[Bedside nursing. Nursing of a patient with contracture of the femoral quadriceps].
Explore the source record for details and available documents.
Contracture↗
SEARCH · Search PubMed
Results for “HIP CONTRACTURE”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[What is the value of the corrective osteotomies in the therapy of the coxarthrosis (author's transl)].
Followup examinations of 29 corrective osteotomies carried out near the hip show that surgical removal of a contracture can yield quite favorable results in osteoarthritis of the hip. Surgery is indicated in cases where rotation and extension of the thigh is no longer possible, resulting in immobilization, whereas, on the other hand, flexion is still possible to a satisfactory extent and the patient is still too young for plastic surgery.
Adult↗
Treatment of hip problems in cerebral palsy.
The two major problems of the hip in cerebral palsy relate to gait abnormalities and hip instability. Gait abnormalities are a result of muscle imbalance and should be corrected with appropriate muscle transfers and releases. Frequently, femoral anteversion may be associated with internal rotation of the limb, and if severe, should be corrected. Hip instability leading to S/D is a very serious problem in cerebral palsy and is usually worse in the more severely involved patients. Early muscle releases should be done before the hips subluxate. Once subluxation occurs, muscle releases must be combined with a varus rotation osteotomy. If acetabular insufficiency is present, pelvic osteotomy is necessary to obtain stability. In the older patient who has a painful S/D hip, the author recommends either a hip arthrodesis or a total hip replacement.
Adolescent↗
Role of surgery in the prevention and correction of hip subluxation and dislocation in cerebral palsy.
Forty-three patients (80 hips) were available for clinical and radiological follow-up. These patients underwent adductor tenotomies separately or in combination with other procedures on the hip, with or without proximal femural correction. The range of abduction in all hips before surgery was 40 degrees or less, and in 54 hips combined with flexion-contracture (10 degrees-50 degrees).
Adolescent↗
LATE RESULTS OF PERTHES' DISEASE.
Explore the source record for details and available documents.
Adolescent↗
Total joint replacement in multiplex congenita contractures: a case report.
A 34-year-old man with multiplex congenita contractures underwent replacement of 2 hips and 1 knee. Even though a good range of movement was achieved at surgery and intensive physiotherapy, his joints returned to their preoperative status within 2 years. This outcome suggests that total joint replacement has little to offer the patient with multiplex congenita contractures who has immobile joints.
Adult↗
Contractures. A historical perspective.
Orthopedic history vividly documents the continuing battle between restoring tissue stability and preserving functional mobility. Prolonged and uninterrupted rest, popularized by Hilton and Thomas, but promoted by many before them and subsequently continued by Jones, Orr, and others, assures healing. Contractures that permanently limit function are not an uncommon consequence. Hippocrates, Hunter, Lucas-Championniere, and David advocated judicious motion. Timing and the interpretation of the patient's pathologic state have proved to be the critical criteria. Modern antibiotics, antiinflammatory medications, acute surgical repair, and techniques that combine stability and early motion provide today's orthopedic surgeons' great versatility and capability. Despite these advantages the threat of contractures remains. The dictum "rest until healed" persists. Physiologic posturing of inflamed or swollen joints to minimize tissue strain introduces resting positions of 15 degrees plantar flexion at the ankle, and 30 degrees flexion at the knee and hip. These will be perpetuated by contractures if not actively counteracted by timely mobilizing procedures. Each of these joint positions is a serious deterrent to walking without stressful substitutive posturing, and the patient's ability to function is impaired.
Contracture↗
Changes in hip muscles after above-knee amputation.
