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At least 883 records · Page 49Linked to original sources
PubMed1989

Importance of the clicking hip in screening for congenital dislocation of the hip.

A birth cohort of 3289 babies was investigated prospectively for one year to assess the importance of risk factors for congenital dislocation of the hip (CDH). 426 (13%) babies had an identifiable risk factor when examined by paediatric senior house officers. On further examination in the first week of life at a screening clinic, 51 proved to have CDH, an incidence of 15.5 per 1000 births. The results confirmed the importance of established factors such as family history, caesarean section, and the breech position, and demonstrated the clinical significance of the presence of clicking hips on initial examination. After up to 4.1 years of follow-up there have been no late presentations. By taking into account the clinical examination by senior house officers, secondary screening of babies at high risk of CDH can be very effective. This extended high risk group may contain all potentially abnormal hips. All such babies should be examined by ultrasonography in hospitals where it is available.

Breech Presentation↗
PubMed1990

Effective use of ultrasound in the management of congenital dislocation and/or dysplasia of the hip.

The use of ultrasound and roentgenography was evaluated in 50 patients with congenital hip dislocation and/or dysplasia treated with the Pavlik harness. The patients were divided into two groups based upon the predominant imaging technique used to monitor the course of treatment. Ultrasound was found to be an effective monitoring technique. A roentgenogram at conclusion of treatment is recommended to assess the acetabular development most accurately.

Braces↗
PubMed2005

Evaluation of the gluteus medius muscle after a pelvic support osteotomy to treat congenital dislocation of the hip.

BACKGROUND: Many authors have reported that the pelvic support osteotomy prevents a Trendelenburg gait by restoring the biomechanics of the abductor muscle in patients with congenital dislocation of the hip. However, we are not aware of any studies in which the hip abductor muscles were examined following pelvic support osteotomy. The purpose of this study was, first, to use magnetic resonance imaging to measure alterations in the length and volume of the gluteus medius muscle after pelvic support osteotomy and, second, to determine which factors influence the results of the Trendelenburg test. METHODS: Eleven patients with a history of congenital hip dislocation who had been treated with a pelvic support osteotomy were examined clinically with the Harris hip score and the Trendelenburg test, radiographically to measure limb-length discrepancy and valgus angulation of the proximal part of the femur, and with magnetic resonance imaging to measure changes in the gluteus medius length and volume. RESULTS: The pelvic support osteotomy achieved a functional and painless hip in all eleven patients. Five of the eleven patients had a persistently positive Trendelenburg gait at the time of the last follow-up visit, at an average of three years after the osteotomy. The muscle volumes were restored to 43% to 89% of the muscle volumes on the normal contralateral side, and the postoperative muscle volume correlated significantly with the result of the Trendelenburg test (r = -0.63; p = 0.03). There was a positive association between age and the result of the Trendelenburg test (p = 0.01): four of the five patients who had a positive test were at least thirty-one years of age at the time of the operation. There was no correlation between the Trendelenburg test and the change in the length of the gluteus medius muscle, which averaged 19.2 mm in the patients with a positive test and 19.3 mm in those with a negative test. CONCLUSIONS: Patient age at the time of the operation and the postoperative change in the volume of the gluteus medius muscle have a significant influence on the result of the Trendelenburg test after a pelvic support osteotomy. Moreover, our study demonstrated that restoration of the muscle volume after a pelvic support osteotomy is not sufficient to prevent a Trendelenburg gait in older patients with congenital dislocation of the hip. LEVEL OF EVIDENCE: Therapeutic Level IV.

Adolescent↗
PubMed2006

[The significance of ultrasonic investigation of the hip joint with dysplasia and congenital hip joint dislocation].

The paper presents results of ultrasonography of the hip joint of 56 newborns with pathology of the hip joint detected by a clinical and ultrasonic screening, and 56 children aged from 1 through 6 months with dysplasia of the hip joint and a congenital hip dislocation. The ultrasonic examination gives an exact evaluation of the development of the joint. Measures of treatment were chosen with special reference to the patient's age and severity of the pathology. The terms of treatment depended on the age of the child and severity of the disease.

Female↗
PubMed1996

Combined acetabuloplasty and varus derotation osteotomy in congenital dislocation of the hip. Long-term results.

