the anterior superior iliac spine to the lateral trochanter at the most convex line was explored , and the relationships between the vessels with muscle gap and neural interface were recorded .The numbers of fascia perforating vessels and the position of the muscle gap in 87 hip operations were observed in our department from June 2011 to June 2013 .Re-sults The fascia vascular had constant position in the muscle gap of the gluteus medius muscle and the tensor fascia was found in 30 cases(about 91%)of the specimens.The perforating vessels were found and they came from the deep surface of muscle celearance .The perforating vessels were found in79 cases(90.8%) who were performed the opera-tion and the peforating vessels came from the deep surface of muscle celearance .The shortest distance from the supe-rior gluteal nerve entry point to fascia latal perforator was (5.62 ±1.18)cm.There were correlations between the safe range with femur length , the iliac crest and the rotor outside the convex distance ( r=0.84,0.61 ) .Conclusion There is a constant relationship between the postion of the fascial lata perforator vessel with the muscle gap of the glu -teus medius muscle and the tensor fascia. The fascial perforating vessels can provide accurate and safe positioning for the OCM approach of the hip join .%目的:探寻在髋关节前外侧( OCM)入路中筋膜穿支血管与肌间隙及神经界面的关系。方法解剖经甲醛溶液常规防腐固定处理33侧髋部,均无肢体畸形及手术史。探查髂前上棘至大转子外侧最凸处连线附近血管穿筋膜点并探明该血管与臀中肌阔筋膜张肌肌间隙的位置

  19. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  20. Tomographic index as auxiliary criteria for surgery indication in fracture dislocation of acetabulum posterior wall

    OpenAIRE

    Fujiki, Edison N; Yamaguchi, Eduardo N; Miachiro, Edison; Chikude, Takechi; Ikemoto,Roberto Y.; de Abreu, Luiz Carlos; Valenti, Vitor Engrácia [UNESP; Rodrigues, Luciano M. R.; Monteiro, Carlos B; Milani, Carlo

    2012-01-01

    There are situations which the tomographic exam is done on the affected hip or situations where the contralateral hip presents abnormalities that make it impossible to compare. In this study we aimed to evaluate a tomographic index that does not require comparison between the both hips. Twenty two patients with unilateral acetabular fracture dislocation with fracture of posterior wall were studied. We established the relationship between the remaining posterior wall and the femoral head diame...

  1. 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.

  2. Dual mobility total hip replacement in a high risk population

    Science.gov (United States)

    Luthra, Jatinder Singh; Al Riyami, Amur; Allami, Mohamad Kasim

    2016-01-01

    Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement. PMID:27924742

  3. Dual mobility total hip replacement in a high risk population

    Directory of Open Access Journals (Sweden)

    Luthra Jatinder Singh

    2016-01-01

    Full Text Available Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement.

  4. Dislocation climb in two-dimensional discrete dislocation dynamics

    NARCIS (Netherlands)

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

    2012-01-01

    In this paper, dislocation climb is incorporated in a two-dimensional discrete dislocation dynamics model. Calculations are carried out for polycrystalline thin films, passivated on one or both surfaces. Climb allows dislocations to escape from dislocation pile-ups and reduces the strain-hardening r

  5. Hip Fracture

    Science.gov (United States)

    ... Medicine. 2014;161:189. Lewiecki EM. Prevention of osteoporosis. http://www.uptodate.com/home. Accessed Dec. 31, 2014. Hip fractures among older adults. Centers for Disease Control and Prevention. http://www. ...

  6. Rose Hip

    Science.gov (United States)

    ... dropsy or edema), gout, back and leg pain (sciatica), diabetes, high cholesterol, weight loss, high blood pressure, ... Painful menstruation. Some evidence suggests that applying an aromatherapy formula containing lavender, clary sage, and rose hip ...

  7. Hip ultrasound

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  8. Multiple carpometacarpal dislocations.

    OpenAIRE

    Kumar, A.; Olney, D B

    1994-01-01

    We present a case of dislocations of the carpometacarpal joints without associated fractures. Although carpometacarpal injuries are relatively uncommon, it is rare for multiple carpometacarpal dislocations to occur without associated fractures. The injury is difficult to diagnose because of swelling of the hand. A lateral radiograph of the wrist has been found to be mandatory to its precise diagnosis if suspected. In the case presented here early diagnosis and closed manipulation in the accid...

  9. Osteochondritis Dissecans of the Hip

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-03-01

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

  10. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

    LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: ellopis@hospital-ribera.com; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: mario.padron@clinicacemtro.com

    2007-04-15

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.

  11. Ipsilateral dislocation of the shoulder and elbow.

    Science.gov (United States)

    Khan, M R; Mirdad, T M

    2001-11-01

    Ipsilateral dislocation of shoulder and elbow joints is a rare injury. Only 2 such cases have been reported in the English literature. We report a case of a 35-year-old man involved in a road traffic accident under the influence of alcohol. He sustained posterior left elbow and anterior left shoulder dislocation with minimally displaced greater tuberosity fracture. He also had partial median nerve palsy. Under intramuscular pethidine and intravenous diazepam, close reduction of elbow followed by shoulder was carried out. At 2 months, median nerve function returned to normal. At 3 months, almost full elbow and shoulder joint movement returned. Although rare and complex, this ipsilateral injury can be treated conservatively.

  12. Hip displacement in relation to age and gross motor function in children with cerebral palsy

    OpenAIRE

    Larnert, Per; Risto, Olof; Hägglund, Gunnar; Wagner, Philippe

    2014-01-01

    Purpose Hip dislocation in cerebral palsy (CP) is a serious complication. By radiographic screening and prophylactic surgery of children at risk most dislocations can be prevented. CPUP, the Swedish CP registry and follow-up program, includes annual radiographic examinations of children at Gross Motor Function Classification System (GMFCS) levels III–V. Data from CPUP were analysed to assess the risk of hip displacement in relation to GMFCS levels and age. Methods All children at GMFCS levels...

  13. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-06-01

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

  14. Statistical characterization of dislocation ensembles

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-05-17

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

  15. Imaging findings in external snapping hip syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Krishnamurthy, Ganesh; Connolly, Bairbre L. [The Hospital for Sick Children, Image Guided Therapy, Diagnostic Imaging, Toronto (Canada); Narayanan, Unni [The Hospital for Sick Children, Pediatric Orthopedic Surgery, Toronto (Canada); Babyn, Paul S. [The Hospital for Sick Children, Diagnostic Imaging, Toronto (Canada)

    2007-12-15

    We describe a case of external snapping hip diagnosed by dynamic sonography. The case prompted us to retrospectively review the imaging findings of children who clinically had presented with snapping hip. From this review we identified the features on MRI and CT of either thickening of the iliotibial band or thickening of the anterior edge of the gluteus maximus muscle as the cause of snapping and atrophy of the bulk of gluteus maximus muscle as an important secondary sign associated with snapping. (orig.)

  16. Risk factors for dislocation of the ulnar nerve after simple decompression for cubital tunnel syndrome.

    Science.gov (United States)

    Murata, K; Omokawa, S; Shimizu, T; Nakanishi, Y; Kawamura, K; Yajima, H; Tanaka, Y

    2014-01-01

    Anterior dislocation of the ulnar nerve is occasionally encountered after simple decompression of the nerve for treatment of cubital tunnel syndrome. The purpose of this study was to determine whether the incidence of dislocation of the nerve following simple decompression of the nerve is correlated with the patient's preoperative characteristics and/or elbow morphology. We studied 51 patients with cubital tunnel syndrome who underwent surgery at our institution. Intraoperatively, we simulated dislocation of the nerve after simple decompression by flexing the elbow after releasing the nerve in each patient. Univariate and multiple logistic regression analysis showed that young age and a small ulnar nerve groove angle are positively correlated with dislocation of the nerve. Our results suggest that patients who are young and/or have a sharply angled ulnar nerve groove identified radiographically have a high probability of experiencing anterior dislocation of the ulnar nerve after simple decompression.

  17. One-stage posterior-anterior approach surgery for cervical fracture and dislocation combined with locked facet%Ⅰ期后、前路手术治疗伴关节突交锁的颈椎骨折脱位

    Institute of Scientific and Technical Information of China (English)

    郭超峰; 张宏其; 刘金洋; 吴建煌; 唐明星

    2014-01-01

    Objective To evaluate the clinical effect of one-stage posterior-anterior approach surgery for patients with cervical fracture and dislocation combined with locked facet.Methods A retrospective review was conducted on 21 cases of cervical dislocation and fracture combined with locked facet treated by one-stage posterior-anterior approach surgery between April 2011 and December 2012.There were 16 males and 5 females at age ranging from 23 to 61 years (mean,38.3 years).Posterior unlocking reduction by partial facetectomy and lateral mass screw fixation was performed,followed by anterior decompression,internal fixation and interbody fusion by titanium meshes.Outpatient or telephone follow-up was performed to evaluate bone fusion and recovery of neurologic function.Results Mean operation time was 140 minutes (130-210 minutes) and mean blood loss was 340 ml (range,150-600 ml).All incisions got primary healing with no operation-correlated complications.Five patients complicated with severe lung infection after surgery and one died of respiratory failure two week later.Titanium meshes achieved bone fusion within 3-9 months (mean,6 months) after surgery.At a mean follow-up of 17 months (range,12-30 months),there was no implant breakage and mesh displacement or collapse.According to the American Spinal Injury Association (ASIA) score,preoperative neurologic deficit restored by mean one grade at final follow-up.Conclusion One-stage posterior-anterior approach surgery is an ideal choice for cervical fracture and dislocation combined with locked facet,for it provides unlocking reduction,canal decompression,and rigid reconstruction of the anterior-posterior column.%目的 探讨Ⅰ期后、前路联合手术治疗伴关节交锁的颈椎骨折脱位的临床疗效.方法 回顾性分析2011年4月-2012年12月采用Ⅰ期后、前路手术治疗的21例颈椎骨折脱位伴关节突交锁患者,其中男16例,女5例;年龄23 ~61岁,平均38.3岁.先行后路手术切除部

  18. Dynamic ultrasound of the external snapping hip syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Sun; Song, Baek Yong; Paik, Sang Hyun; Lee, Tae Gyu; Yoon, Yong Kyu [Eulji Hospital, Eulji University School of Medicine, Deajeon (Korea, Republic of); Lee, Sung Moon [Keimyung University School of Medicine, Deagu (Korea, Republic of)

    2002-09-15

    Snapping hip syndrome has been described as a hip pain accompanied by an audible snapping during motion of the hip or while walking. The variable causes of its external, internal, and intra-articular origins have been described. The most common extemal snapping hip has been associated with a thickened posterior border of the iliotibial band or of the anterior border of the gluteus maximus muscle slipping over the greater trochanter. The aim of this study was to evaluate the dynamic ultrasound findings of external snapping hip syndrome with review of the literature. We studied 5 patients (7 cases) with external snapping hip and pain over the greater trochanter during walking or hip motion (3 males and 2 females, age range, 14-32 years; mean, 19 years). Two patients reported bilateral snapping hips.

  19. Dislocation climb models from atomistic scheme to dislocation dynamics

    Science.gov (United States)

    Niu, Xiaohua; Luo, Tao; Lu, Jianfeng; Xiang, Yang

    2017-02-01

    We develop a mesoscopic dislocation dynamics model for vacancy-assisted dislocation climb by upscalings from a stochastic model on the atomistic scale. Our models incorporate microscopic mechanisms of (i) bulk diffusion of vacancies, (ii) vacancy exchange dynamics between bulk and dislocation core, (iii) vacancy pipe diffusion along the dislocation core, and (iv) vacancy attachment-detachment kinetics at jogs leading to the motion of jogs. Our mesoscopic model consists of the vacancy bulk diffusion equation and a dislocation climb velocity formula. The effects of these microscopic mechanisms are incorporated by a Robin boundary condition near the dislocations for the bulk diffusion equation and a new contribution in the dislocation climb velocity due to vacancy pipe diffusion driven by the stress variation along the dislocation. Our climb formulation is able to quantitatively describe the translation of prismatic loops at low temperatures when the bulk diffusion is negligible. Using this new formulation, we derive analytical formulas for the climb velocity of a straight edge dislocation and a prismatic circular loop. Our dislocation climb formulation can be implemented in dislocation dynamics simulations to incorporate all the above four microscopic mechanisms of dislocation climb.

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

    Directory of Open Access Journals (Sweden)

    Chatla

    2016-03-01

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

  1. Dislocation following total knee arthroplasty: A report of six cases

    Directory of Open Access Journals (Sweden)

    Villanueva Manuel

    2010-01-01

    Full Text Available Background: Dislocation following total knee arthroplasty (TKA is the worst form of instability. The incidence is from 0.15 to 0.5%. We report six cases of TKA dislocation and analyze the patterns of dislocation and the factors related to each of them. Materials and Methods: Six patients with dislocation of knee following TKA are reported. The causes for the dislocations were an imbalance of the flexion gap (n=4, an inadequate selection of implants (n=1, malrotation of components (n=1 leading to incompetence of the extensor mechanism, or rupture of the medial collateral ligament (MCC. The patients presented complained of pain, giving way episodes, joint effusion and difficulty in climbing stairs. Five patients suffered posterior dislocation while one anterior dislocation. An urgent closed reduction of dislocation was performed under general anaesthesia in all patients. All patients were operated for residual instability by revision arthroplasty after a period of conservative treatment. Results: One patient had deep infection and knee was arthrodesed. Two patients have a minimal residual lag for active extension, including a patient with a previous patellectomy. Result was considered excellent or good in four cases and fair in one, without residual instability. Five out of six patients in our series had a cruciate retaining (CR TKA designs: four were revised to a posterior stabilized (PS TKA and one to a rotating hinge design because of the presence of a ruptured MCL. Conclusion: Further episodes of dislocation or instability will be prevented by identifying and treating major causes of instability. The increase in the level of constraint and correction of previous technical mistakes is mandatory.

  2. Halo-vest reduction combined with anterior decompression and internal fixation for lower cervical spine fracture and dislocation%Halo-vest支架复位联合前路减压内固定治疗下颈椎骨折脱位

    Institute of Scientific and Technical Information of China (English)

    姚关锋; 王新家; 王伟东; 郑瑞武; 陈灵梓

    2015-01-01

    Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P < 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.%目的 探讨Halo-vest支架复位联合前路减压内固定治疗下颈椎骨折脱位的临床疗效. 方法 2009年1月-2012年12月采用Halo-vest支架复位联合前路减压融合内固定治疗下颈椎骨折脱位患者26例,其中男18例,女8例;年龄19~64岁,平均42.1岁.致伤原因:交通伤11例,高处坠落伤9例,重物压砸伤6例.骨折脱位部位:C5/610例,C6/79例,C3/44例,C4/53

  3. Surgical Management of Hip Problems in Myelomeningocele: A Review Article

    Science.gov (United States)

    Baghdadi, Taghi; abdi, Reza; Bashi, Ramin Zargar; Aslani, Hossein

    2016-01-01

    Background: Children with myelomeningocele (MMC) develop a wide variety of hip deformities such as muscle imbalance, contracture, subluxation, and dislocation. Various methods and indications have been introduced for treatment of muscle imbalances and other hip problems in patients with MMC but there is no study or meta-analysis to compare the results and complications. This review aims to find the most acceptable approach to hip problems in patients with MMC. Methods: MEDLINE was searched up to April 2015. All study designs that reported on the outcomes of hip problems in MMC were included. From 270 screened citations, 55 were strictly focused on hip problem in MMC were selected and reviewed. Results: Complex osseous and soft tissue reconstructive procedures to correct hip dysplasia and muscle balancing around the hip are rarely indicated for MMC patients without good quadriceps power. Conclusion: Over the years a consensus on the best algorithm for treatment of hip dislocation in myelomeningocele has been missing, however, muscular balancing with/out osseous procedure seems a reasonable approach especially in unilateral mid-lumbar MMC. PMID:27517062

  4. Surgical Management of Hip Problems in Myelomeningocele: A Review Article

    Directory of Open Access Journals (Sweden)

    Taghi Baghdadi

    2016-07-01

    Full Text Available Background: Children with myelomeningocele (MMC develop a wide variety of hip deformities such as muscle imbalance, contracture, subluxation, and dislocation. Various methods and indications have been introduced for treatment of muscle imbalances and other hip problems in patients with MMC but there is no study or meta-analysis to compare the results and complications. This review aims to find the most acceptable approach to hip problems in patients with MMC. Methods: MEDLINE was searched up to April 2015. All study designs that reported on the outcomes of hip problems in MMC were included. From 270 screened citations, 55 were strictly focused on hip problem in MMC were selected and reviewed. Results: Complex osseous and soft tissue reconstructive procedures to correct hip dysplasia and muscle balancing around the hip are rarely indicated for MMC patients without good quadriceps power. Conclusion: Over the years a consensus on the best algorithm for treatment of hip dislocation in myelomeningocele has been missing, however, muscular balancing with/out osseous procedure seems a reasonable approach especially in unilateral mid-lumbar MMC.

  5. Lessons learned from study of congenital hip disease in adults

    Science.gov (United States)

    Hartofilakidis, George; Lampropoulou-Adamidou, Kalliopi

    2016-01-01

    Orthopaedic surgeons specialising in adult hip reconstruction surgery often face the problem of osteoarthritis secondary to congenital hip disease (CHD). To achieve better communication among physicians, better treatment planning and evaluation of the results of various treatment options, an agreed terminology is needed to describe the entire pathology. Furthermore, a generally accepted classification of the deformities is necessary. Herein, the authors propose the use of the term “congenital hip disease” and its classification as dysplasia, low dislocation and high dislocation. Knowledge of the CHD natural history facilitates comprehension of the potential development and progression of the disease, which differs among the aforementioned types. This can lead to better understanding of the anatomical abnormalities found in the different CHD types and thus facilitate preoperative planning and choice of the most appropriate management for adult patients. The basic principles for improved results of total hip replacement in patients with CHD, especially those with low and high dislocation, are: Wide exposure, restoration of the normal centre of rotation and the use of special techniques and implants for the reconstruction of the acetabulum and femur. Application of these principles during total hip replacement in young female patients born with severe deformities of the hip joint has led to radical improvement of their quality of life. PMID:28032030

  6. Behavior of dislocations in silicon

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-08-01

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

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

    CERN Document Server

    Trzesowski, Andrzej

    2007-01-01

    A class of congruences of principal Volterra-type effective dislocation lines associated with a dislocation density tensor is distinguished in order to investigate the kinematics of continuized defective crystals in terms of their dislocation densities (tensorial as well as scalar). Moreover, it shown, basing oneself on a formula defining the mean curvature of glide surfaces for principal edge effective dislocation lines, that the considered kinematics of continuized defective crystals is consistent with some relations appearing in the physical theory of plasticity (e.g. with the Orowan-type kinematic relations and with the treatment of shear stresses as driving stresses of moving dislocations).