To learn about the changes appearing in hip muscles after an above-knee amputation, 3-dimensional reconstructions of the hip and thigh region of 12 patients with above-knee amputations were made based on transverse magnetic resonance images. In all patients, the amputations were done at least 2 years before the study and were necessitated by trauma or osteosarcoma. The results show that, at higher amputation levels, the geometry of the once-biarticular muscles was changed. The cleaved muscles (40%-60%) and the intact muscles (0-30%) at the amputated side were atrophied. The amount of atrophy of the intact muscles at the amputated side was related to stump length. To avoid an abduction contracture in 8 patients with amputations, the iliotibial tract was not fixed. In 4 of these 8 patients, a flexion contracture was visible. If the tract was not fixed, the hip extension torque of the gluteus maximus, which inserts into the tract, decreased. As a result, the risk of appearance of a flexion contracture increased because the strongest hip flexor (iliopsoas muscle) was not involved in the amputation. Abduction contracture could be avoided only if the hip adductors were fixed accurately, especially at higher amputation levels.
Adult↗
Development dysplasia of the hip from birth to six months.
The term "developmental dysplasia or dislocation of the hip" (DDH) refers to the complete spectrum of abnormalities involving the growing hip, with varied expression from dysplasia to subluxation to dislocation of the hip joint. Unlike the term "congenital dysplasia or dislocation of the hip," DDH is not restricted to congenital problems but also includes developmental problems of the hip. It is important to diagnose these conditions early to improve the results of treat- ment, decrease the risk of complications, and favorably alter the natural history. Careful history taking and physical examination in conjunction with advances in imaging techniques, such as ultrasonography, have increased the ability to diagnose and manage DDH. Use of the Pavlik harness has become the mainstay of initial treatment for the infant who has not yet begun to stand. If stable reduction cannot be obtained after 2 weeks of treatment with the Pavlik harness, alternative treatment, such as examination of the hip under general anesthesia with possible closed reduction, is indicated. If concentric reduction of the hip cannot be obtained, surgical reduction of the dislocated hip is the next step. Toward the end of the first year of life, the toddlerTs ability to stand and bear weight on the lower extremities, as well as the progressive adaptations and soft- tissue contractures associated with the dislocated hip, preclude use of the Pavlik harness.
Algorithms↗
Complications following hip fractures.
Explore the source record for details and available documents.
Aged↗
[Orthopaedic examination of 1 500 infants in maternity (author's transl)].
1 500 infants have been examined by two orthopaedic surgeons within forty eight hours. The examination of the feet has showed that the usual position in utero was the dorsiflexion. A new classification of deformities of the feet is proposed. The examination of the knees has permitted to discover a rotatory instability between the femur and the tibia in 2% of the infants. Some of them were actual dislocations. During the examination of the hips, it has been researched an instability; the passive abduction, the tension of the adductors and an abduction contracture have been analysed. Some instable hips are easy to detect because there is a jerk (ressaut) but others are very difficult because there is no snapping sign but only a telescoping displacement (piston). The rate of unstable hips was 1.7%. As the combination of an unstable hip and an adductor hypertonicity is usual it is very important to detect a pelvic obliquity and a bilateral adductor-hypertonicity. The various forms of normal birth postures and the relation to orthopaedic deformities of the inferior limbs are studied.
Fetus↗
[Bilateral total hip prosthesis replacement in a single procedure].
This paper is a case report of a patient with bilateral hip dysplasia, bilateral secondary degenerative changes, adduction contracture and serious walking difficulties. The patient has undergone one-stage bilateral hip replacement. This procedure is advantageous because of fast recovery, fewer complications and rehabilitation easier than in the routine operation of two-stage bilateral total hip replacement.
Adult↗
[Errors and hazards in total hip-joint prosthesis].
Explore the source record for details and available documents.
Contracture↗
[Surgical treatment of patients with juvenile cerebral palsy at the orthopedic clinic of the Charles University Medical School in Prague-Motol].
