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Results for “HIP DISLOCATION, CONGENITAL”

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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↗
PubMed1979

Open reduction for congenital dislocation of the hip using the Ferguson procedure. A review of twenty-six cases.

Twenty-three patients with twenty-six congenital hip dislocations treated by the Ferguson procedure were reviewed. The study was undertaken to determine if this method of treatment has any effect on the incidence of avascular necrosis of the femoral head and if there are preoperative factors that can assist in predicting the success of treatment. Clinical and roentgenographic criteria were utilized and only dislocations of the hip unassociated with other disorders were included. Avascular necrosis did not occur in these patients during the period studied. It was also found that patients who were more than twelve months old at the time of operation and had a acetabular index of 40 degrees or more had a high incidence of redislocation.

Casts, Surgical↗
PubMed1982

Congenital dislocation of the hip. Review at maturity of 147 hips treated by excision of the limbus and derotation osteotomy.

In 1957 Somerville and Scott presented their principles of management for the older child with congenital hip dislocation. They advocated preliminary traction followed, in those hips which remained dislocated, by excision of the limbus and subsequent derotation varus osteotomy of the femur. As alternative regimes are advocated it becomes increasingly important to subject each method to detailed long-term review. One hundred and forty-seven hips in 121 patients aged between 12 months and three years and treated by the standard Somerville and Scott regime have been reviewed. The age at review ranged from 16 to 31 years. The recall rate was 91 per cent. Each patient was seen regularly in a special clinic where detailed notes, radiographs and records were available. The results have been assessed clinically and radiographically by modifications of Severin's criteria to enable comparisons to be made with other published series. Attention has been focused on the good and the bad prognostic factors and on the long-term complications. The most worrying feature has been the premature onset of degenerative arthritis even in hips which seemed to have been satisfactorily reduced.

Child, Preschool↗
PubMedDate not supplied

Histologic, histochemical, and ultrastructural studies of the hip joint capsule and ligamentum teres in congenital dislocation of the hip.

The histology, histochemistry, and ultrastructure were investigated in 12 ligamentum teres and 11 hip joint capsule biopsies obtained at open reduction of 9 patients with congenital dislocation of the hip (CDH) and of 2 normal hips. The ages of the patients ranged from 2 months to 4 years and 2 months. In the joint capsule of the dislocated hips, the cells were irregularly distributed, had different shapes, and appeared to be in different stages of functional activity. The collagen fiber bundles were thicker than in the normal capsule, distributed and of varied thickness. The collagen fibrils in the younger patients were thinner than in the normal hip and their diameter increased slightly with age. In the ligamentum teres of the dislocated hips the elastic fibers were thicker and more numerous than in the normal hip, whereas the cells and collagen fibrils showed changes similar to those observed in the capsule. Fibrocartilaginous metaplasia was found in both the capsule and the ligamentum teres in areas compressed by the femoral head. The morphologic and histochemical changes observed in the joint capsule in CDH appeared to be secondary to the mechanical stresses caused by the dislocation.

Cartilage, Articular↗
PubMed1991

Medial approach open reduction for congenital dislocation of the hip using the Ferguson procedure. A review of 31 hips.

Between January 1979 and October 1984, 31 congenitally dislocated hips in 19 patients were treated using open reduction via the medial approach, as described by Ferguson, at the Ankara University Faculty of Medicine. Patient age at operation ranged from 3 to 33 months (mean 12.1 months). The average follow-up was 94.7 months. All hips were evaluated both radiographically and clinically. Avascular necrosis of the femoral head was observed in 9.7% and slight, transient ischaemic radiographic changes of the femoral head in 22.6% of the hips; 25.8% of the hips have already undergone or are due to undergo subsequent surgery due to an insufficient radiographic result. The medial approach was found to be a reliable procedure for infants who have not had extensive previous conservative treatment and who are between 7 and 18 months of age.

Child, Preschool↗
PubMed1983

Coventry screw fixation of osteotomies about the pediatric hip.

