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Sample records for anterior hip dislocation

  1. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

    Directory of Open Access Journals (Sweden)

    Kumar Sunil

    2014-02-01

    Full Text Available 【Abstract】Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.

  2. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

    Institute of Scientific and Technical Information of China (English)

    Sunil Kumar; Akhilesh Rathi; Sunil Sehrawat; Vikas Gupta; Jatin Talwar; Sumit Arora

    2014-01-01

    Open anterior dislocation of the hip is a very rare injury,especially in adults.It is a hyperabduction,external rotation and extension injury.Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature.Primary resuscitation,debridement,urgent reduction of dislocation,and adequate antibiotic support resulted in good clinical outcome in our patient.At 18 months followup,no signs of avascular necrosis of the femoral head or infection were observed.

  3. 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.

  4. Bilateral anterior shoulder dislocation

    OpenAIRE

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

    2013-01-01

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

  5. Do normal hips dislocate?

    Science.gov (United States)

    Alshameeri, Zeiad; Rehm, Andreas

    2014-11-01

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

  6. Hip dysplasia and congenital hip dislocation

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-11-01

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

  7. Surgical hip dislocation: techniques for success.

    Science.gov (United States)

    Ricciardi, Benjamin F; Sink, Ernest L

    2014-01-01

    Surgical hip dislocation (SHD) is a versatile approach used to address both intra-articular and extra-articular pathology around the hip joint in both pediatric and adult patients. It allows anterior dislocation of the femoral head for direct visualization of the hip joint while preserving femoral head vascularity and minimizing trauma to the abductor musculature. Previously described indications for SHD include femoroacetabular impingement, deformity resulting from Legg-Calve-Perthes disease, slipped capital femoral epiphysis, periarticular trauma, benign lesions of the hip joint, and osteochondral lesions. In this review, we will describe current surgical techniques, indications, and clinical outcomes for SHD. PMID:25207733

  8. 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.

  9. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

  11. CT findings of traumatic posterior hip dislocation after reduction

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

    To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients.

  12. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  13. Anterior Approach Total Hip Replacement

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    Full Text Available ... Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the anterior supine ... renewed interest at this time due to several advantages that it brings. The approach that is performed ...

  14. A Bilateral Traumatic Hip Obturator Dislocation

    Science.gov (United States)

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

    2016-01-01

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

  15. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    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.

  16. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  17. Total hip arthroplasty in paralytic dislocation from poliomyelitis.

    Science.gov (United States)

    Laguna, Rafael; Barrientos, Jesús

    2008-02-01

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

  18. Surgical hip dislocation for treatment of cam femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    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.

  19. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    OpenAIRE

    Er, Mehmet Serhan; Eroglu, Mehmet; Erten, Recep Abdullah; Metineren, Hasan; Altinel, Levent

    2015-01-01

    Anterior shoulder dislocations are the most common major joint dislocations encountered in the emergency departments and fractures of proximal humerus can accompany with dislocations. Although the treatment of acute isolated traumatic anterior shoulder dislocation is generally simple, the treatment of neglected fracture-dislocations becomes more complicated. In this report, a 22-year-old male patient who had posttraumatic locked, shoulder fracture-dislocation is presented. Open reduction and ...

  20. Congenital dislocation of the hip. A review.

    Science.gov (United States)

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

    1981-08-01

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

  1. Audit on necessity of radiographs in anterior shoulder dislocations

    OpenAIRE

    K. Ahmadi, M.D; M. Mofidi, M.D.

    2008-01-01

    AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior should...

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

    OpenAIRE

    Pranita viveki; R. G. Viveki

    2014-01-01

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

  3. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

    Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand). He complained of...

  4. Inferior hip dislocation after falling from height: A case report

    Science.gov (United States)

    Tekin, Ali Çağrı; Çabuk, Haluk; Büyükkurt, Cem Dinçay; Dedeoğlu, Süleyman Semih; İmren, Yunus; Gürbüz, Hakan

    2016-01-01

    Introduction Traumatic inferior hip dislocation is the least common of all hip dislocations. Adult inferior hip dislocations usually occur after high-energy trauma, very few cases are reported without fracture. Presentation of case A 26-year-old female was brought to the emergency department with severe pain in the left hip, impaired posture and restricted movement following a fall from 15 m height. The hip joint was fixed in 90° flexion, 15° abduction, and 20° external rotation. No neurovascular impairment was determined. On radiologic examination, a left ischial type inferior hip dislocation was detected. Hemorrhagic shock which developed due to acute blood loss to thoracic and abdominal cavity and patient died at third hour after she was brought to the hospital. Discussion Traumatic hip dislocations have high morbidity and mortality rates due to multiple organ damage, primarily of the extremities, chest and abdomen. In the treatment of traumatic hip dislocation, closed reduction is recommended through muscle relaxation under general anesthesia or sedation. This procedure should be applied before any intervention for concomitant extremity injuries. A detailed evaluation on emergency presentation, a multi-disciplinary approach and early diagnosis with the rapid application of imaging methods could be life-saving for such patients. PMID:27058153

  5. Anterior Longitudinal Osteotomy of the Greater Trochanter in Total Hip Arthroplasty.

    Science.gov (United States)

    Surace, Michele F; Regazzola, Gianmarco M V; Vulcano, Ettore; Monestier, Luca; Cherubino, Paolo

    2015-08-01

    The extra-articular impingement of the greater trochanter against the ileum is an underrated cause of early dislocation in total hip arthroplasty. In this preliminary study, the authors assess the effectiveness of an anterior longitudinal osteotomy of the greater trochanter for preventing dislocation. A total of 115 patients underwent a total hip arthroplasty through a posterolateral approach. All patients underwent clinical and radiological follow-up at 1, 3, and 6 months. No dislocation was reported. All patients demonstrated fast recovery of range of motion and walking. No trochanter fractures were observed. The osteotomy of the greater trochanter is an effective surgical technique that decreases anterior impingement and consequently lowers the dislocation rate in primary total hip arthroplasty. [Orthopedics. 2015; 38(8):490-493.]. PMID:26313167

  6. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... if, dislocations aside, what about just choice of bearing based on a patient activity? Are you comfortable ... Do you concerns about you post-op weight bearing restrictions with a collarless stem?” No. Okay. I ...

  7. Traumatic hip dislocation with associated femoral head fracture

    DEFF Research Database (Denmark)

    Dortaj, H; Emamifar, A

    2015-01-01

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

  8. Anterior Approach Total Hip Replacement

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    Full Text Available ... the benefits of the Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement ... to your questions that you send in by e-mail. The e- mail button is at the ...

  9. Anterior Approach Total Hip Replacement

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  10. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... we’re doing a right hip. She has mild dysplasia with cystic changes and loss of joint ... different. Yeah. But, you know, even with this mild dysplasia and slight anteversion. Yeah. The point here ...

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

    Directory of Open Access Journals (Sweden)

    Pranita viveki

    2014-11-01

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

  12. Anterior Approach Total Hip Replacement

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    Full Text Available ... it to have any real negative or deleterious effect by removing the anterior capsule. Now I would ... is what happens with one of the competitive designs. Like I told you, I just take a ...

  13. Anterior Approach Total Hip Replacement

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    Full Text Available ... and I’m able to use a modern generation highly cross-linked, highly eradiated, and then vitamin ... commode. Delta ceramic hip, this is the next generation ceramic. 32 enlarger, there’s been no reported fractures. ...

  14. Anterior Approach Total Hip Replacement

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    Full Text Available ... of the Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the ... a little diaper so we’re seeing less skin and more -- Here we go. Here’s what we’ ...

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

    Directory of Open Access Journals (Sweden)

    Bhagwat Kishan R

    2012-04-01

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

  16. Simple self-reduction method for anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2014-01-01

    Conclusion: The presented Boss-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.

  17. Audit on necessity of radiographs in anterior shoulder dislocations

    Directory of Open Access Journals (Sweden)

    K. Ahmadi, M.D

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior shoulder dislocation were referred to Hazrat Rasoul Akram and Haftome Tir Hospitals emergency departments in Tehran, and were investigated for a one year period. The emergency physicians evaluated and documented the possibility of dislocation or relocation, before obtaining radiographs. Outcome measures were the assessment of joint positions on the x-rays by an orthopedic surgeon.Results: 84 cases (72% were male and 32 cases (28% were female. Mean age of the patients was 31.5±8.5 yrs. Thirty (30 patients had recurrent dislocations without traumatic mechanism (group 1 and eighty six (86 patients had no prior dislocation or a blunt mechanism of injury (group 2. The accuracy of the emergency physician’s assessment in dislocations was 100% in group 1 and 98% in group 2. False assessments occurred only in patients with fractures. There is no significant difference between emergency physicians and orthopedic surgeons in the assessment of dislocations and relocations, when the emergency physicians did accuralty diagnose them.Conclusion: Our study showed that the physicians are highly accurate in clinical determination of anterior shoulder dislocation and relocation. Pre-reduction films should be obtained when the mechanism of injury is trauma. Post-reduction films should be obtained in fracture-dislocations or when the physicians are uncertain of correct relocation.

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

    OpenAIRE

    Yashavantha Kumar C; Nalini K B; Lalit Maini; Prashanth Nagaraj

    2013-01-01

    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 dislo...

  19. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

  20. An Unexpected Complication of Hip Arthroplasty: Knee Dislocation

    Directory of Open Access Journals (Sweden)

    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.

  1. Dislocations

    Science.gov (United States)

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

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

    OpenAIRE

    Denard, Patrick J.; Xuesong Dai; 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. Patient...

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

    Science.gov (United States)

    Iwasaki, K

    1983-07-01

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

  4. Differentiating subluxation from developmental dislocation of the hip

    Directory of Open Access Journals (Sweden)

    Joao O. Tavares

    2012-02-01

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

  5. Bilateral anterior shoulder fracture-dislocation : A case report and a review of the literature

    OpenAIRE

    Dinopoulos, H. T.; Giannoudis, P. V.; Smith, R. M.; Matthews, S.J.

    1999-01-01

     We report an unusual case of bilateral anterior shoulder dislocation following trauma. Previously reported cases were either of bilateral dislocations or bilateral fracture dislocations. In our case the patient suffered bilateral anterior dislocation with a three part fracture dislocation on the right. A review of the literature is presented.

  6. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

    Directory of Open Access Journals (Sweden)

    Deepak

    2015-06-01

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

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

    Science.gov (United States)

    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

  8. Endovascular treatment of axillary artery dissection following anterior shoulder dislocation.

    Science.gov (United States)

    Fass, G; Barchiche, M Reda; Lemaitre, J; De Quin, I; Goffin, C; Bricart, R; Bellens, B

    2008-01-01

    Injury to the axillary artery is a rare complication of anterior shoulder dislocation. Open surgical repair is technically demanding because of the anatomical position of the vessel and the propensity for concomitant injuries. Standard surgical exposure techniques involve extensive dissection, including a combination of supraclavicular or infraclavicular incision, median sternotomy, and thoracotomy causing significant morbidity and mortality rates. Endovascular techniques may offer an alternative to these surgically demanding procedures. We present a patient with a traumatic dissection of the axillary artery following anterior shoulder dislocation who was successfully managed with an endovascular stent. PMID:18411587

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Simple self-reduction method for anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Pemberton technique in congenital hip dislocation

    OpenAIRE

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

    2004-01-01

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

  12. Asymmetric traumatic bilateral dislocation of hip. Case report

    Directory of Open Access Journals (Sweden)

    Pedro Gonzalo González González

    2009-05-01

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

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

    OpenAIRE

    Aritamur, Ayhan; Cakmak, Mehmet; Taser, Omer

    2004-01-01

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

  14. 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.)

  15. Imaging of traumatic dislocation of the hip in childhood

    International Nuclear Information System (INIS)

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

  16. 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.

  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. 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.

  19. The external rotation method for reduction of acute anterior shoulder dislocations

    OpenAIRE

    Marinelli, Mario; de Palma, Luigi

    2009-01-01

    Background Shoulder dislocations account for almost 50% of all joint dislocations, and are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the external rotation method (ERM) in the reduction of acute anterior shoulder dislocation. Materials and methods Between August 2006 and April 2007, ERM was applied to 31 patients who presented with traumatic anterior shoulder dislocation to the Emergency Department of our Ho...

  20. Bilateral Anterior Shoulder Dislocation with Symmetrical Greater Tuberosity Fracture following Seizure

    OpenAIRE

    Suryavanshi, Ashish; Mittal, Amber; Dongre, Snehal; Kashyap, Neeti

    2012-01-01

    Introduction: Majority of bilateral shoulder dislocations are posterior. Simultaneous bilateral anterior shoulder dislocations and bilateral anterior fracture-dislocations are rare and mostly of traumatic origin. We present a rare case of bilateral anterior shoulder dislocation with symmetrical greater tuberosity fracture following an episode of seizure with an unusual injury mechanism which was treated conservatively. Case Report: A 45 year old office worker presented to the Casualty of our ...

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

    Directory of Open Access Journals (Sweden)

    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

  2. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department

    OpenAIRE

    Baykal, B; Sener, S; Turkan, H

    2005-01-01

    Background: Shoulder dislocations account for almost 50% of all joint dislocations, which are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the scapular manipulation technique (SMT) to reduce traumatic anterior shoulder dislocations.

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

    International Nuclear Information System (INIS)

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

  4. A Case of Neglected Bilateral Anterior Shoulder Dislocation: A Rare Entity with Unusual Mechanism of Injury

    OpenAIRE

    Raghuram Choulapalle; Ramu Chokkarapu; Ravi Kanth Kolluri; Sreedhar Reddy Anne; Shanmuga Raju Perumal; Pavan Kumar Avadhanam; Ramesh Bheemanathuni

    2015-01-01

    Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury; both hands of the patient were pulled from either side. To the best of our knowledge, this unusual ...

  5. Bilateral Anterior Fracture-Dislocation of Shoulder Joint- A rare case with Delayed Presentation

    OpenAIRE

    Sunku, Nithin; Kalaiah, Kiran; Marulasidappa, G.; Gopinath, P

    2012-01-01

    Introduction: The shoulder is the most frequently dislocated joint. Bilateral glenohumeral dislocations are rare and almost always posterior. Bilateral anterior fracture dislocations of humeral neck in a patient with seizure are extremely rare. We report one such case of delayed presentation of bilateral anterior fracture dislocation of shoulder after an epileptic attack. Case Report: We describe a rare case of 30 year old gentleman who presented with first episode of seizure following alcoho...

  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. 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.

  8. Concurrent cases of bilateral anterior shoulder dislocation: our observations in three cases

    OpenAIRE

    Orhan Akinci; Yavuz Akalin; Ali Otuzbir; Alpaslan Oztürk

    2016-01-01

    Bilateral anterior shoulder dislocations are  rarely seen and usually occur due to the same mechanism arising from traumatic injuries. In here, we discussed three cases of traumatic bilateral anterior shoulder dislocation , one had an additional patella fracture, and the other one had bilateral tuberculum majus fracture. All of the patients were female and our first case that presented here was 65-year-old and given a closed reduction for isolated bilateral anterior shoulder dislocation that ...

  9. 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.

  10. 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).

  11. 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.

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

    Science.gov (United States)

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

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Venkatachalam Santosh

    2009-12-01

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

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

    OpenAIRE

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

    2004-01-01

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

  15. 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.

  16. Neglected Anterior Dislocation of Shoulder: is surgery necessary? A Rare Case with review of literature

    OpenAIRE

    Shah, Kunal; Ubale, Tushar; Ugrappa, Harish; Pilankar, Samir; Bhaskar, Atul; Kale, Satishchandra

    2015-01-01

    Introduction: Shoulder joint is the most frequently dislocated joint. However, it is rarely neglected and treatment is sought immediately. Delayed or neglected shoulder dislocations are difficult to manage and require extensive procedures to obtain good functional outcome. Very few cases are described in literature showing neglected shoulder dislocation with good functional range of movement. We report a case with 3 years of neglected anterior shoulder dislocation with preserved joint functio...

  17. Non-Traumatic Anterior Dislocation of a Total Knee Replacement Associated with Neurovascular Injury

    OpenAIRE

    Aderinto, Joseph; Gross, Allan E.; Rittenhouse, Bryan

    2009-01-01

    Prosthetic total knee replacements rarely dislocate. When dislocation does occur, it is usually in a posterior direction in association with a posterior stabilised, cruciate-sacrificing prosthesis. Neurovascular injury is unusual. In this report, we describe a case of anterior dislocation of a cruciate-retaining total knee replacement in a 67-year-old woman. The dislocation occurred in the absence of overt trauma and resulted in severe neurovascular injury.

  18. A Case of Neglected Bilateral Anterior Shoulder Dislocation: A Rare Entity with Unusual Mechanism of Injury

    Directory of Open Access Journals (Sweden)

    Raghuram Choulapalle

    2015-01-01

    Full Text Available Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury; both hands of the patient were pulled from either side. To the best of our knowledge, this unusual mechanism of injury has not been reported in the literature.

  19. 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

  20. 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.

  1. Simultaneous Bilateral Anterior Shoulder Dislocation Occurred During Sleepwalking

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina; Bae, Kee Jeong

    2016-10-01

    "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. PMID:27502623

  3. Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem.

    Science.gov (United States)

    Martin, Alexander Nicholas; Tsekes, Dimitris; White, William James; Rossouw, Dan

    2016-01-01

    Bilateral anterior shoulder dislocation is a rare clinical entity with few case reports and limited series published in the literature. Bilateral shoulder dislocations are rare and of them, most are posterior. We present a highly unusual case of bilateral, atraumatic, anterior shoulder dislocation with concomitant comminuted greater tuberosity fracture on the right side, secondary to seizure, in a patient without known epilepsy, induced by oral chloroquine medication. We demonstrate the treatment approach that led to a satisfactory clinical outcome, evidenced by radiological union, clinical assessment and Patient Reported Outcome Measure data, following non-operative management of both shoulders. The unusual mechanism for anterior shoulder dislocation, the asymmetric dislocation pattern and peculiar precipitant for the causative seizure all provide interesting learning points from this case. PMID:27005796

  4. 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.

  5. Simultaneous anterior dislocation of the shoulder and fracture of the ipsilateral humeral shaft : Two case reports

    OpenAIRE

    Chen, C.-H.; Lai, P.-L.; Niu, C.-C.; Chen, W.-J.; Shih, C.-H.

    1998-01-01

    Two patients with anterior dislocation of the shoulder and ipsilateral fracture of the shaft of the humerus have been studied and the mechanism of their injuries has been documented. Closed reduction of the dislocations was performed under anaesthesia during surgery for humeral fixation with a dynamic compression plate. The fractures and dislocations healed without any problems at 6 to 9 months postoperatively. At recent follow-up, one patient had returned to work and ...

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

    OpenAIRE

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

    2012-01-01

    【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 grou...

  7. Comparison of four different reduction methods for anterior dislocation of the shoulder

    OpenAIRE

    Guler, Olcay; Ekinci, Safak; Akyildiz, Faruk; Tirmik, Uzeyir; Cakmak, Selami; Ugras, Akin; Piskin, Ahmet; Mahirogullari, Mahir

    2015-01-01

    Background Shoulder dislocations account for almost 50 % of all major joint dislocations and are mainly anterior. Objective The aim is a comparative retrospective study of different reduction maneuvers without anesthesia to reduce the dislocated shoulder. Methods Patients were treated with different reduction maneuvers, including various forms of traction and external rotation, in the emergency departments of four training hospitals between 2009 and 2012. Each of the four hospitals had differ...

  8. First-time anterior shoulder dislocations: should they be arthroscopically stabilised?

    OpenAIRE

    Sedeek, Sedeek Mohamed; Bin Abd Razak, Hamid Rahmatullah; Ee, Gerard WW; Tan, Andrew HC

    2014-01-01

    The glenohumeral joint is inherently unstable because the large humeral head articulates with the small shadow glenoid fossa. Traumatic anterior dislocation of the shoulder is a relatively common athletic injury, and the high frequency of recurrent instability in young athletes after shoulder dislocation is discouraging to both the patient and the treating physician. Management of primary traumatic shoulder dislocation remains controversial. Traditionally, treatment involves initial immobilis...

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

    Directory of Open Access Journals (Sweden)

    Meena Sanjay

    2012-12-01

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

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

    OpenAIRE

    Regauer, Markus; Polzer, Hans; Mutschler, Wolf

    2014-01-01

    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 genera...

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

    Science.gov (United States)

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

    2016-01-01

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

  12. 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.

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

    OpenAIRE

    Knaus, Andreas; Terjesen, Terje

    2009-01-01

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

  14. 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.

  15. 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.

