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PubMedDate not supplied

[Concentric centering of the normal hip and concentric reduction of the dislocated hip. Radiological study on their determination and clinical application].

A radiological method to determine the ideal, geometrical, center of the acetabulum and femoral head is described by the author; the proceedings for these localizations and the interrelationship between them, are also described. These factors were taken from a series of simple radiography and arthograms, which is called; "Concentrical Centring" in normal hips, as well as other seires of dislocated hips, which were radiographed in anteroopsterior view, and in frog position, as well as in histological sections. The necessity to look for the concentrical reduction of the dislocated hips is also emphasized, as a basic point for the good development of the acetabulum, which is achieved, at the time of treatment, if the location is made of the point of the femoral head with that of the acetabulum (Concentrical Reduction). This method will permit to evaluate this interrelationship easily in a numerical scale figure and with a minimum of error. This is a useful resource previous to the arthrography in those hips which have been just recently reduced; and latter, in their follow-up.

Anthropometry↗
PubMed1994

Bilateral femoral head fracture with posterior hip dislocation.

Bilateral posterior hip dislocations with femoral head fractures are rare. We report the case of a 71-year-old woman who was an unrestrained driver involved in a head-on motor vehicle collision. The right hip was stable after reduction, while the left hip was felt to be unstable. Bilateral bipolar endoprostheses were inserted via standard posterior approaches. Fracture fragments composed approximately 35% of the femoral head in both hips. We believe an elderly polytrauma patient with a significant femoral head fracture may benefit from primary arthroplasty as a treatment option, especially in cases of bilateral injury.

Aged↗
PubMed1978

Total hip arthroplasty in chronically dislocated hips. Follow-up study on the protrusio socket technique.

The so-called protrusio socket technique of total hip arthroplasty was shown to be very effective in a series of twenty-two chronically dislocated or subluxated hips. In seventeen patients with follow-up of sixteen to fifty-nine months, excellent results were obtained in all but two hips. Obesity and rheumatoid arthritis or other systemic causes of osteopenia are considered contraindications to the procedure.

Adult↗
PubMedDate not supplied

[Neurophysiologic aspects of the etiology and pathogenesis of congenital hip dislocation].

Till today the meaning of neuromuscular factors in etiology and treatment of congenital dislocation of the hip is not quite clear. Our observation in 62 children with 78 dislocated hips show that neurophysiological mechanisms play of very important role in the development and upkeep of CDH. The neurological examination in 17 children pointed to the typical asymmetries of the children which correlated with the side of the dislocated hip. The knowledge of neurophysiological disturbances on the dislocated hip is of great value for the diagnosis of CDH and even more for the exercise treatment in hips with severe adduction contracture.

Cerebral Palsy↗
PubMedDate not supplied

[[So-called congenital hip dislocation--development of incidence, diagnosis and therapy in the last 7 years].

PROBLEM: How has the Congenital Dislocation of the Hip (CDH) developed in the last 7 years concerning frequency, time of diagnosis and therapy? METHOD: Retrospective analysis of hospital reports, ultrasound- and X-ray images of children treated with CDH in the University Hospital. RESULTS: From 1. 1. 1991 to 31. 12. 1997 21 children with 28 dislocated hips were treated. The number of dislocated hips per anno is less than in a former study. In 17 children the diagnosis was found by ultrasound. The diagnosis was made within the first week of life in 8 children. In 9 dislocated hips, open reduction was necessary; in 7 of these 9 joints, diagnosis was made in the first days of life. CONCLUSIONS: Because of the distinct declination of CDH the "true" congenital dislocations, in which open reductions were often necessary, predominated.

Arthrography↗
PubMed1997

[Hip dislocation without bone injuries].

Dislocation of the hip is rare and so we regard every hip dislocation as an emergency until it has been reduced. From 1977 to 1996 a total of 82 patients with hip dislocation were treated at the Traumatic Surgery Clinic, University of Vienna, Austria. The average age at injury was 29 years. Some 77 patients had unilateral dislocation of the hip, but only in 5 cases was bilateral dislocation found. Iliac dislocation was most common (54 patients). Our treatment consisted in reduction within 6 h of the injury under general anaesthesia (Böhler) and 14 days bedrest. Then the patients were mobilized with full weight bearing, depending on the pain. Of the patients 29 had no clinical infirmities, 8 patients reported temporarily occurring pain and in 6 patients we found a limited range of movement in the hip joint with occasional pain. In all, 43 patients were followed up after 1/2 to 19 years. Radiological signs were seen in 17 patients and avascular necrosis of the femoral head in 1. So after careful evaluation of the patients and the kind of treatment, we recommend the following: 1. Immediate, gentle reduction of the hip joint; 2. Bedrest for 14 days; 3. Early mobilization with full weight bearing.

Adolescent↗
PubMedDate not supplied

Hip dislocation in spinal muscular atrophy.

Hip conditions in 49 patients affected with spinal muscular atrophy were studied: 35 of these were affected with the intermediate form of the disease (patients were able to sit but not walk), and 14 with the mild form (patients were able to walk). The Perkins method was used to measure the migration percentage of the femoral head. Thirty-one percent of the patients affected by the intermediate form of the disease had normal hips, 38% had unilateral or bilateral subluxation, 11% had hip dislocation. In the mild form of the disease, 50% of the patients had normal hips, 28% had unilateral or bilateral subluxation, and 22% had a hip dislocation. In the intermediate form of the disease there was a linear correlation between migration percentage and age, and between migration percentage and scoliosis. In the patients affected with the mild form of the disease who were able to walk, and in the patients affected with the intermediate form and fitted with orthoses who were able to stand, or to walk, there was no hip dislocation. Hence, walking with or without orthoses seems to be an important factor in preventing hip dislocation.

