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PubMed2000

[Acetabular component implantation in coxarthrosis due to dysplasia after high congenital hip dislocation].

A total of 71 (25-110) months after primary total hip replacement, 17 patients with high congenital hip dislocation and false iliac acetabulum were clinically and radiologically assessed. Twenty-one threaded cups were placed, 16 at the site of the true acetabulum, one at the site of the acetabular rim and four at the site of the false acetabulum. The Harris hip score increased from 37.1 (20.2-55.5) points preoperatively to 84.7 (67.4-97.7) points postoperatively. Radiologically there were no signs of cup migration. It can be concluded that even complicated dysplastic hips can be treated successfully by total hip replacement, without prior ileofemoral distraction or additional acetabular augmentation.

Acetabulum↗
PubMed1981

Traumatic hip dislocation with fracture of the ipsilateral femoral shaft in childhood. Report of a case and review of the literature.

Ipsilateral concomitant hip dislocation and femoral shaft fracture in childhood is extremely rare. A further case and a literature review, with 35 additional observations are presented. The dislocation was initially missed in more than 50% of cases, but when immediately diagnosed, closed reduction manoeuvres were effective in all observations but one, and results were rated normal. As delayed reduction predisposes to avascular necrosis, every child with a femoral shaft fracture should be given a routine X-rays of pelvis, including lateral hip views, as a safeguard against missing an associated hip dislocation. If present, its urgent closed reduction is imperious. In case of failure, closed or open purchasing of the proximal shaft fragment to allow a sort of skeletal-handling is to be used. Open reduction of the dislocation is to be regarded as the third-line procedure.

Child, Preschool↗
PubMedDate not supplied

Management of hip dislocations in children with arthrogryposis.

From a review of 131 children with arthrogryposis, we studied 18 patients with hip dislocations. Fourteen patients (10 unilateral, four bilateral) were treated by open reduction. Mean age at surgery was 9.7 months, and follow-up ranged from 9 to 245 months. Range of motion of patients treated by open reduction following the medial approach was greater than in those treated by anterolateral incision and greater than in bilateral cases treated by closed reduction. Acetabular development was satisfactory following the medial approach and there were no re-dislocations, but one hip developed avascular necrosis.

Arthrogryposis↗
PubMed1991

[Traumatic hip dislocation in children].

Three children aged 7, 9 and 11 were treated because of traumatic dislocation of the hip. There was one case of anterior and two cases of posterior iliac dislocation. The reduction was performed under general anaesthesia directly after admission. In two children derotational shoe for 6 weeks and a plaster for 3 weeks in third case were used in after treatment. The unweighing of the limb was maintained for 6 weeks more. Subsequently, the gradual weight bearing was allowed. Radiographic examination of two children 1.5 and 3.75 years after injury revealed normal hip joints. There was no restriction of physical activity of these children.

Casts, Surgical↗
PubMedDate not supplied

Bilateral habitual hip dislocation in a child with Down's syndrome: a case report.

Habitual dislocation of the hips occurred in a 3-year-old girl with Down's syndrome. Dislocations were bilateral and recurrent. This condition seems not to have been reported previously. No treatment was permitted by the family. Capsular plication, femoral or pelvic osteotomy could become necessary in the future.

Child, Preschool↗
PubMed1996

[Long-term investigation of closed reduction of congenital hip dislocation in children with modified frog-leg cast].

From 1978 to 1983, closed reduction and fixation with frog-leg cast were used to treat congenital hip dislocation in children in our hospital. Sixty-two patients with such hip dislocation were treated by these methods. Among them 38 patients under 3 years of age were followed up for 12 to 16 years (mean 13 years). Encouraging results were obtained and the reduction rate was 97.9%. This treatment revealed that after closed reduction the fixation and the slight movement of the femoral head in the cast under the fixation are a self-remould action that may promote the growth of the acetabulum and the femoral head resulting in normal development of the hip.

Casts, Surgical↗
PubMed1981

[Hip dysplasia and congenital hip dislocation - a roentgenometric study in 110 families (author's transl)].

In human genetics and orthopedics quite different answers have been given to the question of hereditary transmission and frequency of hip dysplasia in families of children with congenital hip dislocation. We therefore have made roentgenometric measurements of 110 parents of children with congenital hip dislocation. In 25% we found abnormal flat acetabulae, whereas 12% had pathologic deep hips. This may propose a new concept of morphology of congenital hip dysplasia.