  8. Endoscopic transcervical anterior release and posterior fixation in the treatment of irreducible vertical atlantoaxial dislocation%颈前路内窥镜下松解复位后路内固定治疗难复性寰枢关节垂直脱位

    Institute of Scientific and Technical Information of China (English)

    马泓; 吕国华; 王冰; 李磊; 旷磊

    2014-01-01

    目的:探讨颈前路内窥镜下松解复位后路内固定治疗难复性寰枢关节垂直脱位的效果。方法:5例难复性寰枢关节垂直脱位患者接受一期前路经颈内镜松解复位后路内固定治疗,其中类风湿关节炎2例,原发性颅底凹陷症3例。所有患者均有神经功能受损的症状和体征,术前行颅骨牵引后摄片证实复位失败,采用颈前路内窥镜下松解复位后路内固定术治疗,观察临床症状改善情况,评价术前术后影像学资料及神经功能情况,随访术后并发症及植骨融合情况。结果:平均随访时间为25.8个月(12~40个月),所有患者均取得显著的脊髓功能改善,无并发症发生。前路术中内窥镜视野下可见寰齿关节韧带挛缩及疤痕组织增生,经松解后所有患者均取得寰枢关节解剖复位,患者术前齿状突最高点高于McRae 线5.02~7.02mm,平均5.79±0.75mm,术后为-9.89~1.53mm,平均-3.18±4.19mm(P<0.05);术前颈髓延髓角105°~139°,平均127.2°±11.58°,术后恢复至141°~164°,平均152.8°±9.60°(P<0.05);术前VAS评分4~7分,平均5.4±1.1分,术后改善至1~2分,平均1.6±0.5分(P<0.05);术前JOA评分7~12分,平均9.2±2.3分,术后提高至13~17分,平均15.2±1.6分(P<0.05),改善率为80.5%;术前ASIA分级B级1例、C级3例、D级1例,术后较术前提高1~2级;所有患者均获骨性融合且无并发症发生。结论:颈前路内窥镜下松解复位后路内固定是一种安全有效的治疗难复性寰枢关节垂直脱位的治疗手段。%Objectives: To describe the effect of endoscopic transcervical anterior release and posterior fixa-tion in treating patients with irreducible vertical atlantoaxial dislocation. Methods: Five consecutive patients with vertical atlantoaxial dislocation and upper cervical spinal cord compression underwent endoscopic tran-scervical anterior

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

    Institute of Scientific and Technical Information of China (English)

    康玉闻; 韩月明

    2011-01-01

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

  10. Highlights of hip and knee arthroplasty:feelings of postoperative patients and functional rehabilitation%人工关节置换要重视患者的术后感受与功能康复

    Institute of Scientific and Technical Information of China (English)

    朱庆生; 曹晓瑞; 闫昭; 王刚

    2016-01-01

    Minimally invasive approach for primary total hip arthroplasty ( THA ), including direct anterior approach ( DAA ) and Super-Path approach, has become popular with orthopaedic community. Theoretically there is no damage to the muscles through anterior intermuscular space approach. The main advantages are minimally invasive procedures, avoidance of the risk of hip dislocation via the posterior approach and acceleration of the course of convalescence. The precision of techniques in primary total knee arthroplasty ( TKA ) has been focused on by scholars. In order to improve the accuracy of operation and clinical outcomes, new navigation technology and computer-assisted TKA have been implemented. Bone stock reconstruction in THA and TKA revision surgery is one of the biggest challenges for surgeons. Femoral and acetabular prostheses are usually uncemented in THA revision surgery. Currently, with the development of materialogy, the problem of serious bone loss in THA and TKA revision surgery has been solved with the appearance of acetabular prostheses made of porous materials ( also called coating technology of the 2nd generation ) and metal blocks. As for the reconstruction of ligament imbalance, semiconstrained prostheses or fully constrained prostheses can be chosen. If fully constrained prostheses are used, the prostheses designed on the rotation platform are preferred. To acquire satisfactory clinical outcomes in hip and knee arthroplasty, the surgeons should pay attention to not only surgical results, but also feelings of postoperative patients and functional rehabilitation.

  11. Traumatic posterior atlantooccipital dislocation with Jefferson fracture and fracture-dislocation of C6-C7: a case report with survival

    OpenAIRE

    Park, Jong-Beom; Ha, Kee-Yong; Chang, Han

    2001-01-01

    Atlantooccipital dislocation (AOD) is a rare and usually fatal injury. In the current study, the authors reported an extremely rare case of posterior AOD with Jefferson fracture and fracture-dislocation of C6-C7. The patient survived the injury and had only incomplete quadriplegia below the C7 segment with anterior cord syndrome. He was successfully managed with in situ occipitocervical fusion using the Cotrel-Dubousset rod system, corpectomy of C6, and anterior interbody fusion of C5–C7 with...

  12. Total hip replacement in dancers.

    Science.gov (United States)

    Buyls, Inge R A E; Rietveld, A B M Boni; Ourila, Tiia; Emerton, Mark E; Bird, H A

    2013-04-01

    A case report of a professional contemporary dancer who successfully returned to the stage after bilateral total hip replacements (THR) for osteoarthritis is presented, together with her own commentary and a retrospective cohort study of total hip replacements in dancers. In the presented cohort, there were no post-operative dislocations or infections, the original pain had been relieved, rehabilitation was objectively normal and all resumed their dance (teaching) activities. Nevertheless, they were disappointed about the prolonged rehabilitation. Due to their high demands as professional dancers, post-operative expectations were too optimistic in view of the usual quick and favourable results of THR in the older and less physically active, general population. In all dancers with unilateral osteoarthritis, the left hip was involved, which may reflect the tendency to use the left leg as standing leg and be suggestive that strenuous physical activity may lead to osteoarthritis. Better rehabilitation guidelines are needed for dancer patients undergoing THR, especially drawing their attention to realistic post-operative expectations.

  13. Utility of combined hip abduction angle for hip surveillance in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Akshay Divecha

    2011-01-01

    Full Text Available Background: Spontaneous hip lateralization complicates the management of non-ambulatory children with cerebral palsy (CP. It can be diagnosed early using radiographs, but it involves standardization of positioning and exposure to radiation. Hence, the aim of this study was to assess the utility of Combined hip abduction angle (CHAA in the clinical setting to identify those children with CP who were at greater risk to develop spontaneous progressive hip lateralization. Materials and Methods: One hundred and three children (206 hips with CP formed our study population. There were 48 boys and 55 girls aged 2-11 years (mean 5.03 years. 61 children were Gross Motor Function Classification System (GMFCS level 5, while 42 were GMFCS level 4. Clinical measurements of CHAA were statistically correlated with radiographic measurements of Reimer′s migration percentage (MP for bivariate associations using c2 and t tests. Results: CHAA is evaluated against MP which is considered as a reliable measure of hip subluxation. Thus, for CHAA, sensitivity was 74.07% and specificity was 67.35%. False-positive rate was 32.65% and false-negative rate was 25.93%. Conclusions: Our study shows that correlation exists between CHAA and MP, which has been proved to be useful for hip screening in CP children at risk of hip dislocation. CHAA is an easy, rapid, cost-effective clinical test which can be performed by paraclinical health practitioners (physiotherapists and orthopedic surgeons.

  14. Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients

    Institute of Scientific and Technical Information of China (English)

    WANG Gang; GU Gui-shan; LI Dan; SUN Da-hui; ZHANG Wei; WANG Tie-jun

    2010-01-01

    Objective: To compare the clinical outcome of anterolateral minimally invasive approach versus conventional posterior approach for total hip replacement against femoral neck fractures in elderly patients.Methods: The retrospective study was carried out on 42 patients who suffered from displaced femoral neck fractures (19 cases of Garden type Ⅲ, 23 cases of Garden type Ⅳ) treated by total hip replacement via anterolateral minimally invasive approach or conventional posterior approach by the same experienced surgeon. The average age of the patients was 78.1 years (range: 65-89 years). They were divided into anterolateral mini-invasive group (22 cases) and posterior group (20 cases). The mean time of follow-up was 13 months (range: 6-36 months). The anterolateral approach described by Hardinge goes through between anterior 1/3 and posterior 2/3 of the gluteus medius muscle, reaching the femoral neck from anterior capsule. The traditional posterior approach described by Moore (Southern incision) goes through the insertions of short external rotation muscles,reaching the femoral neck from posterior capsule. The related variables under observation were length of incision,operation time, postoperative limp, length of hospital stay and bed stay and dislolcation rate.Results: The length of the skin incision varied between 7 cm and 12 cm with the anterolateral minimally invasive technique, compared to 15-22 cm in the conventional procedure. It took less time (average 15 minutes) to complete the anterolateral minimally invasive approach (72 min±15 min), compared with the conventional approach (87 min±10 min). The average Harris hip score was 91.23±10.20 inanterolateral approach, 90.03±11.05 in the posterior approach. The average length of hospital stay for patients with the anterolateral approach was (6.4±2.2) days (range:4-9 days), while that in posterior approach was (9.2 ±3.1)days (range: 6-13 days). The average length of bed stay was (3.4±1.1) days (range: 2

  15. Characteristics of children with hip displacement in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Wagner Philippe

    2007-10-01

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

  16. Dislocation Dynamics in Nanocrystalline Nickel

    OpenAIRE

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

    2007-01-01

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

  17. Bilateral spontaneous dislocation of posterior chamber intraocular lens in a patient with gyrate atrophy

    Directory of Open Access Journals (Sweden)

    Michael Kinori

    2012-01-01

    Full Text Available We report a patient with gyrate atrophy, a rare metabolic disease, who had bilateral late spontaneous posterior dislocation of in-the-bag posterior chamber intraocular lens (PCIOL. He underwent pars plana vitrectomy, PCIOL retrieval and anterior chamber intraocular lens implantation in both eyes. This report may imply that patients with gyrate atrophy are at risk for spontaneous dislocation of intraocular lenses.

  18. Nature of Dislocations in Silicon

    DEFF Research Database (Denmark)

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

    1995-01-01

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

  19. Osteoarthritis of the hip; MR features

    Energy Technology Data Exchange (ETDEWEB)

    Kokubo, Takashi; Takatori, Yoshio; Sasaki, Yasuhito (Tokyo Univ. (Japan). Faculty of Medicine)

    1993-07-01

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

  20. The results of adductor magnus tenodesis in adolescents with recurrent patellar dislocation.

    Science.gov (United States)

    Malecki, Krzysztof; Fabis, Jaroslaw; Flont, Pawel; Niedzielski, Kryspin Ryszard

    2015-01-01

    Recurrent dislocation of the patella is a common orthopaedic problem which occurs in about 44% of cases after first-time dislocation. In most cases of first-time patellar dislocation, the medial patellofemoral ligament (MPFL) becomes damaged. Between 2010 and 2012, 33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. The aim of our study is to assess the effectiveness of this surgical procedure. The outcomes were evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination) and radiographically (Caton index, sulcus angle, congruence angle, and patellofemoral angle). Four patients demonstrated redislocation with MPFL graft failure, despite the fact that patellar tracking was found to be normal before the injury, and the patients had not reported any symptoms. Statistically significant improvements in Lysholm and Kujala scales, in patellofemoral and congruence angle, were seen (P magnus tendon in children and adolescents with recurrent patellar dislocation.

  1. Posterior Dislocation of the Hinge-Post Extension in a Rotating Hinge Total Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Givenchy Manzano

    2013-01-01

    Full Text Available The rotating hinge knee prosthesis is a popular intervention in patients lacking stability with highly constrained total knee arthroplasty. Despite improvements in design, nonmechanical and mechanical complications continue to be a problem. Dislocation of the hinge has been widely described, mainly due to the component fracture. Few reports describe isolated dislocation of the rotating stem. We report a case of isolated disengagement of the rotating hinge mechanism, due to severe flexion gap imbalance, leading to subsequent posterior dislocation of the hinge and anterior knee dislocation, in a patient with a history of multiple total knee arthroplasty revisions. This case suggests the importance of the soft tissue balancing, the adequate patellar tracking, and use of a long cylindrical, minimally tapered rotating stem in hinge arthroplasty to minimize hinge dislocation.

  2. 切开 Latarjet 手术治疗复发性肩关节前脱位的临床随访研究%Clinical follow-up study after open Latarjet procedure in patients with recurrent an-terior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    朱以明; 姜春岩; 鲁谊; 李奉龙; 李旭; 李岳

    2015-01-01

    目的:通过病例随访研究总结应用切开Latarjet手术治疗复发性肩关节前脱位的临床疗效。方法:随访22例应用切开Latarjet手术治疗的合并明显肩盂前缘骨缺损的复发性肩关节前脱位患者,平均随访时间为66.0个月。在术前拍摄肩关节X线片以及三维CT以评估术前肩关节骨性关节炎及肩盂骨缺损的严重程度。对患者进行体格检查并采用美国肩肘外科协会( American Shoulder&Elbow Surgeons’ score,ASES)、Constant-Murley和Rowe评分评估肩关节功能及稳定性。术后即刻拍摄肩关节三维CT以检查移位喙突骨块所固定位置。最终随访时,再次拍摄肩关节X线片和三维CT以评估肩关节退行性变的严重程度和喙突骨块的愈合情况,对患者进行体格检查并以前述3种评分标准评价肩关节功能及稳定性。结果:术前患肢平均主动前屈上举158.2°±28.7°,体侧外旋55.3°±15.2°,内旋达T10水平(T3~臀部);平均肩关节ASES评分77.6±17.5,Constant-Murley评分88.3±12.5, Rowe评分40.2±12.0。最终随访时,无患者出现肩关节复发脱位,肩关节平均主动前屈上举167.7°±12.7°,体侧外旋54.3°±16.5°,内旋达 T10水平(T3~L3),与术前相比差异均无统计学意义(P =0.138,P =0.765, P=0.439);平均ASES评分93.7±9.1,Constant-Murley评分95.6±5.6,Rowe评分96.4±4.4,均较术前明显改善(P=0.001,P=0.008,P<0.001)。随访过程中3例患者肩关节退行性改变较术前加重,1例移位喙突骨块不愈合。结论:切开Latarjet手术对合并明显肩盂骨缺损的复发性肩关节前脱位患者有效,术后5年随访观察未发现肩关节骨性关节炎显著加重。%Objective: To investigate the results of treating patients with recurrent anterior shoulder dislocation using open Latarjet technique in a

  3. 纳米羟基磷灰石/聚酰胺66椎体支撑体在下颈椎骨折脱位前路手术重建中的应用%Application of n-HA/PA66 composite artificial vertebral body in anterior reconstruction of lower cervical spine fracture and dislocation

    Institute of Scientific and Technical Information of China (English)

    吕超亮; 屠重棋; 段宏; 宋跃明; 刘浩; 刘立岷; 龚全; 李涛; 曾建成; 孔清泉; 裴福兴

    2012-01-01

    Objective To initially evaluate the application of artificial vertebra of n-HA/PA66 in anterior reconstruction of lower cervical spine fracture and dislocation.Methods In this study,84 patients with lower cervical spine fracture and dislocation received anterior cervical discectomy, spinal canal decompression or subtotal corpectomy, spinal canal decompression and reconstruction by n-HA/PA66composite artificial vertebral body combined with plate instrumentation.Neurological function was followed up by improvement rate of Frankel and situations of the supporting body was observed by X ray and 3D-CT in 3,12,24 months postoperatively.The intervertebral height,physical arc (reflected by Cobb angle) and the locations and fusion rate of the supporting body were assessed in order to evaluate the stability of the cervical spine and alignment improvements. Results All the patients underwent operation successfully and were followed up for 6 to 24 months with an average of 12 months.The preoperative symptoms were improved to varying degrees. Imaging studies showed that in all cases graft fusion were achieved, and cervical alignments,iutervertebral height,cervical spine stability and the locations of the artificial vertebral body were well maintained. No displacement and subsidence of the artificial vertebral body occurred.Postoperative immediate intervertebral height (2.4 ± 0.2 ) cm,preoperative intervertebral height ( 1.9 ±0.1 ) cm,comparisons of the two groups was statistically significant ( q =2.48,P < 0.001 ).The immediate,3 month,1 year,2 year period follow-up group intervertebral height was not statistically significant (P >0.05 ).Preoperative Cobb angle was 9.8 ° ± 1.2 °,postoperative immediate Cobb angle was 16.6° ± 1.2 °comparisons of the two groups was statistically significant (q =14.25,P < 0.001 ). The immediate,3 month,1 year,2 year period follow-up group Cobb angle was not statistically significant (P > 0.05).Conclusions n-HA/PA66 artificial

  4. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Directory of Open Access Journals (Sweden)

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  5. Point-of-Care Ultrasound in Diagnosis and Treatment of Luxatio Erecta (Inferior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Abraham Flinders

    2016-06-01

    Why an emergency physician should be aware of this: POC-US is a useful tool for the emergency physician when confronted with shoulder dislocation. US not only confirms the dislocation, but also differentiates between anterior versus posterior versus inferior dislocation. POC-US can guide the placement of intraarticular lidocaine for anesthesia which then potentially reduces time, expense, and risk of procedural sedation. Finally, POC-US may reduce failed reductions by providing immediate visual confirmation and in the case of reductions performed under sedation, may prevent the need for repeat sedation.

  6. External Snapping Hip Syndrome: Emphasis on the MR Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Eun; Lee, Bae Young [Catholic University St. Paul' s Hospital, Seoul (Korea, Republic of); Sung, Mi Sook; Lee, Ki Haeng; Yoo, Won Jong; Lim, Hyun Wook; Chung, Myung Hee [Catholic University Bucheon St. Mary' s Hospital, Bucheon (Korea, Republic of); Park, Jeong Mi [Catholic University St. Mary' s Hospital, Seoul (Korea, Republic of); Kim, Jee Young [Catholic University St. Vincent' s Hospital, Suwon (Korea, Republic of)

    2010-02-15

    The aim of this study is to evaluate the MR imaging features of patients with external snapping hip syndrome. We retrospectively reviewed 63 hip MR images. The images were analyzed according to the thickness and contour of the iliotibial band and the gluteus maximus, the presence of bone marrow edema, bursitis, joint effusion and other associated findings. The MR imaging of 22 hips with snapping hip syndrome depicted the causes of external snapping hip syndrome in twenty cases (90%). The MR imaging features of the snapping hip included thickening of the iliotibial band in twelve cases (55%) and/or thickening of the anterior band of the gluteus maximus in nineteen (86%), and a wavy contour of the iliotibial band or the anterior band of the gluteus maximus in ten cases (45%). These findings show a significant p value (<0.01). The majority of patients with snapping hip syndrome revealed thickening of the iliotibial band, thickening of the anterior band of the gluteus maximus and wavy contour of the those structures on MR imaging.

