MR imaging after sports-induced hip dislocations. Report of three cases.
The MR findings in 3 patients who had sustained a posterior dislocation of the hip during sports activities are reported.
Acetabulum↗
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Posterior labral tear as a block to reduction in an anterior hip dislocation.
The patient presented with an anterior dislocation of the hip that could not be centrically reduced by closed methods. Computed tomographic imaging after trial reduction revealed a posterior fragment that was limiting reduction. At the time of open reduction, a large posterior labral tear with a small avulsed posterior acetabular rim of bone was found to be blocking the reduction.
Adult↗
Multidirectional habitual bilateral hip dislocation in a patient with Down syndrome.
A multidirectional (anterior and posterior) bilateral habitual nontraumatic dislocation of the hip in a 3-year-old girl with Down syndrome is reported. The treatment was conservative with application of a spica cast for 12 weeks to shrink the capsule. During the first 6 weeks of treatment, the hips were immobilized in abduction and full external rotation. During the last 6 weeks, the hips were in abduction and slight internal rotation. After cast removal, the hips seemed to have been stabilized, and the child has remained asymptomatic for the last 12 months.
Braces↗
'Floating pelvis'. A combination of bilateral hip dislocation with a lumbar ligamentous disruption.
A patient is described with a ligamentous disruption at the L4/L5 level in association with bilateral, traumatic dislocations of the hip. The diagnostic evaluation, acute intervention, and definitive stabilisation are reported. The unstable spine posed a problem in treatment with regard to the timing and technique of the reduction of the hips.
Adult↗
[Remarks concerning diagnostic principles and early treatment of congenital hip dislocation].
Principles of early diagnosis and treatment of congenital dislocation of the hip are presented. The clinical course, complications and results of treatment by Frejka pillow are reported. Indications for surgical treatment in cases of failure by conservative management, as well as in cases of deficient rebuilding of the hip are discussed.
Hip Dislocation, Congenital↗
[Unnecessarily taxing treatment of congenital hip dislocation to be avoided by timely diagnosis at the well-child center].
In 79 children treated in the Sophia Children's Hospital in Rotterdam because of imminent limping due to congenital dislocation of the hip, the contribution of screening tests by physicians of Infant Health Centres to the timely discovery of this disease was examined. When both limitation of abduction of the hip and difference in length of the legs are examined 6 times in the period of 1-8 months of age, the following results in relation to children not or less well screened may be expected: The risk of discovery of the disease at an age when surgery is not excluded, is reduced to one-third. As a result of the shorter delay between discovery and treatment in practice the risk of having to undergo surgery is halved. The risk of discovery at an age when osteotomy according to Salter is required, is nil. In practice the risk of having to undergo osteotomy is reduced to one quarter. Lowering the frequency of the screening tests reduces the contribution. Examination of just limitation of abduction of the hip also appears to reduce the contribution.
Child↗
[Characteristics of bone marrow stromal cell-precursor cells in children with congenital hip dislocation].
Basing on cloning in vitro, colony-forming stromal cells (CFSC) of the bone marrow were studied in 66 children with a congenital dislocation of the hip. Degenerative processes in the bones of the hip joint were followed by a significant decrease of CFSC cloning. A direct correlation between the results of surgical treatment and cloning efficiency is established. Thus, the cloning efficiency may be used as a criterion for determining feasibility, time of surgery and its prognosis.
Adolescent↗
Congenital hip dislocation. Long-range problems, residual signs, and symptoms after successful treatment.
In the treatment of congenital dislocation of the hip, reduction must be obtained and maintained to provide the proper stimulus for resumption of normal hip joint growth and development. Subluxation and avascular necrosis must be avoided, as degenerative joint disease is certain to occur. Acetabular dysplasia leads to degenerative joint disease with time, although no roentgenographic parameters are predictive. "Normal" hip joint anatomy may fail to develop, depending on the age of the patient at reduction and the growth potential of the acetabular cartilage. However, as normal anatomy as can be achieved should be restored at the age of maturity. This should provide the best possible mechanical environment to avoid exceeding the pressure tolerance level of the hip joint articular cartilage, thereby avoiding degenerative joint disease.
Hip Dislocation, Congenital↗
Posterior hip dislocation in a rural emergency department.
Traumatic posterior dislocation of the hip is an infrequent but potentially severe injury. A commonly recognized cause of such injuries is motor vehicle accidents. There is increasing recognition, however, that this injury can be associated with other activities including several sports. Appropriate care requires recognition and prompt treatment to prevent long-term sequelae. A review of these experiences in a rural emergency department demonstrates additional causative agents and associated events as well as makes recommendations for care.
Acetabulum↗
[Ultrasonic neonatal screening of congenital hip dislocation].
Routine echographical neonatal diagnosis of congenital dislocation of the hip is today a good method of treatment of this pathology: early diagnosis, infarct, allows treatment in early years with complete healing as shown by long term follow-up. 596 newborns have met with echographic hip screening: the method has shown good result and the study has led us to realize an anamnestical schema pointed on the familiarity which is one of the pathognomic matters of this pathology.