  16. Irreducible ankle fracture-dislocation due to tibialis anterior subluxation: a case report.

    Science.gov (United States)

    Natoli, Roman M; Summers, Hobie D

    2015-01-01

    Irreducible ankle fracture-dislocations are rare. Several cases of irreducible ankle fracture-dislocation have been reported in published studies secondary to the tibialis posterior tendon, deltoid ligament, or extensor digitorum longus tendon blocking the reduction. We report a case of irreducible ankle fracture-dislocation resulting from posteromedial subluxation of the tibialis anterior tendon around a medial malleolar fracture fragment. Ultimately, the ankle required open reduction of the incarcerated tendon to reduce the joint and proceed with internal fixation of the associated fracture. The patient's postoperative course was uncomplicated, and the tibialis anterior tendon was functioning at 10 months postoperatively, after which he did not return for follow-up examinations. To our knowledge, this is the first reported case of the tibialis anterior tendon blocking closed reduction of an ankle fracture-dislocation. PMID:25618805

  17. 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

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

    OpenAIRE

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

    2004-01-01

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

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Navin

    2015-03-01

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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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.)

  5. Innovative use of computer-assisted tomography in the management of an irreducible anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Rajpal S Nandra

    2011-01-01

    Full Text Available Anterior dislocation of the shoulder is a common injury which is often reduced in the emergency department, without specialist orthopedic input. We report a case of an irreducible locked anterior glenohumeral dislocation with impaction of the humeral head onto the antero-inferior glenoid rim and subsequent generation of a Hill-Sachs lesion. To our knowledge, we describe the first reported case of using computer-assisted tomography to generate a sequence of movements to safely disimpact the locked dislocation without causing further iatrogenic injury or a fracture through the humeral articular surface. This novel image-assisted closed reduction technique spared the patient from the morbidity associated with performing open reduction surgery. At 6-month follow-up, the patient reported no re-dislocations, returned to work and had excellent range of motion.

  6. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

    OpenAIRE

    Amit Mishra; Pulak Sharma; Deepak Chaudhary

    2012-01-01

    Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 yea...

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

    OpenAIRE

    Sivananda; Sudheer; Varun Kumar; Mani Kumar

    2015-01-01

    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. Ante...

  8. [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

  9. 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

  10. 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.

  11. The Milch technique for reduction of anterior shoulder dislocations in an accident and emergency department.

    OpenAIRE

    Johnson, G; Hulse, W; Mcgowan, A.

    1992-01-01

    Following the introduction of the Milch technique as the preferred method of reduction of anterior shoulder dislocations in an A&E department, a retrospective study of the technique was carried out. A total of 187 patients with anterior shoulder dislocations were included. The Milch technique was attempted in 142 cases with a success rate of 86%. There was no statistical difference in the success rates of junior and senior staff. In 73% of the Milch cases either no analgesia or sedation or En...

  12. 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.

  13. 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.

  14. Safety of total hip arthroplasty for femoral neck fractures using the direct anterior approach: a retrospective observational study in 86 elderly patients

    OpenAIRE

    Thürig, Grégoire; Schmitt, Jürgen Wilfried; Slankamenac, Ksenija; Werner, Clément M. L.

    2016-01-01

    Background The femoral neck fracture is one of the most common fractures in the elderly. A variety of methods and approaches are used to treat it. Total hip arthroplasty is a preferred approach in independent, mobile, elderly patients, given its more favorable long-term outcome. Our hypothesis is that the direct anterior approach in geriatric trauma patients has a lower dislocation-rate with the advantage of early recovery due to a muscle sparing approach and therefore early possible full wei...

  15. 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.)

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

    International Nuclear Information System (INIS)

    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.)

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

    OpenAIRE

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

    2004-01-01

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

  18. A new autoreduction method for anterior shoulder dislocation: the GONAIS method.

    Science.gov (United States)

    Gonai, Shiro; Kamio, Yoshito; Matsuoka, Tomoyuki; Harunari, Manabu; Saito, Yutaka; Takuma, Kiyotsugu

    2016-01-01

    Although techniques for autoreduction of anterior shoulder dislocation have been developed, no reports have detailed an autoreduction method using the zero position and traction on the affected arm. Therefore, we developed a new autoreduction technique using the zero position and gentle autotraction. The objective of this study is to present our experience with a new method for autoreduction of anterior shoulder dislocation called the GONAIS (a backronym for “Grasp a waist-high object, Opposite arm assists, Nonsedated, Autoreduction/autotraction, Immobilize the grasped object, and Squatting and stooping”) method. A 41-year-old healthy woman with a history of left shoulder dislocation presented to the emergency department with left shoulder pain while attaching her seatbelt. The X-ray examination revealed subcoracoid dislocation of the left shoulder. The patient tried the GONAIS method after simple guidance and demonstration. Although she felt pain once when weakening traction, she achieved autoreduction successfully in only 2 min and 50 s. Clinical examination after autoreduction revealed normal neurovascular findings and appearance of the shoulder. The X-ray revealed glenohumeral joint reduction and no fracture. Here, our patient using the GONAIS method achieved shoulder autoreduction in a short time. The GONAIS method does not require lying down or sitting on the ground, does not necessarily require the opposite arm, and is minimally invasive. This method would likely be helpful for those who cannot quickly reach a hospital for treatment of anterior shoulder dislocation. PMID:26168697

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

    Science.gov (United States)

    Gharavifard, Mohammad; Tafakori, Azadeh; Zamani Moghadam, Hamid

    2016-01-01

    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 study was aim to compare the efficacy of remifentanil with fentanyl/midazolam in painless reduction of anterior shoulder dislocation. Method: In this randomized, double blind, clinical trial the procedural characteristics, patients’ satisfaction as well as adverse events were compared between fentanyl/midazolam and remifentanil for 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 between groups regarding baseline characteristics. Remifentanil group had lower duration of procedure (2.5 ± 1.6 versus 4.6 ± 1.8 minutes, p shoulder dislocation. PMID:27274520

  20. 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.

  1. 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.

  2. 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

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

    Science.gov (United States)

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

    2016-05-18

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

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Mehmet Gokalp

    2013-10-01

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

  6. 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.

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

    OpenAIRE

    Ninković Srđan; Stanković Milan; Savić Dragan; Matijević Radmila; Milankov Miroslav

    2008-01-01

    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 wo...

  8. Irreducible Anterior Shoulder Dislocation Associated With Displaced Fracture of the Greater Tuberosity: An Analysis of Seven Cases

    Directory of Open Access Journals (Sweden)

    Morteza Nakhaei Amroodi

    2015-11-01

    Full Text Available Background: Although anterior shoulder dislocation is the most prevalent type of body dislocation, irreducible anterior shoulder dislocation is seldom reported in the literature, which is usually due to physical obstacles. Objectives: This study presents our findings regarding the causes of irreducibility of anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Patients and Methods: CT scans, open reduction of the joint, and internal fixation of the tuberosity was performed in seven patients with irreducible anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Results: As confirmed by intraoperative findings, the CT scans showed the cause of irreducible shoulder dislocation in six cases was the interposition of the long head of biceps (LHB in the anterior of the head that was displaced from the fracture line between the greater and lesser tuberosities. In another case, the greater and lesser tuberosities were attached to each other and were separated from the head. This fractured part was trapped. Conclusions: We suggest that performing CT scans in all cases of anterior shoulder dislocations with displaced fracture of the greater tuberosity can help surgeons to diagnose the accompanying fractures and possible complications, such as irreducibility. If the fracture line passes through the bicipital groove or in the case of a shield fracture, possible irreducibility should be borne in mind.

  9. Anterior coverage after eccentric rotational acetabular osteotomy for the treatment of developmental dysplasia of the hip

    OpenAIRE

    Imai, Hiroshi; Kamada, Tomomi; Takeba, Jun; Shiraishi, Yoshitaka; Mashima, Naohiko; Miura, Hiromasa

    2014-01-01

    Background In periacetabular osteotomy for the treatment of developmental dysplasia of the hip, impairments in ADL due to limitations in hip flexion can occur when anterior displacement is added to lateral displacement in order to obtain sufficient femoral head coverage. This study was conducted to determine, by the range of motion (ROM) simulation based on CT images, the minimum angle of hip flexion and internal rotation at 90° of flexion that is necessary to avoid ADL impairments after ecce...

  10. Long-Lever-Arm Manipulation Under Anesthesia With Resultant Traumatic Anterior Shoulder Dislocation.

    Science.gov (United States)

    Roubal, Paul J; Placzek, Jeffrey D

    2016-08-01

    The patient was a 61-year-old woman who underwent long-lever manipulation under anesthesia (MUA) for adhesive capsulitis. Two weeks following MUA, the constellation of clinical findings raised concern for possible adverse outcomes. Radiographs were obtained, as well as subsequent magnetic resonance imaging and computed tomography scans. Images revealed anterior shoulder dislocation with Bankart and Hill-Sachs lesions, and an anterior rotator cuff tear. J Orthop Sports Phys Ther 2016;46(8):707. doi:10.2519/jospt.2016.0412. PMID:27477474

  11. 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.

  12. 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

  13. Determination of prevalence of glenoid bony lesions after recurrent anterior shoulder dislocation using the 3-D CT scan

    OpenAIRE

    Guity, Mohamad Reza; Akhlaghpour, Shaharam; Yousefian, Reza

    2014-01-01

    Background: Glenoid bone damages consisting of anterior rim erosion and bony avulsion are very important in decision making for treatment of recurrent dislocation in shoulder joint. This study was aimed to determine the prevalence of these damages in patients with anterior recurrent shoulder dislocation. Methods: The study was a cross-sectional study evaluating patients with unstable shoulder joint. Glenoid bone damage was assessed using three dimensional (CT) scan implementing either glenoid...

  14. 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.

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Zafer Dogan

    2014-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Jäger M

    2011-05-01

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

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

    OpenAIRE

    Amin Foroughi; Reza Jalli; Mehrdad Mohammadhoseini

    2009-01-01

    "nIntroduction: A prospective detection of developmental dislocation of the hip (DDH) in icteric newborns and comparison with the frequency of DDH in other newborns. "nMaterials and Methods: During a one year period all icteric newborns who were referred to Nemazi hospital’s neonatal emergency room for bilirubin checking were screened by Graf"s ultrasonographic method for DDH.300 newborns (600 hips) were screened during this period. Any newborn with other problems such as ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-12-01

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

  20. Radiographic and anatomic landmarks to approach the anterior capsule in hip arthroscopy.

    Science.gov (United States)

    Salas, Antonio Porthos

    2015-12-01

    Hip arthroscopy (HA) is considered to be a very difficult and demanding surgical procedure, special instruments, an image intensifier and a fracture table or hip distractor are required to access the hip joint, the most common and worldwide used HA technique is entering blindly to the central compartment with the use of fluoroscopy and continuous distraction; with the potential danger if performed in unskillful hands of labral penetrations, labral resections and scuffing of the femoral head cartilage. Our technique describes the arthroscopic management of femoroacetabular impingement (FAI), performing a preoperative planning using radiographic and anatomic landmarks to approach the anterior capsule without the use of fluoroscopy. Access to the hip joint is made extra-articularly from the peritrochanteric compartment palpating the greater trochanter and posteriorly penetrating the iliotibial band sliding the arthroscopic sheath and obturator from the trochanteric border to the anterior femoral neck to visualize the anterior capsule bursa and anterior capsule fibers and posteriorly following our previous landmarks perform an anterior oblique Inverted 'T' or 'H' capsulotomy with a radiofrequency wand to access the cam-type impingement and distraction is made under direct controlled arthroscopic vision. Our technique in HA aiming the anterior capsule using radiographic and anatomic landmarks is safe, reliable and reproducible in FAI with big cams, deep sockets and cases with mild arthritis where the capsule is thick, stiff and calcified. PMID:27011869

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

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    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.)

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. Modified Boytchev procedure for treatment of recurrent anterior dislocation of shoulder

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    Anant Kumar Garg

    2011-01-01

    Full Text Available Background: More than 200 different operations have been described for the treatment of recurrent anterior dislocation of shoulder. The Modified Boytchev procedure employs rerouting of the detached tip of coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis deep to subscapularis and reattaches to its anatomical location. We conducted a study on evaluation of long-term effect of modified Boytchev procedure and to compare our results with other studies published in literature. Materials and Methods: Since June 2002, modified Boytchev procedure was performed on 48 patients, who presented with recurrent anterior dislocation. 45 were men and 3 were women and were in the age group of 18-40 years (mean 27.83±4.95 years. Forty patients were affected on the dominant side and rest on the non-dominant side. The mean number of dislocations in these patients was 18.22±12.08. The mean followup period was 58.13±19.06 months (range 18-96 months. The patients were evaluated by visual analogue score, modified American Shoulder and Elbow Surgeon′s Score (ASES, and Single Assessment Numeric Evaluation (SANE score at the last followup. Results: All the patients regained almost preoperative range of forward flexion at the last followup. In the preoperative period the mean external rotation deficit at 0° and at 90° of abduction was 13.22°±5.16° and 18.06°±6.50°, respectively. At the last followup, the mean external rotation deficit at 0° and at 90° of abduction was 8.06°±2.47° and 8.95°±2.07°, respectively. This improvement in external rotation deficit was statistically significant (P<.05. Preoperative scores were compared with the most recent followup scores for all variables with use of a paired t test. All patients had significant improvement in visual analogue score, modified American Shoulder and Elbow Surgeon′s Score (ASES, and Single Assessment Numeric Evaluation (SANE score at the last followup

  8. Comparison of different approaches to the reduction of anterior temporomandibular joint dislocation: a randomized clinical trial.

    Science.gov (United States)

    Ardehali, M M; Tari, N; Bastaninejad, Sh; Amirizad, E

    2016-08-01

    This randomized clinical trial was designed to compare three different reduction methods for anterior temporomandibular joint (TMJ) dislocation. The three methods evaluated were the conventional method, wrist pivot method, and extraoral method. The study sample comprised 90 consecutive patients suffering from anterior dislocation of the TMJ, who were allocated randomly to one of the three groups. This study found success rates of 86.7% for the conventional method, 96.7% for the wrist pivot method, and 66.7% for the extraoral method. The extraoral method was more difficult for the physician and the patient than the other two methods. For the patients, the wrist pivot method was easier than the other methods. For the doctors, the extraoral method was significantly more difficult than the other methods. In conclusion, due to the absence of a biting risk with the extraoral method and the lack of a significant difference in success between this method and the conventional method, the extraoral method could be considered the appropriate first-line treatment where there is a risk of the patient biting the surgeon's hand. Given the overall benefits of the wrist pivot method, this method could be considered the first-line and gold standard treatment modality in other cases. PMID:27160610

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

    Directory of Open Access Journals (Sweden)

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

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    Periasamy Kumar

    2008-02-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  12. 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.

  13. Combined anterior and posterior surgery for treatment of cervical fracture-dislocation in patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    L(U) Guo-hua; WANG Bing; KANG Yi-jun; LU Chang; MA Ze-min; DENG You-wen

    2009-01-01

    To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondyli-tis-(AS) and the effect of combined anterior and posterior operation. Methods: Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D accord-ing to Frankel's score. There were 15 cases of Grade Ⅲ dislocation and 3 cases of Grade Ⅱ. All patients underwent surgical procedures by combined anterior and posterior approach.Results: There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-an-terior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neorological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a long-term complication in follow-up. Conclusions: The study suggests that anterior com-bined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.

  14. 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. .

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

    OpenAIRE

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

    2004-01-01

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

  16. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

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    Amit Mishra

    2012-01-01

    Full Text Available Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 years, were reviewed in the study. The average followup period was 27 months (range 24-36 months. University of California Los Angeles shoulder rating scale was used to determine the outcome after surgery. The recurrence rates, range of motion, as well as postoperative function and return to sporting activities were evaluated. Results : Thirty six patients (72.0% had excellent results, whereas seven patients (14.0% had good results. The mean pre- and postoperative range of external rotation was 80.38° and 75.18°, respectively. Eighty-six percent patients had stability compared with the normal sided shoulder and were able to return to sports. There were no cases of redislocation observed in this study; however, three cases had mild laxity of the joint. Conclusion: Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent postoperative shoulder motion and low recurrence rates.

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

    International Nuclear Information System (INIS)

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

  18. 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.

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

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    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

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

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    Amin Foroughi

    2009-01-01

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

  2. The effect of abductor muscle and anterior-posterior hip contact load simulation on the in-vitro primary stability of a cementless hip stem

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    Frei Hanspeter

    2010-06-01

    Full Text Available Abstract Background In-vitro mechanical tests are commonly performed to assess pre-clinically the effect of implant design on the stability of hip endoprostheses. There is no standard protocol for these tests, and the forces applied vary between studies. This study examines the effect of the abductor force with and without application of the anterior-posterior hip contact force in the in-vitro assessment of cementless hip implant stability. Methods Cementless stems (VerSys Fiber Metal were implanted in twelve composite femurs which were divided into two groups: group 1 (N = 6 was loaded with the hip contact force only, whereas group 2 (N = 6 was additionally subjected to an abductor force. Both groups were subjected to the same cranial-caudal hip contact force component, 2.3 times body weight (BW and each specimen was subjected to three levels of anterior-posterior hip contact load: 0, -0.1 to 0.3 BW (walking, and -0.1 to 0.6 BW (stair climbing. The implant migration and micromotion relative to the femur was measured using a custom-built system comprised of 6 LVDT sensors. Results Substantially higher implant motion was observed when the anterior-posterior force was 0.6BW compared to the lower anterior-posterior load levels, particularly distally and in retroversion. The abductor load had little effect on implant motion when simulating walking, but resulted in significantly less motion than the hip contact force alone when simulating stair climbing. Conclusions The anterior-posterior component of the hip contact load has a significant effect on the axial motion of the stem relative to the bone. Inclusion of the abductor force had a stabilizing effect on the implant motion when simulating stair climbing.

  3. Propofol Versus Midazolam for Procedural Sedation of Anterior Shoulder Dislocation in Emergency Department: A Randomized Clinical Trial

    OpenAIRE

    Hatamabadi, Hamid Reza; Arhami Dolatabadi, Ali; DERAKHSHANFAR, Hojjat; Younesian, Somaye; Ghaffari Shad, Ensieh

    2015-01-01

    Background: Anterior shoulder dislocation (ASD) is one of the most common reasons for referrals to emergency departments (ED). Usually, a combination of an intravenous narcotic and a benzodiazepine is used for procedural sedation and analgesia (PSA) in such cases. Objectives: This study compares the efficacy of two combinations to reduce ASD. Patients and Methods: The subjects in this clinical trial consisted of 48 patients with ASD who were randomly assigned to midazolam/fentanyl and propofo...

  4. Rehabilitation of a Completely Edentulous Patient with Nonreducible Bilateral Anterior Dislocation of the Temporomandibular Joint: A Prosthodontic Challenge-Clinical Report.

    Science.gov (United States)

    Momani, Moath; Abdallah, Mohamed-Nur; Al-Sebaie, Derar; Tamimi, Faleh

    2016-07-01

    Nonreduced bilateral anterior dislocation of the temporomandibular joint (TMJ) is an extremely rare condition, and its prosthodontic rehabilitation is a clinical challenge, especially in patients who refuse to or cannot undergo surgery. There are no previous clinical reports of successful or standardized prosthetic rehabilitation approaches for patients with this condition. This clinical report describes the successful prosthodontic management of an edentulous patient with nonreduced bilateral anterior dislocation of the TMJ. PMID:26216338

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Jeroni Nadal; Bachar Kudsieh; Ricardo P. Casaroli-Marano

    2015-01-01

    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 ...

  8. Double figure-of-eight reconstruction technique for chronic anterior sternoclavicular joint dislocation.

    Science.gov (United States)

    Kawaguchi, Kohei; Tanaka, Sayo; Yoshitomi, Hiroki; Nagai, Ichiro; Sato, Wakyo; Karita, Tasturo; Kondo, Taiji

    2015-05-01

    Sternoclavicular joint dislocations account for figure-of-eight" using the ipsilateral gracilis tendon. Surgical outcome was successful, based on the Rockwood SC joint rating scale, and the patient maintained excellent stability even after 2 years. This new surgical technique offers superior stability, without harvest site morbidity, to patients with rare, severe, and chronic sternoclavicular joint dislocation. Level of evidence IV. PMID:24722676

  9. “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.

  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. 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.

  12. 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.

  13. 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.