Osteotomies of the hip fixed with the Coventry lag screw were performed in 29 patients (38 hips) from May 1976 to June 1981. The ages of the children ranged from 24 months to 15 years, with an average of 7.3 years. There were 15 boys and 14 girls. Follow-up averaged 24 months, with a range of 11 to 67 months, and all patients were followed to union. The osteotomies were most commonly indicated for hip deformities associated with cerebral palsy, congenital deformities of the hip, congenital dislocation of the hip, neuromuscular abnormalities, post-traumatic deformities, and other miscellaneous conditions. Results were analyzed according to the bone disorder. All of the osteotomies united, averaging 10.5 weeks to union. Complications included one nonunion which required grafting before the osteotomy united, and two malunions. Following union, there was one fracture distal to the plate, and subcutaneous prominence of the screw developed in three patients. The Coventry lag screw is technically easy to use, is tolerated well, and produced satisfactory fixation in the majority of the patients in this study.

Adolescent↗
PubMed1991

Long-term results of total hip arthroplasty in congenital dislocation and dysplasia of the hip. A follow-up note.

Twenty-three of twenty-nine hips that were previously reported on were studied at an average of fourteen years (range, eight to 16.5 years) after total hip arthroplasty with cement. The original arthroplasties had been performed between November 1971 and January 1976. In all hips, there was dislocation or severe dysplasia. In six hips, superolateral bone grafts were used to increase acetabular coverage. At the latest follow-up examination, seven hips were rated excellent; nine, good; and one, fair. There were six failures (26 per cent) that were revised: four hips (17 per cent) had a fractured Trapezoidal-28 stem, one had loose femoral and acetabular components, and one had loosening of only the acetabular component. Radiographic analysis of the remaining hips revealed that one had progressive acetabular radiolucencies. This patient had an excellent clinical result. Two-thirds of the failures were due to a fractured stem.

Adult↗
PubMed1984

[A clinical and genetic study on the congenital dislocation of the hip].

Among 13,779 infants examined from 1974 to 1980 at Takashimadaira and Toride health centers, there were 45 patients with congenital hip dislocation, an incidence of 3.3 per 1,000 live births, that is, 0.08% and 0.53% respectively in male and female. The male to female ratio was 1: 7.4. Its incidence seems to be decreasing year by year with statistic significance, compared with the data previously reported. A family study was conducted based upon 117 patients with this disease diagnosed at the Tokyo Medical and Dental University from 1971 to 1980. Applying the recurrence rate of siblings and the incidence in the general population to the model proposed by Falconer, the heritability of liability to congenital hip dislocation in Japan is estimated to be 80 +/- 20% in males and 135 +/- 10% in females, which is beyond limitation of the heritability and much higher than Woolf's estimation (82% in male and 58% in female). This might be due to the insufficient size of the test population, but the genetic factors are presumed to play a more important role on the etiology of this abnormality.

Adult↗
PubMed1996

Neglected congenital dislocation of the hip. Role of computed tomography and computer-aided design for total hip arthroplasty.

Computed tomography (CT) provides important three-dimensional anatomic details in congenital dislocation of the hip that are useful for total hip arthroplasty (THR) and are not obtainable with conventional radiographic evaluation. In this study, 84 patients (119 hips) with congenital dislocation of the hip were evaluated with CT before surgery. Specifically, both the acetabulum and the femur were analyzed to make the best selection of the prosthesis. The average anteversion of the acetabulum was 23 degrees, with an opening of 30.9 mm and a depth of 14.7 mm. The bone stock of the true acetabulum was calculated and the average available diameter for the acetabular implant was 44.9 mm. The CT topogram revealed the true leg-length discrepancy (average 0.5-1.9 cm), and the amount of a shortening osteotomy when necessary was determined. Finally, to determine the stem with optimum fit and fill, a three-dimensional reconstruction of the femoral canal using CT data and computer-aided design (CAD) was matched with a three-dimensional geometry of several stem designs and sizes obtained from a CAD system.

Computer-Aided Design↗
PubMed1984

Congenital dislocation of the hip and computerised axial tomography.

CT scans of 18 hips with typical congenital dislocation have been studied in 16 children. These show that the common position of dislocation is lateral, superior and slightly anterior, and that a "false acetabulum" can be distinguished even in young children. A defect in the posterior ischium causing distortion of the acetabulum was also present in most cases. The cartilage and the acetabular contents were well shown. Positions of reduction and the anteversion of the acetabulum and the femoral neck were studied. Hypotheses are presented on the mode of dislocation and on the cause of the pathological changes.

Acetabulum↗