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Results for “HIP DISLOCATION”

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PubMed1981

[Dislocated hips in cerebral palsy (author's transl)].

The authors have observed 119 excentrated hips in 81 spastic children. Most of the cases were noted in non walking children under the age of ten. However some excentrated hips were seen in older patients eventually able to walk. The importance of a three dimensional approach of the problem is pointed out. The results of the surgical procedures are analysed. It appeared that it was important to restore a muscle balance before any pelvic or femoral osteotomy. Triple pelvic osteotomy was indicated of obtaining a better orientation of the acetabulum in younger children. Its complications were infrequent. Chiari's osteotomy was indicated in older children. The authors point out the importance of an early diagnosis in cases of lack of muscles balance which can be corrected by minor surgical procedures on soft tissues.

Adolescent↗
PubMed1996

[Congenital hip dislocation associated with spina bifida].

Spina bifida is commonly associated with hydrocephalus and feet malformations, however its association with congenital dislocation of the hip is not well document. We retrospectively analyzed the medical records of 120 children aged 6 months to 15 years old, admited to a rehabilitation center with the diagnosis of spina bifida. Fifty six children (55.4%) had dislocation of the hip (36 of 53 women and 20 of 48 men). These figures are higher than those reported for newborns by the Latin-American Collaborative Stud of Congenital Malformations. We conclude that congenital dislocation of the hip is frequent in children with spina bifida.

Adolescent↗
PubMed2001

Closed reduction of the traumatically dislocated hip: a new technique.

Traumatic dislocation of the hip joint without associated fracture is not common. It is the result of high energy transfer usually a RTA or fall from a height. It is a true emergency, and the joint should be relocated within 6h. Failure to do so increases the risk of avascular necrosis of the femoral head with resultant early degenerative joint disease often in an otherwise fit young patient.

Accidents, Traffic↗
PubMed1992

Closed reduction guided by dynamic ultrasound in late-diagnosed hip dislocation.

The potential for dynamic ultrasound in the primary treatment of late-diagnosed congenital hip dislocation was assessed in 21 patients. The study showed that dynamic ultrasound was a useful technique in guiding closed reduction and for assessing the effects of positioning on the stability of children less than 2 years of age. In older children, however, this assessment was less reliable. Although dynamic ultrasound evaluation can be done without sedation, general anesthesia provides optimal conditions for such evaluation. The benefits of ultrasound are that it does not involve exposure to radiation, that the need for elaborate radiographic methods like arthrography and computed tomography is reduced, and that closed reduction is more reliably achieved when guided by direct visualization. Because a thorough knowledge of the dynamics of hip dislocation is essential, the ultrasound evaluation should be performed by orthopedic surgeons.

Casts, Surgical↗
PubMedDate not supplied

Measuring physical function in children with spina bifida and dislocated hips: the Spina Bifida Hips Questionnaire.

The objective of this study was to develop a questionnaire to evaluate the activities of daily living that are important to children with spina bifida and dislocated hips and their families. Ninety-six items were generated from a review of the literature and interviews with clinicians, parents, and children with spina bifida and dislocated hips. Items were rated independently for "importance" and "severity" by the children and their parents. The 26 most important and severe items were formatted into a self-administered questionnaire, the Spina Bifida Hips Questionnaire (SBHQ). Parents and children completed 2 weeks apart the SBHQ, the Activities Scale for Kids (ASK), and the Pediatric Outcomes Data Collection Questionnaire (PODCQ). The SBHQ showed excellent test-retest reliability (intraclass correlation = 0.97). Construct validity was established by correlations with the ASK (r = 0.79, P < 0.01) and the PODCQ (r = 0.84, P < 0.01). In conclusion, the SBHQ is a valid and reliable questionnaire for the evaluation of treatment outcomes for children with spina bifida and dislocated hips.

