[THE SIGNIFICANCE OF THE ILEOFEMORAL LIGAMENT FOR THE PATHOGENESIS AND THERAPY OF CONGENITAL HIP DISLOCATION].
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
A case of traumatic hip dislocation with spontaneous reduction of the hip joint is presented. The patient was involved in a car accident, and characterized as multitraumatized. On admission to the Emergency Department there were no clinical signs of traumatic hip-dislocation, but because of the severity of the trauma an X-ray of the pelvis was performed and a fracture of the acetabulum diagnosed. The patient was taken to the operating theatre for surgery of several fractures of both upper and lower extremities. This was followed by control X-rays including both anterior-posterior and lateral views of the right hip. This demonstrated that the right hip was now dislocated. The dislocation was reduced. CT showed a larger fracture of the acetabulum, and this was treated with osteosynthesis. Patients with an unstable hip due to trauma, should as a general rule have the hip X-rayed in two planes. It is further suggested that in cases of severely traumatized patients X-ray of the pelvis should be routinely performed.
Hip dislocation of several years duration in cerebral palsy needs treatment only if the patient has serious complaints. With the aim of reducing pain and problems with sitting function and perineal hygiene, we performed shortening osteotomy of the femur in 15 patients (12 girls and 3 boys) with spastic quadriplegia or diplegia at mean age of 14 (8-26) years. The patients were severely mentally and physically retarded, and only one patient had gait function, with support. A subtrochanteric shortening osteotomy of 3-5 cm was performed. The mean follow-up period was 5 (1-10) years. The symptomatic effect of the operation was good. The patients and parents were satisfied because the pain disappeared and the patients had less spasticity and stiffness. Complications were seen in two patients in the form of skin necrosis under both heels; this was caused by the plaster. Although reduction of the dislocation was not the aim of the surgery, radiographs at follow-up of 16 operated hips showed that five hips were reduced, whereas 11 hips remained subluxated or dislocated. We conclude that shortening osteotomy of the femur produces good symptomatic effects, probably due to reduction of the abnormally high muscle tension across the hip joint.
A snapping hip is a common problem in children and young adults. The common etiologies of the syndrome have been well described. We believe that habitual dislocation may be a more frequent cause of the snapping hip syndrome than has been previously described. We report two cases of this rarely reported clinical entity presenting as a snapping hip.
Operative management of concomitant ipsilateral femur fracture and anterior hip dislocation has not been previously described in the literature. We report the case of a 15-years-old girl who was injured in a motorcycle accident and presented with a femoral shaft fracture and a concomitant ipsilateral anterior hip dislocation. Operative management consisted of an attempted closed reduction of the femoral fracture, which was unsuccessful; thus, an external fixator was temporarily applied. Subsequently, the hip dislocation was treated by open reduction through an anterolateral approach. Finally, the femoral fracture was securely stabilized using an unreamed femoral intramedullary nail. The postoperative course was uneventful. MRI follow-up after 6 weeks did not reveal any sign of mangled vascularization of the femoral head and radiographs demonstrated normal bony healing of the shaft fracture. Due to the fact that there is no definitive surgical strategy for this rare combination of injuries, concomitant ipsilateral femoral fracture and anterior hip dislocation is an interesting and challenging situation for the trauma surgeon which requires a subtle and exact surgical technique in order to achieve satisfying results.
Explore the source record for details and available documents.
The combination of traumatic hip dislocation and multiple trauma have not been well documented in the medical literature to date. The role of surgery therefore has not been well defined in these patients. During a 12-year period, 29 consecutive patients with 31 traumatic hip dislocations with concomitant Injury Severity Scores exceeding 18 points were treated at the authors' institution. An initial satisfactory closed reduction was achieved in 23 patients, two patients had failed reductions, and four patients had noncongruous reductions. Open surgical procedures were done on these patients and on 10 additional patients who had associated acetabular or femoral head fractures. Overall, seven patients from the group died including two patients who had surgical procedures. From 17 living patients who did not require surgery for failed or noncongruous reductions, 13 patients were available for followup at a mean of 8 years after their injury. The clinical results at this followup were excellent in three hips, good in seven hips, and fair in four hips. The radiologic results, however, showed that five patients had early (Grades I and II according to Matta) hip degeneration and seven patients had Grade II (according to Ficat) avascular necrosis of the femoral head. These changes were not clinically significant at this followup and it is proposed that these results justify a policy of active treatment of traumatic hip dislocation in patients with multitrauma.
In a small child, the prognosis of hip dysplasia is determined most of all by the quality of the covering over the femoral head. A simple radiometric expression of the extent repositioning has been achieved is Wiberg's CE angle (1939). It is suggested that a new classification be established for the critical area: between 10 degrees and 20 degrees. Other criteria for evaluating dysplasia of the hip are suitable for establishing the prognosis--assuming they include the socket; however, their application is often more complicated. Deformation of the femoral head, the CCD angle, and antetorsion of the femoral head are less suitable predictors. In the 100 patients with uni- or bilateral CDH, the long-term follow-up (mean of 47 years), indicates that there is an extraordinarily high incidence of arthrosis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Chondral and osteochondral impactions are insults to articular cartilage and subchondral bone of the femoral head during hip dislocation. To evaluate the frequency and sites of femoral head impaction, we reviewed CT scans of 35 patients with hip dislocation (32 posterior and three anterior). Osteochondral impaction fractures were present in 20 (63%) of the 32 patients with posterior hip dislocation and in all three patients with anterior dislocation. In patients with posterior dislocation, the impaction occurred anteriorly in an arc between the 11-o'clock and 1-o'clock positions in all seven cases (100%) of right-sided dislocation and in eight (61%) of 13 cases of left-sided dislocation. Twelve (60%) of the 20 patients with femoral head impaction fracture underwent surgery; osteochondral impaction was substantiated in all 12. In those with anterior dislocation, osteochondral impaction occurred at the posterolateral aspect of the femoral head in an arc between the 4-o'clock and 5-o'clock positions. A high rate of osteochondral impaction after hip dislocation was detected in this series. Observing the site of femoral head impaction allows determination of the type of original dislocation. Alternatively, when the type of original dislocation is known, the site of femoral head impaction can be predicted.
Traumatic hip dislocation in the paediatric population is a relatively rare occurrence and constitutes an orthopaedic emergency. A trivial force is all that is required and non-accidental injury should not be necessarily suspected. A case report involving a hip dislocation in a 21-month-old child, the youngest in the recent English literature is detailed.
Explore the source record for details and available documents.
Two cases of monolateral voluntary hip dislocation in Down's syndrome are reported. No surgical procedure was permitted by the family in either case, thus showing the natural evolution of the joint morphology. In the case observed a year after the onset of hip dislocation CT Scan already showed an initial smoothing of the posterior acetabular wall. In the other case, after a 9 year follow-up, the voluntary hip dislocation was followed by progressive subluxation and fixed dislocation at the end. This suggests that only early surgical treatment can prevent this outcome.
Explore the source record for details and available documents.