Twenty-two patients (33 hips) with congenital dislocation of the hip were examined at an average of 26 years after combined acetabuloplasty and intertrochanteric varus derotation osteotomy. Seventeen patients had no problems despite physically demanding jobs and sporting activities in some cases. The CE angle was improved to the lower end of the normal range. The shaft-neck angle was corrected by 31 degrees to 120 degrees. Restoration to the normal valgus subsequently occurred and we found no evidence of subcapital coxa valga. Although there was an increase in the neck epiphysis angle 5 years after operation indicating a horizontal shift in the epiphyseal plate, most cases had normal hip joints. The incidence of postoperative avascular necrosis of the femoral head was 6%, and we found no increase in femoral deformities. Our long-term results show that the combination of acetabuloplasty and femoral osteotomy has no disadvantages, and is the best way of achieving optimal centring of the femoral head and stabilisation of the hip.

Acetabulum↗
PubMed1993

Total hip arthroplasty in the neglected congenital dislocation of the hip. A five- to 14-year follow-up study.

A retrospective study was performed on 34 hips of 28 patients with neglected congenital dislocation of the hip after cemented total hip arthroplasty (THA) using a straight-stem prosthesis in 21 and a curve-stem prosthesis in 13 hips. The mean age at operation was 49 years (28-72 years) and the mean follow-up period was 9.4 years (5.6-14 years). Functional evaluation using Merle d'Aubigné Hip Score showed 71% success rate. Radiographic loosening occurred in three femoral and eight acetabular components attributable to poor cementing in all stems and three sockets, and to dislocation due to trauma and graft collapse in two sockets. Marked acetabular deficiency showed increased incidence of socket loosening. Both types of prostheses showed the same statistical results. Localized endosteal osteolysis appeared in five hips at the sites of less than 1-mm cement thickness. Greater trochanter nonunion reduced the functional status evidenced by pain, limping, and a statistically significant Trendelenburg sign. Proper cementing, effective acetabular reconstruction, and prevention of trochanter nonunion can produce excellent long-term results.

Adult↗
PubMed1979

The African neonatal hip and its immunity from congenital dislocation.

The hips of twenty full-term African neonates have been examined in detail to determine any anatomical factors which might explain the difference in the incidence of congenital dislocation of the hip in the African and in the Caucasian. Measurements included the degree of anteversion of the femoral neck and the acetabulum and the diameter and depth of the acetabulum. The acetabulum tended to be deeper and to vary within a much narrower range than that reported for Caucasians, lending indirect support to the theoretical role of acetabular dysplasia in the aetiology of congenital dislocation of the hip. Measurements of the anteversion of the acetabulum and femoral neck were similar to those given for Caucasians.

Acetabulum↗
PubMed1993

Custom-designed femoral prostheses in total hip arthroplasty done with cement for severe dysplasia of the hip.

A custom-designed femoral prosthesis was implanted with cement and a standard acetabular component was used to treat nineteen severely dysplastic hips in fourteen consecutively managed patients. Components that had been custom-designed with the use of plain radiography were used because the anatomical reconstructive goals could not be achieved with commercially available implants. These goals were to match the offset of the femoral head and the length of the lower limb with those on the normal side for patients who had unilateral involvement and to provide an average (thirty to forty-millimeter) offset with equal limb lengths for patients who had bilateral involvement. A retrospective clinical and radiographic analysis was performed. The diagnoses included coxa vara (one hip), congenital dislocation (twelve hips), achondroplasia (three hips), and spondyloepiphyseal dysplasia (three hips). The mean age at the time of the reconstruction was forty-nine years (range, twenty-two to seventy-three years), and the mean duration of follow-up was fifty-seven months (range, twenty-seven to 108 months). In five hips, bone-grafting of the acetabulum was needed to obtain superolateral coverage. The clinical result was excellent in eighteen hips and good in one. No revisions have been performed to date. Two femoral components were possibly loose radiographically. One was associated with a definite loosening of the acetabular cup. In addition, one other cup was possibly loose. There was a 100 per cent rate of survival if only a revision procedure was considered as a failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

High incidence of congenital dislocation of the hip in Northern Ireland.

To determine the incidence of congenital hip dislocation (CDH) a retrospective study was carried out of cases occurring in a defined population using multiple information sources. Of 138,600 children born in the period 1983-1987, a total of 243 were diagnosed with CDH, defined as those requiring splintage or surgery whose treatment extended beyond 6 months of age. Incidence and estimates of relative risks for pre-disposing factors were determined. The rate was 1.75 cases per 1000 livebirths. Major risk factors were female gender and breech presentation. The proportions of cases identified before 1, 3 and 6 months of age were 8, 14 and 35%, respectively. Despite using a restrictive definition, we have obtained an incidence rate among the highest reported in any United Kingdom population. Early detection is widely accepted as desirable, but neonatal screening has proved ineffective.