Acetabulum↗
PubMed1983

[Hip dislocation with femur head fracture].

It is talked about the classification, the therapy and the late results of the traumatic dislocation of the hip joint with a fracture of the femoral head. Twelve patients with an average age of 36 years (from 18 to 77 years) were treated between the years 1972 and 1982. The rarer anterior dislocation of the hip including a fracture of the femoral head should be specifically classified, in order not to cause any errors for the therapeutic and prognostic assessment following the Pipkin classification. Type I and II with posterior dislocation justify a closed trial of reposition. The miscarried trial, and a continuing fragmental dislocation with a disturbance of the joint's function, or fragments participating in the load area of the femoral head necessitate an open reposition. Small fragments may be taken away, the larger ones require the screwing osteosynthesis. Smaller fragments from the load area must be sustained in an anterior dislocation ("IIb"). The type III injury gives primarily--in exceptional cases sometimes secondarily--an indication for an alloplastic false hip joint. Injuries of type IV should be restored operatively, respectively, it is necessary to perform a secondary operation to set in an endoprosthetic substitute. With the operative therapy--that is: 5 times extirpation of fragments, 4 times screwing osteosynthesis of the femoral head, twice screwing osteosynthesis of the acetabulum--we obtained good results in injuries of type I, II and IV. We performed 3 times a primary total false hip joint in type III injuries.

Adolescent↗
PubMed1979

Circulatory and vascular changes in the hip following traumatic hip dislocation.

An experimental study of the extraosseous and intraosseous vascular and circulatory changes following traumatic hip dislocation in dogs and rabbits is reported. The observations were made by dissection, angiography and histology following posterior dislocation and reduction at varying intervals. Traumatic dislocation of the hip causes extraosseous circulatory disturbance in the hip resulting in intraosseous circulatory deficiency in the femoral head. The sites of the vascular lesions are the extraosseous branches of the femoral circumflex arteries and their extraosseous branches of the epiphyseal and metaphyseal arteries and the retinacular artery of the circulus vasculosus articularis. The types of the vascular damage are irreversible tear of the minority of vessels along the ruptured capsule and teres ligament, and the compression, traction and spasm of the majority of intact vessels which are reversible by early reduction. In prolonged dislocation the circulatory disturbance persists or worsens due to additional pathological changes such as posttraumatic inflammatory changes, fixed deformity in the dislocated position, thrombosis, fibrosis and occlusion of vessels which may eventually cause an ischemic necrosis of the femoral head. Early reduction within several hours after dislocation restores nearly normal regional anatomy and relieves vessels from compression, traction or spasm and restores extra and intraosseous circulation. It also prevents or minimizes thrombosis, fibrosis and occlusion of vessels and avascular necrosis of the femoral head.

Animals↗
PubMed2004

Chiropractic management of patients with bilateral congenital hip dislocation with chronic low back and leg pain.

OBJECTIVE: To discuss conservative methods for treating patients with chronic low back and leg pain associated with the biomechanical and postural alterations related to bilateral congenital hip dislocation. CLINICAL FEATURES: This report describes the cases of 2 adult female subjects with bilateral congenital hip dislocation without acetabula formation who suffered from chronic low back and leg pain managed conservatively by chiropractic methods. The first subject is a 45-year-old woman with a 9-month history of right buttock pain and radiating right leg pain and paresthesia down to the first 2 toes, with a diagnosis of a herniated L4 intervertebral disk. The second subject is a 53-year-old woman who complained of chronic intermittent low back pain and constant unremitting pain on her right leg for the last 3 years. INTERVENTION AND OUTCOME: Chiropractic manipulation utilizing Logan Basic apex and double notch contacts, as well as sacroiliac manipulation on a drop table with a sacrum contact and with a posterior to anterior and superior to inferior (PA-SI) rocking thrust, together with a spinal stabilization exercise program, were used on these 2 patients. Both patients had significant clinical improvement, with reduction on the Visual Analogue Scale (VAS) of 67% and 84%, Oswestry Disability Index improvement of 73% and 81%, and an improvement on the Harris hip score of 71% and 44%, respectively. CONCLUSION: A conservative management approach, including specific chiropractic manipulation and a spinal stabilization exercise program, can help manage the treatment of adult patients with chronic low back and leg pain related to bilateral congenital dislocation of the hips.

Chronic Disease↗