  7. Hip Resurfacing. Case presentation.

    Directory of Open Access Journals (Sweden)

    Pedro Gonzalo González González

    2008-12-01

    Full Text Available Hip resurfacing in youngest patients is an excellent surgical technique for Avascular Necrosis compare with a traditional Total Hip Replacement. Report about a 21 years old female patient involved in a car accident in February 2004 with Fracture of the neck of femur treated with compression hip screw Richard’s type. Two years later the patient was diagnose with avascular necrosis of the contra lateral hip. Hip resurfacing Metal-Metal was carry out in the above mentioned patient.

  8. Genetic linkage analysis of susceptible gene of congenital dislocation of the hip with chromosome 7, 22 in four Yunnan pedigrees%云南地区先天性髋关节脱位4个家系22号与7号染色体易感基因连锁分析

    Institute of Scientific and Technical Information of China (English)

    鲁宁; 张宝华; 胡侦明; 浦波; 王迎松; 虞弘; 曹有良; 王少飞; 杨庆秋; 劳汉昌

    2008-01-01

    Objective To investigate genetic linkage between the phenotype of congenital dislocation of the hip (CDH) and genes located in chromosome 22,7, and attempt initially process of the genome-wide scan for searching disease-susceptibility loci.Methods According to epidemiological data,we studied 4 kindred with CDH in yunna,which include 65 persons in 5 generations.the affected status of 17 individuals had been established on the basis of their clinical and radiological presentation of the disorder.44 blood specimens were collected from those members who could be followed trail, and their nucleus DNA was extracted from peripheral leukocytes as phenol method.35 Tetnuc or Trinuc repeat microsatellite markers exploited by CHLC were chosen.8 markers distributed on chromosome 22, and 10 markers distributed on 7chromosome with an average interval of 10 cm.Genimic DNA were amplified by PCR technique.The PCR products were subjected to vertical electrophoresis in PAGE gel with continous buffer system, followed by siliver staining.graphic analysis system was used to define each allele.Parametric linkage analysi using maximum likelihood estimation were computed by the linkage package for various recombination fraction valus, with a disease gene grequency of 0.02.Results 18 STR loci are showen to provide good discrimination power by highly polymorphism and heterozygosity.Gnotype dated were obtained and conformed to Mendel law.Linkage analysis with those markers gave minus two-point LOD score values (Z<1), which the markers in 22and 7 chromosome indicated that there no linkage between the markers and CDH gene in those pedigrees.Conclusions CDH susceptibility genes are not likely located on chromosome 22, 7.The approach to geno-wide scan using highly density STR markers would play an important role in map the gene responsible for CDH.%目的 探讨先天性髋关节脱位 (CDH) 与22、7号染色体之间的连锁关系.方法 以4个云南地区CDH家系为研究对象,提取所有

  9. Vitreoretinal Surgery for Intraocular Lens Dislocated into the Vitreous Cavity

    Directory of Open Access Journals (Sweden)

    Dilek Özçelik Soba

    2015-04-01

    Full Text Available Objectives: To investigate the sex, age, accompanying eye examination findings, and the outcomes of vitreoretinal surgery (VRS for intraocular lens (IOL dislocated into the vitreous cavity. Materials and Methods: The medical records of 30 patients who underwent VRS for IOL dislocation into the vitreous cavity were retrospectively analyzed in this study. Preoperative and postoperative visual acuity, intraocular pressure, biomicroscopic, and posterior segment examination findings were assessed. Results: The average age of the patients was 63.1 (range: 38-83 years. Twenty-one patients were male (70% and 9 patients were female (30%. As etiologic causes, 18 cases (60% had late spontaneous dislocation, 5 cases (16.6% had dislocation after phacoemulsification surgery, 4 cases (13.3% had trauma, 2 cases (6.6% had previously undergone vitrectomy, and 1 case (3.3% had undergone YAG laser capsulotomy. VRS including 23-gauge triamcinolone-assisted pars plana vitrectomy, intraocular lens extraction, posterior hyaloid membrane removing, endolaser photocoagulation, and fluid-air exchange was performed. Posterior chamber IOL implantation on to the anterior capsule in 13 cases (43.3%, anterior chamber IOL implantation in 10 cases (33.3%, and scleral fixated posterior IOL implantation in 4 cases (13.3% were performed. The corrected visual acuity recorded at the last follow-up was better than the first visit in 23 cases (76.6%, the same in 5 eyes (16.6%, and worse in 2 eyes (6.6%. Conclusion: VRS combined IOL implantation is a successful surgery method for IOL dislocated into the vitreous cavity and can avoid poor visual outcomes. (Turk J Ophthalmol 2015; 45: 56-9

  10. On the permanent hip-stabilizing effect of atmospheric pressure.

    Science.gov (United States)

    Prietzel, Torsten; Hammer, Niels; Schleifenbaum, Stefan; Kaßebaum, Eric; Farag, Mohamed; von Salis-Soglio, Georg

    2014-08-22

    Hip joint dislocations related to total hip arthroplasty (THA) are a common complication especially in the early postoperative course. The surgical approach, the alignment of the prosthetic components, the range of motion and the muscle tone are known factors influencing the risk of dislocation. A further factor that is discussed until today is atmospheric pressure which is not taken into account in the present THA concepts. The aim of this study was to investigate the impact of atmospheric pressure on hip joint stability. Five joint models (Ø 28-44 mm), consisting of THA components were hermetically sealed with a rubber capsule, filled with a defined amount of fluid and exposed to varying ambient pressure. Displacement and pressure sensors were used to record the extent of dislocation related to intraarticular and ambient pressure. In 200 experiments spontaneous dislocations of the different sized joint models were reliably observed once the ambient pressure was lower than 6.0 kPa. Increasing the ambient pressure above 6.0 kPa immediately and persistently reduced the joint models until the ambient pressure was lowered again. Displacement always exceeded half the diameter of the joint model and was independent of gravity effects. This experimental study gives strong evidence that the hip joint is permanently stabilized by atmospheric pressure, confirming the theories of Weber and Weber (1836). On basis of these findings the use of larger prosthetic heads, capsular repair and the deployment of an intracapsular Redon drain are proposed to substantially decrease the risk of dislocation after THA.

  11. Patellar Dislocations and Reduction Procedure.

    Science.gov (United States)

    Ramponi, Denise

    2016-01-01

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

  12. Buckling of dislocation in graphene

    Science.gov (United States)

    Yao, Yin; Wang, Shaofeng; Bai, Jianhui; Wang, Rui

    2016-10-01

    The buckling of dislocation in graphene is discussed through the lattice theory of dislocation and elastic theory. The approximate solution of the buckling is obtained based on the inner stress distribution caused by different structure of dislocations and is proved to be suitable by the simulation. The position of the highest buckling is predicted to be at the vertex of the pentagon far away from the heptagon. The buckling is strongly influenced by the internal stress and the distance between the extrusive area and stretching area, as well as the critical stress σc. The SW defect is proved to be unbuckled due to its strong interaction between extrusion and stretching.

  13. Current Concepts of Using Large Femoral Heads in Total Hip Arthroplasty

    OpenAIRE

    Cho, Myung-Rae; Choi, Won Kee; Kim, Jae Jung

    2016-01-01

    Instability and dislocation after total hip arthroplasty are the most common causes of revisions and major complications for failure of inserted prostheses, leading to a reduction in quality of life. Because the use of artificial femoral head sizes smaller than patient's own size is the important cause for dislocation, the use of large femoral head have increased. Femoral head sizes greater than 32 mm offer multiple advantages in physical function and activity levels of patients by improving ...

  14. [Traumatic elbow dislocations in bouldering].

    Science.gov (United States)

    Sandmann, G H; Siebenlist, S; Lenich, A; Neumaier, M; Ahrens, P; Kirchhoff, C; Braun, K F; Lucke, M; Biberthaler, P

    2014-03-01

    Bouldering is a new trend sport which has become popular in recent years. From April 2011 to June 2012 a total of 5 patients with elbow dislocations from bouldering were admitted to our level 1 trauma center. The injuries varied from simple elbow dislocations to complex fracture dislocations. Elbow dislocations occurred during falling backwards when patients tried to protect themselves by retroversion of both arms. In all cases the falling height was less than 4 meters. The bouldering injury pattern, the diagnostic and therapeutic management as well as the rehabilitation program are described in detail in this article. To the best of our knowledge this is the first report on the special danger of bouldering for complex elbow injuries.

  15. [Increased incidence of developmental hip dysplasia in hypertrophic newborn infants].

    Science.gov (United States)

    Peschgens, T; Skopnik, H; Casser, H R; Rauschning-Sikora, K; Heimann, G

    1993-01-01

    "Lack of space" in utero is considered to be a major factor in the aetiology of the congenital dislocation of the hip. This study tries to answer the question whether hypertrophy of a newborn has to be regarded as a risk factor on the basis of the principle mentioned above. The results of postnatal clinical and sonographical examination performed on 98 large-for-gestational-age (LGA-) newborn were compared to those performed on 310 newborn children during a non selective screening program. Among the LGA-newborn pathological hip joints were found more often mainly female LGA-newborn infants were affected. It seemed that the birth weight did not correlate to the extent of the retardation of the hip joint development. It was again confirmed that the restriction to only clinical diagnostic procedures in the neonatal period is not effective in the early diagnosis of the malformation. Hypertrophy of a newborn has to be considered as a risk factor behind the development of congenital dislocation of the hip. It is recommended to examine all LGA-newborn infants post partum by clinical and most importantly also by sonographical means to recognize a retardation of hip joint development.

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

    Directory of Open Access Journals (Sweden)

    Mantu Jain

    2013-10-01

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

  17. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND AND PURPOSE: Large-size hip articulations may improve range of motion (ROM) and function compared to a 28-mm THA, and the low risk of dislocation allows the patients more activity postoperatively. On the other hand, the greater extent of surgery for resurfacing hip arthroplasty (RHA) c...... for large articulations did not improve the clinical and patient-perceived outcomes. The more extensive surgical procedure of RHA did not impair the rehabilitation. This project is registered at ClinicalTrials.gov under # NCT01113762.......BACKGROUND AND PURPOSE: Large-size hip articulations may improve range of motion (ROM) and function compared to a 28-mm THA, and the low risk of dislocation allows the patients more activity postoperatively. On the other hand, the greater extent of surgery for resurfacing hip arthroplasty (RHA...

  19. Bristow-Latarjet Technique: Still a Very Successful Surgery for Anterior Glenohumeral Instability - A Forty Year One Clinic Experience

    Directory of Open Access Journals (Sweden)

    Vilson Ruci

    2015-05-01

    CONCLUSION: The Bristow-Latarjet procedure is a very good surgical treatment for recurrent anterior-inferior instability of the glenohumeral joint. It must not be used for multidirectional instability or psychogenic habitual dislocations.

  20. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Ultrasound: Infant Hip KidsHealth > For Parents > Ultrasound: Infant Hip A A A What's in this ... en los lactantes What It Is A hip ultrasound is a safe and painless test that uses ...

  1. The Hip Restoration Algorithm

    Science.gov (United States)

    Stubbs, Allston Julius; Atilla, Halis Atil

    2016-01-01

    Summary Background Despite the rapid advancement of imaging and arthroscopic techniques about the hip joint, missed diagnoses are still common. As a deep joint and compared to the shoulder and knee joints, localization of hip symptoms is difficult. Hip pathology is not easily isolated and is often related to intra and extra-articular abnormalities. In light of these diagnostic challenges, we recommend an algorithmic approach to effectively diagnoses and treat hip pain. Methods In this review, hip pain is evaluated from diagnosis to treatment in a clear decision model. First we discuss emergency hip situations followed by the differentiation of intra and extra-articular causes of the hip pain. We differentiate the intra-articular hip as arthritic and non-arthritic and extra-articular pain as surrounding or remote tissue generated. Further, extra-articular hip pain is evaluated according to pain location. Finally we summarize the surgical treatment approach with an algorithmic diagram. Conclusion Diagnosis of hip pathology is difficult because the etiologies of pain may be various. An algorithmic approach to hip restoration from diagnosis to rehabilitation is crucial to successfully identify and manage hip pathologies. Level of evidence: V. PMID:28066734

  2. Hip Injuries and Disorders

    Science.gov (United States)

    ... problems. Osteoarthritis can cause pain and limited motion. Osteoporosis of the hip causes weak bones that break easily. Both of these are common in older people. Treatment for hip disorders may include rest, medicines, physical therapy, or surgery, including hip replacement.

  3. latrogenic fracture of humerus – complication of a diagnostic error in a shoulder dislocation: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Riaz

    2007-07-01

    Full Text Available Abstract Shoulder dislocation is the commonest dislocation presenting to the emergency department, anterior being more common than posterior. The latter being less common has a tendency of being missed; this is supported by many cases in the literature. Kocher's method is one of the many methods of reducing anterior dislocation; there are many reported complications of employing this method. To the best of our knowledge we are reporting the first case of an iatrogenic fracture of the proximal humerus, due to the use of Kocher's method of shoulder reduction in a posterior dislocation following a diagnostic error which led to an avoidable difficult surgical intervention. We also discuss the mechanism of the iatrogenic fracture and the measures that can be undertaken to prevent it.

  4. The mechanical properties of the human hip capsule ligaments.

    Science.gov (United States)

    Hewitt, John D; Glisson, Richard R; Guilak, Farshid; Vail, T Parker

    2002-01-01

    The human hip capsule is adapted to facilitate upright posture, joint stability, and ambulation, yet it routinely is excised in hip surgery without a full understanding of its mechanical contributions. The objective of this study was to provide information about the mechanical properties of the ligaments that form the hip capsule. Cadaver bone-ligament-bone specimens of the iliofemoral, ischiofemoral, and femoral arcuate ligaments were tested to failure in tension. The hip capsule was found to be an inhomogeneous structure and should be recognized as being composed of discrete constituent ligaments. The anterior ligaments, consisting of the 2 arms of the iliofemoral ligament, were much stronger than the posterior ischiofemoral ligament, withstanding greater force at failure and exhibiting greater stiffness. Knowledge of the anatomy and mechanical properties of the capsule may help the hip surgeon choose an appropriate surgical approach or repair strategy.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    OpenAIRE

    Jacek Białecki; Marian Majchrzycki; Antoni Szymczak; Małgorzata Dorota Klimowicz-Bodys; Edward Wierzchoś; Krzysztof Kołomecki

    2014-01-01

    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)...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  8. Temporomandibular joint sounds and disc dislocations incidence after orotracheal intubation.

    Science.gov (United States)

    Rodrigues, Estela T; Suazo, Iván C; Guimarães, Antonio S

    2009-01-01

    The aim of this study was to analyze the temporomandibular joint (TMJ) disc displacement and articular sounds incidence after orotracheal intubation. A prospective cohort study was conducted in the Hospital Universitário do Oeste do Paraná (HUOP), in Cascavel, Brazil. 100 patients (aged 14-74 years, mean 44 years), 34 male and 66 female, in need of surgical procedure with orotracheal intubation were evaluated. The anterior disc displacement with reduction incidence and the nonclassifiable sounds incidence by the Research Diagnostic Criteria Axis I was evaluated in all patients after orotracheal intubation. The patients was evaluated one day before and until two days after the procedure. Eight percent present with anterior disc displacement with reduction and 10% presented nonclassifiable sounds after the orotracheal intubation. There was no correlation of any kind regarding gender related influence in the incidence of disc dislocations (P = 0.2591) and TMJ sounds (P = 0.487). Although anterior disc dislocations and TMJ sounds after anesthetic with orotracheal intubation presented a low incidence (8%-10%), it is recommended that the evaluation of TMJ signs and symptoms be done before the anesthetic procedure to take care with susceptible patients manipulation.

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

    Directory of Open Access Journals (Sweden)

    Won Yong Shon

    2014-01-01

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

  10. Readmissions after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B;

    2010-01-01

    With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced. However, it has been s...... speculated that a decrease in LOS may be associated with an increase in readmissions in general, including risk of dislocation after total hip arthroplasty (THA) or manipulation after total knee arthroplasty (TKA)....

  11. HIP-HOP教室

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    从现在开始我们要为了Hip-hop而奋斗,使身边的人改变对Hip-hop文化的看法,让他们知道什么是真正的Hip-hop,更要让大家学会怎样用肢体去表达,Yo,在这里,永远不会出现半吊子的Hip-hop,因为我们都是来真的,Yo,来真的,因为我要将Hip-hop发扬到底,Yeah!

  12. Dislocation Multi-junctions and Strain Hardening

    Energy Technology Data Exchange (ETDEWEB)

    Bulatov, V; Hsiung, L; Tang, M; Arsenlis, A; Bartelt, M; Cai, W; Florando, J; Hiratani, M; Rhee, M; Hommes, G; Pierce, T; Diaz de la Rubia, T

    2006-06-20

    At the microscopic scale, the strength of a crystal derives from the motion, multiplication and interaction of distinctive line defects--dislocations. First theorized in 1934 to explain low magnitudes of crystal strength observed experimentally, the existence of dislocations was confirmed only two decades later. Much of the research in dislocation physics has since focused on dislocation interactions and their role in strain hardening: a common phenomenon in which continued deformation increases a crystal's strength. The existing theory relates strain hardening to pair-wise dislocation reactions in which two intersecting dislocations form junctions tying dislocations together. Here we report that interactions among three dislocations result in the formation of unusual elements of dislocation network topology, termed hereafter multi-junctions. The existence of multi-junctions is first predicted by Dislocation Dynamics (DD) and atomistic simulations and then confirmed by the transmission electron microscopy (TEM) experiments in single crystal molybdenum. In large-scale Dislocation Dynamics simulations, multi-junctions present very strong, nearly indestructible, obstacles to dislocation motion and furnish new sources for dislocation multiplication thereby playing an essential role in the evolution of dislocation microstructure and strength of deforming crystals. Simulation analyses conclude that multi-junctions are responsible for the strong orientation dependence of strain hardening in BCC crystals.

  13. Loeys-Dietz syndrome with bilateral radial head dislocations: a case report.

    Science.gov (United States)

    Rustagi, Tarush; Agashe, Mandar V; Dhamele, Jaideep; Aroojis, Alaric J; Mehta, Rujuta

    2013-08-01

    Loeys-Dietz syndrome is characterised by vascular aneurysms, hypertelorism, and a bifid uvula. We report on an 11-year-old boy with Loeys-Dietz syndrome who presented with bilateral radial head dislocations and severe osteopaenia with changes of avascular necrosis in both hips causing an out-toeing, wide gait. Considering the poor prognosis for elbow movement and possible radial head dysplasia, surgical reduction of the radial heads was deferred. A subtrochanteric de-rotation osteotomy of the left hip was performed to improve the gait.

