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Biomedical subjects

G C Bennet

Publications and source records attributed to G C Bennet.

25 records · Page 2Linked to original sources

Congenital hip dislocation: an increasing and still uncontrolled disability?

A study of 178 cases of congenital dislocation of the hip in babies born between 1965 and 1978 in Southampton health district showed that the incidence had virtually doubled over this period. Established cases (persisting beyond the first birthday) had risen to around two cases per 1000 per live births. One-third of these were first diagnosed after the age of 1 year and one-fifth after 18 months. The findings are particularly disappointing as there were opportunities after the neonatal period for earlier diagnosis. Thus, neonatal screening appears to have failed to make a substantial impact on the morbidity of the disease, probably because of a combination of inherent difficulties in the neonatal screening test as well as failure in its proper application. Much greater vigilance is needed during the first year of life if congenital dislocation of the hip is to be detected and treated as early as possible. Perhaps this could be achieved if all health professionals were more aware of the problem and were encouraged to examine hips at every opportunity and health authorities periodically audited their results.

Child, Preschool↗

Dislocation of the hip in trisomy 21.

Almost one child in twenty with trisomy 21 will develop spontaneous dislocation of the hip between learning to walk and the age of 10 years. After the age of two years spontaneous habitual dislocation may occur. If left untreated, acute dislocation, subluxation and fixed dislocation follow in sequence. The natural history of the condition is described and the clinical and radiological features of 45 dislocations in 28 patients are presented. Nineteen had received no treatment. The most effective treatment was found to be pelvic or femoral osteotomy, combined with capsular plication, carried out in the phase of habitual dislocation. Once subluxation or fixed dislocation was present, the results of operation were poor and it is not recommended. All patients, even if left untreated, remain mobile. Pain is not a prominent feature.

Adolescent↗

Seating for children with cerebral palsy.

Special seating enables children with even the most severe forms of cerebral palsy to sit comfortably. A straight spine and mobile hips are desirable. Prevention of hip dislocation by operation, or release of a hip extension contracture, is required for 40% of the younger children. Surgical correction of scoliosis is required for 20% of the older ones. Seating problems may be classified by (a) ability--hands free, hand dependent or propped--(b) the pattern of deformity--symmetrically slouched or windswept--and (c) severity of deformity--none, amenable to surgery, or beyond surgery. Each of these categories requires a different therapeutic approach.

Abnormalities, Multiple↗

Prognosis and early management of birth injuries to the brachial plexus.

Twenty-four cases of birth injury to the brachial plexus were seen in 21 infants over 15 years. Obstetric complications were common, and in 11 cases traction was needed to deliver the shoulders. Three out of every four arms fully recovered after exercises. Splints were not needed. Reconstructive procedures were performed on three permanently paralysed arms when the children were aged about 4. There was no way of predicting which patients would recover. The muscles supplied by the suprascapular nerve were paralysed in all patients, and this paralysis persisted in those whose arms failed to recover fully.

Birth Injuries↗