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At least 1,009 records · Page 56Linked to original sources
PubMed1989

Congenital dislocation of hips in Malaysian neonates.

A prospective study was carried out in the Maternity Hospital, Kuala Lumpur over a 2-year period. During this time, 52,379 deliveries took place. 36 neonates (0.7 per 1000 births) were found to have congenital dislocation of the hips (CDH) by both the Ortolani and Barlow's manoeuvre. CDH was most common in the females (female to male ratio was 2.3:1), the first borns (50% of the affected cases) and babies who had breech delivery (10.7 per 1000 births). In 21 (58.3%) of the affected neonates, CDH occurred in both hips. According to the classification of newborn infants' hips by Finlay et al, 88.9% of the neonates had unstable hips while 8.3% had pathological hips. Family history of CDH was present in 5% of the patients. 8 (22.2%) of the neonates had other associated congenital abnormalities.

Hip Dislocation, Congenital↗
PubMed1984

Anetoderma. Clinical findings, associations, and long-term follow-up evaluations.

In 16 patients with anetoderma, a clinicohistologic entity related to a local dermal defect of elastic tissue, old lesions did not heal, and new lesions often continued to form for many years, despite various forms of treatment. Systemic lupus erythematosus, which occurred in one patient, must be ruled out in patients with anetoderma. Discoid lupus erythematosus occurred later in one patient. Other associated findings, noted in one patient each, included cataract, congenital hip dislocation, congenital fusion of the vertebrae at C2-3, diverticulum of the midesophagus, Addison's disease (before the onset of anetoderma), and mitral valve prolapse. Our results and a review of the literature indicate that patients with anetoderma must be examined for associated eye, bone, heart, pulmonary, digestive tract, and endocrine abnormalities for a better assessment of their skin disorders.

Adolescent↗
PubMed1979

[Contribution to the etiology of coxarthrosis. Radiographic and clinical evaluation of 976 arthrotic hip joints (author's transl)].

Radiograms and case histories of 654 randomized patients with 976 arthrotic hip joints have been reviewed in an attempt to make an etiological diagnosis. 98.3% of the patients and 98.8% of arthrotic hips, respectively, could be determined as to their underlying praearthrotic deformities according to Hackenbroch sen. The respective mean value gained from 6556 patients published in the world literature is 74.2% with marked individual variations. Most frequent praearthrotic condition was found to be congenital hip dislocation, followed by epiphyseolysis capitis femoris juvenilis, trauma, coxitis, M. Perthes, coxa vara, protrusio acetabuli, idiopathic femoral head necrosis, ankylosing spondylitis and several more rare basic conditions.--The most important reasons for differing results are discussed: Specific composition of clinic cases, completeness of documentation, experience of the reviewer and considerable space for personal interpretation. Relevant epidemiological data are also mentioned; they are in agreement with clinical experience and published data.--Finally it is stated that present diagnostic methods are not able to detect all praearthrotic conditions.

Adolescent↗
PubMedDate not supplied

[Ultrasonography studies of the fetal hip].

Recent advances in ultrasound technology, especially high-resolution sonography, now permit visualisation of the fetal hip development. Since early diagnosis and treatment of congenital hip dislocation significantly influence the outcome of the disease, ultrasound screening of the newborn infants showed to be the most effective method. In our study assessment of the fetal hip has been performed on the prenatal level in order to provide basic knowledge on fetal hip development from 14th to 40th weeks of gestation. From the 20th week of gestation bony structures are clearly visible and allow the assessment of acetabular configuration. Soft tissue and chondral acetabular components are recognizable from the 21st week. For pre- and postnatal comparative measures Graf's method and standard documentation is used.

Female↗
PubMedDate not supplied

[Radiographic study of the hip in infancy and early childhood].

In the age of sonography, there is increasing disapproval of radiologic examination of the hip in infancy and early childhood. Justifiably, the sonogram has replaced the X-ray in many examinations of the hip joint in infants and small children, thus sparing them radiation exposure. It must be remembered, however, that sonography is primarily a screening method for detecting congenital hip dislocation and dysplasia in infancy. There is still no substitute for radiologic examination of hip joints which require treatment or have been treated. Performance of survey radiograms, and if necessary arthrography, with a specific diagnostic goal permits an interpretation of all pathomorphologic changes associated with hip dislocation in infancy and early childhood. There is no place for computerized tomography in this context. It is still impossible to predict the extent to which, in the future, magnetic resonance imaging, with new coil configurations and shorter examination times, will open a new chapter in hip joint examination.

Child, Preschool↗
PubMedDate not supplied

[The management of congenital hip luxation with arthrographic control, an individual risk-reducing and time-saving method. I. Choice of method and risk assessment based on arthrographic findings].