Activities of Daily Living↗
PubMed2005

Long-term results after open reduction of developmental hip dislocation by an anterior approach lateral and medial of the iliopsoas muscle.

The technique of and especially the approach to open reduction of developmental dislocation of the hip are still a matter of discussion. The anterior approach, first lateral and then medial to the iliopsoas muscle, was described by Tonnis in 1978. A follow-up investigation to adulthood has now been performed. Eighty-seven children (118 hips) out of 105 children (83%) who underwent open reduction of developmental dislocation of the hip before the age of 4 years were reinvestigated 10-21 years after the operation. An anterior approach first lateral, then medial to the iliopsoas muscle was chosen, because this offers the best access to the joint. Additional operations including transiliac osteotomy for acetabuloplasty, shortening osteotomy, and femoral osteotomies were performed as necessary. In 92 (78%) of the 118 hips studied the CE angle exceeded 25 degrees and in 98 hips (83%) the VCA angle exceeded 25 degrees. Critical CE angles between 20 and 25 degrees were found in 14% of the hips, and critical VCA angles in 4%. Residual dysplasia (<20 degrees) was found in 8 and 13% of the hips, respectively. Avascular necrosis according to Hirohashi was observed after operation in grade 1 in 5.9% and grade 2 in 1.7%. No necrosis was found following shortening osteotomy of the proximal femur. The anterior approach, first lateral, then medial to the iliopsoas muscle, offers an optimal access to the medial parts of the joint with control of reduction, protects the vasculature of the femoral neck, and allows simultaneous postero-lateral capsulorrhaphy and pelvic osteotomies.

Child, Preschool↗
PubMedDate not supplied

The treatment of congenital hip dislocation between the ages of 1 and 3.

A total of 81 patients (103 hips) with a diagnosis of congenital hip dislocation were reviewed, who had been treated between one and three years of age. All of the patients were initially treated with adhesive band traction prior to non-surgical reduction, which was performed under general anesthesia using gentle reduction maneuvers followed by immobilization in plaster. Non-surgical reduction was performed in 69 hips (67%), surgical in the remaining 34 (33%). A total of 91 associated surgical procedures were performed for the treatment of residual subluxation. Average follow-up was 12 years (minimum 5, maximum 19). The clinical results of the non-surgical reductions were excellent in 75% of the cases. Radiographically, 48% are hips which have a normal aspect, while 42% have a moderate degree of residual dysplasia or deformity of the femoral epiphysis and of the acetabulum. Hips that were initially classified as grade III dislocations show fair results. Hips treated non-surgically included 11 cases of avascular necrosis (16%); recovery was adequate. Hips treated surgically included 14 cases of avascular necrosis (30%), which was more accentuated in those hips that had initially been treated elsewhere, and in those classified as grade III. The clinical and radiographic results obtained for the hips treated surgically demonstrate poor results in 17% of the cases (6 out of 34), as a consequence of types III and IV osteochondrosis. It may be concluded that in this age group congenital hip dislocation is best treated by non-surgical reduction, possibly followed by surgery of the femur and acetabulum. Surgical reduction was only indicated when conservative methods failed.

Acetabulum↗
PubMedDate not supplied

Traumatic hip dislocation with spontaneous incomplete reduction: a diagnostic trap.

We are reporting three children and adolescents who presented with incongruous reduction of the hip following injury. In each case, the diagnosis was initially missed. None of the patients presented with a hip dislocation, but two gave a history consistent with transient hip subluxation or dislocation. Low-energy trauma was the cause in two cases. Treatment consisted of arthrotomy to remove interposed capsule and labrum to obtain concentric reduction. When reduction of a hip dislocation occurs spontaneously, the condition may be misjudged. Any child or adolescent who complains of hip pain following injury should have radiographs scrutinized for asymmetric widening of the hip joints. Any asymmetry should be evaluated by appropriate imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI). Removal of any interposed tissue is recommended, even when the diagnosis is delayed by several months.

Adolescent↗