Congenital dislocation of the hip (CDH) and seasonality: the gestational age of vulnerability to some seasonal factor.
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Biomedical subjects
Publications and source records attributed to R Salama.
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Between 1971 and 1977, posteromedial release was performed on 47 feet of 30 children 9 months to 4 years of age. At review, full correction of equinus was achieved in 98%, heel varus in 91%, and cavus in 85%, but in only 50% of feet with forefoot adduction. Between 1978 and 1982, surgery was performed on 22 feet of 18 children 3-10 months of age. Recessions of the abductor hallucis and short plantar muscles and fascia were also performed at operation. Correction of equinus, heel varus, and cavus demonstrated results similar to those of the earlier group, but forefoot adduction was also satisfactorily corrected in 91% of feet.
This report is a review of long-term results of 42 consecutive fractures of the neck of the radius in children. More than half the patients were followed for greater than 4 years. The results were assessed clinically and radiologically at 6 months and at review. Twenty-seven children (64%) had a good result, 2 (5%) had a fair result, and 13 (31%) had a poor result. Primary angulation was the most important factor affecting the results. Periarticular ossification, avascular necrosis, enlargement of the radial head and of the proximal end of the radius were the most important causes of poor results. Unlike other fractures with unpredictable results, more accurate reduction is mandatory to improve the final outcome.
Fifty-one adult patients with 54 intra-articular fractures of the calcaneus have been reviewed from one to 11 years after the injury. Treatment consisted in immediate active exercises of the foot without any attempt at reduction or immobilization. The patients resumed full weight-bearing, on the average, three months after injury. The overall results were excellent in 19, good in 24 and unsatisfactory, objectively and subjectively, in 11 feet. In this consecutive series, the majority of the fractures had a marked degree of displacement. Excluding undisplaced fractures which had a good result, no clear cut relation between the type and degree of displacement and the final result could be found. However, there were more unsatisfactory results in fractures in which the tuber-joint angle was equal to or less than 10 degrees.
The high osteogenic potential of living autologous marrow cells can be combined with foreign bone to enhance new bone formation. Xenogeneic bone was combined with autologous red marrow and used in 23 patients aged 5-17 years. Kiel bone was impregnated with marrow aspirated from the iliac crest and, apart from one case of lesion recurrence, gave excellent results in all patients under conditions covering a wide range of indications for bone grafting. Unlimited supplies of xenograft bone and other bone substitutes can be rendered osteogenic by a simple procedure. Combining fresh autologous red marrow with other types of bank bone allograft or xenograft, or even with biological or synthetic biocompatible material that favors the induction of new bone, may provide even better results.
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