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PubMedDate not supplied

Open reduction for congenital hip dislocation: the risk of avascular necrosis with three different approaches.

A review of 49 hips with congenital dislocation that were treated with anterior open reduction after traction and arthrogram showed that partial avascular necrosis can occur even when adequate decompression of the femoral head is obtained. When femoral osteotomy is done in conjunction with open reduction, the rate of avascular necrosis is not greater than for open reduction alone. Open reduction combined with innominate osteotomy had the highest rate of partial avascular necrosis and also the highest rate of additional surgery required.

Child↗
PubMed1997

Morphology of the acetabulum in hip dislocations caused by cerebral palsy.

Twenty-four hip joints in 20 children with spastic cerebral palsy were assessed by standardised three-dimensional reconstructions from computed tomographic scans. All the hip joints showed a channel-like ebony deformity of the acetabulum along which the femoral bead had slid out, indicating a unidirectional instability. The channel was oriented along the longitudinal axis of the body within a sector of 25 degrees anteroposteriorly. In relation to the pelvis, the dislocation was directed more dorsally by 20 degrees as a result of a flexion contracture of the hip. The size of the femoral head corresponded with the size of the acetabulum in every case, even in long-standing dislocations.

Acetabulum↗
PubMed1999

Unsuccessful surgical treatment of hip dislocation in congenital sensory neuropathy with anhidrosis. A case report.

A six-year-old girl with congenital sensory neuropathy with anhidrosis (CSNA) presented with bilateral hip dysplasia and subluxation on the right side. Conservative treatment of the hips by closed reduction and a plaster cast was unsuccessful. When aged seven years the patient had an intertrochanteric varus rotation osteotomy on the right side, but subluxation was again evident after five months. A Salter-type pelvic osteotomy was carried out followed by immobilisation, but one year later subluxation was present in the right hip and dislocation in the left. At the age of nine years, the right femoral head resembled a Charcot joint, although walking ability was preserved. In patients with CSNA, surgery may not always be advisable.

Child↗