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PubMed1986

[An aid toward decision in congenital hip dislocation. Value of decision trees in the determination and treatment of hips at risk (preliminary study)].

Well established procedures exist for treatment of congenital dislocation of hip, whereas unanimity is lacking with respect to management of a hip at risk during the neonatal period. Based on a homogeneous series of 720 case-reports of neonates at risk a decision tree has been developed to determine essential risk factors and to demonstrate preferential pathways when evaluating appropriate therapy.

Algorithms↗
PubMed1990

[Avascular necrosis of the hip in radiologic images during treatment using the Freyka pillow for congenital hip dislocation].

Radiological picture of 823 hips in 636 children treated with the use of Freyka pillow between 1972 and 1976 was assessed. Avascular necrosis of the proximal end of the femur was found in 113 cases. The older the child was at the beginning of treatment the highest were the chances for developing avascular necrosis, but more serious changes were found in younger children. In the hips with greater initial dislocation changes were more frequent. A comparison between hips treated with Freyka pillow and those treated with different methods as to frequency of avascular necrosis was difficult due to the lack of uniformity in criteria for both diagnosis and assessment of the results.

Child, Preschool↗
PubMed1983

Effect of hip dislocation on the blood supply to the femoral head. An experimental study in rabbits.

This work consists of a series of experiments which were made in order: a) to examine the possible alterations of blood flow to the reduced femoral heads of rabbits, after inducing a closed dislocation of their hips and b) to determine the influence of the early or late reduction of the dislocated femoral heads on their blood flow. The estimations of blood flow to the normal and reduced femoral heads were made using radioactive microspheres. The findings are as follows: a) The blood flow of the femoral heads of the reduced hips was never interrupted completely. b) The initially decreased femoral head blood flow progressively increased, in association to the time elapsed from the reduction. c) No statistically significant difference was found in the femoral head blood flow between hips reduced in early and those reduced late. d) Pure traumatic dislocation of the hip can only rarely be the cause of aseptic necrosis of the femoral head.

Animals↗
PubMed1978

Malignant hyperthermia and central core disease in a child with congenital dislocating hips.

We describe a development of a malignant hyperthermia (MH) syndrome, partially aborted by therapy, in a child with central core disease and congenital dislocating hips. Patients with central core disease appear to be more susceptible to MH; possibly those with elevated serum creatine phosphokinase levels, as in our patient, are especially susceptible. We review the clinical and pathologic aspects, possible pathogenesis, and treatment of the MH syndrome. An increased calcium level within the muscle fiber is suggested as the major cytodestructive factor, and that increase could be consequent to a plasmalemmal susceptibility to the provoking drugs hypothesized to be the basic defect in MH. Prevention of the full manifestations of MH is predicated on (1) a high index of suspicion in the search for history of anesthetic complications in the patient and his family, with or without evident neuromuscular disease, (2) recognition that there is a somewhat greater risk of MH developing in a patient who has certain "musculoskeletal" abnormalities or muscle weakness but that is not-except for central core disease-a classic clinicopathologically defined disease, (3) close monitoring of patients during anesthesia, and (4) if the syndrome develops, prompt therapeutic measures, including cessation of anesthesia.

Adult↗
PubMed1989

[Traumatic hip dislocation in childhood].

The article reports on eight cases of traumatic dislocation of the hip in children. Six of these were genuine dislocations and two dislocation fractures. The children were between 5 and 13 years of age at the time of injury. Seven of these 8 children could be followed up one to 21 years after the accident. All 7 children were free from complaints at the time of follow-up examination; in one case only we found a moderate loss of function in the injured hip joint. In this patient the x-ray film showed deformation of the head of the femur after partial necrosis of the femoral head, as well as initial signs of coxarthrosis. Prognosis of this rare injury in children is favourable if repositioning is performed in time and if relief of the hip is effected for the proper period of time, depending on the individual case.

Adolescent↗
PubMedDate not supplied

[The correction of the manifestations of the pathological alterations to the hip joints after the reduction of congenital hip dislocation in children].

