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At least 739 records · Page 41Linked to original sources
PubMed1979

Idiopathic chondrolysis of the hip.

Eight patients were seen with idiopathic chondrolysis in nine hips, with from one to eight years' follow-up. The adolescent patients showed characteristic diagnostic patterns--patients in the hip and a limp. The disease occurs most frequently in black girls and in them it tends to be more severe. Threre is progressive loss of articular cartilage, frequently progressing to flexion-adduction contracture and fibrous ankylosis. The pathological process in our patients mainly consisted of chronic synovitis and loss of articular cartilate in the weight-bearing surface of the femoral head. The patients with mild cases were satisfactorily treated with physical therapy, non-weight-bearing, and analgesics. The other hips, however, did best when allowed to undergo fibrous ankylosis with the hip in a functional position.

Adolescent↗
PubMed1996

Bilateral central acetabular fracture dislocations secondary to sustained myoclonus.

This case report presents a patient with bilateral central acetabular fracture dislocations secondary to sustained myoclonus treated with delayed bilateral total hip arthroplasty. This is an unusual mechanism of injury, but is similar to other uncontrolled muscular contractions, such as electroconvulsive therapy and seizures. Because of ongoing myoclonus, the patient initially was treated nonoperatively. The patient then successfully had staged bilateral total hip arthroplasty 15 months after injury. This case exemplifies that forceful, uncontrolled muscular contraction can cause bilateral symmetric fracture dislocations. In patients with a history of seizure or myoclonic contracture with subsequent pain or loss of function, radiographs are indicated and skeletal fracture or joint dislocation must be ruled out. Secondary reconstruction can be recommended when the patient is medically stable.

Acetabulum↗
PubMedDate not supplied

Current concepts of surgical management of deformities of the lower extremities in cerebral palsy.

In cerebral palsy, principles involved in proper selection of orthopedic management of the lower limbs include diagnosis, timing, goals, degree of involvement, linkage, kinetic electromyography, retention of neonatal automatisms, and dynamic versus fixed deformity, as well as the physical plant and professional skills. Specific lower extremity problems in the hip, knee, ankle, and foot must be analyzed and management for each should be approached on a rational basis. Unsolved enigmatic problems of etiology, pathways of neonatal automatisms that impose abnormal posturing, neurophysiologic mechanisms of spasticity, athetosis, rigidity and ataxia, pathogenesis of contracture, linkage biomechanics, and the neurologic, including the biomechanical effects of surgical intervention, require special research programs.

Ankle Joint↗
PubMed1994

Extensibility of hip adductors in children with cerebral palsy.

The passive extension of relaxed hip adductor muscles was measured in 20 normal children and 10 children (aged nine to 13 years) with cerebral palsy (CP) by a method that could distinguish between shortening of the muscle body and tendon. No muscle-body contracture occurred in the children with CP during treatment (physiotherapy plus moderate stretching on an apparatus for six hours a day); only the tendons were short. However, four children showed signs of muscle-body contracture after interrupting treatment for six to eight weeks. It is possible that muscle-body contracture can be prevented by non-surgical methods, although tendon shortening can, at present, only be treated surgically.

Cerebral Palsy↗
PubMed2002

Total hip replacement in patients with Parkinson's disease.

From 1970 to 1994, 107 total hip arthroplasties (THAs) were performed in 98 patients with Parkinson's disease. The average age of the patients was 72 years. Preoperative diagnoses were osteoarthrosis in 58 hips, failed endoprosthesis in 19, aseptic loosening in ten, femoral neck fracture in 18, and other diagnoses in two. Milder neurological stages I-III were assigned to 96 patients, and tendon release for contracture was performed in eight patients. Of the 38 complications eight were urinary tract infections and six dislocations. Of these 15 occurred in the 58 primary THAs and 23 in the 49 nonprimary THAs. In patients with primary THAs there were no dislocations; however, one of the four postoperative deaths occurred following primary THA. We followed 75 hips for 7 (2-21) years; 51 patients had died by the time of the study. Neurological status deteriorated over time with 57% of patients progressing to functional stages IV or V, although consistent improvement was noted for pain relief. Function was directly related to the stage of the neurological disease.

