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Closure of the epiphysis of the femoral head and of the triradiate cartilage of the acetabulum following surgery for congenital hip dislocation.

Early closure of the epiphysis of the femoral head and of the triradiate cartilage of the acetabulum is reported in two young children following uneventful surgery for correction of deformities caused by congenital hip dislocation. Such epiphyseal arrests cause severe deformities, which frequently cannot be totally corrected. The reasons for epiphyseal arrest of the triradiate cartilage of the acetabulum following a Salter pelvic osteotomy and epiphyseal arrest of the femoral head following a subtrochanteric osteotomy are not known.

Acetabulum↗

Genetic variability in the group of patients with congenital hip dislocation.

Our study of genetic homozygosity degree includes an analysis of the presence, distribution and individual combination of 20 selected genetically controlled morpho-physiological traits in the group of patients (N = 93) with congenital hip dislocation (CDH) and in control sample consisting of school children from Belgrade (N = 200). Assuming that CDH is genetically controlled disease, we made a hypothesis that an increased homozygosity level, as well as the changed variability among the patients, could be population-genetic parameter for the prediction of the illness. Taking into consideration our experience, as well as the experience of numerous scientists who studied the nature of the inheritance of mono- and oligo-genically controlled qualitative traits, we applied a methodology to estimate the proportion of such homozygously recessive characters (HRC-TEST). This population-genetic study did not only show statistically significant difference of the middle values of genetic homozygosity (CDH-7.1+/-0.2; control - 5.2+/-0.1), but of the differences in the type of distribution too, as well as the differences in the presence of certain individual combinations of such traits. The described methodology can be used in further analyses, with hope that it can be applied as an early prognosis for decreased resistance to different diseases. The frequencies of ABO blood types in the sample of CDH patients were similar to the average value of Serbian population, while the percentage of blood group A is slightly increased. Comparing frequencies of Rh blood groups, there is no difference between tested samples.

ABO Blood-Group System↗

CT detection of cortical fracture of the femoral head associated with posterior hip dislocation.

Posterior dislocation of the femoral head is a common injury in automobile accidents and is frequently associated with fractures of the posterior acetabular rim. Fractures of the anterior cortex of the femoral head have not been described. One hundred sixty-four cases of posterior hip dislocation presenting consecutively to our shock trauma unit and emergency department during a 3-year period were evaluated with plain film radiology and CT. In 21 cases (13%), CT showed an anterior cortical fracture of the femoral head that could not be seen on plain radiographs. This injury is similar to the Hill-Sachs lesion of the humerus that results from anterior dislocation. The anterior cortical fracture was associated with fractures of the posterior acetabulum in 18 cases (86%). The anterior fracture is caused by impaction of the anterior femoral head against the posterior acetabular rim at the time of dislocation. We conclude that anterior cortical fracture of the femoral head is a common accompaniment to posterior acetabular dislocation.

Femoral Fractures↗

Prenatal growth deficiency with narrowness of the cervical spine, subglottic stenosis, hip dislocation, and severe delayed bone ossification: a new skeletal dysplasia.

A boy with a severe prenatal onset dysplasia, prominent occiput, hypertelorism, epicanthus inversus, low-set ears, flat nasal bridge, small nares, cleft palate, subglottic stenosis, narrow cervical canal, undermodeled bones, cortical thinning of the diaphyses, hip dislocation, severely delayed bone ossification, and apparently normal intellectual development is described. Osseous histopathological studies were unremarkable. The boy's parents are first cousins, suggesting recessive inheritance. To the best of our knowledge, this association has not been reported before, and may be considered a novel syndrome.

Abnormalities, Multiple↗