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

    OpenAIRE

    Mehmet Gokalp

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tetsunaga,Tomonori

    2009-06-01

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

  16. Hip Ultrasound

    Science.gov (United States)

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

  17. Patient Participation Approach to Reduction of Anterior Shoulder Dislocation: P-R-I-M/O-Y-E-S.

    Science.gov (United States)

    Lachance, Paul-André; Taieb-Lachance, Catherine Isabelle

    2016-07-01

    A variety of successful techniques are available for reduction of shoulder dislocation; none have been shown to be clearly superior to another. Analgesic methods vary as well from none to deep sedation-analgesia. The literature hints at the importance of optimal muscle relaxation as a factor of success. Yet, the literature describes only cursorily the means by which muscle relaxation is optimized. Patient-centered participation and relaxation methods have been used in other contexts to reduce pain, anxiety, and muscle tension. This article proposes to integrate a patient-centered participation approach to the reduction of anterior shoulder dislocation as a way to optimize muscular relaxation nonpharmacologically. It can be used in the field in combination with the practitioner's reduction technique of choice. It minimizes risks because it entails no deep pharmacological sedation. The mnemonic P-R-I-M/O-Y-E-S is used to respectively represent the four phases: Preparation, Rehearsal, Intervention, and Mobilization as well as the 4 repeated steps in each phase of the procedure: Observe, Yield control, Explain, and Support. The focus is on (1) securing optimal patient participation within a patient-centered approach and (2) achieving nonpharmacological muscular relaxation through a simple relaxation routine. More studies are needed to identify the factors that determine success and guide the practitioner's choice among available options in shoulder dislocation reductions. PMID:26584435

  18. 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...

  19. The Epidemiology of Primary Anterior Shoulder Dislocations in Patients Aged 10-16 Years and Age-Stratified Risk of Recurrence

    OpenAIRE

    Leroux, Timothy; Ogilvie-Harris, Darrell; Veillette, Christian; Chahal, Jaskarndip; Dwyer, Tim; Henry, Patrick; Khoshbin, Amir; Mahomed, Nizar; Wasserstein, David

    2015-01-01

    Objectives: Most clinical studies pertaining to shoulder dislocation use age cutoffs of 16 years, and at present, only small case series of patients aged 10-16 years guide our management. Using a general population cohort aged 10 to 16 years, we sought to: 1) determine the overall and demographic-specific incidence density rate (IDR) of primary anterior shoulder dislocation requiring closed reduction (CR), and 2) determine the rate of and risk factors for repeat shoulder CR. Methods: Using ad...

  20. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    OpenAIRE

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic...

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

    OpenAIRE

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

    2015-01-01

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

  2. 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.

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

    Science.gov (United States)

    Nadal, Jeroni; Kudsieh, Bachar; Casaroli-Marano, Ricardo P

    2015-01-01

    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. PMID:26294964

  4. 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.

  5. 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。

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

    International Nuclear Information System (INIS)

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

  7. Evaluation of the patient with hip pain.

    Science.gov (United States)

    Wilson, John J; Furukawa, Masaru

    2014-01-01

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

  8. Systematic Review of Arthroscopic Versus Open Repair for Recurrent Anterior Shoulder Dislocations

    OpenAIRE

    Godin, Jonathan; Sekiya, Jon K.

    2011-01-01

    Context: It remains unknown if arthroscopic repair of recurrent anterior shoulder instability is as effective as open repair. Objective: The purpose of this study is to analyze the literature to provide clinical recommendations regarding the most appropriate therapeutic intervention for recurrent anterior shoulder instability. Study Design: Systematic review of level I and II studies. Data Sources: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and secondary references from 1967...

  9. 肩关节前脱位的诊治体会%The diagnosis and treatment of anterior shoulder dislocations

    Institute of Scientific and Technical Information of China (English)

    曹烈虎; 章浩; 张春才; 翁蔚宗; 李海航; 宋绍军; 纪方; 苏佳灿

    2014-01-01

    Objective To explore the injury assessment and the control measure for the related complication before the manual reduction of anterior shoulder dislocations.Methods General data:5 6 patients suffered anterior shoulder dislocations were retrospectively analyzed in our study.3 1 were male and 25 were female,and their ages ranged from 23 to 85 years old with the mean age of 36.5 years old.10 patients got injured at car accidents.32 injuries resulted from falling,8 of which fell from the height,and 6 were inj ured in sports.The time before going to hospital ranged from 1 5 minutes to 8 hours with a mean time of 1 .6 hours.All of the shoulder dislocations were fresh and traumatic.For the dislocation direction,31 were subcoracoid dislocations,20 were subglenoid dislocations,and 5 were subclavicle dislocations,1 5 patients were associated with fractures of greater tuberosity,1 humeral head fracture,and 3 axillary nerve inj uries,2 Iatrogenic proximal humeral fractures.Inclusion criteria:Patients had a clear history of shoulder trauma.The squared shoulder deformation was showed by physical examination,and the humeral head could be touched in the axillary,subcoracoid,or subclavicle.The shoulder dislocation was also confirmed by the radiographic diagnosis.Treatment:100 mg lidocaine was injected into the shoulder joint,and then the dislocations were reduced using the Hippocrates method after about 10 minutes when the pain was relieved.Results All the patients received closed reduction by the Hippocrates method in the emergency room.48 patients had successful reduction,8 patients failed.Of these 8 cases,closed reduction succeeded in one case with the fracture of greater tuberosity at the operation room with general anesthesia,manual reduction was done in 2 cases with brachial plexus block,and open reduction was done in one case with humeral head fracture. Conclusions A series of careful assessment should be done before gimmick reset of the anterior shoulder dislocation

  10. 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.

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

    Science.gov (United States)

    Pingal, Desai; Marqueen, Timothy; Prakash, Karanvir

    2016-04-01

    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 follow- up. PMID:27140222

  12. 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

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

    Science.gov (United States)

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

    1980-06-21

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

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

    International Nuclear Information System (INIS)

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

  15. 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

  16. 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%.

  17. 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.)

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

    International Nuclear Information System (INIS)

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

  19. 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.)

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Nepple, Jeffrey J; Smith, Matthew V

    2015-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    段军; 李锋生

    2015-01-01

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

  3. 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.

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

    OpenAIRE

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

    2012-01-01

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

  5. 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).

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

    Institute of Scientific and Technical Information of China (English)

    贺明礼; 余春善

    2002-01-01

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

  7. Evaluation of Oxford instability shoulder score, Western Ontario shoulder instability Index and Euroqol in patients with slap (superior labral anterior posterior) lesions or recurrent anterior dislocations of the shoulder

    OpenAIRE

    Skare, Øystein; Liavaag, Sigrud; Reikerås, Olav; Mowinckel, Petter; Brox, Jens Ivar

    2013-01-01

    Background Having an estimate of the measurement error of self-report questionnaires is important both for assessing follow-up results after treatment and when planning intervention studies. Specific questionnaires have been evaluated for patients with shoulder instability, but not in particular for patients with SLAP (superior labral anterior posterior) lesions or recurrent dislocations. The aim of this study was to evaluate the agreement, reliability, and validity of two commonly questionna...

  8. 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. PMID:23924748

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

    Directory of Open Access Journals (Sweden)

    Hamid Honarpisheh

    2015-07-01

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

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

    Science.gov (United States)

    Honarpisheh, Hamid; Ghazavi, Mohammad Taghi

    2015-07-01

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

  11. 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

  12. CONSERVATIVE TREATMENT OF HIP DYSPLASIA

    OpenAIRE

    Mikhail Mikhailovich Kamosko; Mahmoud Stanislavovich Poznovich

    2014-01-01

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

  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. 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

    . Subacute MRI evaluation identified 15 labral tears, 12 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial joint side rotator cuff lesion, and 1 partial rupture of the biceps tendon. Arthroscopic examination revealed 22 labral tears, 15 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial...... joint side rotator cuff tear, 1 partial rupture of the biceps tendon, and 1 osseous Bankart lesion. Anterior capsulolabral tears and Hill-Sachs lesions appeared with a high incidence after acute anterior primary shoulder dislocation. Conventional MRI was only moderately reliable in the preoperative...... evaluation of labral tears and Hill-Sachs lesions, and it failed to give an accurate, differentiated preoperative diagnosis of the capsulolabral lesions....

  15. Break dance hip: Chronic avulsion of the anterior superior iliac spine

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, A.R.; Barnes, J.C.; Ogden, J.A.

    1987-10-01

    A case of chronic, progressive avulsion of the anterior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing.

  16. Break dance hip: Chronic avulsion of the anterior superior iliac spine

    International Nuclear Information System (INIS)

    A case of chronic, progressive avulsion of the anterior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing. (orig.)

  17. 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.

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

    Science.gov (United States)

    Fettweis, E

    1979-02-01

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

  19. 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.

  20. Hip instability.

    Science.gov (United States)

    Smith, Matthew V; Sekiya, Jon K

    2010-06-01

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

  1. 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

  2. Surgical treatment of a concurrent type 5 acromioclavicular joint dislocation and a failed anterior glenohumeral joint stabilization.

    Science.gov (United States)

    Rashid, Abbas; Lawrence, Christopher; Tytherleigh-Strong, Graham

    2016-10-01

    Traumatic glenohumeral joint dislocation and acromioclavicular joint subluxations tend to occur in young active males. Use of the coracoid process either as a transfer in recurrent instability or in suspensory reconstructions of the coracoclavicular ligaments have gained popularity. However this requires careful consideration in the event of concomitant injuries if they both require surgery. PMID:27660658

  3. 肩关节镜治疗复发性肩关节前脱位%Arthroscopic treatment of recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    马佳; 崔国庆; 王健全; 肖健; 敖英芳; 于长隆

    2008-01-01

    目的 对关节镜治疗复发性肩关节前脱位的疗效进行评价.方法 2001年1月至2006年3月关节镜治疗复发性肩关节前脱位患者52例,其中44例获得随访,随访时间12~54个月,平均26个月.对获得随访的44例患者的临床资料进行回顾性研究.采用美国加州洛杉矶大学肩关节评分系统(UCLA)、肩关节简明测试(SST)、Dawson评分对术后效果进行评价.采用Dawson评分对患者年龄、是否存在松弛、术前脱位频率、复位情况和病程长短等因素对术后疗效的影响进行评价.结果 获得随访的44位患者的脱位复发率为4.5%.术后UCLA、SST、Dawson评分与术前比较差异具有统计学意义,肩关节镜治疗术后优良率在91%以上.患者年龄、病程长短、术前脱位频率、是否伴有关节松弛、复位方法对治疗效果无明显影响.结论 关节镜治疗复发性肩关节前脱位手术效果较好,术后肩关节功能改善明显.%Objective To investigate the effect of the arthroscopic procedure on the patients with recurrent anterior shoulder dislocation. Methods From January 2001 to March 2006, 52 patients with recurrent anterior shoulder dislocation were treated by arthroscopy. Among them 44 patients were followed up for 12 to 54 months(on average of 26 months). The data of the 44 patients was reviewed. Three evaluation systems,University of California at Los Angeles Shoulder Scores(UCLA),Simple Shoulder Test(SST) and Dawson,were used. The study evaluated the effect based on the Dawson system by the factors as:age,course of the disease, frequency of dislocation and relocation methods and the range of shoulder movement.Results The ratio of recurrent dislocation after operation was 4.5%. Assessing through 3 evaluation systems,UCLA,SST and Dawson,results were similar:the follow-up evaluation were extraordinarily different from preoperative assessment,and the rating of good or excellent at the time of the final follow-up reached 91

  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. OPEN REDUCTION AND CANNULATED SCREW INTERNAL FIXATION OF TALUS FRACTURE-DISLOCATION THROUGH MEDIAL-ANTERIOR APPROACH

    Institute of Scientific and Technical Information of China (English)

    董宇启; 董英海; 周健; 曹聪

    2004-01-01

    Objective To evaluate the role of open reduction through anterior-medial malleolar approach with cannulated screw internal fixation in the treatment of displaced talus fractures. Methods 16 cases of Hawkin type Ⅱ - Ⅲ displaced talus fractures were treated by open reduction through single anterior medial malleofar approach with cannulated screw internal fixation. Results All the 16 cases of displaced talus fractures achieved bony heal in which 5 cases suffered talus aseptic necrosis. The whole excellence-good ratio reached 62.5%.Conclusion Open reduction through anterior-medial malleolar approach with cannulated screw internal fixation is a less trauma, easy manipulation, effective method of treatment for displaced talus fractures.

  6. 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.

  7. 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

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

    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

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

  9. Relationship between hip and knee kinematics in athletic women during cutting maneuvers: a possible link to noncontact anterior cruciate ligament injury and prevention.

    Science.gov (United States)

    Imwalle, Lauren E; Myer, Gregory D; Ford, Kevin R; Hewett, Timothy E

    2009-11-01

    The purposes of this study were to compare lower-extremity kinematics during a 45 degrees and 90 degrees cutting maneuver and to examine the relationships between lower-extremity rotations during these maneuvers. The hypotheses tested were that greater internal hip and knee rotation angles would be observed during the cutting maneuver at a 90 degrees angle (90 degrees cut) compared with the maneuver performed at a 45 degrees angle (45 degrees cut) and that the increased internal hip and knee rotation would be related to increased knee abduction measures. Nineteen athletes from women's soccer teams (17.6 +/- 2.1 yr, 165.6 +/- 8.2 cm, 60.2 +/- 5.6 kg) were instructed to jump across a line and cut at the appropriate angle (either 45 degrees or 90 degrees side-step cut) and in the appropriate direction. Lower-extremity kinematic measures were taken at peak force during the stance phase. Hip internal rotation and knee internal rotation (p = 0.008) were increased during the 90 degrees cut compared with the 45 degrees cut. Mean hip flexion (p knee abduction during both tasks was hip adduction (R = 0.49). The findings indicate that the mechanisms underlying increased knee abduction measures in athletic women during cutting tasks were primarily coronal plane motions at the hip. Trunk and hip focused strength neuromuscular training may improve the ability of athletic women to increase control of lower-extremity alignment. Therefore, these women may decrease dangerous knee loads that result from increased hip adduction during dynamic tasks, thus decreasing anterior cruciate ligament injury risk. PMID:19826304

  10. 髋关节后脱位伴股骨头骨折:分型与修复方式的影响%Posterior hip dislocation combined with femoral head fractures:effects of typing and repair methods

    Institute of Scientific and Technical Information of China (English)

    谭章勇; 汪建良; 郭峰; 刘卫峰; 许科峰

    2014-01-01

    combined with femoral head fractures in the 101 Hospital of Chinese PLA from September 2004 to May 2010, were enrol ed in this study. According to Pipkin typing, operative approach and the time from injury to surgery, therapeutic effects were evaluated using radiographs and the recovery conditions of hip function (Epstein method), and the occurrence of complications was recorded. RESULTS AND CONCLUSION:A total of 28 patients were fol owed up from 1 to 5 years, averagely 2.8 years. Using the Epstein method, there were excellent in 6 cases, good in 12 cases, average in 7 cases, and poor in 3 cases, with an excellent and good rate of 64%. The therapeutic effects in patients with Pipkin I and II were good, with excellent and good rates of 100%and 78%, respectively. Moreover, the complications were less, with a rate of 17%and 22%, respectively. The therapeutic effects of patients with Pipkin III and IV were poor, especial y, Pipkin IV patients, whose excellent and good rate was only 20%and the incidence of complications was 80%. No significant difference in the incidence of complications was detected in patients undergoing Smith-Peterson anterior approach and K-L posterior approach (P>0.05). No significant difference in the incidence of complications was detectable among patients from three groups (the time from fracture to operation48 hours) (P>0.05). Results indicated that the choice of treatment method should be determined by the type of fracture. The prognosis depends on the patient’s age, time of treatment, types of fracture and dislocation, methods of treatment and related measures of prevention of complications.

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

    Institute of Scientific and Technical Information of China (English)

    姚树新

    2012-01-01

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

  12. CONSERVATIVE TREATMENT OF HIP DYSPLASIA

    Directory of Open Access Journals (Sweden)

    Михаил Михайлович Камоско

    2014-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    闫桂森; 杨征; 张骥; 朱振华

    2010-01-01

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

  14. Taper Hip Prosthesis

    Medline Plus

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

  15. 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

  16. 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.

  17. Anterior approach for lower cervical spine fractures and dislocations combined with spinal cord injury%下颈椎骨折脱位并脊髓损伤的前路手术治疗

    Institute of Scientific and Technical Information of China (English)

    贺宝荣; 许正伟; 郝定均; 郭华

    2013-01-01

    Objectives:To discuss the clinical outcome of anterior surgical treatment for lower cervical spine fractures and dislocations combined with spinal cord injury.Methods:From January 2006 to January 2011,196 patients suffering from lower cervical spine fractures and dislocations combined with spinal cord injury in our hospital were reviewed retrospectively.168 cases were data integrity and obtained follow-up,there were 123 males and 45 females with an average age of 38.7 years old(range,18-71 years).21 cases were in ASIA grade A,46 cases in B,60 cases in C,41 cases in D.According to the degree of dislocation,79 cases were in Ⅰ,42 cases in Ⅱ,31 cases in

  18. Arthroscopic treatment of the athletic recurrent shoulder anterior dislocations%运动员复发性肩关节前脱位的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    马佳; 崔国庆; 王健全; 肖健; 闫辉; 杨渝平; 刘玉雷; 敖英芳; 于长隆

    2009-01-01

    目的 评价关节镜下肩关节前向稳定手术对运动员复发性肩关节前脱位的治疗效果.方法 2001年1月至2006年12月,应用关节镜下肩关节前向稳定手术治疗运动员复发性肩关节前脱位29例,男15例,女14例;年龄15~35岁,平均(20.7±1.4)岁.手术均采用关节镜下盂唇缝合固定术(带线锚钉技术),必要时辅以关节囊折叠缝合术、旋转间隙闭合术或热皱缩术.以脱位复发率、肩关节活动度、恢复运动水平级别及UCLA、Dawson、SST评分系统对术后疗效进行评价.结果 全部病例随访17~66个月,平均30.2个月.4例(13.8%)失败,其中3例(10.3%)脱位复发,1例发生半脱位.24例(82.8%)基本恢复到伤前运动水平(恢复≥90%).UCLA、Dawson及SST评分与术前比较差异均有统计学意义.优良率82.8%~89.7%.术后患侧前屈、0°外展位及90°外展位外旋活动度较术前增加,与健侧差值的差异均有统计学意义.结论 运动员复发性肩关节前脱佗的关节镜下肩关节前向稳定手术的治疗效果良好,术后肩关节功能评分及关节活动度有明显改善,脱位复发率及运动水平的恢复程度与大多数文献报道的切开手术效果相近.%Objective To assess the results of arthroscopic anterior shoulder stabilization of athletes with recurrent anterior shoulder dislocations. Methods From Jan. 2001 to Dec. 2006, 29 athletes (15 males and 14 females) suffered recurrent anterior shoulder dislocations underwent arthroscopic anterior shoulder stabilizations. The age of the patients at the time of surgery was from 15 to 35 years (average, 20.7±1.4 years). The surgical procedure was performed in a consistent manner:, arthroscopic suture anchor repair of the displaced labrum, rotator interval closure supplemented with thermal treatment of the capsule when indicat-ed. The clinical results, including the postoperative recurrence rate, range of motion, and the levels of post-operative recovered to

  19. 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

  20. 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

  1. Tratamento das luxações traumáticas da coluna cervical por meio da abordagem anterior Treatment of traumatic dislocations of the cervical spine through anterior approach

    Directory of Open Access Journals (Sweden)

    Helton L. A. Defino

    2007-01-01

    Full Text Available Foram estudados 20 pacientes portadores de luxação traumática uni ou bifacetária da coluna cervical tratados pela artrodese e fixação anterior. Os pacientes foram avaliados por meio de parâmetros clínicos, radiológicos e funcionais. Os pacientes foram seguidos por um período que variou de 1 a 14 anos. A consolidação radiológica da artrodese foi observada em todos os pacientes e 1 paciente apresentou soltura tardia de um dos parafusos. A angulação no plano sagital do segmento vertebral lesado apresentou alteração no período pré-operatório, sendo obtido redução no pós-operatório imediato e manutenção da mesma após um ano do tratamento cirúrgico. A avaliação clínica e funcional de acordo com o SF-36 e escala de dor e trabalho de Denis demonstrou bons resultados clínicos sendo as principais queixas pós-operatórias decorrentes do grau da lesão neurológica. O hematoma da ferida operatória, que necessitou de drenagem cirúrgica foi a única complicação observada em um paciente. A realização da artrodese e fixação anterior para o tratamento das luxações traumáticas uni ou bifacetárias da coluna cervical apresentou bons resultados clínicos, radiológicos, funcionais e baixo índice de complicações, justificando nossa preferência por esse método de tratamento para esse tipo de lesão da coluna cervical.Twenty patients presenting with single-or bi-faceted traumatic dislocation of the cervical spine treated by means of arthrodesis and anterior fixation have been studied. Patients were assessed by clinical, X-ray, and functional parameters. The patients were followed up during a period ranging from 1 to 14 years. Union of the arthrodesis, as evidenced by X-ray, was noticed in all patients, with one patient presenting with late loosening of one of the screws. Angulations at sagittal plane of the injured vertebral segment showed a change preoperatively, with reduction being achieved at the early postoperative