  14. Perioperative complications in revision hip surgery.

    Science.gov (United States)

    Thomasson, E; Guingand, O; Terracher, R; Mazel, C

    2001-01-01

    Revision hip surgery now constitutes 10-30% of all joint procedures. The morbidity and associated with this demanding operation are not well established. The goal of this paper is to determine these rates and to identify some predictive factors. The complication rate ranges from 31,5 to more than 77% in the literature. Life threatening complications represent 1,8 to 8% of these, leading to death in about 1,6%. ASA score and age above 75 appear to be correlated with medical complications. The injection rate varies from 1 to 5,8%, and may be as high as 14% in cases with a past history of infection. Heterotopic ossification occurred in 13 to 65%, reaching severity in 3,3 to 8,3%. Surgical complications include dislocation and femoral injuries. Dislocations occur in almost 10%, leading to revision in1-4,2%. Age and the number of previous surgical operations appear to be significant risk factors. Femoral injuries (perforations or femoral fractures) occur in 6-37%, especially in impaction grafting technique and when uncemented implants are used. Age over 75 years and femoral defects appear to be significant risk factors for femoral fractures. The rate of complications in revision hip surgery continues to be high, but successful clinical outcome can be attained even in elderly patients. Attentive preoperative exams, good prevention of technical pitfalls, the experience of the surgeon and the use of specific tools may decrease these complications and make this demanding procedure safer.

  15. Concept of healing of recurrent shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Donato D'Angelo

    2014-08-01

    Full Text Available This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others.The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases.Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical–pathological lesions, without considering the so-called essential lesions.The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique.Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles.

  16. Non-singular dislocation fields

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

  17. Dislocations and other topological oddities

    Science.gov (United States)

    Pieranski, Pawel

    2016-03-01

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

  18. 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

  19. Multiscale Theory of Dislocation Climb.

    Science.gov (United States)

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

    2015-12-31

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

  20. Hip resurfacing: history, current status, and future.

    Science.gov (United States)

    Amstutz, Harlan C; Le Duff, Michel J

    2015-01-01

    Hip resurfacing arthroplasty (HRA) presents several advantages over conventional total hip arthroplasty (THA), including conservation and preservation of bone, reduced risk of dislocation, easy replication of hip biomechanics and easy revision if needed. It is a particularly appealing procedure for young patients. HRA has been performed for over 40 years following the same technological advances as THA. The bearing material used by most designs is metal-on-metal (MoM), which has the best compromise between strength and wear properties. However, MoM HRA has a specific set of possible complications. Aseptic femoral failures were initially the most prevalent cause for revision but progress in patient selection and surgical technique seem to have resolved this problem. Wear-related failures (high metal ion levels and adverse local tissue reactions) are now the main concern, and are essentially associated with poor acetabular component design and orientation, to which MoM is more sensitive than other bearing materials. The concept of functional coverage is key to understanding how MoM bearings are affected by edge wear. Only a 3-D assessment of cup position (e.g., the contact patch to rim distance) provides the necessary information to determine the role of cup positioning in relationship with abnormal bearing wear.The concept of hip resurfacing is more valid today than ever as the age of the patients in need of hip arthroplasty keeps getting lower. The recent publication of several excellent long-term survivorship results suggests that selection of a well-designed resurfacing system and accuracy in the placement of the cup can achieve long-term durability.

  1. Central acetabular fracture with dislocation treated by minimally invasive plate osteosynthesis.

    Science.gov (United States)

    2015-06-01

    Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma.

  2. The epidemiology of shoulder dislocation in a state-hospital: a review of 106 cases.

    Science.gov (United States)

    Hazmy, C H Wan; Parwathi, A

    2005-07-01

    This retrospective study was conducted in a state hospital set-up and aimed at identifying the magnitude of shoulder dislocations and their demographic data, characteristics of the injury, mechanism and predisposing factors, and the instituted treatment. Patients with radiographic evidence of shoulder dislocation admitted to the hospital from January 1999 to December 2002 were included. Data were recorded from the case notes. There were 105 shoulder dislocations with male predomination in 77% cases and age ranged between 11 and 90 years (average 30.9 years). The right shoulder was affected in 68% of the cases. The contributing events were fall in 37% of cases, road traffic accident 23%, sports 17% and pathological conditions 13%. Anterior dislocation occurred in 96.2% of the cases. Posterior and inferior dislocations encountered in two patients for each type. Twelve dislocations were associated fracture of the greater tuberosity, two each with humeral neck fracture and cerebral injuries. First time dislocation occurred in 73.6% of the cases. The recurrences ranged between 2 to 6 times (average 3.4 times). Closed manipulative reduction and strapping was the definitive treatment in 92.4% of the cases and the remaining needed surgical reconstruction. Four patients had open reduction and internal fixation of the associated fractures while another four had arthroscopic Bankart's repair. In conclusion, shoulder dislocation represents the most common shoulder problems. It afflicted young adults of reproductive age (21-40 years) and participation in sports was a risk factor in men. Women over 40 years and fall were at risk to develop shoulder dislocation.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Mohammad Saeed Mosleh-shirazi

    2015-01-01

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

  5. Atomistic simulations of dislocation processes in copper

    DEFF Research Database (Denmark)

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

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

  6. Válvula de uretra anterior Anterior urethral valves

    Directory of Open Access Journals (Sweden)

    Silvio Tucci Jr.

    2003-02-01

    Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

  7. Hip resurfacing arthroplasty

    OpenAIRE

    2010-01-01

    Background and purpose Hip resurfacing arthroplasty is claimed to allow higher activity levels and to give better quality of life than total hip arthroplasty. In this literature review, we assessed the therapeutic value of hip resurfacing arthroplasty as measured by functional outcome. Methods An extensive literature search was performed using the PubMed, Embase, and Cochrane databases. Results 9 patient series, 1 case-control study, and 1 randomized controlled trial (RCT) were included. Clin...

  8. Endoscopic treatment of snapping hips, iliotibial band, and iliopsoas tendon.

    Science.gov (United States)

    Ilizaliturri, Victor M; Camacho-Galindo, Javier

    2010-06-01

    Indications for endoscopic surgery of the hip have expanded recently. The technique has found a clear indication in the management of snapping hip syndromes, both external snapping hip and internal snapping hip. Even though the snapping hips (external and internal) share a common name, they are very different in origin. The external snapping hip is produced by the iliotibial band snapping over the prominence of the greater trochanter during flexion and extension. Indication for surgical treatment is painful snapping with failure of conservative treatment. The endoscopic technique is designed to release the iliotibial band producing a diamond shape defect on the iliotibial band lateral to the greater trochanter. The defect allows the greater trochanter to move freely without snapping. The greater trochanteric bursa is resected through the defect and the abductor tendons inspected. This procedure is performed without traction and usually only the peritrochanteric space is accessed. If necessary, hip arthroscopy can also be performed. There is limited literature regarding the results of endoscopic treatment for the external snapping hip syndrome, but early reports are encouraging. The internal snapping hip syndrome is produced by the iliopsoas tendon snapping over the iliopectineal eminence or the femoral head. The snapping phenomenon usually occurs with extension of the hip from a flexed position of more than 90 degree. Two different endoscopic techniques have been described to treat this condition. Iliopsoas tendon release at the level of the hip joint, with this technique the iliopsoas bursa is accessed through an anterior hip capsulotomy and is frequently referred to as a transcapsular release. The second technique is a release at the insertion of the iliopsoas tendon on the lesser trochanter, with this technique the iliospaos bursa is accessed directly. In every report the iliopsoas tendon release has been combined with arthroscopy of the hip joint. It has been

  9. Financial Dislocations among Divorcing Families.

    Science.gov (United States)

    Little, Marilyn J.

    Extensive economic changes may be brought about by divorce. In an attempt to demonstrate that the degree of financial dislocation following divorce depends on three factors--custody arrangements, wife's employment, and social class--data on men's and women's employment, income, and support payments were gathered for 222 divorcing families. Total…

  10. Hip fracture - discharge

    Science.gov (United States)

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

  11. Treatment of Chopart Fracture-Dislocations.

    Science.gov (United States)

    Klaue, Kaj

    2010-06-01

    The Chopart articular space was used by François Chopart (1743-1795) as a practical space for amputation in cases of distal foot tumor. It corresponds to the center of the foot and allows for essential articulation by means of the talo-calcaneo-navicular joint (coxa pedis). Chopart fracture-dislocations may therefore include fractures of the navicular, the cuboid, the talus, and calcaneus. The treatment priorities should therefore include addressing all of the injured soft tissues by immediate joint reduction or restoring bony alignment, including the avoidance of threatening compartment syndromes. Subsequent anatomical bone and joint reconstruction, if possible, should first address the talar head and the navicular. The anterior process of the calcaneus and the cuboid should be aligned to preserve foot alignment in the sagittal and horizontal planes. In severe joint destructions, isolated fusion of the calcaneo-cuboidal joint may help preserve functional mobility of the foot. Isolated or associated talo-navicular fusion considerably limits functional mobility of the foot.

  12. [Case report and literature review: elbow fracture dislocation in children].

    Science.gov (United States)

    Guzmdn, R; Rincón, D; Camacho, J

    2015-01-01

    Elbow dislocation in children is a very infrequent traumatic event which was first described by Stimson in 1900 and then by Tachdjian in 1990. Its estimated incidence ranges from 3% to 6% of all elbow injuries, peaking at 13-14 years. Elbow trauma is classified considering the direction in which the proximal radioulnar joint shifts with respect to the humerus, into posterior and anterior dislocation. The former is the most frequent and accounts for 95% of cases. Elbow fracture dislocation is an even rarer event. The incidence rate of avulsion fracture of the medial epicondyle is 25-36%, of the lateral condyle 4%, of the olecranon 1.7%, of the radial head 8%, of the coronoid process 3.5%, and others, 3.5%. At present there is no consensus in the literature on how to treat this type of lesions, particularly because some authors advocate nonsurgical management, while others propose surgical management as the definitive treatment. What is clear, however, is that a late diagnosis or untimely treatment may affect the child's growth and lead to serious complications. The purpose of this study is to share our experience and good results with the surgical management of these infrequent cases.

  13. [Manubriosternal dislocation caused by indirect flexion-compression trauma. A case report and review of the literature].

    Science.gov (United States)

    Kälicke, T; Feil, E; Steuer, K; Hansis, M

    2001-03-01

    Manubriosternal dislocation caused by indirect flexion-compression trauma is an extremely rare condition. Two forms of manubriosternal luxation are distinguished: in type I the sternum is dislocated posterior and in type II anterior to the manubrium. Direct or indirect trauma may cause manubriosternal dislocation. Mode of injury in direct trauma is mostly a head-on collition in a motor accident resulting either in type I or type II luxation. The unusual origin of manubriosternal dislocation by indirect trauma is put down to flexion-compression injuries of the thoracic spine and results in a type II dislocation. Predisposition to manubriosternal dislocation by indirect trauma consists in rheumatoid arthritis or extreme forms of kyphosis. Outcome of many patients treated conservatively after initial reposition with adhesive tape, symptomatic pain therapy, cryotherapy and prohibition of any physical training over several weeks is subluxation or complete luxation of the manubriosternal joint. This condition may lead to chronic pain, periarticular calcification with ankylosis and progredient deformation. Lacking a controlled study for treatment of manubriosternal dislocation a standard therapeutic regime could not be established yet. In the literature only a few case-reports of patients undergoing operative therapy are published. We report a type II dislocation of the manubriosternal joint caused by indirect flexion-compression trauma. We achieved a very good long-term result using a 8-hole 1/3 tubular plate for fixation of the manubriosternal joint after reposition.

  14. Atlanto-axial dislocation complicating a type II odontoid fracture. Reduction and final fixation.

    Science.gov (United States)

    Riouallon, G; Pascal-Moussellard, H

    2014-05-01

    A case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture is reported. This is a rare case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture. Its management is discussed. A traumatic dislocation of atlanto-axial joint associated with an odontoid fracture remains a rare injury. No case of posterior dislocation has been reported so far in the literature with this type of management. The case is of a 25 year-old-man with a primary atlanto-axial posterolateral dislocation associated with a type II displaced odontoid fracture without any neurological complication. The patient underwent gentle traction during 24 hours with a halo frame. An incomplete reduction was achieved. Two days later, a complete reduction was obtained thanks to a preoperative manual traction maintained by a Mayfield (R) modified skull clamp. Anterior C1-C2 fixation was performed according to Vaccaro's technique. The patient wore a cervical collar and underwent physiotherapy during three months. To our best knowledge, this case represents the first traumatic atlanto-axial dislocation associated with an odontoid fracture which was treated through retropaharyngeal approach. This had been rendered possible thanks to the final reduction maneuver in extension.

  15. Dislocation of the fibular head in an unusual sports injury: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  16. Kinematic assessment of hip movement when retrieving an object from the floor

    Directory of Open Access Journals (Sweden)

    Moorehead John D

    2011-02-01

    Full Text Available Abstract Background Activities that require extreme hip movement can dislocate hip implants in the early post operative phase. One such activity is retrieving an object from the floor. The aim of this study was to assess hip movement using four different techniques to accomplish this task. This assessment would identify the techniques least likely to cause a hip dislocation. Methods An electromagnetic tracker was used to measure the movement of 50 hips in 25 normal subjects. Sensors were attached over the iliac crest and the mid-shaft of the lateral thigh. Data was then collected for 3 repetitions of each of the following retrieval techniques:- 1. Flexing forward to pick up an object between the feet. 2. Flexing to pick up an object lateral to the foot. 3. Squatting to pick up an object between the feet. 4. Kneeling on one knee to pick up beside the knee. Results Kneeling required a mean movement of 30.4 degree(s flexion and 7.2 degree(s external rotation. This was significantly less than all the other techniques (paired t-test, P Conclusion The study showed that squatting had the most flexion and internal rotation, whereas kneeling has the least flexion. Thus, to minimise the dislocation risk when retrieving an object from the floor, kneeling should be adopted and squatting should be avoided.

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

    Science.gov (United States)

    Guruprasad, P. J.; Benzerga, A. A.

    2009-07-01

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

  18. Solute drag on perfect and extended dislocations

    Science.gov (United States)

    Sills, R. B.; Cai, W.

    2016-04-01

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

  19. Hip Resurfacing Implants.

    Science.gov (United States)

    Cadossi, Matteo; Tedesco, Giuseppe; Sambri, Andrea; Mazzotti, Antonio; Giannini, Sandro

    2015-08-01

    EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Describe the advantages of hip resurfacing. 2. Describe the disadvantages of hip resurfacing. 3. Identify the population in which hip resurfacing is most often indicated. 4. Demonstrate how to properly postoperatively manage patients with metal-on-metal prostheses. Hip resurfacing offers a suitable solution for young patients affected by hip disease who have high function demands and good bone quality. Bone stock preservation, restoration of the normal proximal femur anatomy, the lack of stress shielding, and the possibility of resuming sporting activity are proven advantages of hip resurfacing. However, there are some disadvantages, such as fracture of the femoral neck, onset of neck narrowing, and possible complications due to the metal-on-metal bearings, including pseudotumors, peri-implant osteolysis, and chronic elevation of metal ions in serum levels. Recent data suggest that the ideal candidate for hip resurfacing is an active male, younger than 65 years, with primary or posttraumatic osteoarthritis, and with a femoral head diameter larger than 50 to 54 mm. Based on these selection criteria, the literature reports implant survival to be similar to that of total hip arthroplasty. The current authors' experience confirms a low failure rate and excellent functional outcomes, with metal ion serum levels becoming stable over time in well-functioning implants. Proper surgical technique, correct patient selection, and the right choice of a well-established prosthetic model are essential elements for the long-term success of these implants.

  20. TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    Iulian ICLEANU

    2015-11-01

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

  1. Hip joint replacement

    Science.gov (United States)

    ... You will be asked to start moving and walking as soon as the first day after surgery. Some people need a short stay in a rehabilitation center ... may need a second replacement. Younger, more active people may wear out parts of their new hip. It may need to be replaced ... Hip fracture Osteoarthritis vs. rheumatoid ...

  2. Hip joint pathology

    DEFF Research Database (Denmark)

    Tijssen, M; van Cingel, R E H; de Visser, E

    2016-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18-6...

  3. Formed HIP Can Processing

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-07-27

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

  5. Current trends in total hip arthroplasty.

    Science.gov (United States)

    Eingartner, Christoph

    2007-01-01

    After 20 years of application, with excellent short-term and long-term results, uncemented total hip arthroplasty (THA) is now generally regarded as the standard procedure for younger patients undergoing THA. However, expectations regarding hip replacement are continuously rising, along with the increasing number of young and active patients undergoing hip arthroplasty: a complication rate, including postoperative dislocation, close to zero, faster postoperative rehabilitation, low wear even in active patients, high durability and long term survival, etc. Demographic changes in aging societies are also leading to an increased need for cost-effective THA for the low-demand trauma patient. For high-demand patients, modern THA bearings, such as ceramic-ceramic articulations and other improved PE and metal materials, provide high durability and low wear, if the components are properly aligned. Navigation technology has been introduced in THA to ensure perfect component positioning without outliers and concomitant risk of increased wear and implant failure. Minimally and less invasive approaches are becoming increasingly popular in order to facilitate rehabilitation and fast-track surgery in younger patients. Navigation provides assistance for implant positioning in procedures with limited surgical exposure and visibility. New bone-preserving implants, such as surface replacement or short-stemmed femoral shaft prostheses, have been introduced especially for younger patients. Some of these new procedures are still under development,and the long-term results of new implant concepts have to be evaluated over the next decades. Not every modern concept will likely stand the test of time, but some will be beneficial for patients undergoing total hip arthroplasty in the future.

  6. Lattice dislocation in Si nanowires

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

  7. The other hip in unilateral hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Rømer, Lone; Søballe, Kjeld

    2006-01-01

    We reviewed transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. A center-edge angle of 20 degrees or less was considered the upper normal value. Four groups were identified: 69 patients with app...

  8. Prevention of hip fractures.

    Science.gov (United States)

    Meunier, P J

    1993-11-30

    For a 50-year old Caucasian woman today, the risk of a hip fracture over her remaining life-time is about 17%. Tomorrow the situation will clearly be worse because the continuous increase in life expectancy will cause a three-fold increase in worldwide fracture incidence over the next 60 years. Through diagnostic bone mass measurements at the hip and assessment of biochemical parameters, a great deal has been learned in recent years about reduction of hip fracture risk. Preventive strategies are based on prevention of falls, use of hip protectors, and prevention of bone fragility. The latter includes the optimization of peak bone mass during childhood, postmenopausal estrogen replacement therapy, and also late prevention consisting in reversing senile secondary hyperparathyroidism, which plays an important role in the decrease of skeletal strength. This secondary hyperparathyroidism, which results from both vitamin D insufficiency and low calcium intake, is preventable with vitamin D3 and calcium supplements. They have recently been shown capable of providing effective prevention of hip fractures in elderly women living in nursing homes, with a reduction of about 25% in the number of hip fractures noted in a 3-year controlled study in 3,270 women (intention-to-treat analysis). In conclusion, it is never too early to reduce the risk of osteoporosis and never too late to prevent hip fractures.

  9. 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.