Child↗
PubMed1983

Reasons for late detection of hip dislocation in childhood.

A retrospective study of 56 children with dislocation of the hip presenting late found that the mean age at which the parents first noticed that something was wrong (including hip abnormalities found at birth in 10 patients) was 11 months, but that at diagnosis was 26 months, a mean delay of 15 months. The reasons for delay were failure to examine the hips at birth (13 cases), failure to follow up abnormalities at birth (7), failure of symptoms noticed by the parents to alert the health-care professional to the possibility of a dislocated hip (36), failure to check the hips routinely after 3 months (27), and failure of the parents to appreciate the significance of abnormalities and to act on them (28). Hip screening should continue beyond the neonatal period and should include routine checks on all children until they are walking normally. A greater awareness in health-care professionals of the features of hip dislocation and further health education for parents are needed.

Adolescent↗
PubMedDate not supplied

Treatment of hip dislocation in Kabuki syndrome: a report of three hips in two patients.

The incidence of hip dislocation in Kabuki syndrome (KS) is thought to be between 18% and 40%. Although hip dislocation is apparently well recognized in KS, to our knowledge, its management and outcome have not previously been addressed in the literature. We report 2 children (3 hips) with KS and hip dislocation who underwent surgical treatment with a minimum of 24-month follow-up. In addition, we review the current literature on the treatment of orthopaedic problems in KS.

Abnormalities, Multiple↗
PubMed1999

Closed reduction of posterior hip dislocation: the Rochester method.

This paper describes a new technique of closed reduction for a dislocated normal hip or a dislocated prosthetic total hip. The Rochester method is unique in that it can usually be done by one trained medical care provider, whereas many other reduction techniques require one or more assistants. The patient is placed in the supine position and reduction is performed while the patient is sedated, although some patients may require an anesthetic. The medical care provider uses his or her non-dominant arm for pelvic counterforce, while the other arm provides longitudinal traction and rotation control. Most reductions can be done in the emergency department.

Hip Dislocation↗
PubMed2001

Traumatic asymmetrical bilateral hip dislocation in an adult.

Bilateral hip dislocation occurring as a result of trauma is a rare condition. Simultaneous anterior and posterior traumatic dislocation of both hips is even more unusual. A case is reported of asymmetrical bilateral traumatic hip dislocation without an associated fracture of the pelvis or femur occurring in a young adult with no previous history of hip abnormality or ligamentous laxity. An unusual mechanism for this injury is also described.

Accidents, Traffic↗
PubMed1995

Changes on magnetic resonance images after traumatic hip dislocation.

Fourteen patients with traumatic hip dislocation had serial magnetic resonance imaging and routine radiographic studies from the time of injury through 24 months after injury. One experienced radiologist interpreted all images prospectively for abnormalities suggesting osteonecrosis of the femoral head and posttraumatic arthritis. Eight hips demonstrated abnormal marrow signals on T1 and T2 weighted images within 6 weeks of injury. These changes progressed in 3 hips, and osteonecrosis was confirmed subsequently by plain radiography. The abnormal marrow signals in the remaining 5 hips proved to be transient, resolving on magnetic resonance images within 3 months in 4 of the 5 patients. Magnetic resonance imaging can be used with confidence for the early detection of osteonecrosis of the femoral head after traumatic hip dislocation or fracture-dislocation. The presence of acetabular or femoral shaft hardware did not preclude magnetic resonance imaging assessment of these patients when coronal, sagittal, and axial images were obtained. Magnetic resonance imaging was not reliable for assessing marrow changes within the first week after injury, nor was it helpful in predicting which patients were at risk for posttraumatic arthritis to develop. An algorithm is proposed for using magnetic resonance imaging in the early diagnosis of osteonecrosis of the femoral head after traumatic hip dislocation.

Adolescent↗
PubMedDate not supplied

[Long-term follow-up of 166 surgically treated patients with congenital hip dislocation].

UNLABELLED: 166 patients with congenital dislocation of the hip, ranging from 10 months to 5 years old, were operated between 1958 and 1971. 140 patients were women (84%) and 26 patients were men (16%). 96 patients had unilateral and 70 patients had bilateral dislocation; that makes a total of 236 dislocated hips. 61 patients with bilateral hip dislocation were operated simultaneously on both hips. All the patients were treated with adductor tenotomy and open reduction through Smith Petersen incision with section or elongation of the psoas tendon. The postoperative immobilization consisted in a period of one month pelvic toecast followed by 2 plaster casts with abduction rod during 3 to 5 months. The postoperatory follow-up ranged from 9 years to 26 years, 2 months; average 14 years, 5 months. The clinical evaluation comprises pain, hip mobility, gait and muscle power. RESULTS: excellent 138 (59%); good 66 (28%); fair 29 (12%); and poor 3 (1%). The radiological evaluation considered: Mose; acetabular femoral head index; Wiberg's CD-angle; cervico-diaphysiary angle and radial quotient. RESULTS: normal 5 (2%); excellent 44 (19%); good 78 (33%); subtotal 54%; fair 90 (38%), and poor 19 (8%). Complications (hips); infections 12 (5%); 3 of them deep ones (1%); residual subluxation 19 (8%); reluxation 1 (0.5%). Isquemic necrosis Grade II of Tönnis 31 (13%); Grade III 2 (1%) and Grade IV 1 (0.5%).

Adolescent↗