The paper outlines mechanisms underlying the development and predetermining the forms of hip joint disorders consequent to setting of congenital hip dislocation, the results of a 3-8-year follow-up of relevant 75 cases in children. Individual treatment regimens combined appropriate exercise, biomechanical correction, physiotherapy, acupuncture, manual therapy.

Child↗
PubMed2003

Our approach to the conservative treatment of the dislocated hip in developmental dysplasia.

The purpose of this study is to evaluate the effectiveness of the use of traction in achieving closed reduction of a dislocated hip. We evaluated 38 hips in 29 consecutive patients who had been treated at our department between January 1999 and December 2001. There were 26 girls and 3 boys and the average age was 8 weeks. The minimal duration of follow-ups was 12 months after closed reduction. We achieved 32 concentricaly reduced hips, the barriers to the concentric reduction were demonstrated by arthrography in 5 hips an 1 hip redislocated after removal of the spica cast. Avascular necrosis of the femoral head developed in no conservatively treated hip. The traction reduction method is preferred at our department because of high rate of success without damaging the femoral head.

Female↗
PubMed1999

Finite element analysis of a novel design approach to resisting total hip dislocation.

OBJECTIVE: A new design concept has been developed to reduce the propensity for dislocation in total hip patients. The ability of this design to increase the stability of the hip joint is studied. DESIGN: The new design involves a convex-curved acetabular lip, extending from the hemispherical articulating surface to the outer edge of the cup. The femoral component has a matching, reverse curve. BACKGROUND: Dislocation is a continuing problem in total hip arthroplasty, a complication experienced by 2-11% of patients with primary surgeries, and much higher percentage of patients in revision series. Confounding factors and sources of variability in the clinical domain make it difficult to identify specific parameter influences. METHODS: A three-dimensional nonlinear finite element model has been developed for the purpose of studying the dislocation event. We report the first use of this finite element model to analyze the potential for improving hip stability by a new total hip component design concept. RESULTS: The results show that this new design achieves 28% more resisting moment build-up during dislocation, and has a higher range of motion from impingement to onset of subluxation. The new curved lip design also develops 50% less polyethylene von Mises stress in the impingement zone. CONCLUSIONS: This design has excellent potential for increasing the inherent stability of the total hip joint. RELEVANCE: Recurrent dislocation is the second leading cause of total hip failure next to late loosening. This study shows the potential of a new total hip design to increase the stability of the artificial hip joint.

Arthroplasty, Replacement, Hip↗
PubMed2004

[Palliative Schanz osteotomy for irreducible hip dislocation in adolescent patients with cerebral palsy].

PURPOSE OF THE STUDY: Palliative Schanz osteotomy is one of the options for treatment of irreducible hip dislocation in adolescent patients with cerebral palsy. MATERIAL: In 1992 to 2002, Schanz osteotomy was indicated on 46 occasions in 27 nonambulatory patients with the quadriplegic form of cerebral palsy aged 9 to 18 years. METHODS: In the postoperative evaluation, emphasis was placed on the clinical presentation, i.e., improved motion of the hip joints and pain alleviation. X-ray examination was carried out at 2 to 6 months after surgery. RESULTS In all patients, the range of motion in the hip increased in abduction or flexion according to the osteotomy technique used. Because of severe pain, one patient (2.17 %) had to undergo subsequent resection of the femoral head. Transient pain in the hip persisted in four patients (8.7%). DISCUSSION In patients older that 10 years, reconstructive surgery for neurogenic dislocations has an uncertain outcome and a palliative procedure is often the only method of choice for treatment of irreducible dislocations. Schanz angulation osteotomy can provide a better range of motion, alleviate pain and facilitate the care of patients, particularly if they are nonambulatory. CONCLUSIONS Schanz osteotomy is a less invasive method than resection of the proximal femur and should be used preferably in older children with neurogenic hip dislocation in whom reconstructive surgery is not indicated.

Adolescent↗