  10. Cervical facet dislocation adjacent to the fused motion segment

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2016-01-01

    Full Text Available This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B. Cervical computed tomography (CT indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D. In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

  11. Cervical facet dislocation adjacent to the fused motion segment.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kuroiwa, Toshihiko

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

  12. Linguatula serrata in the anterior chamber of the eye

    Directory of Open Access Journals (Sweden)

    Muna Bhende

    2014-01-01

    Full Text Available We report a case of intraocular Linguatula in healthy young female who presented with a history of trivial trauma, dislocated lens, inflammation and secondary glaucoma. A mobile worm was seen in the anterior chamber. Pars plana lensectomy and vitrectomy was planned to remove both the cataractous lens and the parasite during which the worm disappeared from view but was later recovered from the cassette fluid. It was identified as the nymphal form of Linguatula serrata (tongue worm.

  13. Minimally invasive two-incision total hip arthroplasty:a short-term retrospective report of 27 cases

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xian-long; WANG Qi; SHEN Hao; JIANG Yao; ZENG Bing-fang

    2007-01-01

    Background Total hip arthroplasty (THA) is widely applied for the treatment of end-stage painful hip arthrosis.Traditional THA needed a long incision and caused significant soft tissue trauma. Patients usually required long recovery time after the operation. In this research we aimed to study the feasibility and clinical outcomes of minimally invasive two-incision THA.Methods From February 2004 to March 2005, 27 patients, 12 males and 15 females with a mean age of 71 years (55-76), underwent minimally invasive two-incision THA in our department. The patients included 9 cases of osteoarthritis, 10 cases of osteonecrosis, and 8 cases of femoral neck fracture. The operations were done with VerSys cementless prosthesis and minimally invasive instruments from Zimmer China. Operation time, blood loss, length of incision, postoperative hospital stay, and complications were observed.Results The mean operation time was 90 minutes (80-170 min). The mean blood loss was 260 ml (170-450 ml) and blood transfusion was carried out in 4 cases of femoral neck fracture (average 400 ml). The average length of the anterior incision was 5.0 cm (4.6-6.5 cm) and of the posterior incision 3.7 cm (3.0-4.2 cm). All of the patients were ambulant the day after surgery. Nineteen patients were discharged 5 days post-operatively and 8 patients 7 days post-operatively. The patients were followed for 18 months (13-25 months). One patient was complicated by a proximal femoral fracture intraoperatively. No other complications, including infections, dislocations, and vascular injuries, occurred. The mean Harris score was 94.5 (92-96).Conclusions Two-incision THA has the advantage of being muscle sparing and minimally invasive with less blood loss and rapid recovery. However, this technique is time consuming, technically demanding, and requires fluoroscopy.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-03-15

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

  15. Hip salvage surgery in cerebral palsy cases: a systematic review.

    Science.gov (United States)

    de Souza, Rafael Carboni; Mansano, Marcelo Valentim; Bovo, Miguel; Yamada, Helder Henzo; Rancan, Daniela Regina; Fucs, Patricia Maria de Moraes Barros; Svartman, Celso; de Assumpção, Rodrigo Montezuma César

    2015-01-01

    Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients' quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals. The literature search focused on studies that evaluated results from hip salvage surgery in cases of cerebral palsy, published from 1970 to 2011, which are present in the Embase, Medline, PubMed, Cochrane Library and SciELO databases. Although the results were not statistically comparable, this systematic review demonstrates that hip salvage surgery should be indicated after individual evaluation on each patient, due to the wide spectrum of presentations of cerebral palsy. Therefore, it seems that no surgical technique is superior to any other. Rather, there are different indications.

  16. Hip salvage surgery in cerebral palsy cases: a systematic review

    Directory of Open Access Journals (Sweden)

    Rafael Carboni de Souza

    2015-06-01

    Full Text Available Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients' quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals. The literature search focused on studies that evaluated results from hip salvage surgery in cases of cerebral palsy, published from 1970 to 2011, which are present in the Embase, Medline, PubMed, Cochrane Library and SciELO databases. Although the results were not statistically comparable, this systematic review demonstrates that hip salvage surgery should be indicated after individual evaluation on each patient, due to the wide spectrum of presentations of cerebral palsy. Therefore, it seems that no surgical technique is superior to any other. Rather, there are different indications.

  17. Graft Suturing for Lenticule Dislocation after Descemet Stripping Automated Endothelial Keratoplasty

    Directory of Open Access Journals (Sweden)

    Wai-Kwan Wu

    2011-01-01

    Full Text Available Purpose: To report the mid-term outcomes of graft suturing in a patient with lenticule dislocation after Descemet stripping automated endothelial keratoplasty (DSAEK. Case Report: A 78-year old woman was found to have graft dislocation involving the nasal half of the cornea after uneventful DSAEK. Graft repositioning, refilling the anterior chamber with air, and placement of four full-thickness 10/0 nylon sutures over the detached area were performed two weeks after the initial surgery. The sutures were removed 6 weeks later. Serial specular microscopy and anterior segment optical coherence tomography were performed. At 18 months, there was good lenticule apposition and a clear graft. Conclusion: Anchoring sutures seem to be effective for management of graft detachment following DSAEK.

  18. Traumatic Lumbosacral Dislocation Treated with Posterior Lumbar Interbody Fusion Using Intersomatic Cages

    Directory of Open Access Journals (Sweden)

    Katsuhiro Tofuku

    2009-01-01

    Full Text Available A 35-year-old man was struck by a car on his right side and presented with paraparesis of both lower extremities. Radiographic examination revealed multiple transverse process fractures and anterior displacement of L5 on S1. Computed tomography revealed a bilateral anterior facet dislocation of the fifth lumbar vertebra on the sacrum. MRI showed rupture of the posterior ligamentous complex. A posterior lumbar interbody fusion using two intersomatic cages and pedicle screw instrumentation and posterior fusion were performed. Although no major disc lesion was found at the level of L5-S1 on preoperative MRI, a severely collapsed L5-S1 disc was found intraoperatively. Two years after surgery, the patient was asymptomatic with normal neurological findings, and has resumed normal activity. We believe that lumbosacral dislocation can be considered a three-column injury with an L5-S1 disc lesion, and, therefore, requires a solid circumferential segmental arthrodesis to improve fusion rate.

  19. Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury

    Institute of Scientific and Technical Information of China (English)

    JIANG Tao; REN Xian-jun; WANG Wei-dong; ZHANG Xia; LI Chang-qing; HAO Yong

    2010-01-01

    Objective: To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.Methods: This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF)magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.Results: There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.Conclusions: Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.

  20. Analogy betwen dislocation creep and relativistic cosmology

    OpenAIRE

    J.A. Montemayor-Aldrete; J.D. Muñoz-Andrade; Mendoza-Allende, A.; Montemayor-Varela, A.

    2005-01-01

    A formal, physical analogy between plastic deformation, mainly dislocation creep, and Relativistic Cosmology is presented. The physical analogy between eight expressions for dislocation creep and Relativistic Cosmology have been obtained. By comparing the mathematical expressions and by using a physical analysis, two new equations have been obtained for dislocation creep. Also, four new expressions have been obtained for Relativistic Cosmology. From these four new equations, one may determine...

  1. A Numeric Study on Chaotic Dislocation Emission

    Institute of Scientific and Technical Information of China (English)

    HonglaiTan; WeiYang

    1996-01-01

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

  2. MOVING SCREW DISLOCATION IN CUBIC QUASICRYSTAL

    Institute of Scientific and Technical Information of China (English)

    ZHOU Wang-min; SONG Yu-hai

    2005-01-01

    The elasticity theory of the dislocation of cubic quasicrystals is developed.The governing equations of anti-plane elasticity dynamics problem of the quasicrystals were reduced to a solution of wave equations by introducing displacement functions,and the analytical expressions of displacements, stresses and energies induced by a moving screw dislocation in the cubic quasicrystalline and the velocity limit of the dislocation were obtained. These provide important information for studying the plastic deformation of the new solid material.

  3. HIP osteoarthritis and work.

    Science.gov (United States)

    Harris, E Clare; Coggon, David

    2015-06-01

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

  4. Hip Implant Systems

    Science.gov (United States)

    ... made of metal or ceramic, and the socket (acetabulum) is removed and replaced with a prosthetic cup. ... its socket in the hip bone (pelvis) Bone fracture Joint infection Local nerve damage with numbness/weakness ...

  5. Evaluation of a treatment algorithm for acute traumatic osseous Bankart lesions resulting from first time dislocation of the shoulder with a two year follow-up

    OpenAIRE

    Spiegl, Ulrich J A; Ryf, Christian; Hepp, Pierre; Rillmann, Paavo

    2013-01-01

    Background Studies dealing with acute osseous Bankart lesions and corresponding treatment strategies are rare. The purpose of this study is to analyze the results after applying our treatment algorithm for acute glenoid rim fractures caused by first time traumatic anterior shoulder dislocations. Methods 25 patients were included in this retrospective case series. All patients sustained a first time shoulder dislocation caused by ski or snowboard accidents. An osseous Bankart lesion was detect...

  6. Structure of the Dislocation in Sapphire

    DEFF Research Database (Denmark)

    Bilde-Sørensen, Jørgen; Thölen, A. R.; Gooch, D. J.;

    1976-01-01

    of ⅓ 01 0 and are separated by two identical faults. The distance between two partials is in the range 75-135 Å, corresponding to a fault energy of 320±60 mJ/m2. Perfect 01 0 dislocations have also been observed. These dislocations exhibited either one or two peaks when imaged in the (03 0) reflection......Experimental evidence of the existence of 01 0 dislocations in the {2 0} prism planes in sapphire has been obtained by transmission electron microscopy. By the weak-beam technique it has been shown that the 01 0 dislocations may dissociate into three partials. The partials all have a Burgers vector...

  7. Congenital dislocation of the patella - clinical case

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Sá

    2016-02-01

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

  8. Radiographic findings in restrained hip joints associated with ACL rupture.

    Science.gov (United States)

    Ellera Gomes, João L; Palma, Humberto Moreira; Becker, Ricardo

    2010-11-01

    Although decreased hip range of motion has been detected in many soccer players with noncontact anterior cruciate ligament (ACL), it is not clear whether it is associated with bone spurs, capsular soft tissue stiffness or both. Our aim was to investigate abnormal radiographic findings in soccer players with limited hip range of motion and noncontact ACL injury. Fifty consecutive male soccer players with restricted hip range of motion and noncontact ACL injury were subjected to radiographic examination to identify bone changes that could be associated with decreased hip range of motion. Of 50 patients, 56% revealed abnormal radiographic findings: pericapsular calcifications or acetabular rim osteophytes (24%), femoral neck deformity (10%), femoral neck and acetabular rim disorders (18%), neck groove caused by impingement (4%). Radiographic evaluation of those individuals showed a high number of bone abnormalities around the hip joint. This was considered to be an important finding to guide a decision-making process between three different approaches: changing the type of sports practiced, undergoing a more restrictive surgery (such as a double-bundle intra-articular reconstruction or an intra plus extra technique) or the onset of a hip-stretching program in addition to the conventional ACL rehabilitation protocol. In this last option, ACL-operated patients without radiographic hip abnormalities may have better outcomes for their decreased hip range of motion when submitted to a stretching program targeting the prevention of rotational overload on the reconstructed intra-articular grafts. The decision-making process concerning soccer players with ACL ruptures should take into consideration the amount of motion-limiting abnormalities around the hip joint.

  9. Hip-Hop

    Institute of Scientific and Technical Information of China (English)

    张敬伟

    2008-01-01

    Hip-Hop是一种美国街头黑人文化,可分成五个要素:音乐、舞蹈、涂鸦、刺青和衣著。源自80年代美国纽约的黑人社区BRONX,他们将生活上的娱乐发展成为现今多样的HIP-HOP文化,发挥黑

  10. Muscular strength after total hip arthroplasty

    Science.gov (United States)

    Winther, Siri B; Husby, Vigdis S; Foss, Olav A; Wik, Tina S; Svenningsen, Svein; Engdal, Monika; Haugan, Kristin; Husby, Otto S

    2016-01-01

    Background and purpose Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. Patients and methods In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up. Results Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups. Interpretation The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery. PMID:26141371

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

    Science.gov (United States)

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

    2016-01-01

    The stress-driven motion of dislocations in crystalline solids, and thus the ensuing plastic deformation process, is greatly influenced by the presence or absence of various pointlike defects such as precipitates or solute atoms. These defects act as obstacles for dislocation motion and hence affect the mechanical properties of the material. Here we combine molecular dynamics studies with three-dimensional discrete dislocation dynamics simulations in order to model the interaction between different kinds of precipitates and a 1/2〈111〉{110} edge dislocation in BCC iron. We have implemented immobile spherical precipitates into the ParaDis discrete dislocation dynamics code, with the dislocations interacting with the precipitates via a Gaussian potential, generating a normal force acting on the dislocation segments. The parameters used in the discrete dislocation dynamics simulations for the precipitate potential, the dislocation mobility, shear modulus, and dislocation core energy are obtained from molecular dynamics simulations. We compare the critical stresses needed to unpin the dislocation from the precipitate in molecular dynamics and discrete dislocation dynamics simulations in order to fit the two methods together and discuss the variety of the relevant pinning and depinning mechanisms.

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

    Directory of Open Access Journals (Sweden)

    van Raaij Jos JAM

    2008-10-01

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

  13. "Dislocation"

    Institute of Scientific and Technical Information of China (English)

    Li Wei

    2006-01-01

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

  14. Dislocation

    Science.gov (United States)

    To help prevent injuries in children: Create a safe environment around your home. Help prevent falls by placing ... no substitute for close supervision, no matter how safe the environment or situation appears to be. Teach children how ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-05

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

  16. An evaluation of merits of total hip arthroplasty done for traumatic and non-traumatic displaced fracture neck of femur

    Directory of Open Access Journals (Sweden)

    Vipul Agarwal

    2016-05-01

    Results: On clinical and functional evaluation, patients scored 84% excellent/good in non-traumatic group whereas 68% excellent/good score in traumatic group. 12% and 16% patients scored poor in non-traumatic group and in traumatic group respectively. In non-traumatic group, following complications were observed. Dislocation rate of 4% (one hip, 4% incidence of aseptic acetabular loosening (one hip, and 16% incidence of heterotrophic ossification (four hips. In traumatic group, we observed 2 (8% dislocations, 4 (16% heterotopic ossifications. Loosening of acetabulum and subsidence were observed in two (8% patients. Conclusions: There are higher chances of dislocation among patients undergoing total hip replacement for a traumatic indications as compared to their non-traumatic indications. Chances of dislocation can be curtailed by keeping known factors in mind along with careful patient selection, adherence to postoperative protocol and use of a lateral approach with large head in high risk patients. [Int J Res Med Sci 2016; 4(5.000: 1632-1635

  17. Dislocated interests and climate change

    Science.gov (United States)

    Davis, Steven J.; Diffenbaugh, Noah

    2016-06-01

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

  18. Formation of disorientations in dislocation structures during plastic deformation

    DEFF Research Database (Denmark)

    Pantleon, W.

    2002-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-11-15

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

  20. Dislocation pinning effects on fracture behavior: Atomistic and dislocation dynamics simulations

    Science.gov (United States)

    Noronha, S. J.; Farkas, D.

    2002-10-01

    We introduce an approach in which results from atomistic simulations are combined with discrete dislocation dynamics simulations of crack-tip plasticity. The method is used to study the effects of dislocation pinning due to grain boundaries or secondary particles on the fracture behavior of aluminum. We find that the fracture resistance is reduced with decreasing pinning distance. The results show that the pinning of the dislocations causes a net decrease in the shear stress projected on the slip plane, preventing further dislocation emission. Semibrittle cleavage occurs after a certain number of dislocations is emitted.

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

    Institute of Scientific and Technical Information of China (English)

    周志敏; 孙艳蕊; 周海涛

    2004-01-01

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

  2. Treatment of displaced neck fractures of the femur with total hip arthroplasty.

    Science.gov (United States)

    Rudelli, Sergio; Viriato, Sergio P; Meireles, Tadeu L O; Frederico, Tiago N

    2012-02-01

    We report our experience in unstable fractures of the femoral neck in a consecutive series of patients who underwent total hip arthroplasty. Over a period of 12 years, 88 patients were treated with a cemented total hip arthroplasty; 3 patients were lost to follow-up, leaving 86 fractures (85 patients) for retrospective analysis. Seven patients had dislocations, all but 1 of which were treated successfully without reoperation. Four patients required reoperation in the same hip undergoing arthroplasty. There was a graded increase in mortality rates across the continuum of risk groups at the time of surgery. The low incidence (4.6%) of a second procedure on the hip repaired initially, as well as low mortality rates, makes this treatment strategy quite satisfactory.

  3. Hip pathology in Hutchinson-Gilford progeria syndrome: a report of two children.

    Science.gov (United States)

    Akhbari, Pouya; Jha, Shilpa; James, Kyle D; Hinves, Barry L; Buchanan, Jamie A F

    2012-11-01

    Hutchinson-Gilford progeria syndrome (HGPS) is a rare genetic disorder. The estimated incidence is one in 4 million births. Orthopaedic manifestations include abnormality of the hips occurring early in the disease process. Severe coxa valga can be apparent by the age of 2 years. We report two cases of HGPS, one in a 7-year-old girl with avascular necrosis of the left hip and the second in a 13-year-old girl with recurrent traumatic hip dislocations. We demonstrate the pathoanatomical changes in the hip with HGPS using a combination of imaging modalities including radiographic, computed tomographic and MRI scans. These include coxa magna, coxa valga and acetabular dysplasia. We also comment on how these would affect the surgical management of this high-risk group of patients.

  4. Dislocation generation during early stage sintering.

    Science.gov (United States)

    Sheehan, J. E.; Lenel, F. V.; Ansell, G. S.

    1973-01-01

    Discussion of the effects of capillarity-induced stresses on dislocations during early stage sintering. A special version of Hirth's (1963) theoretical calculation procedures modified to describe dislocation nucleation on planes meeting the sintering body's neck surface obliquely is shown to predict plastic flow at stress levels know to exist between micron size metal particles in the early stages of sintering.

  5. Statistics of dislocation pinning at localized obstacles

    Energy Technology Data Exchange (ETDEWEB)

    Dutta, A. [S. N. Bose National Centre for Basic Sciences, Salt Lake, Kolkata 700098 (India); Bhattacharya, M., E-mail: mishreyee@vecc.gov.in; Barat, P. [Variable Energy Cyclotron Centre, 1/AF Bidhannagar, Kolkata 700064 (India)

    2014-10-14

    Pinning of dislocations at nanosized obstacles like precipitates, voids, and bubbles is a crucial mechanism in the context of phenomena like hardening and creep. The interaction between such an obstacle and a dislocation is often studied at fundamental level by means of analytical tools, atomistic simulations, and finite element methods. Nevertheless, the information extracted from such studies cannot be utilized to its maximum extent on account of insufficient information about the underlying statistics of this process comprising a large number of dislocations and obstacles in a system. Here, we propose a new statistical approach, where the statistics of pinning of dislocations by idealized spherical obstacles is explored by taking into account the generalized size-distribution of the obstacles along with the dislocation density within a three-dimensional framework. Starting with a minimal set of material parameters, the framework employs the method of geometrical statistics with a few simple assumptions compatible with the real physical scenario. The application of this approach, in combination with the knowledge of fundamental dislocation-obstacle interactions, has successfully been demonstrated for dislocation pinning at nanovoids in neutron irradiated type 316-stainless steel in regard to the non-conservative motion of dislocations. An interesting phenomenon of transition from rare pinning to multiple pinning regimes with increasing irradiation temperature is revealed.

