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PubMed1988

Vascular disorders of the proximal femur following treatment of congenital hip dislocation.

Early diagnosis of congenital dislocation of the hip entails treating patients in a very young age-group. These patients present a high risk of vascular disorder in the femoral capital epiphysis in the course of either surgical or nonsurgical treatment. Thirty-five cases of anomalies in the proximal femur of vascular origin were observed, corresponding to 3% of hips treated for congenital dislocation. Roentgenographic diagnostic elements are included in an evolutive classification. In recent cases, radionuclide bone scans were used to obtain supplementary information. Based on bone scans, two distinct groups of patients can be identified: in the first group, vascular disorders of the proximal femur (VDPF) are iatrogenic in origin; in the second, VDPF are due either to the precariousness of prereductional blood flow to the epiphysis or to the summation of risk factors.

Epiphyses↗
PubMed1985

[Traumatic hip dislocations and acetabular fractures in children].

This paper concerns 39 children, 15 with dislocation of the hip, 8 with acetabular fracture and 16 in which both lesions occurred together. The three types of lesion each had a different outcome. The results were good in 86 p. 100 of the isolated dislocations treated conservatively. They were good in 75 p. 100 of acetabular fractures, only one of which was operated on. The results were good in 50 p. 100 of cases with both lesions. Five cases were operated on to restore a congruent and adequate acetabulum. The overall rate of complications was 20 p. 100 and were mainly post-traumatic degenerative arthritis (2 cases), destruction of the triradiate cartilage (1 case), necrosis of the femoral head (2 cases due to separation of the femoral epiphysis). Seventy per cent of the patients finally had a satisfactory result. However, the risks of development of a late degenerative arthritis are high. These children should be followed up for a long period of time.

Acetabulum↗
PubMed2000

Coxarthrosis after traumatic hip dislocation in the adult.

Sixteen percent of patients with uncomplicated hip dislocations have posttraumatic arthritis develop. Incidences as high as 88% are reported for patients with dislocations associated with severe acetabular fractures. The surgical treatment of patients with posttraumatic arthritis includes arthroscopy, arthrodesis, osteotomy, and arthroplasty. Although arthroplasty offers the best solution for the painful arthritic hip in the older or inactive patient, the treatment of an active patient in the prime of life with severe osteoarthritis of the hip is problematic. In the younger, active patient, it may be prudent to consider alternative treatment in an attempt to avoid, or delay, total hip arthroplasty. Although improving the longevity of primary arthroplasty is desirable, measures to prevent or delay the onset of the osteoarthritis seem more appropriate. Arthroscopic lavage, debridement and chondral abrasion, and osteochondral fragment removal after dislocation may have a role in the treatment of young patients with the early stages of coxarthrosis. Any patient with isolated posttraumatic arthritis of the hip who has a life expectancy greater than 30 years may be a candidate for hip arthrodesis. The ideal candidates for hip arthrodesis are only laborers younger than 35 years of age. Osteotomy of the hip for posttraumatic arthritis remains an appealing alternative for many patients because of the long-term failures of total hip arthroplasty. The clinical results of osteotomy are variable and do not match the results of a total hip arthroplasty. However, primary arthroplasty may fail, and revision arthroplasty is routinely more difficult and shorter lived than the primary operation.

Adult↗
PubMed1993

[Traumatic hip dislocations. Epidemiologic data at Davos Hospital and a multicenter study in Graubünden Canton].

We report about 86 patients with traumatic dislocation of the hip. Group 1 consisted of 26 patients of the hospital of Davos, group 2 of 60 patients of a multi-center evaluation of 7 hospitals in the Kanton Graubünden. 53 were males and 33 females. 13 patients were 16 years old or younger, of these 5 below 10 years. 69% are injuries in sports, 66% in alpine skiing. 78 had a posterior, 5 an anterior and 3 central dislocation with a fracture of the floor of the acetabulum. Concomitant local injuries were seen in 76.9% of traffic accidents and only in 22% of skiing injuries. Closed reduction was performed in 81 patients on the average less than two hours after injury, in 5 cases an open reduction was necessary. The subsequent treatment was in 15 cases operative, consisting in reconstruction of the concomitant injuries.

Adolescent↗
PubMed2000

Diagnosis and imaging studies of traumatic hip dislocations in the adult.

Traumatic dislocation of the hip represents a major injury that is associated with significant morbidity. In particular, the risk of osteonecrosis of the femoral head is greatly affected by the time it takes to reduce the hip. Therefore, thorough understanding of the clinical and radiologic features is essential if this injury is to be recognized and treated promptly. Most patients present in severe distress after a high-energy injury such as a motor vehicle accident. Associated injuries, particularly of the knee, are common and the leg usually is held in a specific posture characteristic of the direction of dislocation. Plain anteroposterior radiographs of the pelvis will clearly show the dislocation in most patients but lateral views or a computed tomography scan may be required to confirm the diagnosis and to show the direction if the signs are subtle. Associated acetabular wall fractures and femoral head fractures also may be identified by computed tomography scans. After reduction, plain radiographs alone are not adequate to assess reduction; computed tomography is more sensitive in detecting osteochondral fragments and may reliably detect residual subluxation of 2 mm in any part of the joint. Magnetic resonance imaging is useful in detecting changes of osteonecrosis but rarely is indicated in the early treatment of this condition.

Adult↗
PubMed1979

Growth and development of congenitally dislocated hips reduced in early infancy.

We determined the acetabular angles, center-edge angles, comprehensive quotients, and Shenton's lines from sequential roentgenograms of thirty-seven children with congenitally dislocated hips treated by closed non-manipulative reduction in early infancy. The values were compared with those obtained from roentgenograms of 164 normal children who ranged in age from three months to five years and of forty-three adolescents and adults. The hip recovering from congenital dislocation developed similarly to the normal hip but differed in that it showed a greater rate of decrease of the acetabular angle and an increase in the center-edge angle. Significant development after the age of five years still was manifested in the reduced hips.

Acetabulum↗
PubMed1985

Transarticular pinning for repair of hip dislocation in the dog: a retrospective study of 40 cases.

Transarticular pinning was used for the repair of hip dislocation in 40 dogs. The mean follow-up period was 18.4 months. Satisfactory results were achieved in 80% of the cases. Body weight, ipsilateral femoral head fracture, and hip dysplasia appeared to affect long-term prognosis. The most frequent complication was pin breakage, but this did not affect final outcome and could be avoided by using pins of larger diameter. Osteonecrosis was observed in two cases.

Animals↗
PubMed1986

Real-time sonography of infant hip dislocation.

Real-time sonography offers many advantages in the evaluation of suspected hip dislocation: The procedure is short, cost-effective, requires no sedation and does not expose the patient to ionizing radiation.

Hip Dislocation, Congenital↗
PubMed2006

[Traumatic obturator hip dislocation in a five-year-old boy: open reduction after a six-week delay in diagnosis].

Hip dislocations are relatively uncommon in children, they may occur before five years of age as a result of seemingly trivial trauma. A 5-year-old boy was admitted with knee pain six weeks after a fall from bed. Physical examination showed obturator dislocation of the left hip. Owing to the late presentation and without attempting closed reduction, the patient was treated with open reduction and capsulorrhaphy. At the end of a year follow-up, the patient had no complaints and no functional restriction.

Accidental Falls↗