In the period of 1976-1987 there were in total 181 patients operated on with the diagnosis of infantile cerebral palsy at the Orthopaedic Clinic of the Faculty of Pediatrics of Charles University in Prague-Motol. 412 operations were performed in total in these patients. The indication was mainly the improvement of the statics and gait, therefore operations on lower extremities prevailed. Within the preoperative preparation it is essential to precisely classify the type of affection of the patient from the neurological viewpoint and mainly estimate the future physical and psychical abilities of the child which is of substantial importance in the postoperative treatment. The surgical solution is always individual and respects the specificity which need not be symmetric on both extremities. Therefore the range of orthopaedic operations is wide. The surgeon has to treat the equinus position of the foot, the valgus position, flexion contractures of knees, adduction position in hip joints. In case it is necessary to operate the affection of the entire lower extremity the specialists at the above mentioned Orthopaedic Clinic prefer a single solution to the stepwise one. Recently the surgical treatment of patients suffering from spasm has achieved a certain progress. Substantial is the contribution for patients who on the basis of the operation regain the ability to walk. Therefore the authors emphasize the importance of the cooperation of the neurologist and the rehabilitation worker with the orthopaedic surgeon when considering comprehensive therapeutical possibilities.
Cerebral Palsy↗
[Paralytic hip dislocation in cerebral palsy--soft tissue surgical procedures].
Results of a combination of soft tissue procedures performed for the first time in treating paralytic dislocation of the hip in cerebral palsy are presented. All hip flexors and adductors release, along with possible transposition or elongation of knee flexors on the side of the dislocation (if knee contracture exceeded 20) were peformed. 75 hips in 57 patients were operated on. 54 patients were analyzed. The average age of the patients was 6.6 years, the average follow-up was 7 years. Excellent result was achieved in 33patients (61%), good in 10 (18,6%), fair in 4 (7,4%) poor in 7 patients (13%). Poor results were registered in patients over 10 years of age and in patients with athetosis. Results were assessed according to clinical finding, radiological finding (migrational percentage) and the ability of patients to walk. When based on radiological findings only, excellent results were achieved in 63 hips (84%). This combination of soft-tissue procedures which includes all muscles that take part in the dislocation proved to be very successful in achieving reposition. It can be recommended to patients suffering from the spastic form of cerebral palsy up to 10 years of age.
Cerebral Palsy↗
Resection arthroplasty of the hip in paralytic dislocations.
The chronically dislocated paralytic hip causes postural difficulties, nursing and hygiene problems, and pain. Therapeutic options are limited. This study reviews the results of resection arthroplasty on 18 hips of 15 such patients. This procedure has many complications, including hip ankylosis, heterotopic ossification, abduction contracture and bony overgrowth. Despite this, all of the nursing goals were achieved and most patients had relief of pain. The operation is most successful in the skeletally mature patients, and it relies on soft-tissue interposition between the bony fragments and postoperative positioning to ensure optimum posture.
Adolescent↗
Reconstruction of the dysplastic spastic hip with peri-ilial pelvic and femoral osteotomy followed by immediate mobilization.
All children with cerebral palsy who had a pelvic osteotomy performed by the senior author (F.M.) from 1989 through 1991 were reviewed. Indications for operative reconstruction were failed muscle lengthening in a child younger than 8 years or a painful hip. The operative procedure included adductor muscle lengthening, varus shortening femoral osteotomy, and peri-ilial pelvic osteotomy. Patients were immediately mobilized after surgery by physical therapy. Fifty-one children had reconstruction of 49 subluxated and 21 dislocated hips. Femoral and pelvic osteotomies were performed on 59 hips, and 11 hips had only a femoral osteotomy. Forty-nine hips had adductor muscle lengthening, and 27 hips had femoral osteotomy to provide for relief of contractures. At mean follow-up of 34 months, two hips in two patients had redislocated, requiring repeated surgery. Two hips remained subluxated and asymptomatic. Twenty-three hips in 18 patients were painful before surgery. One hip continued with severe pain after surgery, requiring further surgery. Three hips continued with mild pain not requiring surgery, and 14 (82%) hips had complete pain relief. Of 37 caretakers interviewed, 80% felt the procedure was beneficial and would recommend it to others. Eight percent were uncertain, and 6% (two caretakers) thought it was not helpful.
Acetabulum↗