  6. CUSTOMIZED ACETABULAR COMPONENTS IN REVISION HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    G. M. Kavalersky

    2016-01-01

    Full Text Available In recent years, there is a trend of increasing demand for revision hip arthroplasty. Among these patients there are many with complex acetabular defects, including patients with pelvic discontinuity. To ensure stability for revised acetabular components in such cases becomes a challenging or unachievable task. Such defects give indications for printing customized tri-flange acetabular component. The authors analysed own experience of creating and applying custom made acetabular components in 3 patients with complex acetabular defects. Material and methods. Among the patients there were 2 women and 1 man. Average age was 60,3±19,4 years (38 to 78 years. Two patients had III B defects with pelvic discontinuity and one patient had III A defect by Paprosky classification. As the first step, the authors in collaboration with engineers printed a plaster full size pelvic 3D model, as the second step a customized tri-flange acetabular component was designed and printed. Harris Hip Score was evaluated preoperatively and 3 months postoperatively. Results. Average follow-up period was 5,3±2,5 months (3 to 8 months. The authors observed no cases of implant loosening, dislocation or deep periprosthetic infection. Average Harris Hip Score before surgery was 27,13 and after surgery – 74,1 indicating a significant improvement in 3 months postoperatively. Conclusion. Indications for use of individual acetabular components in reported patients correspond to indications formulated by Berasi et al. The authors obtained encouraging early follow-up outcomes that correspond to data of other authors. In one patient certain difficulties were reported due to insufficient pelvic distraction. Component’s flanges prevented achieving adequate pelvic distraction. Nevertheless, good primary stability was achieved. Modern software and 3D metal printers can significantly reduce the production cost of customized acetabular components. Application of this technology can be

  7. Dislocation patterning in a two-dimensional continuum theory of dislocations

    Science.gov (United States)

    Groma, István; Zaiser, Michael; Ispánovity, Péter Dusán

    2016-06-01

    Understanding the spontaneous emergence of dislocation patterns during plastic deformation is a long standing challenge in dislocation theory. During the past decades several phenomenological continuum models of dislocation patterning were proposed, but few of them (if any) are derived from microscopic considerations through systematic and controlled averaging procedures. In this paper we present a two-dimensional continuum theory that is obtained by systematic averaging of the equations of motion of discrete dislocations. It is shown that in the evolution equations of the dislocation densities diffusionlike terms neglected in earlier considerations play a crucial role in the length scale selection of the dislocation density fluctuations. It is also shown that the formulated continuum theory can be derived from an averaged energy functional using the framework of phase field theories. However, in order to account for the flow stress one has in that case to introduce a nontrivial dislocation mobility function, which proves to be crucial for the instability leading to patterning.

  8. THERMODYNAMIC VARIATIONAL APPROACH FOR CLIMB OF AN EDGE DISLOCATION

    Institute of Scientific and Technical Information of China (English)

    Yunxin Gao; A.C.F. Cocks

    2009-01-01

    A general thermodynamic variational approach is applied to study the force on an edge dislocation, which drives the dislocation to climb. Our attention is focused on the physical mechanism responsible for dislocation climb. A dislocation in a material element climbs as a result of vacancies diffusing into or out from the dislocation core, with the dislocation acting as a source or a sink for vacancy diffusion in the material element. The basic governing equations for dislocation climb and the climb forces on the dislocation are obtained naturally as a result of the present thermodynamic variational approach.

  9. HIP-HOP

    Institute of Scientific and Technical Information of China (English)

    QunyKing; 人在羽中; 钱李明

    2005-01-01

    自从一群摇滚青年开始跟风 Elvis 的《Blue SuedeShoes》风格,hip-hop 似乎就成为了全球最具影响力的音乐风格。它最初起源于美国的黑人和拉丁美洲人,之后迅速在全世界流行,成为80年代、90年代和新千年的主流音乐。无论是在广告界还是在电影业,从各类排行榜到各种酒吧,hip-hop 的影响逐年增加。在1997年,英国的 hip-hop 还只是一种地下音

  10. 直接前入路微创髋关节置换学习曲线早期病例的短期结果%Primary total hip arthroplasty via minimally direct anterior approach:short-term results in cases of early learning curve

    Institute of Scientific and Technical Information of China (English)

    彭慧明; 钱文伟; 翁习生; 冯宾; 蒋超; 叶灿华; 肖刻

    2016-01-01

    Background:The direct anterior approach (DAA) is gaining popularity in the hip arthroplasty (THA). We still concern about the learning curve and early complications of this approach. Objective:To investigate short-term results and feasibility of THA via minimally invasive DAA. Methods:From April 2014 to September 2015, 17 patients underwent THA via minimally invasive DAA. There were 5 males and 12 females with an average age of 62.4 years (55-84 years). Their av-erage BMI was (23.9±4.5) kg/m2. Diagnosis included 2 cases of osteoarthritis, 7 of osteonecrosis, 3 of developmental dyspla-sia hip and 1 of ankylosing hip. ASA score was 1-2 points in 11 cases and 3 points in 6 cases. Preoperative average VAS score was 6±1.3 and Harris scale was 43.4±5. Operation time, intraoperative blood loss, length of incisions, hospitalization time, operation related complication, radiological outcomes and postoperative pain relief and function rehabilitation were an-alyzed. Results:We performed simultaneous bilateral THA for 3 patients, unilateral THA for 12 patients (6 in the left and 6 in the right) and femoral head replacement for 2 patients. All the operations were performed under general anesthesia and no special traction table was used. The average operation time and intraoperative blood loss was 140.7 min (90-195 min) and 520 ml (200-1000 ml) in unilateral THA. The average operation time and intraoperative blood loss was 265.0 min (242-295 min) and 80-1500 ml in bilateral THA. Thirteen cases received intraoperative fluoroscopy and five cases received postopera-tive transfusion. The patients were followed up for a median of 6 months (5-12 months). The average postoperative leg-length discrepancy, femoral offset, angles of acetabular abduction and anteversion were (3 ± 2) mm, (3.1 ± 0.6) mm, 42.3° ± 5.7°, and 19.8°±5.7°. In this cohort, the complications were:4 calcar fractures (all healed), 3 lateral femoral cutaneous nerve dysfunction (all resolved). No infection

  11. Developmental Dysplasia of the Hip

    Science.gov (United States)

    ... in the motion of the hip and obvious shortening of the affected leg in older kids, an ... socket. During the procedure, doctors loosen the tight muscles and tissues around the hip joint and then ...

  12. Hip resurfacing: a large, US single-surgeon series.

    Science.gov (United States)

    Brooks, P J

    2016-01-01

    Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series. We report our early to mid-term results in 1333 cases followed for a mean of 4.3 years (2 to 5.7) using a prospective, observational registry. The mean patient age was 53.1 years (12 to 84); 70% were male and 91% had osteoarthritis. Complications were few, including no dislocations, no femoral component loosening, two femoral neck fractures (0.15%), one socket loosening (0.08%), three deep infections (0.23%), and three cases of metallosis (0.23%). There were no destructive pseudotumours. Overall survivorship at up to 5.7 years was 99.2%. Aseptic survivorship in males under the age of 50 was 100%. We believe this is the largest United States series of a single surgeon using a single resurfacing system.

  13. Sports Injuries about the Hip: What the Radiologist Should Know.

    Science.gov (United States)

    Hegazi, Tarek M; Belair, Jeffrey A; McCarthy, Eoghan J; Roedl, Johannes B; Morrison, William B

    2016-10-01

    Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations. Stress fractures, thigh splints, and posterior hip dislocations are important structural injuries to consider in the athlete, initially imaged with radiographs and often best diagnosed with MR imaging. Apophyseal injuries are particularly important to consider in young athletes and may be acute or related to chronic repetitive microtrauma. Femoroacetabular impingement has been implicated in development of labral tears and cartilage abnormalities. Tear of the ligamentum teres is now recognized as a potential cause of hip pain and instability, best evaluated with MR arthrography. Greater trochanteric pain syndrome encompasses a group of conditions leading to lateral hip pain, with US playing an increasingly important role for both evaluation and image-guided treatment. Muscle injuries and athletic pubalgia are common in athletes. Lastly, snapping hip syndrome and Morel-Lavallée lesions are two less common but nonetheless important considerations. (©)RSNA, 2016.

  14. Hip resurfacing: a technology reborn

    OpenAIRE

    2006-01-01

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

  15. Evolution, Interaction, and Intrinsic Properties of Dislocations in Intermetallics: Anisotropic 3D Dislocation Dynamics Approach

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qian [Iowa State Univ., Ames, IA (United States)

    2008-01-01

    The generation, motion, and interaction of dislocations play key roles during the plastic deformation process of crystalline solids. 3D Dislocation Dynamics has been employed as a mesoscale simulation algorithm to investigate the collective and cooperative behavior of dislocations. Most current research on 3D Dislocation Dynamics is based on the solutions available in the framework of classical isotropic elasticity. However, due to some degree of elastic anisotropy in almost all crystalline solids, it is very necessary to extend 3D Dislocation Dynamics into anisotropic elasticity. In this study, first, the details of efficient and accurate incorporation of the fully anisotropic elasticity into 3D discrete Dislocation Dynamics by numerically evaluating the derivatives of Green's functions are described. Then the intrinsic properties of perfect dislocations, including their stability, their core properties and disassociation characteristics, in newly discovered rare earth-based intermetallics and in conventional intermetallics are investigated, within the framework of fully anisotropic elasticity supplemented with the atomistic information obtained from the ab initio calculations. Moreover, the evolution and interaction of dislocations in these intermetallics as well as the role of solute segregation are presented by utilizing fully anisotropic 3D dislocation dynamics. The results from this work clearly indicate the role and the importance of elastic anisotropy on the evolution of dislocation microstructures, the overall ductility and the hardening behavior in these systems.

  16. Ultrasonic Study of Dislocation Dynamics in Lithium -

    Science.gov (United States)

    Han, Myeong-Deok

    1987-09-01

    Experimental studies of dislocation dynamics in LiF single crystals, using ultrasonic techniques combined with dynamic loading, were performed to investigate the time evolution of the plastic deformation process under a short stress pulse at room temperature, and the temperature dependence of the dislocation damping mechanism in the temperature range 25 - 300(DEGREES)K. From the former, the time dependence of the ultrasonic attenuation was understood as resulting from dislocation multiplication followed by the evolution of mobile dislocations to immobile ones under large stress. From the latter, the temperature dependence of the ultrasonic attenuation was interpreted as due to the motion of the dislocation loops overcoming the periodic Peierls potential barrier in a manner analogous to the motion of a thermalized sine-Gordon chain under a small stress. The Peierls stress obtained from the experimental results by application of Seeger's relaxation model with exponential dislocation length distribution was 4.26MPa, which is consistent with the lowest stress for the linear relation between the dislocation velocity and stress observed by Flinn and Tinder.

  17. X-Ray Exam: Hip

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Hip KidsHealth > For Parents > X-Ray Exam: Hip A A A What's in ... español Radiografía: cadera What It Is A hip X-ray is a safe and painless test that ...

  18. Positioning the hip with respect to the COM: Consequences for leg operation.

    Science.gov (United States)

    Blickhan, Reinhard; Andrada, Emanuel; Müller, Roy; Rode, Christian; Ogihara, Naomichi

    2015-10-07

    In bipedal runners and hoppers the hip is not located at the center of mass in the sagittal projection. This displacement influences operation and energetics of the leg attached to the hip. To investigate this influence in a first step a simple conservative bouncing template is developed in which a heavy trunk is suspended to a massless spring at a pivot point above the center of mass. This model describes the orientation of the ground reaction forces observed in experiments on running birds. In a second step it is assumed that an effective telescope leg with its hip fixed to the trunk remote from the COM generates the same ground reaction forces as those predicted by the template. For this effective leg the influence of hip placement on leg operation and energetics is investigated. Placing the hip directly below, at, or above the pivot point results in high axial energy storage. Posterior placement increases axial losses and hip work whereas anterior placement would require axial work and absorption at the hip. Shifting the hip far posteriorly as observed in some birds can lead to the production of pure extension torques throughout the stance phase. It is proposed that the relative placement of the hip with respect to the center of mass is an important measure to modify effective leg operation with possible implications for balancing the trunk and the control of legged motion systems.

  19. Distribution of distances between dislocations in different types of dislocation substructures in deformed Cu-Al alloys

    Energy Technology Data Exchange (ETDEWEB)

    Trishkina, L., E-mail: trishkina.53@mail.ru; Zboykova, N.; Koneva, N., E-mail: koneva@tsuab.ru; Kozlov, E. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); Cherkasova, T. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); National Research Tomsk Polytechnic University, 50 Lenin Ave., Tomsk, 634050 (Russian Federation)

    2016-01-15

    The aim of the investigation was the determination of the statistic description of dislocation distribution in each dislocation substructures component forming after different deformation degrees in the Cu-Al alloys. The dislocation structures were investigated by the transmission diffraction electron microscopy method. In the work the statistic description of distance distribution between the dislocations, dislocation barriers and dislocation tangles in the deformed Cu-Al alloys with different concentration of Al and test temperature at the grain size of 100 µm was carried out. It was established that the above parameters influence the dislocation distribution in different types of the dislocation substructures (DSS): dislocation chaos, dislocation networks without disorientation, nondisoriented and disoriented cells, in the walls and inside the cells. The distributions of the distances between dislocations in the investigated alloys for each DSS type formed at certain deformation degrees and various test temperatures were plotted.

  20. Selective lengthening of the psoas and rectus femoris and preservation of the iliacus for flexion deformity of the hip in cerebral palsy patients.

    Science.gov (United States)

    Matsuo, T; Hara, H; Tada, S

    1987-01-01

    Between 1978 and 1983, 52 Japanese patients with cerebral palsy underwent operative correction of flexion deformity of the hip. The results of lengthening of the psoas, rectus femoris, and proximal hamstrings were satisfactory. The iliacus was left intact. Improvement in gait and activities of daily living was attained. Concentric reduction was obtained in 27 of 33 dislocated or subluxated hips. Sitting and perineal care were facilitated, and pain was alleviated. We conclude that preservation of the iliacus is important.

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

    Directory of Open Access Journals (Sweden)

    Somashekar

    2014-03-01

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

  2. Surgical Treatment for Subaxial Cervical Facet Dislocations with Incomplete or without Neurological Deficit: A Prospective Study of 52 Cases.

    Science.gov (United States)

    Jiang, Xingjie; Yao, Yu; Yu, Mingchen; Cao, Yong; Yang, Huilin

    2017-02-09

    BACKGROUND This study aimed to treat patients with subaxial cervical facet dislocations with incomplete or without neurological deficit by a prospectively designed surgical protocol and observe the short-term clinical outcomes. MATERIAL AND METHODS Fifty-two consecutive subaxial cervical dislocation patients with incomplete or without neurological deficit were enrolled. The surgical strategy was determined based on whether or not the initial anterior closed reduction was successful and whether or not the patients were simultaneously combined with traumatic disc herniation (TDH). Postoperative radiographs were used to assess the reduction and fusion, and kyphosis and lordosis of cervical spines were calculated. The neck pain was assessed by visual analog scale. Body function and neurologic status was evaluated according to the Neck Disability Index and classification of American Spinal Injury Association. Clinical and radiologic outcomes were compared before and after the surgery and during the follow-up. The average follow-up period was 23 months. RESULTS Five patients with TDH and 17 with non-TDH were successfully treated by a single anterior approach, 22 non-TDH patients by a posterior-anterior approach, and another eight TDH patients by an anterior-posterior-anterior approach. No neurologic deterioration or other severe adverse events occurred postoperatively. The kyphosis angle of the dislocated levels was well restored after surgery, and the neck pain was significantly relieved as well. The neurologic status was obviously improved, and bony fusion was obtained in all patients within one-year follow-up. CONCLUSIONS Our prospectively designed surgical strategy is effective for the treatment of patients with subaxial cervical dislocation with incomplete or without neurological deficit.

  3. INL HIP Plate Fabrication

    Energy Technology Data Exchange (ETDEWEB)

    B. H. Park; C. R. Clark; J. F. Jue

    2010-02-01

    This document outlines the process used to bond monolithic fuel plates by Hot Isostatic Pressing (HIP). This method was developed at Idaho National Laboratory (INL) for the Reduced Enrichment for Research and Test Reactors (RERTR) program. These foils have been used in a number of irradiation experiments in support of the United States Global Threat Reduction Initiative (GTRI) program.

  4. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

    ... Week of Healthy Breakfasts Shyness Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  5. Targeted screening of hip dysplasia in newborns: experience at a district general hospital in Scotland

    Directory of Open Access Journals (Sweden)

    Rahul Tyagi

    2016-09-01

    Full Text Available National Health Service Quality Improvement Scotland (NHS QIS published a health technology scoping report in 2006 acknowledging that there are serious concerns within Scotland in relation to Developmental Dysplasia of Hip (DDH as there is no formal screening program in place and there are significant variations between NHS boards leading to confusion for staff and parents. NHS QIS identified need for audit work to improve hip screening in Scotland. The aim of this study is to review of current practice of selective screening for DDH. All newborns who had their first hip scan during one year period (2014 were included in this retrospective study and followed up until June 2015 to include any surgical intervention for dysplastic hip. Out of 428 babies (856 hip scans, abnormality was seen in 119 babies/147 hips (134 Graf 2a/2b, 10 hips were 2c and 3 hips were Graf grade 3. Average age when first scan was performed was 5 weeks (range 3 weeks to 22 weeks. Analysis of risk factors in 119 babies with abnormal scan was consistent with literature (83 breech, 12 family history, 12 HBW, 10 instability and 2 twins of breech. Twelve babies (16 hips required treatment and were successfully treated in Pavlik harness. There was one case of missed/late dislocation, which lived in outside catchment area for 3 years since birth. During this study period there was no case of avascular necrosis or femoral nerve palsy as a result of treatment. In our experience, selective hip screening by ultrasound scan is useful in avoiding overtreatment and minimizing late presentations.

  6. Mechanisms for decoration of dislocations by small dislocation loops under cascade damage conditions

    DEFF Research Database (Denmark)

    Trinkaus, H.; Singh, B.N.; Foreman, A.J.E.