In 388 congenital hip dislocations arthrography was used to indicate the safest form of treatment. Immediate reduction in the squatting (human) position of plaster cast (Fettweis, Salter) was followed by 3.4% of avascular necrosis of the femoral head, while plaster casts after preliminary traction showed 14.8% necrosis and unsuccessful closed reductions preceeding open reductions 11.8%. Further investigations demonstrated the influence of mechanical factors. A higher percentage of avascular necrosis was found in a narrow capsular entrance between a deformed upper limbus (or acetabular bulge) and a protruding transverse ligament with insufficient reduction (lateral displacement greater than 5 mm) and abduction of more than 45 degrees. The percentage of avascular necrosis was also depending on the development of the epiphyseal nucleus, it was 0.9% in normal forms of nuclei, 4.5% when the nucleus had not appeared at the beginning of treatment, 4.7% in small and 12.5% in retarded nuclei. The rate of necrosis was increasing with age and the degree of dislocation. Critical arthrographic findings have been described. In sufficiently open joints and full reductions Pavliks harness or hip spicas in squatting (human) position are applied immediately. With moderate narrowing of the acetabular entrance and lateral displacement traction is used for 3-4 weeks with repeated arthrography. In severe soft tissue changes of the acetabulum and lateral displacement (greater than 5-7 mm) open reduction is safer than a forced closed reduction.

Adolescent↗
PubMedDate not supplied

Assessment of complex hip deformity using three-dimensional CT image.

We used three-dimensional computed tomography (CT) to define the bony configuration of the acetabulum and the proximal femur and their relationship to complicated and/or neglected congenital hip dislocations and Legg-Calvé-Perthes disease. Three-dimensional CT was useful for preoperative planning and postoperative evaluation of hips with complex deformities, which were often difficult to assess by means of plain radiographs or conventional two-dimensional CT. The coverage of the femoral head under the acetabular roof and the severity of the hip dysplasia could be assessed easily with three dimensional CT, and acetabular and femoral torsion could be measured.

Child↗
PubMed1981

The sagging rope sign in Perthes' disease and allied disorders.

The sagging rope sign is the term used to describe the radiographic appearances which sometimes occur after Perthes' disease. It is severe examples of that disease and indicates damage to the growth plate with a marked metaphysial reaction. The same appearance follows severe epiphysitis after forcible reduction of a congenitally dislocated hip, and certain rare epiphysial dysplasias. The origin and significance of the sign are discussed.

Adolescent↗
PubMed1992

[A radiological measurements of growing hip joint in 4,000 normal children].

Roentgenograms of 4,000 hip joints of normal children were analyzed. The indices we used were as follows, the YO-value as the standard of growth (half of the distance between the both Y-cartilages), the CO-value as an index of lateralization (the distance between the center line of the pelvis and the center point of the head of the femur), the EO-value as the index of formation of the acetabulum (the distance between the center line of the pelvis and the tip of the acetabular tegmen), epiphyseal height (A), epiphyseal width (B), the alpha-angle, the CE-angle, the Sharp angle etc. The evaluation method we used consisted basically of comparisons made among values indicating length and by which the pelvis showed nearly proportional growth. The correlation coefficient among the YO-, CO-, and EO-values was extremely good. Accordingly, those indices are considered useful for the prognosis of congenital hip dislocation.

Adolescent↗
PubMed1991

[The transosseous approach to the hip joint in reconstructive operations].

The authors noted a number of peculiarities and positive moments in case of application of hip joint transosseous access after Kulish with 87 patients, aged 14-64 years, with deforming coxarthrosis, femoral head aseptic necrosis, coxa vara, congenital hip dislocation and femoral head epiphyseolysis. The access is simple, effective, comparatively low traumatic and can be successfully applied in hip joint reconstructive orthopedics.

Adolescent↗
PubMedDate not supplied

[Congenital hip dysplasia. The controversial results of a screening program].

The authors report their experience in a screening program for congenital hip dislocation. Goal of this study is to recognize the best technique for early diagnosis in this disease. The result show that we need further study and complete cooperation between pediatrician, radiologist and orthopedist to realize the best cost/benefit ratio.

Female↗
PubMed1986

The Chiari osteotomy. A review of 58 cases.

Fifty-eight Chiari osteotomies performed in 51 patients were reviewed retrospectively. The indications for surgery were painful subluxation, instability, or poor acetabular coverage. The average age at surgery was 16 years (range, 7-45), and the average follow-up period was 40 months. The majority of the patients had congenital hip dislocation, but also included were patients with cerebral palsy, Legg-Calvé-Perthes disease, polio, infection, coxa vara, and epiphyseal dysplasia. Supplemental bone grafts were applied as needed. The functional results were unrelated to age, with 26 excellent, 28 good, and four poorly functional hips. After operation, 39 out of 41 had total pain relief, 41 out of 58 had a normal acetabular index, and 54 out of 58 had a normal center-edge angle. Trendelenburg gaits were unchanged by the Chiari osteotomy, but trochanteric transfer improved the gait in few cases.

Acetabulum↗
PubMed1981

Circulatory and vascular changes in the hip following innominate osteotomy: an experimental study.