Female↗
PubMed1990

[Experimental study on the etiology of pathogenesis of acetabular dysplasia in congenital dislocation of the hip].

In order to investigate the etiology of pathogenesis of congenital hip dislocation and acetabular dysplasia, experiments using fetuses of pregnant rabbits were conducted. The following findings were obtained. (1) Dislocation occurred in approximately 40% of total animals used. The earliest dislocation was seen 2 days after birth. (2) The hip dislocation could be relatively and easily generated by exogenous factors during the perinatal period, even without such primary cause, as hip joint dysplasia. The acetabular dysplasia could be generated secondarily to dislocation. (3) There was a difference in the cause of acetabular dysplasia between areas of the acetabulum with and without load. (4) The acetabular depth growth in the dislocated hip was more seriously impaired than the longitudinal and transverse diameters of the acetabular entrance. These results have indicated that endochondral ossification of the epiphyseal cartilage of the acetabulum in the dislocated hip was more markedly impaired than that of Y epiphyseal cartilage.

Acetabulum↗
PubMed1975

Congenital dislocation of the hip associated with central core disease.

Central core disease is a congenital, non-progessive myopathy with proximal muscle weakness most prevalent about the pelvic girdle. Including out two patients there have been seven recorded cases of congenital hip dislocation associated with central core disease in children. Initial and recurrent contractures about the hip and knee should suggest the possibility of central core disease. However, the definitive diagnosis can only be made by muscle biopsy.

Adult↗
PubMed1993

Joint laxity and hip rotation in normal children and in those with congenital dislocation of the hip.

We measured the range of rotation in both hips of 397 normal children and in the unaffected hip of 135 children with unilateral congenital dislocation of the hip. Both groups were assessed for generalised joint laxity. Joint laxity was more common in normal children with an internally centred arc of hip rotation than in normal children with a neutral or an externally rotated arc. The children with congenitally dislocated hips had significantly more joint laxity than did the control group and significantly more of them had an internally centred arc of hip rotation. We suggest that the lax joint capsule fails to mould away the neonatal anteversion of the femoral neck during the first few months of life.

Adolescent↗
PubMed1994

Total hip replacement using femoral neck bone to graft the dysplastic acetabulum. Follow-up study of 18 patients with old congenital dislocation of the hip.

We performed total hip replacement on 25 congenitally dislocated hips using corticocancellous bone from the femoral neck as a bone graft to reconstruct the deficient acetabulum. Two patients (two hips) died less than five years after surgery and three hips developed deep infection. We reviewed the remaining 20 hips at an average interval of 8.4 years (5.2 to 12.9). Their functional scores (modified Merle d'Aubigné and Postel) averaged 5.7 for pain, 5.1 for walking ability, and 4.2 for range of motion. Radiographs showed union and remodelling of the grafted bone in every case. There were radiological signs of aseptic loosening in three sockets (15%) without collapse of the grafted bone. None of the femoral stems was loose. No revision operation has been performed. Our results confirm the usefulness in the long term of femoral autografts for severe acetabular deficiency.

Acetabulum↗
PubMed1997

[Sonographic measures of the hip joint of 1328 newborns of Han and Uygur nationalities-relative factors of congenital dislocation of hip].

The four sonographic methods (Engesaeter, Terjesen, Graf, Morin-Harcke) were used for examining the hip joint of 1328 newborns of Han and Uygur nationalities. The difference between Han and Uygur newborns was not statistical significant, but some literatures reported that in our country, the incidence of different nationalities in different regions varied. Our conclusion is that there is no obvious relationship between the depth of the acetabulum and the percentage of the femoral head covered by the acetabulum. It is caused by other factors, inherent or acquired. The value of the hip joint of the male and female has significant difference (P < 0.0005). The incidence of CDH in girls is much higher than that in boys. This may be related to the different depth of the acetabulum and different percentage of the femoral head covered by the acetabulum. In the period of newborn, girl's depth of the acetabulum is smaller than that of boys.

Anthropometry↗
PubMed1979

Total hip replacement in congenital dislocation and dysplasia of the hip.

The results of thirty-one total hip replacements in twenty-four patients with either severe congenital dysplasia or dislocation, after an average follow-up of four years, were excellent in eleven, good in sixteen, fair in one, and poor in one. The operative technique included superolateral bone grafts to increase the acetabular coverage in six hips. Twenty-seven hips required smaller and straighter femoral components than normal. The incidence of major complications was 19 per cent.

Acetabulum↗