  2. Hip joint replacement

    Science.gov (United States)

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

  3. Analysis of hand foot pedal method in the treatment of 56 cases anterior shoulder dislocation%56例手牵足蹬法治疗肩关节前脱位的临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    陈玉保

    2015-01-01

    Objective:To analyze the clinical effect of hand foot pedal method in the treatment of anterior dislocation of the shoulder. Methods:Retrospective analysis of the hand and foot pedal method treatment of 56 cases of patients with anterior dislocation of shoulder joint.Results:56 cases were all successful reduction, good treatment effect.Conclusion:The hand and foot pedal method should be ef-fective for the treatment of anterior dislocation of shoulder joint , and fewer complications.%目的:分析手牵足蹬法治疗肩关节前脱位的临床效果。方法:回顾性分析我院采用手牵足蹬法治疗的56例肩关节前脱位患者。结果:56例全部复位成功,治疗效果良好。结论:手牵足蹬法是治疗肩关节前脱位的有效方法,且并发症少。

  4. 复发性肩关节前脱位的关节镜治疗%Arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    朱以明; 鲁谊; 冯华; 洪雷; 姜春岩

    2008-01-01

    目的 探讨肩关节镜下Bankart重建手术治疗复发性肩关节前脱位的疗效、适应证和手术要点.方法 随访40例应用肩关节镜下Bankart重建进行治疗的复发性肩关节前脱位患者,随访时间为24~58个月,平均35.9个月;年龄15~54岁,平均27.8岁.40例均为单方向性不稳定.术前平均脱位次数为14.1次(2~90次),其中28例发生于主力侧.术中采用金属缝合锚(Mini-Revo)进行Bankart重建.随访内容包括ASKS评分、Constant-Murley评分、VAS不稳定评分及ROWE评分进行功能评估.结果 40例患者术前和终末随访时肩关节前屈上举平均为[(157.5±20.6)°,x ±s.下同]和(170.0±6.7)°,体侧外旋平均为(58.5±18.9)°和(55.9±15.0)°,ASES评分平均为(82.7±16.7)和(97.2±6.9),VAS不稳定评分平均为(6.2±1.6)和(1.3±1.4),Constant-Murley评分平均为(80.5 ±11.1)和(98.1±3.1),Rowe评分平均为(30.4±8.7)和(92.8±15.2).除体侧外旋术前和术后差异无统计学意义外,其余各项结果差异均有统计学意义.终末随访时有1例患者曾出现肩关节半脱位.随访时发现残存恐惧试验阳性3例(占7.5%).所有患者均恢复术前工作,29例(占70.7%)恢复到第一次脱位前的运动水平.结论 肩关节镜下Bankart重建手术是治疗复发性肩关节前脱位的有效方法之一.适当的病例选择、术者的关节镜下操作技术水平及术后长期而严格的功能康复锻炼是手术成功的关键.%Objective To discuss the indications, surgical techniques and results of arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation. Methods Fourty patients with recurrent anterior shoulder dislocation treated by athroscopic Bankart repair were reviewed with a mean follow- up period of 35.9 (24 -58) months. The mean age was 27.8 (15 -54) years. All patients were diagnosed as unidirectional anterior instability. They were treated with arthroscopic Bankart repair. Metal suture anchors

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

    Institute of Scientific and Technical Information of China (English)

    徐永通; 孙建东; 郭瑞; 冯涛; 黄楠

    2014-01-01

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

  6. 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%.

  7. 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

  8. Hip Problems in Infants

    Science.gov (United States)

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

  9. 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.

  10. Midterm results after operatively stabilised shoulder dislocations in elderly patients

    OpenAIRE

    Maier, Marcus; Geiger, Emanuel V.; Ilius, Christine; FRANK, JOHANNES; Marzi, Ingo

    2008-01-01

    Anterior shoulder dislocation is frequently seen in young patients. The therapeutic regime in elderly patients after shoulder dislocation is less clearly defined. The aim of this study was to compare the clinical benefit of operative stabilisation following anterior shoulder dislocation in young versus elderly patients. Seventy-two patients with anterior shoulder dislocations were allocated into two groups. Group 1 (> 40 years of age) consisted of 23 patients, and group 2 (

  11. 肩关节前脱位坐位复位法及其解剖学基础%Anterior Dislocation of Shoulder Joint Seat reset Method and Its Anatomical Basis

    Institute of Scientific and Technical Information of China (English)

    韩七十三

    2015-01-01

    Objective To study and analysis the anterior dislocation of shoulder joint seat reset method and anatomical basis. Methods According to the clinical work, 27 cases of patients with symptoms of shoulder joint dislocation were under the treatment through seat reset technology by orthopaedic surgeons. Results Through the treatment of shoulder joint dislocation by seat reset method, 25 cases succeeded and 2 cases after two reset successful, this method was effective. Conclusion Shoulder joint relevant anatomy knowledge and master reset technology, was great helpful to improve treatment and anterior dislocation of shoulder joint, seat reset method was worth promoting.%目的:研究分析肩关节前脱位坐位复位法与解剖学基础。方法针对临床工作中的27例具有肩关节脱位症状的患者,骨科医生通过坐位复位技术对其进行治疗。结果通过对肩关节脱位的患者进行坐位复位法治疗,25例一次性就复位成功,另外2例经过两次复位成功,此方法效果显著。结论了解肩关节相关解剖学知识与掌握复位技术,对治疗和改善肩关节前脱位有很大帮助,坐位复位法值得推广。

  12. 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.

  13. Computed tomography in abnormalities of the hip

    International Nuclear Information System (INIS)

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

  14. TREATMENT OF NEUROLOGICAL CONGENITAL HIP LUXATION

    OpenAIRE

    Iulian ICLEANU; Mariana CORDUN

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    周颖; 楼跃

    2014-01-01

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

  16. 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.

  17. 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.

  18. Multiligamentous injuries and knee dislocations.

    Science.gov (United States)

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

    2015-11-01

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

  19. 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

  20. 创伤性髋关节脱位合并膝关节损伤的临床研究%Knee injury in patients with high-energy traumatic ipsilateral hip dislocation

    Institute of Scientific and Technical Information of China (English)

    吕辉照; 赵枫; 曹杰; 陈阳; 张冬福

    2011-01-01

    Objective To observe the incidence of coexislenl ipsilaleral knee inury in patients with Lraumatic hip dislocation. Methods From April 2004 Lo May 2010, the ipsilaleral knees in 28 palienls who had a traumalic hip dislocation were evaluated prospeclively on the basis of a standardized history, physical examination, and magnelic resonance imaging. Results 21 (75% ) of the 28 knees were painful. 25 ( 89% ) knees had visible evidence of soft-tissue injury by inspection. As one knee was excluded because of artifacts, magnetic resonance imaging revealed evidence of abnormality in 25 (93%) of the left 27 knees, among which effusion (37% ) , bone bruise (33% ) , and meniscal tear (30% ) were the most common findings. Conclusions The present study provides evidence for a high incidence of associated ipsilaleral knee injuries in palients with traumalic hip dislocation. Bone contusion may be a possible explanation for persislenl knee pain following a traumalic hip dislocation. Regular use of magnetic resonance imaging is recommanded for the evaluation of these patients in order to detect injury that may not be discoverable by history and physical examination.%目的探讨创伤性髋关节脱位中合并的膝关节损伤的发病情况.方法 2004年4月至2010年5月本组共收治创伤性髋关节脱位患者28例,通过同侧膝关节的病史、体格检查和MRI检查,研究所有创伤性髋关节脱位患者同侧膝关节的损伤情况.结果 28例髋关节脱位患者中有21例(75%)同侧膝关节疼痛.体格检查中25例(89%)发现软组织损伤的可见证据,2例(7%)交叉韧带或侧副韧带损伤,10例(36%)膝关节积液,4例(14%)半月板损伤的体征.28例膝关节MRI检查中1例产生伪影予排除,其余27例中有25例MRI上发现异常信号,其中膝关节积液(37%)、骨挫伤(33%)、半月板撕裂(30%)是最常见的异常.结论 该研究中发现创伤性髋关节脱位患者合并同侧膝关节损伤的发病率较高,骨挫伤可

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

    OpenAIRE

    Vasileios Sakellariou; Michael Christodoulou; Gregory Sasalos; George Babis

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王楠; 覃倩; 叶蕾

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    梁栋; 史颖奇; 郑允直; 范丁安; 张荣英; 王承武; 范源

    1986-01-01

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

  4. 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.

  5. CORRELATION ANALYSIS BETWEEN RECURRENT ANTERIOR SHOULDER DISLOCATION AND SECONDARY INTRA-ARTICULAR INJURIES%复发性肩关节前脱位与关节内继发损伤的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李海峰; 刘玉杰; 李众利; 李春宝; 董晓艳; 朱娟丽; 刘洋

    2012-01-01

    目的 通过分析肩关节前脱位次数、病程与关节内继发损伤的关系,探讨复发性肩关节前脱位对关节内继发损伤的影响. 方法 回顾分析2005年1月- 2009年6月关节镜下应用缝合锚钉行Bankart重建术治疗的59例复发性肩关节前脱位患者临床资料.男48例,女11例;年龄15~42岁,平均27.6岁.初次脱位原因:接触性体育运动21例,非接触性体育运动13例,日常活动11例,外伤14例.术前脱位3~32次,平均10.6次.初次脱位至手术时间为11个月~12年,中位时间5.9年.患者恐惧试验及复位试验均呈阳性.术前美国加州大学洛杉矶分校(UCLA)肩关节功能评分为(22.3±2.4)分,Constant-Murley评分为(73.1±5.8)分.关节镜下观察关节内继发损伤情况,并进行统计分析. 结果 术后患者切口均Ⅰ期愈合.患者均获随访,随访时间16~58个月,平均37.3个月.末次随访时,UCLA肩关节功能评分为(34.6±1.7)分,Constant-Murley评分为(86.7±6.1)分,与术前比较差异均有统计学意义(P<0.05).术前关节脱位次数和关节软骨损伤的严重程度成正相关(rs=0.345,P=0.007),和Hill-Sachs损伤严重程度成正相关(rs=0.708,P=0.000);首次脱位至手术时间和关节软骨损伤严重程度成正相关(rs=0.498,P=0.000),与Hill-Sachs损伤严重程度无相关性(rs=0.021,P=0.874). 结论 复发性肩关节前脱位早期行Bankart重建有利于肩关节功能恢复,避免或延缓关节内继发损伤的发生和发展.%Objective To explore the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries through analyzing the correlation between the number of dislocation, disease duration, and the secondary intra-articular injuries. Methods The clinical data were analyzed retrospectively from 59 patients with recurrent anterior shoulder dislocation who underwent arthroscopic Bankart reconstruction using suture anchor between January 2005 and June 2009. There were 48

  6. 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

  7. 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.

  8. Study on the Effect of Anterior Operation for Treatment of Cervical Fracture and Dislocation%前路手术治疗颈椎骨折脱位的效果研究

    Institute of Scientific and Technical Information of China (English)

    孙忠林

    2015-01-01

    Objective Anterior surgery treatment effect to cervical spine fracture and dislocation is to be studied.MethodsChoose 44 patients with cervical spine fracture and dislocation who were received and treated in hospital from November 2013 to December 2014 and separate them into two groups according to their hospitalization sequence with 22 patients in study group and 22 patients in control group, patients in study group are given anterior surgery treatment, while patients in control group are given posterior surgery treatment, and then compare treatment effects between two groups.Results Patients’ treatment efficacy, ASIA rating and complication incidence in study group are much more favorable than counterparts in control group, there is a treatment differential between two groups, and such a differential has statistic value (P<0.05).Conclusion Anterior surgery treatment is of efficacy in treatment of patients with cervical spine fracture and dislocation, it is conducive to patients’ recovery and reducing complication incidence, thus, such a surgery treatment is quite worthwhile to be promoted and applied clinically..%目的:探讨前路手术治疗颈椎骨折脱位的效果。方法选取2013~2014年12月我院收治的44例颈椎骨折脱位患者,按照入院的先后顺序分为22例研究组和22例参照组,研究组采用前路手术,参照组采用后路手术,观察两组患者的治疗效果。结果研究组患者的治疗总有效率、ASIA评级、并发症的发生率明显优于参照组,差异显著,有统计学意义(P<0.05)。结论前路手术治疗颈椎骨折脱位的效果显著,患者的恢复情况好,有效降低并发症的发生率。

  9. 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...

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

    Directory of Open Access Journals (Sweden)

    Stanislav Vyacheslavovich Ivanov

    2014-12-01

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

  11. 尺骨截骨钢板内固定治疗儿童陈旧性桡骨头前脱位%Ulnar osteotomy and internal fixation for old anterior dislocation of radial head in children

    Institute of Scientific and Technical Information of China (English)

    陈志文; 丁真奇; 林斌; 翟文亮; 刘晖

    2011-01-01

    目的:探讨尺骨截骨内固定手术治疗儿童桡骨头陈旧性前脱位的临床疗效.方法:2004年1月至2010年1月,采用切开复位桡骨头、尺骨上段截骨内固定治疗18例陈旧性桡骨头前脱位患者.其中男12例,女6例;年龄3~15岁,平均(6.9±1.3)岁;受伤至手术时间为5~65个月,平均(24.0±5.5)个月.所有患者术前均有肘关节屈伸活动和前臂旋转活动受限,但均无桡神经损伤,桡骨头无明显变形.结果:所有患者伤口均Ⅰ期愈合,未发生骨不连、桡骨头再脱位及神经损伤等并发症.所有患者均获随访,时间9~38个月,平均(17.0±4.5)个月;骨折愈合时间2.3~3.9个月,平均(2.8±0.5)个月.术后肘关节屈曲活动及前臂的旋转活动较术前明显改善.根据朱玉奎等评定标准,优14例,良3例,可1例.结论:尺骨截骨内固定治疗儿童陈旧性桡骨头前脱位疗效满意,可以有效地改善肘关节屈伸及前臂旋转的功能,防止桡骨头再次脱位.%Objective: To evaluate the clinical results of ulnar osteotomy and internal fixation in treating old anterior dislocation of radial head in children. Methods: From Jan.2004 to Jan.2010,18 patients with old anterior dislocation of radial head were treated with open reduction for radial head and ulnar osteotomy and internal fixation,including 12 males and 6 females with an average age of (6.9± 1.3 ) years (3 to 15 years). Among them, 15 cases had history of external injury, from injury to operation was for 5-65 months with an average of (24.0±5.5) months. Limitation of activity occurred in all patients including flexion and extension of elbow joint and rotation of forearm ,without radial nerve injury and obviously radial head deformation.Results:All incisions obtained primary healing and no nonunion, re-dislocation of radial head and nerve injury were found. All patients were followed up from 9 to 38 months with an average of(17.0±4.5) months. Union time of fracture was from 2

  12. 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.

  13. Techniques and Results for Open Hip Preservation.

    Science.gov (United States)

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

    2015-01-01

    While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is the most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/or acetabulum. Chronic slipped capital femoral epiphysis may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy. PMID:26649292

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

    Science.gov (United States)

    Kolb, A; Windhager, R; Chiari, C

    2015-11-01

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

  15. Subtalar dislocation

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-05-01

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

  16. Subtalar dislocation

    International Nuclear Information System (INIS)

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

  17. 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

  18. 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.

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

    Institute of Scientific and Technical Information of China (English)

    韦宜山; 刘万林; 丁良甲; 王炳海; 白锐; 李岱鹤; 赵振群

    2012-01-01

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

  20. 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

  1. Early clinical efficacy of total hip arthroplasty through direct anterior approach%直接前侧入路全髋关节置换的早期临床疗效

    Institute of Scientific and Technical Information of China (English)

    高辉; 陈震东; 徐房添; 何春耒

    2016-01-01

    Objective To compare the difference of short-term clinical effects of primary total hip arthroplasty (THA) through direct anterior approach (DAA) versus standard lateral approach, and to explore the application value of DAA THA. Methods Clinical data of 35 patients were collected who underwent THA in First Affiliated Hospital of Gannan Medical University from August 2013 to August 2014, and were analyzed retrospectively. They were treated by unilateral DAA THA with the assistance of lower extremity traction device and reamer with greater curvature (DAA group), length of incision, operation time, intraoperative estimate blood loss, hospital stay, complications and Harris scores were evaluated. Another 47 patients treated by THA through standard lateral approach (standard group) over the same period were also included, and their parameters were recorded and compared with those in DAA group. Results In DAA group and standard group, the average length of incision, operation time, intraoperative estimate blood loss and hospital stay were (9.5 ± 1.5) cm and (12.3 ± 1.6) cm, (110 ± 14) min and (133 ± 12) min, (219 ± 105) mL and (260 ± 62) mL, (7.8 ± 1.9) days and (9.1 ± 1.8) days respectively, there were statistical differences between two groups (P<0.05). The mean follow-up time was 18 months (range, 14-26 months). The average hip Harris scores were significantly higher at 6 weeks, 3 and 6 months postoperatively in DAA group compared with those in standard group, while the difference had not statistical significance at 1 year postoperatively between two groups. No complications of intraoperative femur fracture, lateral femoral cutaneous nerve injury, postoperative surgical site infection, hip joint dislocation, deep venous thrombosis, implant loosening or heterotopic ossification was observed. Conclusions Compared to THA through standard lateral approach, DAA THA could reduce soft tissue injury, decrease intraoperative estimate blood loss, and be beneficial to

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

    Institute of Scientific and Technical Information of China (English)

    房论光; 马承宣; 王雅琴; 许瑞江

    1989-01-01

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

  3. Hennipen 法治疗老年患者肩关节前脱位的临床疗效观察%Clinical effect of Hennipen method to treat elderly patients with anterior dislocation of the shoulder joint

    Institute of Scientific and Technical Information of China (English)

    陈孙裕; 肖展豪; 李坚

    2016-01-01

    Objective To analyze the clinical curative effect of Hennipen method to treat elderly patients with anterior dislocation of shoulder joint.Methods Between February 2013 and June 2015,57 elderly patients with acute anterior dislocation of shoulder joint were colleted in our hospital.The patients aged from 65 to 81,with average age of 72.3 years.Hennipen method was used to replace the dislocation of shoulder joint.Visual analogue scale (VAS)scores and joint range of motion before and after treatment were recorded to evaluate its clinical effect.Results All cases were checked with X -ray to comfirm had been reducted,and had no complications,such as proximal humeral fractures,axillary nerve injured.1 case failed maneuver reduction,so was tracted and reseted again after anesthesia.Before treatment,the VAS scores was (5.4 ±0.9)points,which after treatment was (1.9 ±0.7)points, and the difference was significant(t =12.43,P <0.01).The range of motion of the shoulder joint was significantly improved.Conclusion Hennipen method is simple,to threat anterior dislocation of shoulder joint of elderly patients, it can effectively relieve pain,reduce complications,which is worthy of clinical promotion.%目的:分析 Hennipen 法治疗老年患者肩关节前脱位的临床疗效。方法收集厦门大学附属福州市第二医院治疗的急性肩关节前脱位老年患者57例,年龄65~81岁,平均72.3岁。所有患者采用Hennipen 法复位肩关节,治疗前后记录肩关节活动度,采用疼痛视觉模拟量表(VAS)评分,评估其临床效果。结果所有患者行 X 线检查,证实整复成功,未出现肱骨近端骨折、腋神经损伤等并发症,1例复位失败,改麻醉下牵引复位。治疗前 VAS 评分为(5.4±0.9)分,治疗后 VAS 评分为(1.9±0.7)分,治疗前后 VAS 评分差异有统计学意义(t =12.43,P <0.01)。治疗后患者关节活动度均明显改善。结论Hennipen 法复

  4. 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

  5. Application of MSCT and MRI in diagnosing Bankart injury of recurrent anterior dislocation of shoulder joint%MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值

    Institute of Scientific and Technical Information of China (English)

    易雪冰; 张德洲; 钟鉴

    2011-01-01

    目的:探讨MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值.方法:回顾性分析经临床、影像证实的复发性肩关节前脱位Bankart病损10例患者的MSCT、MRI表现,主要观察肩关节盂唇前方的CT、MRI改变.结果:10例中,CT发现肩关节盂前下份撕脱性骨折4例,MRI发现肩关节前下盂唇撕脱性骨折1例;MRI发现肩关节盂唇损伤10例,CT不能显示;CT发现合并Hill-Sachs损伤6例,MRI发现Hill-Sachs损伤8例;CT未能发现肱骨头骨挫伤3例;MRI发现肩袖损伤6例,Slap损伤1例.结论:MSCT、MRI能够相互补充,清晰显示Bankart病损及其他合并病变,为临床诊断及治疗提供更加充分的资料.%Objective : To investlgate the application of MSCT and MRI in B ankart injury of recurrent anterior dislocation of shoulder joint Methods :Retrospectively analyse 10 cases Bankart injury of recurrent anterior dislocatlon of shoulder joint by clinic and radiology.Analysed the manifestations of shoulder joint an terior labrum articularis of spiralCT and MRI.Results : In 10 cases of Bankart injury of recurrent an terior dislocation of shoulder pint , there were 4 cases of avulsion fiacture of shoulder pint anterior labrum examined by CT , 1 case by MRI; 6 cases of Hill-Sachs injury were found examined by CT , 8 cases of Hill-Sachs injury and 3 cases of bone contusion of hum eralhead were found by MRI; 6 cases of rotator cuff injury and 1 case of slap injury were found exam ined by MRI.Conclusion :Spial CT and MRI can display Bankart injury and other coexisting lesion , which provide sufficient data for the clinic.

