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At least 1,153 records · Page 64Linked to original sources
PubMed1981

[Studies of shelf operation on congenital dislocation of hip (author's transl)].

Part I The author examined 62 hips in 58 patients treated by shelf operations, and their long-term results were studied as a follow-up for an average of 10 years. Satisfactory results of the shelf operation were obtained in 51.7% of patients, if over 10 years of age when operated on, but in as many as 72.0%, if under 6 years of age. But as the age of each group changed from that of the time of follow-up age it was impossible to carry out any comparable study between the two groups. Better roentgenographical results appear to be obtained, if this procedure is performed on those over 10 years of age. Part II In an attempt to detect the changes of a hip after the destruction of the outer rim of the acetabulum, experimental studies were undertaken on 50 young rabbits about 40 days after birth. In order to destroy the outer rim of the acetabulum, a small piece of autogeneous iliac bone was embedded in the outer rim of acetabulum where the bone graft is done in human's acetabuloplasty. The results showed that this procedure had no influence on the development of osteoarthritis in a rabbit.

Acetabulum↗
PubMed1992

Conservative treatment of congenital dislocation of the hip in the newborn and infant.

Five practical questions, concerning which hips should be treated, method of treatment, duration of treatment, treatment failure, and whether pretreatment traction is advised in congenitally dislocated hips, are discussed and answered. All hips positive for Ortolani's sign, hips positive for Barlow's sign, dislocated and irreducible hips, and hips that appear unstable by sonography should be treated. A large number of studies document the safety and effectiveness of early treatment in the Pavlik harness. Treatment may be stopped at six weeks in the newborn and three or four weeks after stability is achieved in children three or four months old at the time of initial treatment. Sonography is helpful in determining when to stop treatment. Hips that fail Pavlik harness treatment are at risk to fail with other types of treatment as well and require a cautious approach. Traction before treatment of congenital dislocation of the hip (CDH) may not be necessary. Recent studies have shown that safe reductions may be performed without preliminary traction.

Hip Dislocation, Congenital↗
PubMed1985

[Congenital anterior dislocation of the hip].

An apparently congenital antero-superior hip dislocation is identified during surgery. With reference to this case, three possible clinical courses for congenital hip dislocations are outlined: As a rule full recovery is most frequent. However, a posterior dislocation which is persistent tends to become postero-superior upon weight-bearing. Anterior dislocations as well as antero-superior subluxation appear to be rather common. Both pathology and the CAT scan attest to this fact. Extension, which is a true dislocating position for a retracted hip in adduction anc rotated externally, is probably responsible for such an evolution. Anterior dislocation and especially antero-superior subluxation are frequent findings which can be explained anatomically. The eventual complications of the antero-superior wall of the acetabulum resulting from these, will be the objective of most of the usual treatments for residual hip dysplasia.

Female↗
PubMed1993

[Delayed detection of hip dislocation: is the physician to blame?].

Despite the screening campaigns for early detection of congenital dislocation of the hip, some cases continue to be diagnosed late. The main reason for the failure to diagnose this disorder at an early stage is still unclear. A dislocated or a dislocatable hip is not always apparent during the initial newborn screening examination, and repeated clinical examinations throughout the first 12 months are necessary in order to establish the presence or absence of this disorder. At birth, radiographs are usually normal and a systematic pelvic radiograph of the neonate has no place in neonatal screening. Sonography helps to detect hip pathology early. However, owing to the dynamic nature of the disorder, a single early non-selective ultrasound has proved to be too sensitive and to lack specificity. In the United States, failure to diagnose the congenital dislocation of the hip is the most common musculoskeletal cause of litigation brought against pediatricians. In Europe, the system of fault liability implicates an obligation of ability and means. Failure to diagnose or misdiagnosis is not a fault in itself as long as a complete history, careful physical examination and adequate and appropriate complementary examinations have been performed by an adequately trained physician. If congenital hip dislocation is recognized and treated early, most of the affected children will develop functionally and radiologically normal hips. The longer the dislocation remains untreated, the harder it is to relocate the hip and the higher the incidence of secondary acetabular dysplasia, necessitating surgical correction. However, early treatment is not always successful or without complication. Consequently, the damages due to late onset of the treatment are difficult to assess.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1978

A long-term follow-up of congenital dislocation of the hip.

Drawing upon a total experience of 450 hips affected by established congenital dislocation or subluxation, the author presents the long-term results in 177 hips treated for the first time between the ages of nine months and three and a half years, in support of his contention that surgical endeavour should in the first place be directed towards the limbus and upper end of femur rather than the acetabulum. The 144 patients, all treated on lines previously described in this journal (Scott 1953; Somerville 1953a, b; Somerville and Scott 1957), have now been followed up annually for between ten and twenty-five years, both hips receiving equal scrutiny. In brief, the routine has consisted of arthrography, excision of any limbus shown to be inverted, reduction by traction in abduction, and rotation osteotomy of 70 degrees. The addition of 10 to 15 degrees of varus was found beneficial and has become routine. Some hips required secondary procedures, and regret is expressed that these were not carried out sooner. The upper age at which recovery of the acetabulum may occur was found to be much higher than generally supposed, with a critical period between eleven and fourteen. The main conclusion is that in the great majority of cases first seen in this particular age group, improvement of the mechanics of the joint, especially by attention to the upper end of femur, leads to satisfactory development of the acetabulum and good functional results, at least up to early adult life.

Acetabulum↗
PubMed1980

Teratological hip dislocation.

The hallmark of teratological congenital hip dislocation is its advanced severity at birth, signifying longer antenatal duration and accentuation of distortion. There may be contributions from a multiplicity of unrelated syndromes, such as local intrauterine factors, failure of proper formations early in the embryonic period, or genetically determined disorders. Treatment is generally difficult and the end result is uncertain.

Abnormalities, Multiple↗