Hip Dislocation, Congenital↗
[Traumatic hip dislocation during the years of growth. A review of the literature].
Traumatic dislocation of the hip joint is an uncommon traumatic emergency in children. On the basis of literature reviews as well as our own experience we report on this injury. The most serious complication is the avascular necrosis of the femoral head. A detailed protocol is given.
Adolescent↗
One-stage hip reconstruction with Dega's transiliacal osteotomy in the treatment of congenital hip dislocation in children.
Results of surgical treatment of the congenital dislocation of the hip in 40 children (2-5 years) are presented. The mean observation period was 8 years. 80% of very good and good results were obtained in the included material. One-stage hip reposition -reconstruction with Dega's transiliacal osteotomy, applied to children of 2-3 years, gives positive results, adding to further development of the hip joint.
Child, Preschool↗
[History and epidemiology of congenital hip dislocation in Brittany].
Brittany is a region of France with a high rate of congenital dislocations of the hip (CDH). This was shown by Le Damany, who, in 1912, did a systematic screening of newborns and compared the number of CDH in Paris and Rennes. In Paris, there was 0.8% and in Rennes 3.6% CDH. This frequency is not generalized in Brittany, however; and Setter, who did a large survey in Finistère in 1961 and 1962, showed that the epicenter was the canton of Pont l'Abbé, also called "pays Bigouden". However, this disease did not occur in this region of France in earlier times. In 1795, Cambry, according to the "Convention de la Jeune République", travelled in Finistère from village to village and did not notice any limping women. This was a very serious and precise study, and we may conclude that there was no CDH at that time; the disease occurred later in "pays Bigouden". From these basic facts, certain hypotheses are considered. From the point of view of genetics, a mutation apparently occurred in the 19th century, but there is no reliable genetic study. Autosomic heredity with incomplete penetrance, with variable penetrance according to sex may be considered: it includes a multifactorial origin of the disease involving genetics, environmental, biochemical and ethnic factors, including local customs and traditions.
Adult↗
[Screening for congenital hip dislocation in Belgium. Results of a survey in maternity wards. Proposals].
Congenital dislocation of the hip (CDH) is probably more frequent in our country than generally appreciated. In most European countries, the incidence of CDH varies from 6 to 20 per thousand living births. The screening for the condition is organized with the help of public services. Our purpose was to survey the maternity wards to estimate the extent of the occurrence in Belgium. A volunteer orthopedic surgeon met with the pediatrician and the obstetrician in every hospital with a maternity ward to complete a questionnaire. We present a detailed analysis of the results of the survey and propose a better system for screening.
Belgium↗
[Pavlik's harness in congenital hip dislocation before the first birthday].
Three hundred cases of congenital dislocation of the hip have been treated with the Pavlik harness since 1979. The reduction is obtained by progressive flexion of the thighs. The femoral head penetrates the acetabulum from bottom to top. Placing the harness and managing the treatment must be very carefully done. The explanation given to the family is essential to success. Complications are rare. Arthrography followed by reduction in traction should be considered in case of failure. The Pavlik harness is indicated under the age of 9 months.
Braces↗
[First-choice orthopedic treatment in congenital hip dislocations discovered after walking age].
The incidence of late discovery of congenital dislocation of the hip is getting lower, thanks to systematic screening. We have treated 14 children during the past 5 years. Clinical diagnosis was confirmed by radiography. Thirteen children were treated by slow reduction, and immobilization according to Somerville-Petit's method. Four surgical treatments were performed (1 Klisic operation by first intention, 3 Salter operations by second intention). Good clinical results have not always correlated with radiologic normalization. These results were evaluated by Séverin's classification: 9 excellent or good (I or II), 4 poor results (III). Although improvement is expected in the future, repeated clinical and radiological supervision permits evaluation of the indications for a subsequent operation at the most favorable time.
Age Factors↗
[The development of early diagnosis and treatment of congenital hip dislocation in Czechoslovakia].
The author gives an account of the early diagnosis and treatment of congenital dislocation of the hip joint in Czechoslovakia since 1918. He pays more detailed attention to the period before the Second World War and the period immediately after the war when aids now used on a world-wide scale were introduced into practice such as Hanausek's apparatus, Frejka's cushion and Pavlik's stirrups. At the same time screening of neonates in some areas was started. The author mentions also methods of preventive examinations of the entire population introduced in the fifties. He also pays attention to efforts to reduce the radiation load in X-ray screening of the population.
Czechoslovakia↗
[Congenital hip dislocation; causes and sequelae of late diagnosis].
The causes of late diagnosis of congenital dislocation of the hip were examined retrospectively in a group of 49 children (56 hips affected). It appears that at neonatal examination as well as a further screening during the first year of life, the classical symptoms of this condition are not infrequently missed. The classical tests for the early diagnosis are described and the consequences of late diagnosis are studied. In spite of late detection, the final result of the treatment in most cases is quite favourable. However, this result can only be achieved by prolonged and intensive treatment, including hospitalization and surgery.
Child, Preschool↗