  6. 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.

  7. 伴有骶髂关节完全性前脱位的骨盆骨折治疗%Management of pelvic injury associated with complete anterior sacroiliac joint dislocation

    Institute of Scientific and Technical Information of China (English)

    吴宏华; 吴新宝; 李宇能; 杨明辉; 王满宜

    2015-01-01

    Objective:To investigate the management of pelvic injury associated with complete anterior sacroiliac joint dislocation.Methods:In the study, 6 cases of pelvic injury associated with complete an-terior sacroiliac joint dislocation treated in Beijing Jishuitan Hospital from February 2008 to June 2014 were analyzed.We described the history and severity of injury, emergency treatment, and fracture radio-logy.In all the cases, the surgical treatment and postoperative functional exercise were performed.We followed up all the cases on an average of 1.6 years, assessed the postoperative recovery and summed up the treatment experience.Results:All the 6 patients with fractures recovered without infection and nerve symptoms after surgery.Their X-rays showed good reduction of sacroiliac joints.All the cases were followed up on an average of 1.6 years.Six months after surgery, the Majeed scores were perfect in 2 cases, good in 2, fair in 1, and poor in 1.The patients with poor scores suffered persistent pain, and decreased physical activity, and when walking long distances, they needed a walking stick.The 2 patients with low scores could not resume the original work.Conclusion:Pelvic injury associated with complete anterior sacroiliac joint dislocation is a special type of the pelvic injury since the managements during the emergency phase are difficult.The surgery should be done as early as possible, and the anterior approach is available for the reduction and fixation.%目的:总结伴有骶髂关节完全性前脱位的骨盆骨折的治疗经验。方法:对北京积水潭医院2008年2月至2014年3月收治的6例伴有骶髂关节完全性前脱位骨盆骨折的资料进行回顾性分析,描述患者病史、损伤程度、急诊救治等特征,通过影像学判断损伤情况,给予手术治疗,术后功能锻炼,并对患者进行随访以评估术后恢复情况,总结治疗经验。结果:全部6例患者术后愈合良好,无感染和术后

  8. 学龄儿童双侧先天性髋关节脱位的手术治疗及术后功能锻炼%Operation and postoperative functional exercise for congenital dislocation of double hips in school-age children

    Institute of Scientific and Technical Information of China (English)

    雷伟; 李明全; 黄耀添; 赵黎; 崔庚; 袁志

    2002-01-01

    Objective To discuss different methods of operation for congenital dislocation of double hips in school-age children. Method 25 patients (50 hips) were operated with Salter, self-acetabuloplasty and combined operation. Result 22 patients with 44 hips were followed up for 2 to 18 years (an average of 9.5 years) with 86.4% reporting excellent and good results. Conclusion Acetabuloplasty and shelf can effectively increase the width of acetabulaum resulting in a better coverage of the femoral head. So acetabuloplasty and shelf operation is highly recommended because of its wider range of indication and good results. Joint function can regain best after early, continuous, passive and active functional exercise.

  9. Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation%肩关节镜下带线锚钉内固定治疗复发性肩关节前脱位

    Institute of Scientific and Technical Information of China (English)

    姜侃; 孙荣鑫; 钟广军

    2012-01-01

    Objective:To investigate the curative effect of arthroscopic glenoid labrum repair by biodegradable anchor fixation for recurrent anterior shoulder dislocation. Methods: Twenty-one patients of recurrent anterior shoulder dislocation with the average UCLA function score of 22. 3 ±4. 1 were treated with arthroscopic glenoid labrum repair by biodegradable anchor fixation. The shoulder was fixed by shoulder-elbow elastic band for 4 - 6 weeks and canonical exercise of shoulder joint was taken postoperatively. Results; The patients were followed up for 3-18 (mean 8) months; and the average UCLA score was 32. 3 ± 2. 6 postoperatively. The excellent results (34 -35) were obtained in 11 patients, good (28-33) in 7 patients and fair (21-27) in 3-'patients. The activity of shoulder joint was normal in all patients with an excellent subjective degree of satisfaction. Conclusion; Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation has the advantages of less invasiveness, simpler procedure , reliable fixation, less complications and rapid functional recovery.%目的:探讨肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位的疗效与方法.方法:本组21例复发性肩关节前脱位患者,肩关节功能评估采用美国加州洛杉矶大学UCLA功能评分标准,术前评分平均(22.3±4.1)分.全部采用肩关节镜下可吸收带线锚钉内固定修复盂唇损伤.术后肩肘固定带固定患肩4~6周,按规定程序进行康复锻炼.结果:经3~18个月(平均8个月)的随访,术后UCLA评分平均(32.3±2.6)分.优(34~35分)11例,良(28 ~ 33分)7例,中(21 ~27分)3例,无差病例.术后肩关节活动范围正常.患者主观满意度:均较满意.结论:肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位,具有创伤小、操作简便、内固定可靠、术后并发症少、功能恢复快等优点,是

  10. Observation on the Curative Effect of Anterior Approach Surgery for the Treatment of Cervical Fracture-Dislocation%前路手术治疗下颈椎骨折脱位的疗效观察

    Institute of Scientific and Technical Information of China (English)

    谢旭垣; 孔志强; 龙朝仪; 成本强

    2016-01-01

    目的:探讨颈椎前路减压复位植骨融合内固定手术治疗下颈椎骨折脱位的疗效。方法对本院自2010年6月至2014年6月收治的24例下颈椎骨折脱位患者采用前路减压复位、自体骨植骨、锁定钛板或加钛网内固定手术,评估术后颈椎生理曲度、植骨融合程度、神经功能恢复情况。结果术后随访4~24个月,定期X线检查,发现术后颈椎Cobb角测量结果比术前明显改善。按照Lenke标准分级,椎间植骨在术后6个月内均得到有效融合。根据Franke1分级显示,绝大部分患者术后神经功能得到不同程度的改善。所有患者的JOA得分均有明显提高。结论下颈椎骨折脱位应用前路减压复位植骨融合内固定手术操作简单,可早期稳定脊柱,恢复颈椎正常弯度及高度,能有效解除脊髓压迫,促进脊髓神经功能的恢复。%Objective To explore the curative effect of anterior cervical decompression and reduction, bone graft fusion and internal fixation for the treatment of subaxial cervical fracture-dislocation. Methods A total of 24 patients with cervical fracture-dislocation admitted to our hospital from June 2010 to June 2014 were selected. All patients received anterior decompression and reduction, autograft, and internal fixation. The postoperative cervical curvature, bone graft fusion degree and recovery of nerve function were evaluated. Results All patients were followed-up for 4~24 months. The X-ray examination showed that the cervical Cobb angle after operation was significantly better than that before operation. According to Lenke classification standard, all the lumbar intervertebrae fusion achieved to effective integration within 6 months. According to the Frankel classification, most patients had varying degrees of improvement in the postoperative nerve function, and the JOA score of all patients had significant improvement. Conclusions Anterior cervical decompression and reduction

  11. Anterior Approach Total Hip Replacement

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    Full Text Available ... have been anxiously waiting for some long-term data on the metal on metal here in the ... vitamin E doped polyethylene, and, you know, the data on this from the lab and the early ...

  12. Anterior Approach Total Hip Replacement

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

  13. Anterior Approach Total Hip Replacement

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    Full Text Available ... completely different sideline. So I’ve got these soft tissue preserving reamers that only have one band of ... which is an inset ring lock to keep soft tissue out of it, titanium, which obviously has a ...

  14. Anterior Approach Total Hip Replacement

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    Full Text Available ... That’s an excellent question. We actually have a publication in press looking at that exact question. And ... muscle. It’s so important because there’s been some literature suggesting otherwise. Well as I explain, Roger, that ...

  15. Anterior Approach Total Hip Replacement

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    Full Text Available ... going on here. And I’ll particularly pay attention to this tensor fascia latae. Yeah. The time ... don’t, that posterior capsule can get your attention, so what you do is you know, expose ...

  16. Anterior Approach Total Hip Replacement

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    Full Text Available ... assistant, Kurt, has the foot next to his knee and he’s figuring-fouring the leg, and this ... very gently, nothing hard, and he’s flexing the knee slightly. The more you flex the knee, the ...

  17. Anterior Approach Total Hip Replacement

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    Full Text Available ... you were using metal/metal. What is your thinking there? I have been anxiously waiting for some ... on this from the lab and the early critical data is outstanding. Yeah. It doesn’t wear, ...

  18. Anterior Approach Total Hip Replacement

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    Full Text Available ... t do anything silly. You know there was reports in the “JBJS” a while back about two ... it from jumping over the pelvis. There’s been reports with two incisions in particular, when you do ...

  19. Anterior Approach Total Hip Replacement

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    Full Text Available ... that. The other one was about using a fracture table. Was the learning curve any different with the fracture table versus the regular OR table? I do ... same position that you would achieve with the fracture table. But the fracture table it’s an uncomplaining ...

  20. Anterior Approach Total Hip Replacement

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    Full Text Available ... microplasty stem. If you compare it to the standard stem, you can see it’s not only shorter, ... with the microplasty if I template one size standard Taperloc, I almost get in a one size ...

  1. Anterior Approach Total Hip Replacement

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    Full Text Available ... they do have a power corkscrew, I understand, works much better. Yeah. But through these small incisions ... Yes. Yes. Start against the calcar and then work laterally. See that? That makes it very safe, ...

  2. Anterior Approach Total Hip Replacement

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    Full Text Available ... dysplasia with cystic changes and loss of joint space. No real significant osteophytes we’re going to ... sort of used to looking at things in space. I agree completely. But when you put your ...

  3. Anterior Approach Total Hip Replacement

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    Full Text Available ... Let’s go. Great. Well, thanks, Roger, for that introduction, and welcome everyone to the Mount Carmel New ... just good tools. So I would say the learning is about the same. Well ... ahead while I got the machine in there, and pre-treat that posterior capsule ...

  4. Anterior Approach Total Hip Replacement

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    Full Text Available ... is Dr. Roger Emerson from Plano, Texas, and I will be moderating this webcast. I will ask Dr. Berend questions, and we can ... webcast, you have an interest in this procedure. I have used this approach myself since 2005, and ...

  5. Anterior Approach Total Hip Replacement

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    Full Text Available ... Let’s save that image. Go to the other side. Now I’ll tell you one other thing about this approach, Roger, is that the stem size and stem position is right on every time, because if you look at this image, I feel like that’s a really good size there. Perfect. I like the way it’s ...

  6. Anterior Approach Total Hip Replacement

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    Full Text Available ... capsule. Okay. What do you think on the learning curve? 4 No, I think that’s good. I ... to the other camera, Roger, I think the learning curve in my hands is about 36, but ...

  7. Anterior Approach Total Hip Replacement

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    Full Text Available ... them. 3 I tend to if they’re big. But if they’re smaller, I’ve gotten ... very comfort and to eliminate the outliers the big blood-loss case and the real increased time ...

  8. Anterior Approach Total Hip Replacement

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

  9. Anterior Approach Total Hip Replacement

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

  10. Anterior Approach Total Hip Replacement

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

  11. Anterior Approach Total Hip Replacement

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    Full Text Available ... use fluoro, and I’ve really fallen in love with it. So I’m going to use ... and I’m able to use a modern generation highly cross-linked, highly eradiated, and then vitamin ...

  12. Anterior Approach Total Hip Replacement

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    Full Text Available ... that you release. So, Roger, we’re just working our way around here. 5 You know what ... flex the leg at all when you’re working? Under the rectus, that’s a good view. There ...

  13. Anterior Approach Total Hip Replacement

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    Full Text Available ... important because there’s been some literature suggesting otherwise. Well as I explain, Roger, that literature comes from the cadaver, where everything has to be forced and the tissues are not normal. So ...

  14. Anterior Approach Total Hip Replacement

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    Full Text Available ... that occurs with this device is dependent upon energy and time. So you want to treat these ... re flattening the bed out and putting a clean drape down because it was down towards the ...

  15. Anterior Approach Total Hip Replacement

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    Full Text Available ... he said that there’s not a patient on earth that doesn’t have these vessels. And in ... table that’s extending; right? Yeah. Not on the flat part. It’s on the part that’s hyperextended. Yeah. ...

  16. Anterior Approach Total Hip Replacement

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    ... he said that there’s not a patient on earth that doesn’t have these vessels. And in ... table that’s extending; right? Yeah. Not on the flat part. It’s on the part that’s hyperextended. Yeah. ...

  17. Anterior Approach Total Hip Replacement

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    Full Text Available ... We have a question here from a Dr. Johnson. “How often do you see fractures while doing ... stable. Okay. We have another question from Dr. Johnson. He’s been very good with his questions tonight. ...

  18. Anterior Approach Total Hip Replacement

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    Full Text Available ... OR-Live” webcast presentation, live from Mount Caramel New Albany Surgical Hospital in New Albany Ohio, and brought to you by Biomet ... to tonight’s webcast. We are here at the New Albany Surgical Hospital outside of Columbus Ohio, and ...

  19. Anterior Approach Total Hip Replacement

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    Full Text Available ... take a quick look at this patient’s preoperative x-rays, which we have templated using the Biomet Microplasty ... just like you’re looking at your AP X-ray on the view box. That’s right. Or in ...

  20. Anterior Approach Total Hip Replacement

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    Full Text Available ... attributed to the Jeu de brothers, Robert and John, who practiced orthopedic surgery in France in the ‘ ... So I agree completely. I know Chris and John Cagey have worked on saving the capsule. I ...

  1. Infant hip sonography: current concepts.

    Science.gov (United States)

    Harcke, H T; Grissom, L E

    1994-08-01

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

  2. Effects of Push-up Exercise with Hip Adduction on the COP Deviation and the Serratus Anterior and L1 Paraspinal Muscles

    OpenAIRE

    Kim, Min-Hee; Yoo, Won-Gyu

    2013-01-01

    [Purpose] This study investigated the effect of push-up exercise with hip adduction on the COP deviation and SA and L1 spinal muscle activation. [Subjects] Twelve males aged 20–30 years were recruited. [Methods] We measured the COP deviation and SA and L1 spinal muscle activities during push-up exercise with and without hip adduction [Results] The COP deviation significantly decreased and the SA and L1 spinal muscles were significantly increased during push-ups with hip adduction when compare...

  3. Tratamento das luxações traumáticas da coluna cervical por meio da abordagem anterior Treatment of traumatic dislocations of the cervical spine through anterior approach

    OpenAIRE

    Defino, Helton L. A.; Fábio Gomes Figueira; Lauro Schledorn de Camargo; Fabiano Ricardo de Tavares Canto

    2007-01-01

    Foram estudados 20 pacientes portadores de luxação traumática uni ou bifacetária da coluna cervical tratados pela artrodese e fixação anterior. Os pacientes foram avaliados por meio de parâmetros clínicos, radiológicos e funcionais. Os pacientes foram seguidos por um período que variou de 1 a 14 anos. A consolidação radiológica da artrodese foi observada em todos os pacientes e 1 paciente apresentou soltura tardia de um dos parafusos. A angulação no plano sagital do segmento vertebral lesado ...

  4. 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.

  5. 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.

  6. 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...... arthroplasty (THA). METHODS: Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study. RESULTS: We...

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

    OpenAIRE

    Lewis, Cara L.; Garibay, Erin J.

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    韦宜山; 刘万林; 丁良甲; 王炳海; 白锐; 李岱鹤; 赵振群

    2012-01-01

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

  9. Management of dislocated intraocular implants.

    Science.gov (United States)

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

    2001-12-01

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

  10. Multi-slice CT evaluation of glenoid bone loss in patients with recurrent anterior shoulder dislocation%多层螺旋CT评价复发性肩关节前方脱位的前方关节盂骨质缺损的临床意义

    Institute of Scientific and Technical Information of China (English)

    崔志新; 张悦; 郑卓肇; 任阿红

    2012-01-01

    目的 在复发性肩关节前方脱位中,利用MSCT评估关节盂前方骨质缺损情况.方法 回顾分析108例复发性肩关节前脱位和12例单次肩关节脱位患者的MSCT检查,对比评价前方关节盂骨质缺损的发生率、程度及位置.利用Fisher精确概率法分析前方关节盂骨质缺损的发生率,利用Wilcoxon秩和检验比较前方关节盂骨质缺损的上下长径、深度及比例.结果 在复发性肩关节前脱位中,91.7%(99/108)存在前方关节盂的骨质缺损,缺损比例为(16.0±6.0)%,缺损中心位置介于时钟分区的2:20~ 4:25点(平均3:20点),62.0%(67/108)前方出现骨性Bankart病变,包括游离型39例(58.2%)及黏附型28例(41.8%).12例单次肩关节脱位中,9例出现前方关节盂骨质缺损,其缺损发生率(9/12;P=0.100)和缺损比例[(15.2±7.1)%;P=0.453]与复发性肩关节脱位比较差异均无统计学意义.结论 前方关节盂骨质缺损为复发性肩关节前方脱位的常见表现.%Objective To evaluate multi-slice CT (MSCT) in glenoid bone loss of patients with recurrent anterior shoulder dislocation.Methods MSCT findings of 108 patients with recurrent anterior shoulder dislocation and 12 with single anterior shoulder dislocation were retrospectively studied.The incidence,degrees and locations of glenoid bone losses were recorded.The incidence was analyzed with Fisher exact test.The maximum length,depth and proportion were compared with Wilcoxon rank sum test.Results Glenoid bone loss was detected in 91.7% (99/108)patients with recurrent anterior shoulder dislocation.The proportion of glenoid bone loss was ( 16.0 ± 6.0)%,and the central locations of glenoid bone loss were from 2: 20 to 4: 25 ( mean 3: 20).Sixty-two percent (67/108) patients had bony Bankart lesions in which 58.2% (39/67) bony fragments were free and 41.8% (28/67) were adherent to the anterior border of the glenoid cavity.Seventy-five percent (9/12) patients with single

  11. 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.

  12. Pathologic ligamentous constraint of the hip.

    Science.gov (United States)

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

    1983-12-01

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

  13. 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.

  14. 下颈椎脱位早期复位前路内固定疗效分析%Analysis of Dislocation of the Lower Cervical with Early Reset Combined Internal Fixtion of Anterior Fusion

    Institute of Scientific and Technical Information of China (English)

    付涟桥; 刘晓岚; 张金明; 唐金平; 谭震; 童杰; 刘社庭

    2011-01-01

    objective To observe the clinical effect with early reset combined internal fixation of anterior fusion in treatment of patients with dislocation of the lower cervical. Methods Dislocation of the lower cervical early closed traction reset (Skull traction reset and general anesthesia closed traction reset) and open surgery Skiing dial vertebral reset.and the vertebral between bone graft fusion fixation 64 cases. Results Closed reduction 54 cases of success,a-mong skullt traction reset 33 cases ,general anesthesia closed traction reset 21 cases, 10 cases in the way traction and rotating prying reset success. There are 48 cases have 8~30 months follow-up,All patients were with cervical reset completely,fusion bone graft, no internal fixation loose, fracture. Nerve damage in different degree recovery. Spinal cord Frankel grading by an average of grade 1. Conclusion Early traction reset combine fixation surgery therapies, make spinal cord compression time shorten, favors the neural function recovery .complication less, recover faster, effective relieve nursing difficulty. It is a safe and effective treatment.%目的 观察下颈椎脱位患者早期复位结合前路内固定手术治疗的临床效果.方法 选择下颈椎骨折脱位早期行闭合复位(颅骨牵引复位和在全麻下行闭合牵引复位)以及前路开放撬拨椎体复位,并予以椎间植骨融合内固定64例.结果 闭合复位成功54例,其中颅骨牵引复位33例,全麻下闭合手法牵引复位21例;在前路手术中牵引下行旋转撬拨复位成功10例.48例患者获8~30个月随访,颈椎复位完全,植骨均融合,无内固定松动、断裂及脱出,神经损伤均有恢复,脊髓Frankel分级平均提高1级.结论 早期复位结合前路内固定手术治疗下颈椎骨折脱位是一种安全、有效的治疗方法.

