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At least 397 records · Page 22Linked to original sources
PubMed1988

[Pavlik's method of reduction treatment of congenital hip dislocation].

In 68 patients with 101 congenital dysplasias of the hip results of treatment by Pavlik harness were retrospectively analysed. Of the 101 there were 61 dislocations. After six weeks of treatment with the Pavlik harness reduction was achieved in 48 of the 61 dislocated hips (80%). However, because of persisting dysplasia 50% of all cases had to be treated with an abduction device for a few months. There were no complications, in particular osteonecrosis of the femoral head was not observed. Provided well controlled, the Pavlik harness is a good, safe and easy method for treating congenital dislocation of the hip.

Age Factors↗
PubMed2006

[Dislocations hip arthroplasty].

The authors present analysis of dislocation following hip arthroplasty based on their own clinical material of 1985-2005 year. It contain 2712 cases of total hip arthroplasty, 2171 (80.1%) cases were cemented including 64 (2.4%) cases of revised arthroplasty, 541 (19.9%) cases were cement-free stabilized including 7 (0.2%) cases of revised arthroplasty. Obtained outcomes of analysis permit to make assertion that dislocation following hip arthroplasty occurred during first three month after surgery, more frequently in case of revised arthroplasty and following fractures of femoral neck. Requirement of success is appropriate steady of implant and right done supervision of rehabilitation with learned necessary motoric behaviors.

Arthroplasty, Replacement, Hip↗
PubMed1993

[Treatment of pathologic hip dislocation caused by hematogenic osteomyelitis in children and adolescents].

The article discusses 94 patients with pathological dislocation of the hip after hematogenous osteomyelitis who underwent reconstructive-restorative operations on 101 joints. According to the clinical and X-ray signs, all patients were divided into 4 main groups. The types of surgical interventions performed depending on the severity of involvement of the proximal part of the femur and the acetabulum are indicated. Patients with acute hematogenous osteomyelitis of the proximal femur must be subjected to early orthopedic prophylaxis and kept under strict medical control of a specialist. Pathological dislocations of the hip are managed by operation which is determined by the type of the condition.

Acute Disease↗
PubMed1982

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↗
PubMed1986

[Use of the Pavlik harness before the age of 3 months in congenital hip dislocation].

The authors report 128 cases of reduction of congenital dislocation of the hip by the Pavlik harness with more than one year of follow-up. They studied 60 patients who had less than 3 months of age at the beginning of the treatment. They obtain 59 reductions (98%) without necrosis of femoral heads. The only case of unsuccess, treated after by continuous extension, has doubtful femoral heads at 15 months of age. The femoral heads appear in normal delay and walk was normal between 10 and 18 months. Only a strict watchfulness, as strict as a continuous extension, can obtain good results with progressive flexion. Bath is not authorized and harness is not removed before stable reduction. Parents are taught how to hold their infant without bringing his knees together. The most important thing is the X-ray control on D8, D21, and D60, the prevent the trap of too much flexion, too nice penetration or persistent eccentration. Under these conditions, the authors think that the treatment of congenital dislocation of the hip by the Pavlik harness is the safest method especially before 3 months of age.

Braces↗
PubMed1994

[Hip dislocation without fracture--a trauma surgery emergency].

Between 1968 and 1990, 26 patients (medium age 24.2 years) with a traumatic hip dislocation without fracture were treated at the Dept. of Trauma Surgery of the University Erlangen-Nuremberg. Only 26.9% of the patients had no further injuries beside the hip dislocation. An early closed reduction was carried out whenever possible. In 96.0% of the cases, radiological acceptable results have been achieved with the closed reduction. In 4.0% an open reduction became necessary. After a period of three to four weeks of extension, the patients had been mobilized to nonweight bearing status. Stress on the injured leg was increased progressively, that full weight bearing capacity was achieved after three months. It was possible to examine 12 of the 26 patients. Good and very good results based on the Merle d'Aubigné score and on the Thompson and Epstein score were obtained in 11 of the 12 patients. The complication seen most often was posttraumatic coxarthritis of the hip. We have not seen any necroses of the head of femur in our patients to date. All our results indicate, that the immediate and careful reposition under anaesthesia seems to be the most important factor in preventing a necrosis of the head of femur.

Adolescent↗
PubMed2004

Results of reoperation for hip dislocation: the big picture.

Hip instability remains a costly complication of primary (3%) and revision (10%) procedures. In those with well-oriented components, instability may be anticipated in about 70% from advancement of the trochanter. Articular reorientation readily is affected by the use of modular cups with elevated rims. This has proven to be an effective strategy both to lessen the likelihood of an initial dislocation after both primary and revision procedures. It has also proven to be an effective strategy to treat the unstable implant, especially if cup orientation has been defined as the primary problem. Larger head sizes in the range of low-friction arthroplasty, such as 32 mm, are not any more stable than 22-mm diameter implants. Anatomic-sized heads as used in bipolar devices are effective in treating established instability in up to 90% of instances. The most popular current option is that of the constrained head/cup articulation. Good short-term results have revealed success in more than 90%. However, the effectiveness is design dependent, and the long-term effectiveness understandably is questioned as reports of mechanical failure begin to emerge.

Arthroplasty, Replacement, Hip↗
PubMed1984

Concentric reduction of the dislocated hip. Computed-tomographic evaluation.

Concentric reduction of a dislocated hip can be evaluated by anteroposterior views or linear tomography. Anterior relationships, however, may be difficult to evaluate from a frontal radiograph despite good visibility. Computed tomography (CT), because of its cross-sectional imaging capabilities, is superior in demonstrating these relationships. The CT appearance of two types of dislocations (posterior and lateral) is described. A posterior dislocation should be suspected if the femoral metaphysis approximates the acetabulum, a mass projects behind the ischium, or the fat plane anterior to the gluteus maximus is deformed or displaced posteriorly.

Female↗
PubMedDate not supplied

Long-term follow-up after one-stage reconstruction of dislocated hips in patients with cerebral palsy.

Twelve consecutive patients (average age 10.6 years) with 14 dislocated hips underwent one-stage hip reconstruction between 1973 and 1981. The procedure consisted of (1) adductor myotomy and anterior obturator neurectomy, (2) circumferential capsulotomy, iliopsoas and external rotator tenotomies, and ligamentum teres and pulvinar excision, (3) shortening femoral varus derotational osteotomy, (4) acetabuloplasty, and (5) spica immobilization for 4 weeks. All patients were followed clinically and radiographically at an average of 16.7 (range 12.4-19.5) years. No patients were lost to follow-up. Long-term results revealed complete stability in 13 of 14 hips, with no redislocations or subluxations. The one patient with "instability" had undergone bilateral proximal femoral resections for severe arthritis 12 years after left hip reconstruction; at the time of resection, the left hip was stable and reduced. Pain was absent in 13 of 14 hips. There were no problems with perineal care, decubitus formation, or sitting tolerance. Extension and abduction improved an average of 23 degrees and 10 degrees, respectively. Two patients' ambulatory status improved; none deteriorated. The mean center-edge angle was 35 degrees (range 22-50 degrees), and the mean migration percentage was 10.6% (range 0-31%). Complications included one case of degenerative arthritis, one case of painless coxa vara, and three episodes of supracondylar femur fractures. None of these patients developed radiographic evidence of avascular necrosis. In the authors' experience, one-stage hip reconstruction consisting of soft tissue lengthening, open reduction, femoral osteotomy, and pericapsular acetabuloplasty results in a painless, mobile, and stable hip at long-term follow-up that greatly improves the patient's quality of life.

Adolescent↗