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At least 271 records · Page 15Linked to original sources
PubMed1994

[A new technique of osteotomy for femoral varisation in the management of hip dislocation and paralytic subluxation of the hip].

PURPOSE OF THE STUDY: Severe valgus deformity of the upper femur is a frequent feature of the unstable paralytic hip. Thus, the insertion of the osteosynthesis material during a varization osteotomy can be technical demanding. Risks and benefits of a modified femoral varization osteotomy were evaluated in a retrospective follow-up study. MATERIAL: 53 paralytic hips (33 patients) have been operated from September 1989 to april 1993. Mean age at surgery was 6 years. The etiologies were Spinal Amyotrophy in 12 hips, Cerebral Palsy in 31 hips and miscellaneous neurologic diseases in 10 hips. The average neck-shaft angle before surgery was 162 degrees. The mean Reimers' Index was 58 per cent. METHODS: The upper femoral shaft was exposed by subperiosteal dissection in a circumferential manner. An intertrochanteric osteotomy was carried out. The direction of the femoral neck was identified. An AO 100 degree blade plate was then introduced under direct visual control through the cancellous osteotomy surface of the proximal fragment. Radiological and clinical outcome were assessed at last follow-up. Mean follow-up was 16 months. RESULTS: Solid fusion was obtained in all patients. The mean postoperative neck-shaft angle was 104 degrees. The mean Reimers' Index was 17 per cent at last follow-up. Two infections were noted. Voluminous calcifications under the femoral neck have been observed in 6 cases. Recurrence of the valgus deformity was noted in 9 hips at last follow-up. DISCUSSION: This simplified varization technique permits a large amount of varization. The medialization diminishes the problem of protruding hardware. The complications rate appears to be low without any femoral head necrosis in this series despite subperiosteal dissection of the femoral neck. CONCLUSION: The authors think that this modified varization technique may deserve consideration in the treatment of the unstable paralytic hip.

Adolescent↗
PubMed2001

Femoral anteversion osteotomy for the treatment of hip dislocation in Down syndrome: long-term evolution.

We propose a femoral desrotational osteotomy to antevert the femoral head associated with plication of the anterior and superior capsule for treatment in the early stages of hip dislocation in Down syndrome. Eight patients (10 hips) with Down syndrome and hip dislocation were reviewed. Five children (seven hips) were operated. We used the proposed surgical technique in three patients (four hips). The average follow-up was 11 years (range, 5-16 years). No infections or complications were observed. In our short experience, this is the recommended procedure in the early stages of hip dislocation in Down syndrome.

Child, Preschool↗
PubMed1993

[Delayed detection of hip dislocation: is the physician to blame?].

Despite the screening campaigns for early detection of congenital dislocation of the hip, some cases continue to be diagnosed late. The main reason for the failure to diagnose this disorder at an early stage is still unclear. A dislocated or a dislocatable hip is not always apparent during the initial newborn screening examination, and repeated clinical examinations throughout the first 12 months are necessary in order to establish the presence or absence of this disorder. At birth, radiographs are usually normal and a systematic pelvic radiograph of the neonate has no place in neonatal screening. Sonography helps to detect hip pathology early. However, owing to the dynamic nature of the disorder, a single early non-selective ultrasound has proved to be too sensitive and to lack specificity. In the United States, failure to diagnose the congenital dislocation of the hip is the most common musculoskeletal cause of litigation brought against pediatricians. In Europe, the system of fault liability implicates an obligation of ability and means. Failure to diagnose or misdiagnosis is not a fault in itself as long as a complete history, careful physical examination and adequate and appropriate complementary examinations have been performed by an adequately trained physician. If congenital hip dislocation is recognized and treated early, most of the affected children will develop functionally and radiologically normal hips. The longer the dislocation remains untreated, the harder it is to relocate the hip and the higher the incidence of secondary acetabular dysplasia, necessitating surgical correction. However, early treatment is not always successful or without complication. Consequently, the damages due to late onset of the treatment are difficult to assess.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed2000

Classification of traumatic hip dislocation.

The commonly used classification systems of hip dislocation are based on the direction of the dislocation and the presence of associated lesions. However, no rating system can reliably predict the patient's outcome and prognosis based on the initial presentation and classification. In general, patients with anterior dislocations have the best prognosis. Other factors affecting the prognosis are the associated injuries and more importantly the delay between dislocation and reduction.

Hip Dislocation↗
PubMed2006

Assessment of the correlation between commonly used radiographic parameters in normal, subluxated and dislocated hips.

The correlations between the commonly used radiographic parameters, center-edge angle (CEA), acetabular-head index (AHI), acetabular index angle (AIA), acetabular angle (AA) and ACM angle, in normal, subluxated and dislocated hips were investigated in the radiographs of 364 normal, 23 subluxated and 19 dislocated hips of patients between 5 and 18 years of age. A significant correlation was observed between all the parameters in normal hips. A significant correlation between AIA and the other four parameters, and between CEA-AHI and AA-ACM, was noted in subluxated hips. AIA-AA and AIA-ACM had significant correlations in dislocated hips. It was concluded that measurement of more than one radiographic parameter might be better to exactly evaluate the radiographic hip anatomy in developmental dysplasia of the hip.

Acetabulum↗
PubMed1986

Distribution and severity of injuries associated with hip dislocations secondary to motor vehicle accidents.

The injuries associated with traumatic hip dislocations and their quantitated morbidities were evaluated in this retrospective study of 38 patients. Ninety-five per cent of the patients had associated injuries severe enough for hospitalization on their own merit. Head, chest, and abdominal injuries were seen most frequently. Central dislocations were associated with the most morbidity, but were not different in distribution of injuries. Using eight different measurements of morbidity, including the Injury Severity Score, hip dislocations, in general, had more morbidity than the national injury rates.

Abdominal Injuries↗
PubMed1984

Cost-benefit evaluation of systematic radiological diagnosis of congenital dislocated hip.

The question of radiological mass screening for congenital dislocated hip is still debated. We have tried to evaluate the cost-benefit ratio of radiological detection at the age of 3-4 months, taking into account the socio-economic cost and radiation risk. Assuming a frequency of this disorder of 1% the average cost of treatment of one case detected by X-ray screening at the age of 3-4 months, including the price of X-ray examinations of 99 normal babies, is 23,374 FF. The average cost of treatment of a case detected when walking (i.e. after 9 months) is 84,230 FF. The cost-benefit ratio is 3.6. In countries where the frequency reaches 2% the cost benefit ratio is 4.57. It also appears from our study that the irradiation of the patient is much smaller when the diagnosis is made earlier. Comparing the slight irradiation delivered to normal infants by this mass screening to the heavy irradiation received by a few individuals whose treatment is started after 9 months, the calculated risk of leukemia or of genetic disorder for the whole population still favours a systematic X-ray film of the pelvis at age 3-4 months. However, if it were decided to make obligatory this mass radiological detection programme during the fourth month of life, this would necessitate a serious effort to train all radiologists to obtain adequate films with the best radiation protection.

Cost-Benefit Analysis↗
PubMed1983

Hip dislocations in myelodysplasia: a functional assessment.

We reviewed the records of 281 patients with myelodysplasia to ascertain the effect of hip dislocation on their ability to walk. There was no difference in the prevalence of myelodysplasia by gender. When adjusted for neurologic level and patient age, no statistical differences were found in the methods of locomotion between patients with hip dislocations and those without. Data (from this report and other published investigations) show that treatment for hip dislocation in myelodysplasia is unnecessary and fraught with many complications.

Adult↗