  15. Hip sonography in the newborn

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  17. 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.

  18. 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.

  19. 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.

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

    OpenAIRE

    Lacy, Kyle; Cooke, Chris; Cooke, Pat; Schupbach, Justin; Vaidya, Rahul

    2015-01-01

    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 im...

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

    Institute of Scientific and Technical Information of China (English)

    李志威

    2011-01-01

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

  2. 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

  3. Double Dislocation of Interphalangeal Joints Accompanied with Contralateral Shoulder Dislocation: A Case Report.

    Science.gov (United States)

    Raval, Pradyumna Ramchandra; Jariwala, Arpit

    2016-02-01

    Dislocation of any joint is an orthopaedic emergency and needs immediate attention by the attending physician. A delay in reducing a dislocated joint can lead to disastrous complications both immediately as well as in the long run. Although anterior dislocation of a shoulder joint is by far the commonest dislocation encountered by any emergency care physician, other joints may also get dislocated. In certain cases two joints may get dislocated simultaneously. Such dislocation is known as a double dislocation. Double dislocation of the proximal interphalangeal joint and the distal interphalangeal joint in the same finger is a rare injury. High impact loading at the fingertip is the primary cause in most cases and it is often associated with younger individuals playing contact sports. The right little finger is the digit commonly involved and this injury is evident in football players more often than not. Although closed reduction is a preferred treatment, it may not be always successful. Time of presentation, tendon interposition, associated swelling and co-existent phalangeal fractures are certain key impediments to a successful closed reduction manoeuvre. In patients with an open injury, a thorough wash out and appropriate antibiotic cover is mandatory. We report a rare case of double dislocation of the interphalangeal joints accompanied with contralateral shoulder dislocation in an elderly man sustained after a fall which was treated successfully with closed reduction and early mobilization. PMID:27028386

  4. 前后联合入路治疗经鹰嘴肘关节骨折脱位%Combined anterior and posterior approach in treatment of transolecranon fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    程宇; 张志刚; 徐耀增; 杨惠林; 张洪涛; 徐明

    2016-01-01

    目的 探讨前后联合入路治疗经鹰嘴肘关节骨折脱位的临床疗效. 方法 回顾性分析2010年9月至2014年10月采用肘关节前后联合入路治疗的6例经鹰嘴肘关节骨折脱位患者资料,男4例,女2例;年龄25 ~ 63岁,平均42.5岁.开放性损伤1例(Gustilo-Anderson I型),闭合性损伤5例.合并伤:尺骨冠状突骨折6例,桡骨头骨折5例.术后根据肘关节正、侧位X线片观察骨折愈合的情况,末次随访时通过肘关节Broberg-Morrey功能评分评定疗效. 结果 术后切口均一期愈合,无早期并发症发生.6例患者术后获平均14个月(9 ~ 22个月)随访,术后6个月时骨折均已愈合.末次随访时肘关节的平均活动范围:屈伸127°(90°~145°),旋转112°(80 ~150°),Broberg-Morrey功能评分平均89分(74~96分),其中优2例,良3例,可1例.未出现肘关节不稳、异位骨化和内固定物松动、断裂等情况. 结论 肘关节前后联合入路治疗经鹰嘴肘关节骨折脱位视野清晰,有利于解剖复位并坚强固定,术后可早期行肘关节功能锻炼,短期疗效佳.%Objective To observe the treatment of transolecranon fracture-dislocation using combined anterior and posterior approach.Methods From September 2010 to October 2014,6 patients (4 males and 2 females) with transolecranon fracture-dislocation were treated via the combined anterior and posterior approach at our department.Their average age was 42.5 years (from 25 to 63 years).One case had open injury (Gustilo-Anderson type I) and 5 closed injury.Six cases were associated with coronoid process fracture and 5 with radial head fracture.Bone union was assessed by elbow anterioposterior and lateral radiographs.The elbow function was assessed at the last follow-up according to the Broberg-Morrey functional rating indexes.Results All the 6 patients achieved primary incision healing with no early complications.They were followed up for an average period of 14 months (from 9 to 22

  5. Shoulder dislocation in patients older than 60 years of age

    Directory of Open Access Journals (Sweden)

    Rapariz Jose

    2010-01-01

    Full Text Available Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test and by imaging testing (X-ray, MRI. Results: Nine (31.03% out of 29 patients had a recurrent dislocation. Four of them required reconstructive surgery to maintain joint stability. Injury to the anterior support (anterior labrum, anterior glenoid rim showed a statistically significant relation to the recurrence of dislocations. The occurrence or non-occurrence of a rotator cuff tear does have an impact on the shoulder function. The degree of rotator cuff involvement on the coronal plane does not significantly affect the shoulder′s functional outcome. The tear extension on the sagittal plane does cause impairment on the Constant test. Conclusions: Labrum and/or anterior glenoid involvement should be suspected in elderly patients presenting with recurrent shoulder dislocation. Recurrence is due to an injury in the anterior support or both (anterior and posterior, even though shoulder function gets impaired when a rotation cuff tear occurs with anterior extension on the sagittal plane. Evidence level: IV Case series.

  6. Avaliação dos resultados do tratamento cirúrgico artroscópico da luxação traumática anterior de ombro: primeiro episódio Assessment of the results from arthroscopic surgical treatment for traumatic anterior shoulder dislocation: first episode

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2012-04-01

    Full Text Available OBJETIVO: Avaliar os resultados dos pacientes submetidos ao tratamento cirúrgico artroscópico após o primeiro episódio de luxação traumática anterior do ombro. MÉTODOS: Entre agosto de 2000 e outubro de 2008, foram tratados 14 ombros de 14 pacientes pelo Grupo de Ombro e Cotovelo da Santa Casa de São Paulo. Treze (93% eram do sexo masculino e um (7% do sexo feminino; a idade variou de 17 a 41 anos, com média de 28 anos. Todos os pacientes avaliados eram praticantes regulares de alguma atividade esportiva (que exigem vigor físico dos membros superiores. O tempo entre o trauma e o tratamento cirúrgico variou de sete a 60 dias, com média de 20 dias. O procedimento cirúrgico foi realizado sob visualização artroscópica, com o paciente posicionado em decúbito lateral, sendo realizada a fixação do complexo lábio-ligamentar com a utilização de âncoras bioabsorvíveis. A avaliação pós-operatória foi realizada por meio do Rowe e da UCLA, e a mobilidade articular foi mensurada segundo as orientações da ASES. O tempo de seguimento pós-operatório variou de 24 a 120 meses, com média de 45 meses. RESULTADOS: Todos os pacientes obtiveram resultados satisfatórios (85% excelentes e 15% bons, conforme a UCLA, e 100% de resultados excelentes conforme o Rowe. O teste de apreensão foi negativo em todos os pacientes. CONCLUSÃO: O tratamento cirúrgico após o primeiro episódio de luxação traumática anterior do ombro parece ser uma boa opção terapêutica para pacientes jovens, ativos e praticantes de atividades esportivas.OBJECTIVE: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. METHODS: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93% were male and one (7% was female; their ages ranged

  7. 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

  8. 制动方法对初发肩关节脱位术后脱位复发率和生活质量改善情况的荟萃分析%External rotation immobilization does not reduce recurrence rate or improve quality of life after primary anterior shoulder dislocation:the result of a meta analysis

    Institute of Scientific and Technical Information of China (English)

    马驰原; 刘安; 严世贵

    2015-01-01

      结论:根据本研究的结果,与内旋制动相比,外旋制动在降低初次肩关节脱位术后的脱位复发率和提高患者的术后生活质量方面均无明显优势。%Background:Shoulder dislocations, especially anterior shoulder dislocation, are common injuries in our daily life. But the choice of external rotation or internal rotation immobilization remains controversial. Objective:To evaluate the rate of recurrence and patient-based quality-of-life after external rotation (ER) versus internal ro-tation (IR) immobilization in primary anterior shoulder dislocation by a meta-analysis. Methods:The PubMed, EMBASE, Cochrane Library and ISI Web of Science were searched up to January 2013, using the Boolean operators as follows:(Bankart lesion OR shoulder anterior dislocation) AND (external rotation AND internal rota-tion OR immobilization). All prospective randomized controlled trials (RCTs) directly comparing recurrence rate and pa-tient-based quality-of-life between ER and IR immobilization were retrieved. All data were conducted with STATA 11.0. Results:Seven RCT studies involving 663 patients (338 in ER group and 325 in IR group) were included in the meta analy-sis. No significant difference was observed in the recurrence rate in different age groups (in all patients:risk ratio [RR]=0.65, 95% confidence interval [CI]: 0.41-1.03, P=0.067; in the patients aged less than 30 years: RR=0.70, 95%CI: 0.38-1.29, P=0.250;in the patients aged more than 30 years:RR=0.86, 95%CI:0.38-1.97, P=0.722). In four trials assessing quali-ty-of-life after ER or IR immobilization, only one demonstrated borderline statistical significance (P=0.05) and probable su-periority of the ER group based on the ASES. No significant difference was observed in other three trials. Conclusions:Based on the results of our analysis, the ER immobilization cannot reduce the rates of recurrence after primary anterior shoulder dislocation or improve the quality of life compared

  9. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    OpenAIRE

    Patro Dilip K; Agarwal Dinesh K; Saseendar S; Menon Jagdish

    2009-01-01

    Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in Engl...

  10. Study on the improved stimson with immobilization of external expansion and rotation in treatment primary traumatic anterior shoulder dislocation%悬垂踩踏整复法结合外展外旋位固定治疗初发性肩关节脱位40例

    Institute of Scientific and Technical Information of China (English)

    李志华; 丘青中

    2012-01-01

    Objective: To explore improved stimson used in curing the primary traumatic anterior shoulder dislocation while analysis its mechanism,and compare the effect of two immobilization methods of shoulder dislocation reduction. Methods: 80 patients with primary traumatic anterior shoulder dislocation successfully received a manual reduction with the improved stimon methods. All the cases were divided into two groups,Two methods for immobilization(external expansion and internal adduction rotation)were used.Shoulder function and recurrence rates were analyzed. Results:The UCLA score reflecting joint function showed no significant difference between the two groups(P>0.05).Recurrence rate of interna1 and external immobilization was 27.5% and 5%, respectively(P0.05).对照组复发率27.5%,治疗组复发率5.0%,两组比较,差异有统计学意义(P<0.01),且治疗组在并发肩关节病亦低于对照组(P<0.01).结论:悬垂踩踏整复法治疗初发性肩关节脱位符合解剖及生物力学原理,复位后外旋固定法较内旋固定复发率低,且利于关节功能恢复.

  11. 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

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

    Institute of Scientific and Technical Information of China (English)

    尹海霞

    2015-01-01

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

  14. Has the management of shoulder dislocation changed over time?

    OpenAIRE

    Chalidis, Byron; Sachinis, Nick; Dimitriou, Christos; Papadopoulos, Pericles; Samoladas, Efthimios; Pournaras, John

    2006-01-01

    Anterior shoulder dislocation is a disabling injury affecting all ages, young and old alike. Recently, the treatment of traumatic shoulder dislocation has included immobilisation for varying periods of time followed by physiotherapy. This study is the first in this country to address the demographic data and recurrence rates of shoulder dislocation. Three hundred and eight patients (170 men and 138 women) were followed up for an average of 5.9 years. The most frequent mechanism of injury was ...

  15. Shoulder dislocation in patients older than 60 years of age

    OpenAIRE

    Rapariz Jose; Martin-Martin Silvia; Pareja-Bezares Antonio; Ortega-Klein Jose

    2010-01-01

    Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test) and by imaging testing (X-ray, MRI). ...

  16. Bilateral locked posterior shoulder dislocation in a footballer.

    OpenAIRE

    Ryan, J; Whitten, M

    1997-01-01

    Posterior dislocation of the shoulder is an uncommon injury, accounting for between 2% and 4% of all shoulder dislocations. It occurs most frequently in patients following convulsions or direct anterior force to the shoulder. It is a particularly uncommon injury in sport. This paper reports an unusual case of bilateal locked posteriorly dislocated shoulders in a previously healthy young man who fell while playing football.

  17. Bipolar hip arthroplasty.

    Science.gov (United States)

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

    2011-12-01

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

  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. The hip in cerebral palsy.

    Science.gov (United States)

    Bleck, E E

    1980-01-01

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

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Magnetic resonance imaging of hip joint cartilage and labrum

    Directory of Open Access Journals (Sweden)

    Christoph Zilkens

    2011-09-01

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

  3. Arthroscopic management of an intraarticular osteochondroma of the hip

    Directory of Open Access Journals (Sweden)

    Brian T. Feeley

    2009-04-01

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

  4. Sports-related shoulder dislocations: a state-hospital experience.

    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 incidence of sports-related shoulder dislocations and their characteristics and the sports events involved. All patients with shoulder dislocation related to sporting activities admitted to the hospital from January 1999 to December 2002 were included in the study. There were 18 sports-related shoulder dislocations out of 106 all shoulder dislocations admitted during this 4-year period. The average age of the patients was 25.4 years. All but two were male. All were anterior dislocations. Recurrent dislocation constitutes 78% of the cases with an average of 3 times re-dislocation. Rugby and badminton were the major contributors to the injuries followed by volleyball, soccer and swimming. Conservative treatment was successfully instituted for 88% of the patients and 12% opted for surgical intervention.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-11-01

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

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

    International Nuclear Information System (INIS)

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

  7. 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.

  8. 牵引复位联合前路减压内固定治疗低位颈椎骨折脱位的疗效分析%The efficacy analysis of lower cervical spine fracture-dislocation treated by traction reduction combined with anterior decompression and internal fixation

    Institute of Scientific and Technical Information of China (English)

    邱小波; 潘显明; 公丕安; 黎娇

    2012-01-01

    Objective To investigate the efficacy of lower cervical spine fracture-dislocation treated by traction reduction combined with anterior decompression and internal fixation. Methods A total of 22 patients with lower cervical spine fracture-dislocation were treated by operation from October 2007 to October 2010. The skull traction under local anesthesia was performed in the first step, and then under traction reduction anterior decompression and internal fixation were carried out in the second step. Results After surgery, all patients were followed up for more than 12 months. According to the X-ray films, the fracture-dislocation was made in a complete reset, the natural array 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 Frangkel grading, the grade of 6 cases were remarkably reduced (2 levels), 3 cases effectively reduced (1 level), and 3 cases were invalid. Conclusions The treatment of lower cervical spine fracture-dislocation with traction reduction combined with anterior decompression and internal fixation is effective.%目的 探讨牵引复位联合前路减压内固定治疗低位颈椎骨折脱位的疗效.方法 对2007年10月至2010年10月22例低位颈椎骨折脱位患者,第一步在局部麻醉下行颅骨牵引术,第二步在牵引复位情况下,行前路减压内固定术.结果 该组病例术后随访12个月以上,X线片显示骨折脱位均复位,颈椎的正常序列及生理弧度恢复,植骨全部融合,无内固定断裂及松动.按Frangkel分级,显效(降低2级)6例,有效(降低1级) 13例,无效3例.结论 在颈椎牵引复位的基础上行前路减压植骨融合内固定是治疗低位颈椎骨折脱位的有效方法.

  9. 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。

  10. 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.

  11. Hip Revision

    Medline Plus

    Full Text Available Hip Revision Featuring the ZMR® Hip System Tapered Distal Stem Zimmer, Inc. Winfield, Illinois September 3, 2009 Welcome to this OR Live webcast presentation, brought to you by Zimmer. ...

  12. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

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

  13. 3.0TMRI 在肘关节脱位后内侧副韧带前束损伤中的应用%Diagnosis of anterior bundle injury of medial collateral ligament after elbow dislocation with 3 .0T MRI

    Institute of Scientific and Technical Information of China (English)

    余景武; 沈国鑫; 唐杰; 叶永强; 黄金兰; 沈钰; 王晓慧

    2016-01-01

    Objective To apply 3 .0T MRI in diagnosing injuries of anterior bundle of medial collateral ligament after elbow dislo‐cation .Methods The MRI features of the injuries of medial collateral ligament anterior bundle were analyzed retrospectively in 20 patients with elbow dislocation .The coronal ,sagittal ,axial and lamina oblique coronal were scanned routinely with SE T1WI ,T2WI‐FS sequences .Results Varying degrees of anterior bundle injuries of medial collateral ligament were observed in all the 20 patients ,in‐cluding the mild injury(n=8) ,part avnlsion(n=5) ,completely rupture(n=7) .Furthermore ,concomitant injuries including lateral collateral ligament(n=11) ,ringlike ligament(n=5) ,flex/stretch muscle tendon(n=9) ,and the fracture(n=7) were also observed . Conclusion The injuries of medial collateral ligament anterior bundle after elbow dislocation could be diagnosed accurately with 3 .0T MRI and the degree of injuries could also be defined on image .The 3 .0T MRI could be recommended as regular examination to pa‐tients with elbow dislocation .%目的:探讨3.0TMRI在肘关节脱位后内侧副韧带前束损伤中的应用。方法回顾性分析20例肘关节脱位患者内侧副韧带前束损伤的M RI征象;常规行冠状位、矢状位、轴位及薄层斜冠状位扫描,扫描序列包括SET1WI、T2加权预饱和脂肪抑制序列(T2 WI‐FS)。结果20例患者中,内侧副韧带前束均有不同程度损伤,其中轻度损伤8例,部分撕裂5例,完全断裂7例;另外11例伴外侧副韧带损伤,5例伴环状韧带损伤,9例伴屈/伸肌总腱损伤,7例伴发骨折。结论3.0TMRI能准确诊断肘关节脱位后内侧副韧带前束损伤,并能明确其损伤程度;对肘关节脱位患者宜常规行M RI检查。

  14. Ipsilateral fracture dislocation of the shoulder and elbow: A case report and literature review

    OpenAIRE

    Behr, Ian; Blint, Andy; Trenhaile, Scott

    2013-01-01

    Ipsilateral dislocation of the shoulder and elbow is an uncommon injury. A literature review identified nine previously described cases. We are reporting a unique case of ipsilateral posterior shoulder dislocation and anterior elbow dislocation along with concomitant intra-articular fractures of both joints. This is the first report describing this combination of injuries. Successful treatment generally occurs with closed reduction of ipsilateral shoulder and elbow dislocations, usually reduc...

  15. 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.

  16. Neurofibromatosis induced hip arthritis. An unusual presentation

    OpenAIRE

    Alrumaih, Husam; Ilyas, Imran; Kashif, Syed

    2014-01-01

    Patient: Male, 43 Final Diagnosis: Neurofibromatosis Symptoms: Hip pain Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Neurofibromatosis type 1 is a disease known for orthopedic manifestations such as spine deformities, congenital pseudarthrosis of the tibia and other bony dysplasias; joint dislocations are rare. Joint arthritis caused by neurofibromatosis, with a stable hip, has never been reported in the English literature bef...