    1997-01-01

    In metals under cascade damage conditions, dislocations are frequently found to be decorated with a high density of small clusters of self-interstitial atoms (SIAs) in the form of dislocation loops, particularly during the early stages of the microstructural evolution in well annealed pure metals....... This effect may arise as a result of either (a) migration and enhanced agglomeration of single SIAs in the form of loops in the strain field of the dislocation or (b) glide and trapping of SIA loops (produced directly in the cascades) in the strain field of the dislocation, In the present paper, both...... of these possibilities are examined. It is shown that the strain field of the dislocation causes a SIA depletion in the compressive as well as in the dilatational region resulting in a reduced rather than enhanced agglomeration of SIAs. (SIA depletion may, however, induce enhanced vacancy agglomeration near dislocations...

  7. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

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

  8. Stress Field of Straight Edge Dislocation in Magnetic Field

    Institute of Scientific and Technical Information of China (English)

    LIU Zhao-long; HU Hai-yun; FAN Tian-you

    2007-01-01

    To study the changes in mechanical properties of materials within magnetic fields and the motion of dislocations,stress fields of dislocation in magnetic field need to be calculated.The straight edge dislocation is of basic importance in various defects.The stress field of straight edge dislocation in an external static magnetic field is determined by the theory of elasticity and electrodynamics according to the Volterra dislocation model for continuous media.This reduces to the known stress field when the magnet field is zero.The results can be used for further study on the strain energy of dislocations and the interactions between dislocations in magnetic fields.

  9. Dislocation dynamics simulations of interactions between gliding dislocations and radiation induced prismatic loops in zirconium

    Science.gov (United States)

    Drouet, Julie; Dupuy, Laurent; Onimus, Fabien; Mompiou, Frédéric; Perusin, Simon; Ambard, Antoine

    2014-06-01

    The mechanical behavior of Pressurized Water Reactor fuel cladding tubes made of zirconium alloys is strongly affected by neutron irradiation due to the high density of radiation induced dislocation loops. In order to investigate the interaction mechanisms between gliding dislocations and loops in zirconium, a new nodal dislocation dynamics code, adapted to Hexagonal Close Packed metals, has been used. Various configurations have been systematically computed considering different glide planes, basal or prismatic, and different characters, edge or screw, for gliding dislocations with -type Burgers vectors. Simulations show various interaction mechanisms such as (i) absorption of a loop on an edge dislocation leading to the formation of a double super-jog, (ii) creation of a helical turn, on a screw dislocation, that acts as a strong pinning point or (iii) sweeping of a loop by a gliding dislocation. It is shown that the clearing of loops is more favorable when the dislocation glides in the basal plane than in the prismatic plane explaining the easy dislocation channeling in the basal plane observed after neutron irradiation by transmission electron microscopy.

  10. Effect of Mg on the Grain Growth and Dislocation Creep of Calcite

    Science.gov (United States)

    Xu, L.

    2004-12-01

    We tested the effect of variations in the amount of the solute impurity (Mg) on grain growth and strength of calcite aggregate. Synthetic marbles were produced by hot isostatic pressing mixtures of powders of calcite and dolomite at 850° C and 300 MPa confining pressure for different intervals (2 to 30 hrs). The HIP treatment resulted in homogeneous aggregates of calcite with Mg content from 0.5 to 17 mol%. Stress stepping tests and constant strain rate tests were used to examine the effect of Mg content on the dislocation creep of calcite. The grain growth rate under static conditions was decreased with Mg content from 7 to 17 mol%, indicating perhaps that grain boundary mobility is suppressed by the solute drag effect. In the diffusion creep at stresses below 40 Mpa, the strength of calcite decreases with increasing Mg content owing to the difference in grain size at 800° C and 300 MPa confining pressure. The contribution of dislocation creep increases with increasing stress, and the transition between diffusion and dislocation creep occurs at higher stresses for the samples with higher magnesium content and smaller grain size. The creep data were fit assuming a composite flow law consisting of a linear combination of diffusion and dislocation creep and a single-valued grain size. The best agreement was obtained by using a dislocation creep law with exponential dependence of strain rate on stress (e.g. Peierls law). More evidence from microstructure is needed to identify the dominant deformation mechanism conclusively. Most of the samples were compressed up to strains of 0.25; small recrystallized grains are formed resulting in a bimodal grain size distribution in some of the deformed samples. Preliminary data shows that the recrystallized grain sizes are smaller for Mg-calcite compared with that of pure calcite. This study will help to understand the effect of impurities on grain-growth kinetics and strain weakening in localized shear zones.

  11. On quantum corrections to dislocations mass

    CERN Document Server

    Kwiatkowski, Grzegorz

    2011-01-01

    Quasi-classical quantization of crystal dislocations field is considered in terms of functional integral. The generalized zeta-function is used to evaluate the functional integral and quantum corrections to mass in quasi-classical approximation. The quantum corrections to few classical solutions of one-dimensional Sin-Gordon model are evaluated with account of rest $n-1$ dimensions. The results are applied to appropriate crystal dislocation models.

  12. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  13. Traumatic Dislocation of the Elbow Joint

    OpenAIRE

    de Haan, Jeroen

    2011-01-01

    textabstractThis thesis addresses the major issues encountered in the diagnosis and treatment of adult elbow dislocation. Firstly, a literary review (Chapters Five and Eight) makes it clear that there is much uncertainty regarding trauma mechanism, biomechanics, and even anatomy (Chapter Two). Furthermore, an overview of the treatment options indicates that there is no uniformity in the treatment modalities applicable to elbow dislocation (Chapter Six). And last but not least, there is no Dut...

  14. Posterior sternoclavicular dislocation: an American football injury

    DEFF Research Database (Denmark)

    Marker, L B; Klareskov, B

    1996-01-01

    Posterior dislocation of the sternoclavicular joint is uncommon, accounting for less than 0.1% of all dislocations. Since 1824 a little more than 100 cases have been reported, and the majority in the past 20 years. A review of published reports suggests that this injury is seen particularly in co...... in connection with American football. A typical case is described. The importance of this injury is that there is often a delay in diagnosis with potentially serious complications....

  15. Atomistic modeling of dislocation-interface interactions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jian [Los Alamos National Laboratory; Valone, Steven M [Los Alamos National Laboratory; Beyerlein, Irene J [Los Alamos National Laboratory; Misra, Amit [Los Alamos National Laboratory; Germann, T. C. [Los Alamos National Laboratory

    2011-01-31

    Using atomic scale models and interface defect theory, we first classify interface structures into a few types with respect to geometrical factors, then study the interfacial shear response and further simulate the dislocation-interface interactions using molecular dynamics. The results show that the atomic scale structural characteristics of both heterophases and homophases interfaces play a crucial role in (i) their mechanical responses and (ii) the ability of incoming lattice dislocations to transmit across them.

  16. Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis.

    Science.gov (United States)

    Beckmann, Nicholas; Crawford, Lindsay

    2016-08-01

    Sternoclavicular injuries are relatively rare, composing less than 1 % of all musculoskeletal fractures or dislocations. When sternoclavicular injuries do occur, they typically present as an isolated dislocation of the sternoclavicular joint without associated fracture of the clavicle or manubrium. However, in patients with unfused medial clavicle physis, sternoclavicular joint injuries can present as a fracture-dislocation through the unfused physis. These physeal injuries are important to recognize as the displaced epiphysis can block reduction of the sternoclavicular joint. We present a case of a 15-year-old female basketball player presenting with suspected sternoclavicular joint injury after sustaining a direct blow to the left shoulder. An initial shoulder CT confirmed the presence of the clinically suspected posterior sternoclavicular dislocation without fracture identified. An MRI of the left sternoclavicular joint was then performed for suspected physeal fracture, which confirmed the presence of a fracture through the medial clavicle physis with anterior displacement of the unossified epiphysis, blocking reduction of the metaphysis. Given the findings on MRI, the pediatric orthropedic surgeon was able to counsel the family of the high likelihood of failed closed reduction of the sternoclavicular joint requiring conversion to open reduction and internal fixation. The patient underwent successful open reduction and internal fixation of the medial clavical physeal fracture after an initial gentle attempt at closed reduction was unsuccessful.

  17. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  18. Conus hip prosthesis.

    Science.gov (United States)

    Wagner, H; Wagner, M

    2001-01-01

    50 years ago, prosthetic replacement of the hip joint ushered in a new epoch in orthopaedics. Total hip replacement made it possible to remove a severely diseased, painful hip and restore normal function and a normal quality of life to the afflicted patient. The early results of total hip replacement are almost all spectacular and hip replacement has become the most successful type of orthopaedic surgery. These good results using an approach that was technically relatively simple resulted in a temptation to implant prosthetic hip joints with ever increasing frequency in ever younger patients. This led to the emergence of new problems, which were not so clearly recognised at the outset: it emerged that the stability of prosthetic hip joints was of limited duration. This had the following consequence: If a total hip prosthesis is implanted in an elderly person whose remaining life-expectancy is shorter than the longevity of the prosthesis, hip replacement is a life-long solution. We can therefore say that, for a patient who has only 10 to 15 years left to live, their hip problem is solved by total hip replacement. For young people, who still have a long life expectancy in front of them, it is different. They will experience failure of the artificial joint and require further surgery. The commonest and most important type of failure in total hip prostheses is aseptic loosening, which is associated with resorption of bone at the site of the prosthesis. The cause of this phenomenon has only gradually been recognised in the course of the years. Initially, the unanimous opinion was that the methacrylate cement, used to fix the components of the prosthesis in the bone, was the definitive cause of aseptic loosening because fissures and fractures of the cement were almost always found during surgical revision of loosened joints. There was talk of "cement disease" and great efforts were made to improve the quality of the cement and the cementing technique. Moreover, even

  19. Chemical theory of dislocation mobility

    Energy Technology Data Exchange (ETDEWEB)

    Gilman, J.J. [Materials Science and Engineering, University of California at Los Angeles, Los Angeles, CA 90095 (United States)]. E-mail: gilman@seas.ucla.edu

    2005-11-15

    Crystal dislocations were invented (circa. 1930) to explain why pure metal crystals are soft compared with homogeneous shear strengths calculated from atomic theory. They do this very well. However, later (circa. 1945) it was found that pure semiconductor crystals (e.g., Ge and Si) have hardnesses at room temperature comparable with calculated homogeneous shear strengths. Furthermore, it was known that pure metal-metalloid crystals (e.g., TiC and WC) are very hard, although they conduct electricity like metals. How can these differences be explained? The differences just outlined cannot be explained by means of a classical mechanical model. However, they can be explained by considering the chemical bonding in differing solid crystals. In particular, hardness depends on the degree of localization of the valence (bonding) electrons. Qualitatively, this is a very old idea. What is new is that it is possible to provide quantitative theories by using the results of quantum chemistry, and relatively simple analysis. Selected sets of crystal types must be treated, of course, just as selected sets of molecules are treated in theoretical chemistry. Otherwise the rationalization becomes unmanageable.

  20. Creep Deformation by Dislocation Movement in Waspaloy

    Directory of Open Access Journals (Sweden)

    Mark Whittaker

    2017-01-01

    Full Text Available Creep tests of the polycrystalline nickel alloy Waspaloy have been conducted at Swansea University, for varying stress conditions at 700 °C. Investigation through use of Transmission Electron Microscopy at Cambridge University has examined the dislocation networks formed under these conditions, with particular attention paid to comparing tests performed above and below the yield stress. This paper highlights how the dislocation structures vary throughout creep and proposes a dislocation mechanism theory for creep in Waspaloy. Activation energies are calculated through approaches developed in the use of the recently formulated Wilshire Equations, and are found to differ above and below the yield stress. Low activation energies are found to be related to dislocation interaction with γ′ precipitates below the yield stress. However, significantly increased dislocation densities at stresses above yield cause an increase in the activation energy values as forest hardening becomes the primary mechanism controlling dislocation movement. It is proposed that the activation energy change is related to the stress increment provided by work hardening, as can be observed from Ti, Ni and steel results.

  1. Predicting dislocation climb: Classical modeling versus atomistic simulations

    OpenAIRE

    Clouet, Emmanuel

    2011-01-01

    International audience; The classical modeling of dislocation climb based on a continuous description of vacancy diffusion is compared to recent atomistic simulations of dislocation climb in body-centered cubic iron under vacancy supersaturation [Phys. Rev. Lett. 105 095501 (2010)]. A quantitative agreement is obtained, showing the ability of the classical approach to describe dislocation climb. The analytical model is then used to extrapolate dislocation climb velocities to lower dislocation...

  2. Empirical potential simulations of interstitial dislocation loops in uranium dioxide

    Science.gov (United States)

    Le Prioux, Arno; Fossati, Paul; Maillard, Serge; Jourdan, Thomas; Maugis, Philippe

    2016-10-01

    Stoichiometric circular shaped interstitial dislocation loop energies are calculated in stoichiometric UO2 by empirical potential simulation. The Burgers vector directions studied are and . The main structural properties of each type of interstitial dislocation loop are determined, including stacking fault energy. Defect energies are compared and a maximum size for stable dislocation loops before transition to dislocation loops is given. A model of dislocation loop energy based on elasticity theory is then fitted on the basis of these simulation results.

  3. Creep of quartz by dislocation and grain boundary processes

    Science.gov (United States)

    Fukuda, J. I.; Holyoke, C. W., III; Kronenberg, A. K.

    2015-12-01

    Wet polycrystalline quartz aggregates deformed at temperatures T of 600°-900°C and strain rates of 10-4-10-6 s-1 at a confining pressure Pc of 1.5 GPa exhibit plasticity at low T, governed by dislocation glide and limited recovery, and grain size-sensitive creep at high T, governed by diffusion and sliding at grain boundaries. Quartz aggregates were HIP-synthesized, subjecting natural milky quartz powder to T=900°C and Pc=1.5 GPa, and grain sizes (2 to 25 mm) were varied by annealing at these conditions for up to 10 days. Infrared absorption spectra exhibit a broad OH band at 3400 cm-1 due to molecular water inclusions with a calculated OH content (~4000 ppm, H/106Si) that is unchanged by deformation. Rate-stepping experiments reveal different stress-strain rate functions at different temperatures and grain sizes, which correspond to differing stress-temperature sensitivities. At 600-700°C and grain sizes of 5-10 mm, flow law parameters compare favorably with those for basal plasticity and dislocation creep of wet quartzites (effective stress exponents n of 3 to 6 and activation enthalpy H* ~150 kJ/mol). Deformed samples show undulatory extinction, limited recrystallization, and c-axis maxima parallel to the shortening direction. Similarly fine-grained samples deformed at 800°-900°C exhibit flow parameters n=1.3-2.0 and H*=135-200 kJ/mol corresponding to grain size-sensitive Newtonian creep. Deformed samples show some undulatory extinction and grain sizes change by recrystallization; however, grain boundary deformation processes are indicated by the low value of n. Our experimental results for grain size-sensitive creep can be compared with models of grain boundary diffusion and grain boundary sliding using measured rates of silicon grain boundary diffusion. While many quartz mylonites show microstructural and textural evidence for dislocation creep, results for grain size-sensitive creep may apply to very fine-grained (<10 mm) quartz mylonites.

  4. [Juvenile hip pain. 2. Femur head epiphysiolysis, hip dysplasia, tumors].

    Science.gov (United States)

    Hackenbruch, W; von Gumppenberg, S; Karpf, P M

    1978-11-09

    The early symptom in hip joint diseases in children is pain. Pain is localized in the groin and thight, but mostly in the knee. Other important signs are limping and reduced internal rotation. If a hip disease is suspected it is necessary to take X-rays in two planes. If diagnosis is early and special therapy started immediately, the results are usually excellent without deformation of the hip. Otherwise early osteoarthritis can develop. This is important because osteoarthritis in the hip joint is in 75% of the cases due to hip joint diseases in childhood. The problems of diagnosis and treatment of the most common hip joint diseases in children (transient synovitis, rheumatoid arthritis, osteomyelitis, Legg-Perthes disease, slipped capital femoral epiphysis, dysplasia, tumors) are discussed.

  5. Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

    Directory of Open Access Journals (Sweden)

    Faria MY

    2016-08-01

    Full Text Available Mun Yueh Faria,1–3 Nuno Pinto Ferreira,1–3 Joana Medeiros Pinto,1–3 David Cordeiro Sousa,1–3 Ines Leal,1–3 Eliana Neto,1–3 Carlos Marques-Neves1–3 1Centro de Estudos da Visão, Universidade de Lisboa, 2Department of Ophthalmology, Hospital de Santa Maria, 3Faculty of Medicine, University of Lisbon, Lisbon, Portugal Background: Nowadays, dislocated intraocular lenses (IOLs and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL.Methods: This study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had dislocated three-piece IOL. The latter underwent iris suture of the same IOL and were excluded from this study. The remaining 66 eyes with dislocated one-piece IOL underwent pars plana vitrectomy, that is, explantation of dislocated IOL through corneal incision and an implantation of retropupillary ICIOL. Operative data and postoperative outcomes included best corrected visual acuity, IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and anterior chamber depth.Results: The mean follow-up was 23 months (range: 6–48 months. The mean preoperative best corrected visual acuity was 1.260±0.771 logMAR, and postoperative best corrected visual acuity was 0.352±0.400 logMAR units. Mean vision gain was 0.909 logMar units. The patients had the following complications: 1 retinal detachment was found in one patient, 2 corneal edema was found in three patients, 3 high intraocular pressure was observed in

  6. Nonarthritic hip joint pain.

    Science.gov (United States)

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

    2014-06-01

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

  7. [Iritis with destabilization of the intraocular pressure due to dislocation of a posterior chamber intraocular lens].

    Science.gov (United States)

    Handzel, D M

    2012-04-01

    This report concerns the case of a 67-year-old male patient who underwent uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL). After an interval of 2 months the patient developed iritis together with an uncontrollable increase in intraocular pressure. After a detailed examination a dislocated haptic of the IOL was identified as the cause of the symptoms. The dislocation had led to uveitis-glaucoma-hyphema syndrome although no hemorrhage was observed. In addition to this complication the haptic had arroded the zonular complex which made implantation of an anterior chamber lens necessary. Although improvements in operating techniques, lens materials and designs have been made uveitis-glaucoma-hyphema syndrome has to be kept in mind. Surgical intervention is the only therapeutic option.

  8. Pars plana vitrectomy with posterior iris claw implantation for posteriorly dislocated nucleus and intraocular lens

    Directory of Open Access Journals (Sweden)

    Kishor B Patil

    2011-01-01

    Full Text Available We evaluated the safety and efficacy of pars plana vitrectomy (PPV with primary posterior iris claw intraocular lens (IOL implantation in cases of posterior dislocation of nucleus and IOL without capsular support. This was a retrospective interventional case series. Fifteen eyes underwent PPV with primary posterior iris claw IOL implantation performed by a single vitreoretinal surgeon. The main outcome measures were changes in best corrected visual acuity and anterior and posterior segment complications. A total of 15 eyes were included in this study. Eight had nucleus drop, three had IOL drop during cataract surgery and four had traumatic posterior dislocation of lens. The final postoperative best corrected visual acuity was 20/60 or better in 11 patients. This procedure is a viable option in achieving good functional visual acuity in eyes without capsular support.