Aged↗
PubMed1991

Total hip replacement after central fracture dislocation of the acetabulum.

We performed total hip replacement (THR) for traumatic arthritis following central fracture dislocation of the acetabulum in 19 patients (15 men and four women). This situation is significantly challenging, as most patients have scarring, contractures, and unequal leg length. The average age was 49 years, and all patients were followed for a minimum of 2 years. A two-piece cementless acetabular component and a cemented or cementless femoral component were utilized. In each patient, prophylactic low-dose irradiation was administered to discourage heterotopic ossification, and gentamicin with either cefazolin or vancomycin were given as prophylaxis for infection. Overall, the results were excellent. The mean Harris hip score after surgery was 84. No infections, dislocations, or significant heterotopic ossification occurred. Limb length was within 1 cm in each patient. No revision surgeries were performed, and no components were roentgenographically loose. There was one case of transient nerve palsy. We conclude that THR after central fracture dislocation of the acetabulum is a safe and effective procedure.

Acetabulum↗
PubMed1978

A family with primary protrusio acetabuli.

The family of a child who developed symptoms and flexion contractures with protrusio acetabuli rapidly between the age of 8 and 11 was examined. The mother and one sib showed limitation of hip movements, while radiological criteria for protrusio were found in the mother and 4 of the proband's 8 sibs; only one had complained of pain. At the age of 16 the proband underwent bilateral total replacement arthroplasty; histologically the changes were those of fibrocartilaginous replacement and osteophyte formation.

Acetabulum↗
PubMed2005

Myotonic dystrophy: muscle involvement in relation to disease type and size of expanded CTG-repeat sequence.

This study aimed to: classify a cohort of children and adolescents with myotonic dystrophy (dystrophia myotonica: DM) into congenital and childhood onset forms; estimate CTG expansion size; and quantify muscle strength, contractures, and motor function in children with DM and compare results with those of controls. Participants were clinically examined, medical records were reviewed, and isometric muscle strength, contractures, and motor function were measured. Participants were: 42 children with DM (18 females, 24 males; mean age 8y 9mo [SD 4y 7mo], range 10mo to 17y) and 42 age- and sex-matched, healthy controls. Children with DM were divided into three groups: severe congenital (n=13), mild congenital (n=15), and childhood (n=14). Children with childhood DM were significantly weaker than controls (wrist and ankle dorsiflexors [p=0.0044, p=0.0044 respectively]; hip abductors and flexors [p=0.0464, p=0.0217]; and knee flexors and extensors: [p=0.0382, p=0.0033]). Children with mild congenital DM were significantly weaker than controls in all assessed muscle groups. Contractures and skeletal deformities were more frequent at time of investigation than at birth, suggesting that foot and spine deformities in particular increase over time. Motor function score was significantly lower for children with DM than for controls. Children with severe congenital DM had the lowest motor function, with correlation between motor function and size of CTG repeat (p=-0.743). Children found jumping, heel standing, and head lifting the most difficult items to perform but few had difficulty walking, running, or stair climbing. DM in children is a heterogeneous disorder with a wide spectrum of muscle involvement, and owing to increased risk of contractures and skeletal deformities, regular follow-ups are recommended.

Adolescent↗
PubMed1989

Preventive aspects of mobility and functional disability.

Among bone and joint diseases, frequent causes of disability include (a) fractures from falls and osteoporosis, (b) osteoarthritis of hips, knees, and lumbar spine, (c) painful feet, (d) back pain, and (e) intractable rheumatoid arthritis. Risk factors for falling may arise from factors intrinsic to the patient and from hazards in the environment. The prevention and management of osteoporosis are controversial. Most experts endorse the use of estrogens in postmenopausal women and the need for continuing physical activity, particularly walking, in both elderly men and women. To preserve independent living, conservative management of osteoarthritis of hip, knee, and low back consists of properly balancing rest, non-weight-bearing exercises, and the use of walking aids. In rheumatoid arthritis, the clinician should emphasize (a) exercises to maintain range of motion and (b) muscle strength, both to prevent flexion contractures and to maintain the ability to carry on activities of daily living.