  17. 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

  18. Dislocated shoulder - aftercare

    Science.gov (United States)

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

  19. Traumatic Elbow Dislocations

    OpenAIRE

    Iordens, Gijs

    2014-01-01

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

  20. Internal Fixation with Absorbable Screws for Femoral Head Fractures Combined with Posterior Hip Dislocation%可吸收钉内固定治疗股骨头骨折并髋关节后脱位的临床体会

    Institute of Scientific and Technical Information of China (English)

    贾斌; 张勇; 曹国庆; 马雪峰; 郑杰; 高迪; 刘彦勋

    2012-01-01

    Objective To summarize the clinical experiences in internal fixation with absorbable screws for femoral head fractures with posterior dislocation of the hip. Methods There were 7 cases of femoral head fractures with posterior dislocation of hip were treated with the absorbable screw fixation. The fractures of the femoral head were scored by the Pipkin ' s fracture classifications with 2 of type I , 3 of type II , 1 of type HI and 1 of type IV. The size of the femoral head fracture mass was minimum 2. 0 cm x 2. 0 cm x 2. 5 cm and maximum 4.5cm x 3.5 cm x4. Ocm. 5 cases of type I and type II were operated by Smith-Peterson approach and the others were operated by Kocher-Langenbeck approach. The absorbable screws of 4. 5mm diameter and 35 ~ 55mm length were used to fix the femoral heads. Results All the 7 cases were followed up in average 31.7 (14 ~ 57) months. According to the Thompson-Epstein standard, there were 3 cases of excellent, 2 of fine, 1 of fair and 1 of worth. The total good rate was 71. 4%. 1 patient with type IV occurred femoral neck fracture nonunion followed by the necrosis of the femoral head, which converted to total hip arthroplasty 2. 5 years later. Conclusions It is recommended of the absorbable screw in the treatment of femoral head fractures combined with posterior dislocation of hip with adventures of no secondary surgery, conveniently obtained material and extensive clinical application.%目的 总结可吸收钉内固定治疗股骨头骨折并髋关节后脱位的临床体会. 方法 采用可吸收钉内固定治疗股骨头骨折并髋关节后脱位患者7例.股骨头骨折按照Pipkin's骨折分型:Ⅰ型2例,Ⅱ型3例,Ⅲ型1例,Ⅳ型1例.股骨头骨折块最小2.0 cm×2.0 cm×2.5 cm,最大4.5 cm×3.5 cm×4.0 cm.受伤至就诊时间为1 h~12d.Ⅰ型2例和Ⅱ型3例经Smith-Peterson入路,Ⅲ型1例和Ⅳ型1例采用Kocher-Langenbeck入路,以直径4.5 mm,长度35~55mm的可吸收螺钉内固定股骨头骨折块.结果

  1. The clinical effect of reposition by manual reduction at different postures in 70 patients with anterior dislocation of shoulder joint%不同体位手牵足蹬法治疗肩关节前脱位70例临床疗效

    Institute of Scientific and Technical Information of China (English)

    姚丽; 应盛国

    2015-01-01

    Objective: To observe the clinical effect of reposition by manual reduction at different postures in patients with the primary anterior dislocation of shoulder joint.Methods:Seventy patients with the primary anterior dislocation of shoulder joint were collected and divided into a prone position group with 35 cases and a supine position one with 35 ones according to the different postures. The treatment effects of two groups were evaluated with the reference of the standard of shoulder joint reposition.Results: The reposition rate without anesthetic and total reposition rate were 71.43% (25/35) and 94.29% (33/35) in the prone position group and 62.86% (22/35) and 80.00% (28/35) in the supine group. The difference between two groups had the statistical signiifcance (P<0.05).Conclusion: In the treatment of anterior dislocation of shoulder joint, the effect of Hippocrates (manual reduction) is obviously better in the prone posture than in the supine posture.%目的:观察不同体位手牵足蹬法治疗原发性肩关节前脱位的临床疗效.方法:收集原发性肩关节前脱位患者70例,根据不同体位分为俯卧位手牵足蹬法复位治疗(俯卧位组)35例和仰卧位手牵足蹬法复位治疗(仰卧位组) 35例.参照肩关节复位标准评价两组疗效.结果:观察组无麻药复位率为71.43%(25/35),总复位率为94.29%(33/35);对照组无麻药复位率为62.86%(22/35),总复位率为80.00%(28/35),组间差异有统计学意义(P<0.05).结论:俯卧位手牵足蹬法治疗肩关节前脱位疗效优于仰卧位手牵足蹬法.

  2. 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 .

  3. İki taraflı anterior omuz çıkığı: Olgu sunumu ve literatür taraması

    OpenAIRE

    Ozan, F; Altay, T; Koyuncu, Ş; Çeliker, H

    2014-01-01

    Dislocation is more often encountered due to multilateral mobility of the shoulder joint, its anatomic characteristics, and its being more exposed to traumas. Shoulder dislocations are often anterior and unilateral; though rare, bilateral shoulder dislocations are also encountered. Such dislocations are mostly posterior. A simultaneous bilateral anterior shoulder dislocation is extremely rare. In the current study, we present the case of a 55-year-old female patient, with a simultaneous bilat...

  4. 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

  5. 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

  6. 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

  7. To Observe the Clinical Effect of Stimson Reduction Method Cooperate with Zhuang Medicated Thread Moxibustion in Treating Adults with Acute Anterior Dislocation of Shoulder Joint%Stimson复位法配合壮医药线点灸治疗青壮年肩关节前脱位疗效观察

    Institute of Scientific and Technical Information of China (English)

    于小中; 洪定钢; 王效柱

    2013-01-01

    Objective:To observe the clinical effect of Stimson reduction method cooperate with Zhuang medicated thread moxibus-tion in treating adults with acute anterior dislocation of shoulder joint. Methods:36 cases of patients with Stimson reduction method are reset, and cooperate with Zhuang medicated thread moxibustion therapy in the treatment of intraoperative and postoperative. Re-sults:36 patients were all one-time success, with no use of anesthesia, patients were followed up for 6 months, the shoulder joint function of the patients recovered well, the total efficiency was 100%. Conclusion:Using Stimson reduction method cooperate with Zhuang medicated thread moxibustion in treating adults with acute anterior dislocation of shoulder joint is simple and effective, avoiding the use of anesthesia, and worth further clinical application.%  目的:观察Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位的临床疗效。方法:对36例青壮年急性肩关节前脱位采用Stimson复位法进行复位,并在术中及术后配合患肩壮医药线点灸治疗。结果:36例患者全部一次性复位成功,无一例使用麻醉,随访半年,患者肩关节功能均恢复良好,总有效率100%。结论:采用Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位操作方法简单,疗效肯定,避免了使用麻醉,值得临床进一步推广应用。

  8. 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.

  9. 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

  10. Cervical facet joint kinematics during bilateral facet dislocation

    OpenAIRE

    Panjabi, Manohar M.; Simpson, Andrew K.; Ivancic, Paul C.; Pearson, Adam M.; Tominaga, Yasuhiro; Yue, James J.

    2007-01-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet s...

  11. Sternoclavicular dislocation: case report and surgical technique

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available Abstract Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the "figure of eight" technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified "figure of eight" and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our

  12. Dislocation Formation in Alloys

    Science.gov (United States)

    Minami, Akihiko; Onuki, Akira

    2006-05-01

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

  13. Primary traumatic patellar dislocation

    Directory of Open Access Journals (Sweden)

    Tsai Chun-Hao

    2012-06-01

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

  14. 关节镜下盂唇修补与关节囊复合部分肩胛下肌紧缩修复复发性肩关节前脱位%Arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    徐斌; 涂俊

    2015-01-01

    BACKGROUND:Arthroscopic glenoid labrum repair is the main therapy for recurrent anterior shoulder dislocation, which cannot meet the demands of shoulder stability. How to strengthen the anterior shoulder stability is an issue that is always explored and pursued. OBJECTIVE:To explore the effectiveness of arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation. METHODS:Seventy patients admitted for recurrent anterior shoulder dislocation at the Department of Orthopedics, First Affiliated Hospital of Anhui Medical University in China from October 2010 to August 2013 were enroled, who received the arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture. Patients undergoing post-operative systematical rehabilitation were folowed up for Constant-Murley Score and the ROWE Score for Instability, and shoulder stability and motor functions were evaluated in patients. RESULTS AND CONCLUSION: The 70 patients were folowed-up for 11-46 months. Complications only appeared in one patient with acute pulmonary edema and five patients with elbow or forearm skin blisters, but al were cured by treatment. Anterior shoulder dislocation disappeared postoperatively in al patients. Sixty-five patients almost recovered in the range of motion of the shoulder, who were satisfied with normal life and work activity. Al the patients returned to work. At the last folow-up, the Constant-Murley score was improved from 71.2±5.3 to 94.3±4.9, and the ROWE score was increased from 32.1±4.2 to 95.1±4.7, both of which were better than before (P < 0.05). This study demonstrated arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture is better for recurrent anterior shoulder dislocation, which is conductive to shoulder stability and motor function recovery.%背景:复发性肩关节前脱位的修复目前以关节镜下盂唇修补为主,

  15. Hip ultrasound.

    Science.gov (United States)

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

    2012-12-01

    In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up. PMID:21571471

  16. 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.

  17. Hip arthroscopy

    Directory of Open Access Journals (Sweden)

    Henrique Antônio Berwanger de Amorim Cabrita

    2015-06-01

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

  18. 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.

  19. 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.

  20. Traumatic Elbow Dislocations

    NARCIS (Netherlands)

    G.I.T. Iordens (Gijs)

    2014-01-01

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

  1. Closed posteromedial dislocation of ankle in a 12 year-old boy: a case report

    OpenAIRE

    Yurttaş, Yüksel; Kilinçoğlu, Volkan; Toker, Serdar; Kürklü, Mustafa; Atilla, Atil; Başbozkurt, Mustafa

    2009-01-01

    Ankle fractures and fracture dislocations are common injuries in orthopaedic practice however pure ankle dislocation without an associated fracture is extremely rare. There are a few cases reporting such a lesion in the literature. Also this injuries are generally open high energy trauma injuries. Closed treatments are reported to be effective and ligament injuries are generally not reported. In this study, we report a closed pure posteromedial ankle dislocation with anterior talofibular liga...

  2. 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.)

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

    Directory of Open Access Journals (Sweden)

    Yang Nan-Ping

    2011-11-01

    Full Text Available Abstract Background The epidemiology of acute orthopedic dislocations is poorly understood. A nationwide database provides a valuable resource for examining this issue in the Taiwanese population. Methods A 6-year retrospective cohort study of 1,000,000 randomly-sampled beneficiaries from the year 2005 was used as the original population. Based on the hospitalized and ambulatory data, the concomitant ICD9-CM diagnosis codes and treatment codes were evaluated and classified into 8 and 3 major categories, respectively. The cases matching both inclusive criteria of dislocation-related diagnosis codes and treatment codes were defined as incident cases. Results During 2000-2005, the estimated annual incidence (per 100,000 population of total orthopedic dislocations in Taiwan was 42.1 (95%CI: 38.1-46.1. The major cause of these orthopedic dislocations was traffic accidents (57.4%, followed by accident falls (27.5%. The annual incidence dislocation by location was shoulder, 15.3; elbow, 7.7; wrist, 3.5; finger, 4.6; hip, 5.2; knee, 1.4; ankle, 2.0; and foot, 2.4. Approximately 16% of shoulder dislocations occurred with other concomitant fractures, compared with 17%, 53%, 16%, 76% and 52%, respectively, of dislocated elbow, wrist, hip, knee, and ankle cases. Including both simple and complex dislocated cases, the mean medical cost was US$612 for treatment of a shoulder dislocation, $504 for the elbow, $1,232 for the wrist, $1,103 for the hip, $1,888 for the knee, and $1,248 for the ankle. Conclusions In Taiwan, three-quarters of all orthopedic dislocations were of the upper limbs. The most common complex fracture-dislocation was of the knee, followed by the wrist and the ankle. Those usually needed a treatment combined with open reduction of fractures and resulted in a higher direct medical expenditure.

  4. 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.

  5. Hip Instability: Current Concepts and Treatment Options.

    Science.gov (United States)

    Dumont, Guillaume D

    2016-07-01

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

  6. 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.

  7. 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...

  8. 'Hip' pain.

    Science.gov (United States)

    Zacher, Josef; Gursche, Angelika

    2003-02-01

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

  9. Luxatio erecta: Inferior glenohumeral dislocation

    OpenAIRE

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

    2007-01-01

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

  10. Luxatio erecta: Inferior glenohumeral dislocation

    Directory of Open Access Journals (Sweden)

    Baba Asif

    2007-01-01

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

  11. Arthroscopic Bankart repair for treatment of recurrent anterior shoulder dislocation with Mitek bioknotless suture anchors%关节镜下非打结型缝合锚钉修补Bankart损伤治疗复发陛肩关节前脱位

    Institute of Scientific and Technical Information of China (English)

    黄华扬; 郑小飞; 张余; 尹庆水

    2008-01-01

    Objective To investigate the clinical results of arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation with Mitek bioknotless suture anchors.Methods Fourteen patients of recurrent anterior shoulder dislocation were treated by arthroscopic Bankart repair with Mitek bioknotless suture anchors.All patients had unidirectional instabilities on the dominant sides.The average age at surgery was 25.2 years (range,18-34 years).The mean times of dislocations before surgery were 13.5 (range,3-36).American Shoulder and Elbow Surgeons(ASES) and Constant-Murley score were adopted for final evaluation at the last follow-up.Results The mean follow-up period was 17 months (range,11-22 months).A Hill-Sachs lesion was observed in 9 patients.A bony Bankart lesion was found in 3 patients.A type Ⅱ SLAP lesion was associated in 2 patients and treated with arthroscopie fixation.A posterior-inferior labral lesion was found in 2 patients and treated with arthroseopic debridement.A joint mouse was removed in 1 patient.The mean forward flexion was 163.4°±8.6° and 169.7°± 4.2° pre-and postoperatively.The mean external rotation in 90° abduction was 58.5°±13.6° and 90.30°±5.5°pre-and postoperatively,which was less 8.40°±6.2° than that of normal side shoulder postoperatively.The pre-and postoperative mean ASES score was 77.4±3.7 and 94.3±2.6,the mean VAS instability score were 7.2±1.4 and 1.2±0.6.The pre-and postoperative mean Constant-Murley score was 78.1 ±4.6 and 93.9±3.7.All patients did not suffer postoperative s houlder dislocation.All patients returned to their pre-injury works.Conclusion Arthroseopic Bankart repair with Mitek bioknotless suture anchors is a good option for treating recurrent anterior shoulder dislocation.%目的 探讨关节镜下非打结型缝合锚钉修补Bankan损伤治疗复发性肩关节前脱位的疗效.方法 复发性肩关节前脱位患者14例,均为男性;年龄18~34岁,平均25.2岁;左侧4

  12. 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...

  13. 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

  14. Hip Revision

    Medline Plus

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

  15. 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.

  16. 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

  17. Bilateral temporomandibular joint dislocation in a 29-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Thangarajah Tanujan

    2010-08-01

    Full Text Available Abstract Introduction A dislocation of the temporomandibular joint represents three percent of all reported dislocated joints. The treatment entails reduction of the deformity and this can often be achieved in a ward setting. Case presentation We present the case of a 29-year-old Caucasian man with a non-traumatic bilateral anterior temporomandibular joint dislocation. Following several unsuccessful attempts, due to both inadequate patient analgesia and sedation, joint reduction had to be performed in theatre with the patient under general anesthesia. Conclusion This case highlights the importance of providing the patient with adequate analgesia and sedation when attempting the reduction of temporomandibular joint dislocations.

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

    NARCIS (Netherlands)

    Poorter, Jolanda de

    2010-01-01

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

  19. 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...

  20. 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.

  1. Early Clinical Results of Arthroscopic Remplissage in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran

    OpenAIRE

    Hamid Reza Aslani; Zohreh Zafarani; Adel Ebrahimpour; Shahin Salehi; Ali Moradi; Soheil Sabzevari

    2014-01-01

    Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion...

  2. 先单纯肩关节前脱位复位后评定疗效4种评分量表的比较研究%Comparison of four scoring scales in functional evaluation of anterior shoulder after reduction for simple join dislocation

    Institute of Scientific and Technical Information of China (English)

    贾雪峰; 毕擎; 方基石; 林格生; 王之宇; 吴志勇

    2014-01-01

    Objective To compare four scoring scales in functional evaluation of anterior shoulder after reduction for simple joint dislocation. Methods One hundred patients with simple anterior shoulder join dislocation, including 48 males and 52 females with a mean age of 42.3y (21~54y), underwent reduction procedure under brachial plexus block. The CMS (Constangt- Murley score), Rowe score, UCLA (University of California at Los Angeles scale), ASES (rating scale of the American shoulder and elbow surgeons) were used to evaluate shoulder function and SF- 36 was used to assess the quality of life on 3 months after reduction, and the second evaluation with the same scales were performed 1 week later. Results The Cronbach's Alpha values of CMS, Rowe score, UCLA and ASES were 0.871, 0.765, 0.766 and 0.822, respectively. The intra- class correlation coefficient of CMS, Rowe score, UCLA and ASES were 0.918, 0.430, 0.772 and 0.970(P<0.05). The correlation coefficients of CMS, Rowe score, UCLA and ASES with SF- 36 were 0.841, 0.737, 0.665 and 0.912, respectively(P<0.05). Conclusion The performance of ASES for ante-rior shoulder function evaluation is relatively good, but lacks specificity for overal shoulder joint assessment. More balanced sub-jective and objective scales are needed for functional evaluation of anterior shoulder dislocation after joint reduction.%目的:分析4种肩关节评分量表评估肩关节前脱位功能的稳定性和可靠性。方法纳入两家医院共100例符合标准的肩关节前脱位患者,男48例,女52例;平均42.3岁(21~54岁)。均臂丛麻醉下复位,采用Constant- Murley肩关节评分(CMS表)、Rowe肩关节功能评分(Rowe表)、美国加州大学洛杉矶分校肩关节功能评分标准(UCLA表)、美国肩肘外科医生评估表(ASES表)和SF-36量表评估患者3个月后的量表分值,第1次评估1周后再次对患者进行4个肩关节量表评估。结果 CMS、Rowe、U-CLA

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

    Ventura, Sandra Rua; Monteiro, Altino

    2010-01-01

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

  5. 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.

  6. Subtalar dislocation without associated fractures: Case report and review of literature.

    Science.gov (United States)

    Giannoulis, Dionisios; Papadopoulos, Dimitrios V; Lykissas, Marios G; Koulouvaris, Panagiotis; Gkiatas, Ioannis; Mavrodontidis, Alexandros

    2015-04-18

    Isolated subtalar dislocations are unusual injuries due to the inherent instability of the talus. Subtalar dislocations are frequently associated with fractures of the malleoli, the talus, the calcaneus or the fifth metatarsal. Four types of subtalar dislocation have been described according to the direction of the foot in relation to the talus: medial, lateral posterior and anterior. It has been shown that some of these dislocations may spontaneously reduce. A rare case of a 36-year-old male patient who sustained a closed medial subtalar dislocation without any associated fractures of the ankle is reported. The patient suffered a pure closed medial subtalar dislocation that is hardly reported in the literature. Six months after injury the patient did not report any pain, had a satisfactory range of motion, and no signs of residual instability or early posttraumatic osteoarthritis. The traumatic mechanism, the treatment options, and the importance of a stable and prompt closed reduction and early mobilization are discussed. PMID:25893182

  7. 直接前入路与后方入路对全髋关节置换术疗效及安全性影响的系统评价及meta分析%A systematic review and meta-analysis of direct anterior approach versus posterior approach in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    刘新光; 王卫国; 张念非; 郭万首

    2016-01-01

    Background:The efficacy and safety of direct anterior approach (DAA) for total hip arthroplasty (THA) is still unclear. Objective:To conduct a systematic review and meta-analysis of published studies comparing DAA and posterior ap-proach (PA) for THA. Methods:Controlled trials about comparison between DAA and PA for THA were searched in major databases. Suitable studies were selected according to inclusion and exclusion criteria. The data were extracted and the quali-ty of included studies was evaluated by two reviewers. Meta analysis was conducted using RevMan5.2 software, and the studies that could not be combined were analyzed descriptively. Results:Eleven literatures were included in this study, and a total of 1612 patients were involved. There were 817 patients in DAA group and 795 patients in PA group. All surgeons who performed DAA THA had already completed their learning curves. The patients in DAA group were able to walk earlier without the need for an assistive device than PA group (WMD=-11.05, 95%CI:-17.79,-4.31, P=0.001), and DAA was su-perior to PA in early postoperative function rehabilitation and activities. There was no statistical difference in the incidences of intraoperative and postoperative complications (OR=1.48, 95%CI:0.69, 3.20, P=0.32), intraoperative fractures (OR=1.31, 95%CI: 0.50, 3.45, P=0.58), postoperative dislocations (OR=0.34, 95%CI: 0.09, 1.28, P=0.11), heterotopic ossification (OR=1.01, 95%CI:0.26, 3.94, P=0.99) or groin pain (OR=2.73, 95%CI:0.62, 12.06, P=0.19) between two groups. Neither were the operative time (WMD=10.25, 95%CI:-6.33, 26.83, P=0.23), length of hospital stay (WMD=-0.34, 95%CI:-0.76, 0.07, P=0.10) or the percentage of acetabular cups placed within the Lewinnek safe zone (OR=2.08, 95%CI:0.65, 6.72, P=0.22). DAA could avoid postoperative dislocations as compared with PA and lead to a lower incidence of abnormality in ace-tabular cup position when using intraoperative fluoroscopy during DAA THA. Conclusions DAA is a

  8. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three months of operation and six months of operation in the observation group were respectively (12.38± 1.69)points and (15.96±2.33)points, which were obviously higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The curative effect of anterior cervical decompression and bone graft fusion with locking plate internal fixation in treatment of SCIWORA is definite.%目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协

  9. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协会(JOA)评分,评估两组术后临床症状好转率及半年后植骨融合率.结果 观察组术后半年后植骨融合率为96.67%显著高于对照组80.0%,差异具有统计学意义(P<0.05);观察组术后3、6个月JOA评分分别为(12.38±1.69)分、(15.96±2.33)分均显著高于对照组,差异具有统计学意义(P<0.05). 结论 颈前路减压植骨融合带锁钛板内固定治疗SCIWORA疗效确切.%Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three

  10. Hip fracture - discharge

    Science.gov (United States)

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

  11. Quantitative calculation of dislocation mobility

    Energy Technology Data Exchange (ETDEWEB)

    Swaminarayan, S.; Preston, D.L.