  9. Anchor-induced chondral damage in the hip.

    Science.gov (United States)

    Matsuda, Dean K; Bharam, Srino; White, Brian J; Matsuda, Nicole A; Safran, Marc

    2015-01-01

    The purpose of this study is to investigate the outcomes from anchor-induced chondral damage of the hip, both with and without frank chondral penetration. A multicenter retrospective case series was performed of patients with chondral deformation or penetration during initial hip arthroscopic surgery. Intra-operative findings, post-surgical clinical courses, hip outcome scores and descriptions of arthroscopic treatment in cases requiring revision surgery and anchor removal are reported. Five patients (three females) of mean age 32 years (range, 16-41 years) had documented anchor-induced chondral damage with mean 3.5 years (range, 1.5-6.0 years) follow-up. The 1 o'clock position (four cases) and anterior and mid-anterior portals (two cases each) were most commonly implicated. Two cases of anchor-induced acetabular chondral deformation without frank penetration had successful clinical and radiographic outcomes, while one case progressed from deformation to chondral penetration with clinical worsening. Of the cases that underwent revision hip arthroscopy, all three had confirmed exposed hard anchors which were removed. Two patients have had clinical improvement and one patient underwent early total hip arthroplasty. Anchor-induced chondral deformation without frank chondral penetration may be treated with close clinical and radiographic monitoring with a low threshold for revision surgery and anchor removal. Chondral penetration should be treated with immediate removal of offending hard anchor implants. Preventative measures include distal-based portals, small diameter and short anchors, removable hard anchors, soft suture-based anchors, curved drill and anchor insertion instrumentation and attention to safe trajectories while visualizing the acetabular articular surface.

  10. Anchor-induced chondral damage in the hip

    Science.gov (United States)

    Matsuda, Dean K.; Bharam, Srino; White, Brian J.; Matsuda, Nicole A.; Safran, Marc

    2015-01-01

    The purpose of this study is to investigate the outcomes from anchor-induced chondral damage of the hip, both with and without frank chondral penetration. A multicenter retrospective case series was performed of patients with chondral deformation or penetration during initial hip arthroscopic surgery. Intra-operative findings, post-surgical clinical courses, hip outcome scores and descriptions of arthroscopic treatment in cases requiring revision surgery and anchor removal are reported. Five patients (three females) of mean age 32 years (range, 16–41 years) had documented anchor-induced chondral damage with mean 3.5 years (range, 1.5–6.0 years) follow-up. The 1 o'clock position (four cases) and anterior and mid-anterior portals (two cases each) were most commonly implicated. Two cases of anchor-induced acetabular chondral deformation without frank penetration had successful clinical and radiographic outcomes, while one case progressed from deformation to chondral penetration with clinical worsening. Of the cases that underwent revision hip arthroscopy, all three had confirmed exposed hard anchors which were removed. Two patients have had clinical improvement and one patient underwent early total hip arthroplasty. Anchor-induced chondral deformation without frank chondral penetration may be treated with close clinical and radiographic monitoring with a low threshold for revision surgery and anchor removal. Chondral penetration should be treated with immediate removal of offending hard anchor implants. Preventative measures include distal-based portals, small diameter and short anchors, removable hard anchors, soft suture-based anchors, curved drill and anchor insertion instrumentation and attention to safe trajectories while visualizing the acetabular articular surface. PMID:27011815

  11. Dislocation Dynamics in Al-Li Alloys. Mean Jump Distance and Activation Length of Moving Dislocations

    NARCIS (Netherlands)

    Hosson, J.Th.M. De; Huis in 't Veld, A.; Tamler, H.; Kanert, O.

    1984-01-01

    Pulsed nuclear magnetic resonance proved to be a complementary new technique for the study of moving dislocations in Al-Li alloys. The NMR technique, in combination with transmission electron microscopy and strain-rate change experiments have been applied to study dislocation motion in Al-2.2 wt% Li

  12. Quantum dynamics of a single dislocation

    Science.gov (United States)

    de Gennes, Pierre-Gilles

    We discuss the zero temperature motions of an edge dislocation in a quantum solid (e.g., He4). If the dislocation has one kink (equal in length to its Burgers vector b) the kink has a creation energy U and can move along the line with a certain transfer integral t. When t and U are of comparable magnitude, two opposite kinks can form an extended bound state, with a size l. The overall shape of the dislocation in the ground state is then associated with a random walk of persistence length l (along the line) and hop sizes b. We also discuss the motions of kinks under an applied shear stress σ: the glide velocity is proportional to exp(-σ*/σ), where σ* is a characteristic stress, controlled by tunneling processes. Mouvements quantiques d'une dislocation. On analyse le mouvement à température nulle d'une dislocation coin dans un solide quantique (He4). La dislocation peut avoir un cran (d'énergie U) dans son plan de glissement. Le cran peut avancer ou reculer le long de la dislocation par effet tunnel, avec une certaine intégrale de transfert t. Deux crans de signe opposé peuvent former un état lié. En présence d'une contrainte extérieure σ, la ligne doit avancer avec une vitesse ~exp(-σ*/σ) où σ* est une contrainte seuil, contrôlée par l'effet tunnel.

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

    Directory of Open Access Journals (Sweden)

    Junwei Sun

    2014-01-01

    Full Text Available Some important dynamical properties of the memristor chaotic oscillator system have been studied in the paper. A novel hybrid dislocated control method and a general hybrid projective dislocated synchronization scheme have been realized for memristor chaotic oscillator system. The paper firstly presents hybrid dislocated control method for stabilizing chaos to the unstable equilibrium point. Based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization has been studied for the drive memristor chaotic oscillator system and the same response memristor chaotic oscillator system. For the different dimensions, the memristor chaotic oscillator system and the other chaotic system have realized general hybrid projective dislocated synchronization. Numerical simulations are given to show the effectiveness of these methods.

  14. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    OpenAIRE

    Sporer, Scott M.; Bernard R. Bach, Jr

    2009-01-01

    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, Sc...

  15. Negative Pressure Pulmonary Edema Associated with Anterior Cervical Spine Surgery

    Science.gov (United States)

    Yoneda, Masana; Tanaka, Yasuhito

    2014-01-01

    We report a very rare case of negative pressure pulmonary edema (NPPE) that occurred immediately after anterior cervical discectomy and fusion (ACDF). The patient was a 25-year-old man who sustained a facet fracture-dislocation of C5 during a traffic accident. After ACDF, he developed NPPE and needed mechanical ventilation. Fortunately, he recovered fully within 24 hours. NPPE is a rare postoperative complication that may occur after cervical spine surgery. The aims of this report are to present information regarding the diagnosis and emergent treatment of NPPE, and to review the previous literature regarding this serious complication. PMID:25558327

  16. Salam: Of Dislocation, Marginality and Flexibility

    Directory of Open Access Journals (Sweden)

    Efenita M. Taqueban

    2012-12-01

    Full Text Available This paper reconstructs the life stories of residents of SalamCompound. The compound serves as entry point for many Muslim migrants who leave the southern Philippines. Salam is both a refuge and a halfway point. A sense of dislocation permeates the stories. Dislocation begins with the movement away from a homeland that is familiar and defining of identity. The dislocation is, in a sense, an escape, a desperate project to avoid armed conflict in the southern Philippines or a desperate enterprise in search of work.Salam is a halfway point for transients prospecting for overseas work, the staging area for a global labor exodus. The sense of dislocation is not unlike locating oneself in the margins, portrayed in the residents’ negotiated identitiesand spaces, constantly challenged, implicitly regulated. Dislocation is also depicted as flexibility, portrayed by the residents making do and their everyday creative resistance and struggle in new locations in the city. Gathered throughethnographic method, the stories offer a glimpse into the lives of the residents of the compound, how they negotiate around social constructions of identities — resisting and accommodating internal and external forces that impinge ontheir lives, revealing a rich and poignant tapestry of family relations, community ironies and an ever-impinging world beyond its walls.

  17. Isolated dorsal dislocation of the tarsal naviculum

    Directory of Open Access Journals (Sweden)

    Kaziz Hamdi

    2015-01-01

    Full Text Available Isolated dislocation of the tarsal naviculum is an unusual injury, scarcely reported in the literature. The naviculum is surrounded by the rigid bony and ligamentous support hence fracture dislocation is more common than isolated dislocation. The mechanism and treatment options remain unclear. In this case report, we describe a 31 year old man who sustained an isolated dorsal dislocation of the left tarsal naviculum, without fracture, when he was involved in a motor vehicle collision. The reported mechanism of the dislocation is a hyper plantar flexion force applied to the midfoot, resulting in a transient disruption of the ligamentous support of the naviculum bone, with dorsal displacement of the bone. The patient was treated with open reduction and Krischner-wire fixation of the navicular after the failure of closed reduction. The wires were removed after 6 weeks postoperatively. Physiotherapy for stiffness and midfoot pain was recommended for 2 months. At 6 months postoperatively, limping, midfoot pain and weakness were reported, no X-ray abnormalities were found. The patient returned to his obvious activities with a normal range of motion.

  18. Use of cervical collar in temporomandibular dislocation.

    Science.gov (United States)

    Jaisani, Mehul R; Pradhan, Leeza; Sagtani, Alok

    2015-06-01

    Dislocation of the temporomandibular joint represents 3 % of all reported dislocated joints. In the last 3 decades many cases of TMJ dislocation have been reported with a wide variety of treatment options ranging from non-surgical conservative approaches to open joint procedures. The question remains whether one method is superior to the others. Conservative treatments are still the option in this part of the continent due to financial constraints and as well as due to availability of skilled manpower. A variety of conservative techniques have been described for reducing dislocations, all of which require 10-14 days of immobilization of the jaw post reduction so as to prevent further episodes of dislocation. Immobilization of the jaw can be done in the form of barrel bandage, barton bandage, head chin cap or maxillomandibular fixation using arch bars. We suggest the use of a cervical collar as a form of post reduction immobilization technique to overcome the inherent disadvantages of conventional forms of immobilization techniques.

  19. High dislocation density of tin induced by electric current

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Yi-Han; Liang, Chien-Lung; Lin, Kwang-Lung, E-mail: matkllin@mail.ncku.edu.tw [Department of Material Science and Engineering, National Cheng Kung University, Tainan 70101, Taiwan, R. O. C (China); Wu, Albert T. [Department of Chemical and Material Engineering, National Central University, Jhongli 32001, Taiwan, R. O. C (China)

    2015-12-15

    A dislocation density of as high as 10{sup 17} /m{sup 2} in a tin strip, as revealed by high resolution transmission electron microscope, was induced by current stressing at 6.5 x 10{sup 3} A/ cm{sup 2}. The dislocations exist in terms of dislocation line, dislocation loop, and dislocation aggregates. Electron Backscattered Diffraction images reflect that the high dislocation density induced the formation of low deflection angle subgrains, high deflection angle Widmanstätten grains, and recrystallization. The recrystallization gave rise to grain refining.

  20. [Postoperative management of hip and knee endoprostheses].

    Science.gov (United States)

    Seitz, S; Rüther, W

    2012-10-01

    Rheumatoid arthritis is often accompanied by massive destruction of the smaller and larger joints even with early therapy using antirheumatic drugs. In these cases total joint arthroplasty is the only surgical option, especially for the knee and hip joint. Knowledge of the specific disease-related postoperative characteristics is a prerequisite for the successful treatment of patients with rheumatoid arthritis. As dislocation of the arthroplastic joint does not occur more often in rheumatoid arthritis, the risk of periprosthetic infection is increased due to the use of biologicals. Therefore, a perioperative optimization is obligatory. In order to facilitate independence in daily living physiotherapy in combination with aids such as arthritis crutches, gripping pliers or raised toilet seat need to be started as soon as possible after surgical treatment. To achieve this goal it is recommended to refer patients with inflammatory arthritis to inpatient rehabilitation facilities. With respect to the specific postoperative treatment after joint replacement the long-term results are comparable with those from patients with primary osteoarthritis.

  1. Hip and Knee Osteoarthritis Affects Younger People, Too.

    Science.gov (United States)

    Ackerman, Ilana N; Kemp, Joanne L; Crossley, Kay M; Culvenor, Adam G; Hinman, Rana S

    2017-02-01

    Synopsis Although osteoarthritis (OA) has traditionally been considered a disease of older age, hip and knee OA can and does affect younger adults, with a profound impact on psychosocial well-being and work capacity. Obesity and a history of traumatic knee injury (eg, anterior cruciate ligament rupture and/or meniscal tear) are key risk factors for the accelerated development of knee OA, while structural hip deformities (including those contributing to femoroacetabular impingement syndrome) are strong predictors of early-onset hip OA. In view of these associations, rising rates of obesity and sports injuries are concerning, and may signal a future surge in OA incidence among younger people. Assessment of hip and knee OA in younger people should focus on a patient-centered history, comprehensive physical examination, performance-based measures, and patient-reported outcome measures to enable monitoring of symptoms and function over time. Referral for imaging should be reserved for people presenting with atypical signs or symptoms that may indicate diagnoses other than OA. Nonpharmacological approaches are core strategies for the management of hip and knee OA in younger people, and these include appropriate disease-related education, activity modification (including for work-related tasks), physical therapist- prescribed exercise programs to address identified physical impairments, and weight control or weight loss. High-quality evidence has shown no benefit of arthroscopy for knee OA, and there are no published clinical trials to support the use of hip arthroscopy for OA. Referral for joint-conserving or joint replacement surgery should be considered when nonpharmacological and pharmacological management strategies are no longer effective. J Orthop Sports Phys Ther 2017;47(2):67-79. doi:10.2519/jospt.2017.7286.

  2. Successful Conservative Management of a Dislocated IUD.

    Science.gov (United States)

    Inal, Hasan Ali; Ozturk Inal, Zeynep; Alkan, Ender

    2015-01-01

    Background. Intrauterine contraceptive devices (IUDs) are widely utilized all over the world owing to their low cost and high efficacy. Uterine perforation is a rare complication that may occur at IUD insertion resulting in extrauterine location of the IUD. Traditionally, surgical removal of dislocated IUDs has been recommended. Case. A 68-year-old patient who had an IUD (Lippes loop) inserted 32 years ago and whose routine examination incidentally revealed a dislocated IUD in the abdominal cavity. The patient remained asymptomatic during three years of follow-up and the IUD was left in place. Conclusion. Asymptomatic patients, whose vaginal examinations and ultrasonography or X-ray results reveal a dislocated IUD, may benefit from conservative management.

  3. Micromechanics and dislocation theory in anisotropic elasticity

    CERN Document Server

    Lazar, Markus

    2016-01-01

    In this work, dislocation master-equations valid for anisotropic materials are derived in terms of kernel functions using the framework of micromechanics. The second derivative of the anisotropic Green tensor is calculated in the sense of generalized functions and decomposed into a sum of a $1/R^3$-term plus a Dirac $\\delta$-term. The first term is the so-called "Barnett-term" and the latter is important for the definition of the Green tensor as fundamental solution of the Navier equation. In addition, all dislocation master-equations are specified for Somigliana dislocations with application to 3D crack modeling. Also the interior Eshelby tensor for a spherical inclusion in an anisotropic material is derived as line integral over the unit circle.

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

    DEFF Research Database (Denmark)

    Heitmann, B L; Lissner, L

    2011-01-01

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

  5. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten; Maagaard, Niels

    2016-01-01

    and Pincer resection in 93.5% of the cases. Labral refixation or repair was done in 70.3% of the cases. The most common type of acetabular chondral damage was grade II lesions (36.6%). Grade III and IV changes were seen in 36.1% of the cases. The preoperative iHOT12 was 45 (mean) based on all 12 items. EQ-5D....... The problems with development and maintaining a large clinical registry are described and further studies are needed to validate data completeness. We consider the development of a national clinical registry for hip arthroscopy as a successful way of developing and maintaining a valuable clinical...

  6. Dislocation evolution with rheological forming of metal

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    It is known that some internal defects exist in metal materials. Preliminary attempt to relate dislo cation evolution with metal rheological forming was done. By the attempt, it is learned that the evolution of dislocation density p( x, y, t ) is essentially the change of n independent internal variables qα (α = 1, 2, …n ) with material. The preliminary research in theory and experiments showed that dislocations piling-up could be avoided. One can improve the internal microstructure and mechanical properties of products by rheological forming method.

  7. Chondroblastoma of the femoral neck as a cause of hip synovitis.

    Science.gov (United States)

    Kaneko, Hiroshi; Kitoh, Hiroshi; Wasa, Junji; Nishida, Yoshihiro; Ishiguro, Naoki

    2012-03-01

    Chondroblastoma is a rare benign chondroid bone tumor, which typically arises from the epiphysis of a long tubular bone. We present a 13-year-old girl with persistent hip synovitis caused by a chondroblastoma that arose from the femoral neck (metaphysis) and uniquely extended extraosseously into the hip joint. Computed tomography scan clearly demonstrated a tumoral lesion of the left femoral neck and a periosteal reaction along the anterior cortex of the femur, distal to the legion. Magnetic resonance imaging showed reactive synovitis with marked joint effusion of the hip and an extensive edema in the proximal femur and the surrounding soft tissues. Aneurysmal bone cysts formation secondary to chondroblastoma was confirmed by histologic examinations of the excised specimens. Complete relief of pain and an improvement in the range of movement of the hip joint was obtained after surgical resection of the tumor.

  8. A study of the "capsular" shadow in disorders of the hip in children.

    Science.gov (United States)

    Brown, I

    1975-05-01

    Displacement and blurring of the soft-tissue shadows about the hip has been described in several conditions, particularly in transient synovitis. A study was made between such displacements and the posture commonly adopted by an "irritable hip". Examination of radiographs of normal hips, and of those in cases of transient synovitis and Perthes' disease showed that the appearance of "capsular swelling" is related to the position of lateral rotation and abduction. This was confirmed by anatomical dissections of the lateral plane, which appears to be an intermuscular plane lying anterior to the hip, and an explantation is given for the blurring which may accompany its lateral displacement. "Capsular swelling" appears to be a radiological artefact.

  9. Surgical treatment of synovial osteochondromatosis of the hip using a modified-Hardinge approach with a Z-shaped capsular incision

    Directory of Open Access Journals (Sweden)

    Yu Takeda

    2015-12-01

    Full Text Available Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip.

  10. Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

    Science.gov (United States)

    Faria, Mun Yueh; Ferreira, Nuno Pinto; Pinto, Joana Medeiros; Sousa, David Cordeiro; Leal, Ines; Neto, Eliana; Marques-Neves, Carlos

    2016-01-01

    Background Nowadays, dislocated intraocular lenses (IOLs) and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL) are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL. Methods This study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had