The circulatory and vascular changes in the hip following Salter-type innominate osteotomy were studied in 35 dogs to determine the effects of innominate osteotomy on the blood supply of the hip joint. Microangiography, bone scanning, and isotope clearance were employed four months after the innominate osteotomy. Microangiography showed increased vascularity at the osteotomy site, in the ipsilateral side acetabulum, and in the femoral head in 65% of the dogs. Bone scanning with 99mTc diphosphonate showed increased activity at the osteotomy site, in the acetabulum, and in the femoral head and neck in 75% of the dogs. The 99mTc diphosphonate clearance studies showed that the blood supply to the femoral head was increased by almost 30% after innominate osteotomy in 50% of the dogs studied. These observations indicate that innominate osteotomy could increase the vascularity and blood supply of the hip by increasing the collateral circulation in the process of healing of the osteotomy. The physiologic basis of the joint to innominate osteotomy constitutes a rational basis for recommending the operation for the treatment of selected cases of congenital hip dislocation, Legg-Perthes disease of the femoral head, and degenerative osteoarthritis of the hip with or without acetabular dysplasia.

Acetabulum↗
PubMed1997

Natural history and treatment outcomes of childhood hip disorders.

Normal hip joint growth and development occur as a result of a genetically determined balance of growth of the acetabular and triradiate cartilages and the presence of a well located centered spheric femoral head. The majority of acetabular development is determined by age 8 years. This is a watershed age for prognosis in many pediatric hip disorders. Hip joint growth and development and how these are affected by the disease process and treatment interventions profoundly affect outcome. Outcomes of these disease processes (congenital hip dislocation and dysplasia, Legg-Calvé-Perthes disease and slipped capital femoral epiphysis), is multifactorial but profoundly influenced by the age at the disease onset (birth to the adolescent growth spurt), and the effects of treatment on the relationship between femoral head and acetabular development. The natural history of many of these childhood hip disorders is the development of degenerative joint disease. Degenerative joint disease and clinical disability may develop in these conditions despite standard up to date treatment interventions. In most of the hip diseases discussed, patients usually do well clinically for many years regardless of treatment.

Adolescent↗
PubMed1998

Salter's innominate osteotomy: the biologic stimulating effect.

This study entails the follow-up of 28 patients (33 hips) with congenital hip dislocation. The primary treatment was one-stage open reduction and Salter type osteotomy. The mean follow-up period was 5 years and 6 months (range = 3 years to 7 years 4 months). At last follow-up, 9 hips (27%) were classified as excellent, 22 hips (67%) as good, and 2 hips (6%) as fair. Avascular necrosis developed in two hips (6%) postoperatively. The difference between the acetabular index at immediate postoperative time and at last follow-up was statistically significant (p < 0.01). The Salter osteotomy by itself may have a biologic stimulating effect on the acetabulum, which accentuates reversal of the dysplastic changes.

Acetabulum↗
PubMed1999

Open reduction for congenital dislocation of the hip: comparison of the long-term results of the wide exposure method and Ludloff's method.

We compared the long-term clinical and radiographic results of two methods of open reduction for congenital dislocation of the hip; a wide exposure method (360-degree circumferential capsulotomy) versus Ludloff's method (limited capsulotomy via the medial approach). Thirty-one hips in 24 patients assigned to group A received the wide exposure method and 32 hips in 27 patients assigned to group B had the Ludloff reduction. All patients were surgically reduced at less than 3 years of age. The follow-up averaged 16 years. None of the hips in group A required additional operations; however, 34.4% of the hips in group B did. At the latest review, 26 (83.9%) of the hips in group A were rated as Severin class I or II. Except for one patient, none had pain or a limp. Of the hips in group B, 18 (56.3%) were rated as Severin class I or II. Three patients had pain or Trendelenburg gait. Avascular necrosis occurred in 3.2% of hips in group A and in 21.9% of hips in group B. The wide exposure method is capable of completely releasing the posterosuperior tightness resulting from capsular adhesion to the ilium and the contracted short external rotators. Releasing the posterosuperior tightness from these structures seemed to provide a better chance of achieving an anatomically and functionally satisfactory hip.

Acetabulum↗
PubMedDate not supplied

Long-term results of congenital dislocation of the hip treated with the Pavlik harness.

We present the radiographic and clinical results of 158 hips (127 congenital dislocations of the hip, 31 acetabular dysplasias) that were followed-up for > 20 years after the application of the Pavlik harness. The mean Sharp angle of these hips was larger than that of the normal Japanese hip, and the mean center-edge angle was smaller. Thirty hips (19%) were classified as class III, according to Severin's classification. Of 48 unaffected hips in the unilateral cases, 15 hips (31%) had steep acetabula. We believe an intrinsic factor disturbs the normal development of acetabular cartilage in both hips of the patients. Thirty-five hips (22.2%) showed variable grades of deformity of the femoral head, neck, or both. Clinically, most of the treated hips were good in the 3rd decade.

Braces↗
PubMed1994

[Treatment for congenital dislocation of the hip at the orthopedic department of the Institute of Orthopedics and Rehabilitation in Poznan from 1946 to 1991].

During forty-five years (1946-1991) over 6000 children were treated conservatively and over 6000 surgical procedures for congenital dislocation of the hip were carried out at Orthopedic Department of Institute of Orthopedics and Rehabilitation in Poznań. Modalities of treatment, types and numbers of operations are presented.

Child, Preschool↗