    1999-07-01

    The authors present a new method to calculate the response of dislocations to applied stress. This new method, called the dislocation treadmill, can be used to study the effect of vacancies, interstitials, stresses, strain rate, temperature, etc., on the steady state velocity of the dislocation. The authors demonstrate the use of the method by calculating the response of a dislocation to a constant applied shear stress.

  12. 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.

  13. 120 Cases of Shoulder Dislocation referred to Emergency Department during One Year; a Case Series Study

    Directory of Open Access Journals (Sweden)

    Payman Asadi

    2015-05-01

    Full Text Available Shoulder dislocation is identified as displacement of humerus head from the glenoid cavity of scapula bone, which makes up about 50% of total joint dislocations. Taking into account the importance of the side effects and disabilities caused by this type of dislocation and that it can be prevented, the present study was designed aiming to evaluate the epidemiologic characteristics of the patients with shoulder dislocation. In this retrospective cross-sectional study, all the patients referred to the emergency department (ED with complaint of shoulder dislocation throughout one year were evaluated. Demographic data and characteristics regarding the type of dislocation, presence of accompanying fractures, mechanism of dislocation, history of dislocation and the method of reduction were extracted from the patients’ profiles and recorded in a checklist designed for this purpose. Data were then statistically analyzed using SPSS version 19. Statistics showed that 120 patients with the mean age of 39.3 ± 21.2 years had been admitted to ED of the studied center in one year (79.2% male. The most common type of dislocation was anterior dislocation (95.8% and in the right shoulder (52.5% and the most common cause was falling on open arm (34.2%. Reduction method was non-operative in 93.3% of the cases and surgery in 6.7%. Based on the results of this study, in the studied population, most patients with shoulder dislocation were young men who had an anterior dislocation in their right shoulder because of falling on out stretched hand and treated with close reduction.

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

    Directory of Open Access Journals (Sweden)

    Fernando Farcetta Junior

    2010-01-01

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

  15. Understanding and Treating the Snapping Hip.

    Science.gov (United States)

    Yen, Yi-Meng; Lewis, Cara L; Kim, Young-Jo

    2015-12-01

    Snapping hip, or coxa saltans is a palpable or auditory snapping with movement of the hip joint. Extra-articular snapping is divided into external and internal types, and is caused laterally by the iliotibial band and anteriorly by the iliopsoas tendon. Snapping of the iliopsoas usually requires contraction of the hip flexors and may be difficult to distinguish from intra-articular coxa saltans. Ultrasound can be a useful modality to dynamically detect tendon translation during hip movement to support the diagnosis of extra-articular snapping. Coxa saltans is typically treated with conservative measures including anti-inflammatories, stretching, and avoidance of inciting activities. Recalcitrant cases are treated with surgery to lengthen the iliopsoas or the iliotibial band. PMID:26524554

  16. 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.

  17. Finite strain discrete dislocation plasticity

    NARCIS (Netherlands)

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

    2003-01-01

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

  18. Dislocation triggers uninterpretability

    NARCIS (Netherlands)

    H. Zeijlstra

    2009-01-01

    In current minimalist analyses dislocation (Move/Agree) is motivated by Full Interpretation: Move/Agree is said to check uninterpretable features. In this paper I address several of the background assumptions behind such analyses, and discuss several problems that go with them. I this paper I first

  19. 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

  20. Magnetic resonance findings in knee dislocation: pictorial essay

    International Nuclear Information System (INIS)

    The role of MRI in the preoperative assessment of knee dislocation is well documented. e present our experience with a series of images graphically displaying the spectrum of abnormalities associated with these injuries. These images were derived from a local internal audit reviewing the preoperative MRI and correlating this with the surgical findings. Twenty-two cases between April 1997 and April 1999 were reviewed. Traumatic dislocation of the knee is rare, although many believe it is often unrecognized because of spontaneous reduction.' The injury may present as (i) frank dislocation; (ii) a knee that is dislocated while under anaesthesia; or (iii) a pattern of soft-tissue injury which suggests dislocation. Dislocation is described by the position of the tibia relative to the femur and may be anterior, posterior, lateral, medial or rotatory. Conservative management has traditionally been advocated and in this setting clinical examination and plain radiographs are adequate. Because of the trend toward increased surgical intervention, however, the more accurate characterization of soft-tissue injuries provided by MRI aids the planning of ligamentous reconstruction and the operative approach. Copyright (1999) Blackwell Science Pty Ltd

  1. 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.

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

    Science.gov (United States)

    Lewis, Cara L; Garibay, Erin J

    2015-01-01

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

  3. Ultrasound: Infant Hip

    Science.gov (United States)

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

  4. One stage solution and posterior fusion surgery through the high anterior cervical retropharyngeal approach for irreducible atlantoaxial dislocation%一期前方咽后入路松解后路融合治疗难复性寰枢椎脱位

    Institute of Scientific and Technical Information of China (English)

    徐峰; 蔡贤华; 陈庄洪; 康辉; 黄勇

    2011-01-01

    Objective To explore the feasibility of one stage solution and posterior fusion surgery through the high anterior cervical retropharyngeal approach for irreducible atlantoaxial dislocation and its curative effect. Method The solution and posterior fusion surgery was performed in 12 patients (age range, 26~58 years; mean age, 46 years) with irreducible atlantoaxial dislocation, of whom, 8 were males and 4 females. All the patients received skull traction and the translocation and rotation of the atlas were assessed by X-ray, MRI and CT three-dimensional reconstruction before the surgery in all the patients. The articular capsules of articulatio atlantoepistrophicas were exposed and the scar tissue and steophyma were resected by the surgery. With continuous skull traction, the atlas was reduced and fixed with pedicle screws and the atlantoaxial fusion was performed by iliac bone graft during one stage surgery. Japanese orthopaedic Association (JOA) score system was used to evaluate the clinical outcomes before the surgery and 12 months after the surgery. Results All the patients were followed up from 12 to 28 months (mean, 18 months). Hypoglossal palsy occurred in one patient, who recovered from hypoglosed palsy 2 months after the surgery. The nerves, vertebral arteries and esophagus injuries, and leakage of cerebrospinal fluid were not observed in all the patients. JOA score [(15.6±l.l)points] was significantly higher 12 months after the surgery than that [(9.3±l.l)points] before the surgery (P<0.05). The grafted bones was well fused into the receptor bones and there was good internal fixation in all the patients. Conclusion The one stage solution and posterior fusion surgery through the high anterior cervical retropharyngeal approach is an effective method to treat the irreducible atlantoaxial dislocation.%目的 探讨一期颈椎前方高位咽后入路松解后路寰枢椎融合治疗难复性寰枢椎脱位的可行性及效果.方法 本组共收治

  5. 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.

  6. MRI findings in posterior disc prolapse associated with cervical fracture dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Go; Shiba, Keiichiro; Ueta, Takayoshi; Shirasawa, Kenzo; Ohta, Hideki; Mori, Eiji; Rikimaru, Shunichi; Hida, Shinichi; Tokunaga, Masami (Spinal Injuries Center, Fukuoka (Japan))

    1994-03-01

    Although disc injury is common in cervical spinal fractures the mechanism of disc herniation in cervical fracture dislocations is not known. This study evaluated the pathogenesis of disc hernia in cervical fracture dislocations. Twenty-two patients who underwent anterior and posterior spinal fixation were studied. Findings of preoperative magnetic resonance imaging (MRI) were compared with surgical findings. During surgery, cervical disk hernia were found in six patients (27 %), and the MRI finding of these patients were evaluated in detail. We concluded that the characteristic MRI findings of cervical disc hernia are as follows: (1) discontinuity of injured disc, (2) anterior indentation of spinal cord at the site of dislocated vertebral body, and (3) signal irregularity at the site of interspace between dislocated vertebral body and spinal cord. (author).

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

    Directory of Open Access Journals (Sweden)

    Khaled Aly Matrawy

    2014-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李文波; 张文明; 白国昌; 黄子达; 沈荣凯

    2013-01-01

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

  9. Arthroplasty versus arthroscopy for recurrent anterior dislocation of the shoulder joint with severe bone defects:3-year follow-up%关节置换与关节镜下修复肩关节复发性前脱位伴重度骨缺损:3年随访对比

    Institute of Scientific and Technical Information of China (English)

    陈辉; 王群; 燕双喜; 董天云; 邹海兵

    2015-01-01

    背景:随着外科技术、重建材料技术的发展,关节置换在肩关节脱位中也得到了广泛应用,特别是各种定制型或装配型假体使得置换适应证明显提高。  目的:观察与随访关节镜与关节置换治疗肩关节复发性前脱位伴重度骨缺损的远期疗效。  方法:纳入肩关节复发性前脱位伴重度骨缺损患者144例,根据随机抽签分为治疗组与对照组,每组72例。对照组行关节镜下内固定治疗,治疗组行关节置换治疗。通过电话调查与复诊完成3年随访,记录患者Neer肩关节功能评分、肩关节活动度及并发症发生情况。  结果与结论:随访3年,治疗组的肩关节功能优良率90%明显高于对照组81%(P RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

  10. 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.

  11. 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

  12. 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.

  13. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Directory of Open Access Journals (Sweden)

    Patro Dilip K

    2009-11-01

    Full Text Available Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed.

  14. 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.

  15. Design rules for dislocation filters

    International Nuclear Information System (INIS)

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

  16. Design rules for dislocation filters

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-14

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

  17. 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.

  18. Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

    Science.gov (United States)

    Durban, Claire Marie C.; Kim, Je Kyun; Kim, Sae Hoon

    2016-01-01

    Background The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed. PMID:27247742

  19. 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

  20. Missing Screw as a Rare Complication of Anterior Cervical Instrumentation

    OpenAIRE

    Yusuf Kurtuluş Duransoy; Mesut Mete; Baha Zengel; Mehmet Selçukı

    2013-01-01

    Although anterior cervical arthrodesis is an effective procedure for the treatment of cervical disorders, the method has some complications. Here, we describe this rare complication of cervical instrumentation with a literature review. A 23-year-old male patient was operated for a C6-C7 dislocation. At postoperative month 10, he presented with hemoptysis and dysphagia. Cervical roentgenograms showed anterior migrations of one broken screw and a plate-locking screw at the C6 corpus. One screw ...

  1. The Relationship between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity

    OpenAIRE

    Shultz, Sandra J.; Anh-Dung, Nguyen; Levine, Beverly J.

    2009-01-01

    Background: Lower extremity alignment may influence the load distribution at the knee, potentially predisposing the anterior cruciate ligament to greater stress. We examined whether lower extremity alignment predicted the magnitude of anterior knee laxity in men and women. Hypothesis: Greater anterior pelvic angle, hip anteversion, tibiofemoral angle, genu recurvatum, and navicular drop will predict greater anterior knee laxity. Study Design: Descriptive laboratory study. Methods: Women (n = ...

  2. Nature of Dislocations in Silicon

    DEFF Research Database (Denmark)

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

    1995-01-01

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

  3. Concept of healing of recurrent shoulder dislocation.

    Science.gov (United States)

    D'Angelo, Donato

    2014-01-01

    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. PMID:26229839

  4. Hip arthroplasty by matching cups.

    Science.gov (United States)

    Gerard, Y

    1978-01-01

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

  5. 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 ...

  6. Taper Hip Prosthesis

    Medline Plus

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

  7. Pain distribution in primary care patients with hip osteoarthritis

    DEFF Research Database (Denmark)

    Poulsen, Erik; Overgaard, Søren; Vestergaard, Jacob T;

    2016-01-01

    by 109 patients of which 108 (99%) were valid. The mean age of patients was 65 (SD 9) years and 44% were females. The mean pain intensity was 5.4 (SD 2.0). A total of 77% had marked the greater trochanter area, 53% the groin area, 42% the anterior/lateral thigh area, 38% the buttock area, 17% the knee......BACKGROUND: Hip osteoarthritis (OA) is the most common diagnosis in primary care adult patients presenting with hip pain but pain location and pain distribution in primary care patients with hip OA have been reported inadequately. OBJECTIVE: To describe pain location and pain distribution...... in primary care patients with clinical and radiographic confirmed hip OA. METHODS: Primary care patients with unilateral clinical and radiographic hip OA living on the island of Funen, Denmark were recruited from primary care to participate in a randomized clinical trial. At baseline, patients recorded pain...

  8. Hip supporting device

    DEFF Research Database (Denmark)

    2011-01-01

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

  9. 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

  10. 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!

  11. Hip arthroscopy in the setting of hip dysplasia

    OpenAIRE

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

    2016-01-01

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

  12. 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.

  13. Patellar Dislocations and Reduction Procedure.

    Science.gov (United States)

    Ramponi, Denise

    2016-01-01

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

  14. 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.

  15. Moving Dislocations in Disordered Alloys.

    Energy Technology Data Exchange (ETDEWEB)

    Marian, J; Caro, A

    2006-11-18

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

  16. 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

  17. 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

  18. [Post-traumatic bipolar dislocation of the clavicle: is operative treatment reasonable?].

    Science.gov (United States)

    Dudda, M; Kruppa, C; Schildhauer, T A

    2013-02-01

    Bipolar dislocation of the clavicle ("floating clavicle") is extremely rare. It exists no standardised treatment for this trauma and the treatment is often conservative. This is mainly an anterior displacement of the sternoclavicular joint (type III according to Allman) and a posterior dislocation of the acromioclavicular joint (type IV according to Rockwood).We report on a 60 year old male who fell onto the right shoulder. He sustained a 'floating clavicle' and had a massive dislocation, impairment of range of motion and pain. Venous congestion was observable. We stabilised the dislocated acromioclavicular joint with a Balser's plate, the sternoclavicular joint was fixed with PDS cord tension band technique around the first rip and the sternum. In addition we resected the anterior part of the distal clavicle to get a better cosmetic result. Post-operatively the patient had an excellent range of motion without any further symptoms after six weeks and one year. Venous congestion was not more observable.In most of the cases dislocations of both ends of the clavicle are treated conservatively. We recommend an operative treatment especially in young and active patients to avoid re-dislocation and to archive better cosmetic results. PMID:22367519

  19. 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.

  20. 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.

  1. Catastrophic failure of ceramic-polyethylene bearing total hip arthroplasty.

    Science.gov (United States)

    Needham, Justin; Burns, Travis; Gerlinger, Tad

    2008-06-01

    Complications of ceramic-polyethylene bearing total hip arthroplasty (THA) include osteolysis, loosening, dislocation, and component failure. Catastrophic acetabular component failure involves severe damage to both the polyethylene liner and metal shell. This case study presents the first reported complete wear-through of the acetabular portion of a ceramic-polyethylene arthroplasty presenting as a dislocation and a review of the literature. In this study, a patient's alumina ceramic femoral head penetrated the polyethylene liner and titanium shell and presented as a dislocated THA. The contributing factors for this catastrophic failure include young patient age, high activity level, thin polyethylene liner, backside wear, component positioning, polyethylene sterilization with gamma irradiation in air, and lack of appropriate follow-up. Revision THA was performed without complications. PMID:18514888

  2. Simultaneous shoulder and elbow dislocation

    OpenAIRE

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

    2014-01-01

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

  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. 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.

  5. 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

  6. 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.

  7. MRI in late sequelae of Perthes` disease: imaging findings and symptomatology in ten hips

    Energy Technology Data Exchange (ETDEWEB)

    Lahdes-Vasama, T.T. [Children`s Hospital, Helsinki University Central Hospital, Stenbaecki II, FIN-00290 Helsinki (Finland); Lamminen, A.E. [Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Marttinen, E.J. [Department of Radiology, Children`s Hospital, Helsinki (Finland); Merikanto, J.E.O. [Department of Orthopaedic Surgery, Children`s Hospital, Helsinki (Finland)

    1996-09-01

    Five painful (group A) and five symptomless (group B) hips in nine patients with late sequelae of Perthes` disease were studied with plain radiography and magnetic resonance imaging (MRI) in order to correlate MRI findings with symptomatology. The unaffected hips were also studied. In group A hips, poor congruence of the articular cartilage surfaces was present in three of five cases, whereas good congruence was found in all group B hips. In one spherical but painful hip (group A), MRI revealed a protuberance in the anterolateral cartilage of the femoral head. The joint cartilage in group A and B hips was, on average, 0.5 and 1.5 mm thicker, respectively, than the cartilage in the unaffected hips. The lateral joint capsule was, on average, 3.0 mm thicker in group A hips than in the unaffected hips (P < 0.05), which possibly reflects reactive changes due to chronic irritation in the painful hips. The mean joint capsule thickness differed by only 0.5 mm between the unaffected and group B hips. Mean anterior acetabular coverage by MRI was 97 % in group A and 98 % in group B, while in the unaffected hips mean anterior coverage was 102 %. In an aspherical painful hip, MRI revealed a juxta-articular cyst not visible by radiography. A symptomless intra-articular fragment, due to osteochondritis dissecans, was well visualized with MRI. MRI is recommended for evaluation of pain in hips with late sequelae of Perthes` disease. It may show abnormalities in bony structures, as well as in joint capsule and cartilage. (orig.). With 5 figs., 1 tab.

  8. 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.

  9. Painful Hip Prosthesis: Definition

    OpenAIRE

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

    2010-01-01

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

  10. Válvula de uretra anterior Anterior urethral valves

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    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.

  11. Dislocations in Monolayers and Semiconductors.

    Science.gov (United States)

    Ren, Qiang

    1995-01-01

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

  12. 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

  13. 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.

  14. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    OpenAIRE

    Tomio Nishi; Noriyuki Suzuki; Takayuki Tani; Hiroshi Aonuma

    2013-01-01

    A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal si...

  15. A Rare Complication of Tuberculous Meningitis Pediatric Anterior Glenohumeral Instability

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    Kerem Bilsel

    2012-01-01

    Full Text Available Dislocation and instability of the shoulder joint are rare occurrences in childhood. Traumatic, infectious, congenital, and neuromuscular causes of pediatric recurrent shoulder dislocations are reported before. Central nervous system infection in infancy may be a reason for shoulder instability during childhood. This situation, which causes a disability for children, can be treated successfully with arthroscopic stabilization of the shoulder and postoperative effective rehabilitation protocols. Tuberculous meningitis may be a reason for neuromuscular shoulder instability. We describe a 12-year-old child with a recurrent anterior instability of the shoulder, which developed after tuberculous meningitis at 18 months of age. We applied arthroscopic treatment and stabilized the joint.

  16. 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.

  17. Dislocation-density function dynamics - An all-dislocation, full-dynamics approach for modeling intensive dislocation structures

    Science.gov (United States)

    Leung, H. S.; Ngan, A. H. W.

    2016-06-01

    It has long been recognized that a successful strategy for computational plasticity will have to bridge across the meso scale in which the interactions of high quantities of dislocations dominate. In this work, a new meso-scale scheme based on the full dynamics of dislocation-density functions is proposed. In this scheme, the evolution of the dislocation-density functions is derived from a coarse-graining procedure which clearly defines the relationship between the discrete-line and density representations of the dislocation microstructure. Full dynamics of the dislocation-density functions are considered based on an "all-dislocation" concept in which statistically stored dislocations are preserved and treated in the same way as geometrically necessary dislocations. Elastic interactions between dislocations in a 3D space are treated in accordance with Mura's formula for eigen stress. Dislocation generation is considered as a consequence of dislocations to maintain their connectivity, and a special scheme is devised for this purpose. The model is applied to simulate a number of intensive microstructures involving discrete dislocation events, including loop expansion and shrinkage under applied and self stress, dipole annihilation, and Orowan looping. The scheme can also handle high densities of dislocations present in extensive microstructures.

  18. 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.

  19. TREATMENT OF HIP DYSPLASIA

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    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.

  20. Hip joint injection

    Science.gov (United States)

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