Accidental Falls↗
PubMed1998

An intramedullary cement spacer in total hip arthroplasty .

Revision arthroplasty of the hip is often complicated by infection, bone loss, and perioperative fracture of the femur. A simple, inexpensive spacer that keeps tissue planes intact and prevents soft tissue contracture during the interoperative period of a 2-stage revision is described. This can provide intramedullary support to a fractured or weak femur and enable local antibiotic delivery, as well as permit limited mobilization of the patient. It can be easily fabricated during surgery using universally available materials and can be tailored for specific requirements. Such a spacer was used in 5 cases. The experience is presented, and the technique and pitfalls are discussed.

Arthroplasty, Replacement, Hip↗
PubMed1979

[Aetiopathogenesis of scoliosis, hip dysplasia and torticollis in infancy (author's transl)].

The special risk of the newborn to acquire, skeletal deformities is based on the increased plasticity, intensity of growth and extrapyramidal activity of reflexes which influence each other. These 3 factors may lead to structural growth- and weight bearing deformities in the presence of shrinking contractures and a unilateral oblique habitual position of the trunk. Considering the "Seventh Syndrome" the dual pathogenesis of scoliosis in infancy is discussed from our present point of view (including scoliosis due to oblique body position - moulded baby syndrome - and its deterioration as against true idiopathic infantile or advanced juvenile scoliosis respectively. Similarly is discussed the relation of hip dysplasia due to oblique habitual trunk position in regard to hip dysplasia in connection with CDH as well as the habitual oblique position of the head as against true muscular torticollis.

Diagnosis, Differential↗
PubMed1997

Functional leg-length inequality following total hip arthroplasty.

A consecutive series of 100 patients undergoing primary total hip arthroplasty were assessed for functional leg-length inequality (FLLI). In addition, the medical records of all patients treated for FLLI by the senior author (C.S.R.) in the past 15 years was reviewed. A questionnaire was distributed to the members of the Hip Society specifically to query the prevalence, etiology, and management of FLLI. Fourteen percent of patients were noted to have pelvic obliquity and FLLI.1 month after surgery. All had resolution of the symptoms by 6 months after surgery. Nine patients have been identified over the past 15 years with persistent FLLI. Among the causes suggested by respondents to the questionnaire are tightness of periarticular soft tissues with resultant pelvic obliquity and degenerative conditions of the spine with contracture. Methods of treatment and prevention are discussed.

Aged↗
PubMed1983

[Development of the S-form hip brace of Wakayama Medical College type for osteoarthritis of the hip].

In order to improve the therapeutic results of conservative treatment for coxarthrosis and to start functional training soon after surgery, the S-form hip brace of Wakayama Medical College type has been developed with due regard to the instability of the hip joint which is related to the origin of coxarthrosis and to biomechanics of the hip joint. Functional investigation was made by electromyography, etc. Even healthy people tend to develop gradual lack of stability at the hip joint with aging and the tendency is more pronounced in secondary coxarthrosis. This brace has been designed to reinforce such an unstable hip joint both mechanically and functionally, to permit flexion, extension and abduction, to correct the inadequate position of the limb such as adduction, both internal and external rotation contractures, to prevent up- and outward movement of the femoral head and to keep it in a more centripetal position. This brace had been applied to 1,678 cases in 17 years from 1964 to 1980 and the following results were obtained. In the period from pre-osteoarthritis to the first half of advanced stage, complaints were improved and progression of the disease was suppressed. In the period from advanced to terminal stage, this brace was used after surgery and walking ability was soon improved.

Adult↗