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Results for “HIP DISLOCATION, CONGENITAL”

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At least 1,189 records · Page 66Linked to original sources
PubMed1991

Ultrasound in the diagnosis of congenital dysplasia and dislocation of the hip joints in children older than two years.

To evaluate the use of ultrasound in the diagnosis to congenital dysplasia and dislocation of the hip (CDH) in children older than two years of age, 64 patients with normal hip joints and 47 patients with present or previous CDH were examined. Lateral and anterior ultrasound scanning was employed, and the coverage of the femoral head by the acetabular roof was assessed. The ultrasound measurements were compared with standard roentgenography, and a good accordance between the methods was found. A lateral projection of the femoral head in relation to the bony acetabular rim of more than 8 mm in children younger than ten years of age indicated subluxation and more than 15 mm at age two to four years indicated dislocation. Reliable images were obtained by ultrasound at any age between two and 18 years. Ultrasound is recommended as the primary imaging technique in the evaluation of hip joints, even in older children, and ultrasound should replace roentgenography in most of the follow-up examinations of children with previous CDH.

Adolescent↗
PubMed1984

Treatment of hip dislocation after walking age.

Between 1979 and 1981, 35 patients were treated at our institution. All patients were more than 18 months of age and 50 congenitally dislocated hips were treated. The average age at operation was 7 years and 3 months. Whereas children under the age of 6 were typically operated upon by open reduction and Salter, Pemberton, or Dega osteotomy partly combined with femoral osteotomy, in the group of the patients older than 6 years with high iliac hip dislocations, a method was used to avoid femoral shortening. By means of the Wagner distractor the dislocated hips were brought opposite to the acetabulum. This procedure was followed by femoral osteotomy and in most cases Chiari pelvic osteotomy. Despite a number of complications the results turned out better than expected. Compared with the preoperative X-ray classifications (Severin) the postoperative result was excellent in 10 cases, good in 20, fair in 15, and poor in 1 case.

Adolescent↗
PubMed1992

Prognostic factors in congenital dislocation of the hip treated with closed reduction. The importance of arthrographic evaluation.

We reviewed the clinical records, arthrograms, and roentgenograms of sixty-one children who had seventy-two congenitally dislocated hips in an effort to identify factors that can be used to predict the outcome of treatment. Only patients who had been followed clinically and roentgenographically for a minimum of two years after the initial closed reduction were included in the study. The mean age at the time of closed reduction was thirteen months (range, three to forty-one months). The mean age at the time of the most recent follow-up was six years (range, two to fifteen years). The mean duration of follow-up after the initial closed reduction was five years (range, two to thirteen years). There was no statistical difference between the good, fair, and poor-result groups with regard to sex, the age at the initial reduction, the traction station, the side of involvement, the initial acetabular index, the initial grade of displacement, the effect of adductor tenotomy, and several of the arthrographic measurements. The medialization ratio (the percentage of the horizontal radius of the cartilaginous femoral head that lay medial to the Perkins line), measured at the time of the reduction, was significantly different (p < 0.04) between the hips for which the result was good or fair and those for which the result was poor. The medialization ratio averaged 75 per cent in the hips for which the result was good, 66 per cent in those for which the result was fair, and 57 per cent in those for which the result was poor. Limbus shapes 5 through 8 were associated with avascular necrosis (p < 0.05) and a poor result (p < 0.03).

Acetabulum↗
PubMed1983

Acetabular floor thickening and femoral head enlargement in congenital dislocation of the hip: lateral displacement of femoral head.

The thickness of the acetabular floor and the horizontal diameter of the femoral head often appear enlarged on X-ray films of congenitally dislocated hips, particularly in the later stages. These distances were, therefore, measured and compared with the normal side in 49 strictly unilateral cases. Increased floor thickness was an early change and usually persisted, often in spite of a satisfactory reduction. Increased head diameter was detectable later and these two features together increased the distance between the centre of the femoral head and the midline of the body. This lateral displacement, even when the head is well covered, increases abductor effort and force transmitted to the femoral head on weight bearing and may have an adverse effect on the joint's long term future.

Acetabulum↗
PubMed1982

Treatment concepts for proximal femoral ischemic necrosis complicating congenital hip disease.

A retrospective review of fifty-three congenitally dislocated hips (in forty-four patients) in which ischemic necrosis developed was undertaken to assess patterns of growth disturbance and to establish treatment protocols. We utilized the Bucholz and Ogden classification of the four roentgenographic patterns of ischemic necrosis complicating the treatment of congenital hip disease. Patients with Type-I disease had transient ischemia with early recovery. Significant growth disturbances requiring surgical treatment were not observed. Limb-length discrepancy, increased height of the greater trochanter relative to the femoral neck and head, and problems with femoral head coverage were more likely to develop in hips with Type-II or Type-III ischemic necrosis. Equalization of limb lengths, trochanteric epiphyseodesis, and surgical means of improving femoral head coverage were also more commonly indicated in these patients. In patients with Type-IV disease, mild deformities of the femoral head and occasional limb-length discrepancies developed; other sequelae were uncommon and surgical intervention was rarely required.

Child, Preschool↗
PubMed1985

Radiological evaluation of asymmetrical limitation of hip abduction during the first year of life.

Asymmetrical limitation of abduction of the hip may be found on screening of children in the first year of life. The clinical features identified may occur in congenital dislocation of the hip but most infants do not have or develop hip dislocation. Radiological changes are present on the side of limitation of abduction and include a higher acetabular angle, retardation of femoral head epiphyseal development, pelvic obliquity and a rotational deformation of the pelvis in the transaxial plane. The appearances are postural deformities due to persistent infant positioning and are self-correcting. If aggressive treatment methods are to be avoided, the radiologist should not confuse these changes with those of congenital hip dislocation or subluxation.

Female↗
PubMed1982

Congenital bilateral hip and knee dislocation treated without surgery: 18-year follow-up.

Report of an 18-year-old black girl successfully treated for congenital dislocation of the hips and knees is presented. Progress from date of birth, methods of treatment, and results are given. It is concluded that the condition is unusual, that dysplasia and intrauterine forces are the cause, that early treatment gives excellent results without surgery, and that follow-up through the entire growth period is essential.

Female↗
PubMedDate not supplied

Results of congenital dislocation of the hip joint with open reduction followed up to an age of fifteen years or more.

Forty-three hips (35 patients) with congenital dislocation with open reduction were reviewed. They were under 7 years old at the time of open reduction and over 15 years old at the follow-up. According to Severin's classification, 11 hips were classified as Group I, 7 hips as Group II, and 20 hips as Group III. Avascular necrosis was observed in 20 hips, but no Kalamchi's groups III and IV. The findings were that the younger the patient's age at open reduction, the higher the incidence of avascular necrosis. The cases in which the cartilaginous acetabular floor was demonstrated to be thicker in preoperative arthrography tended to yield unsatisfactory results.

Adolescent↗
PubMed1993

Acetabular development after closed reduction of congenital dislocation of the hip.

We reviewed the serial radiographs of 54 hips in 47 children treated by closed reduction for congenital dislocation of the hip and followed to at least 14 years of age, to determine the causes of acetabular dysplasia. We excluded hips with femoral head deformity or residual subluxation and compared the results with those from a control series of unaffected hips of patients with unilateral CDH. Acetabular development after the age of 11 or 12 years was significantly worse in Severin group III than in Severin group I hips on the affected side or Severin group III in unaffected control hips. One of the causes of acetabular dysplasia at maturity was found to be impairment of acetabular development after 11 or 12 years of age. This may be attributable to impaired secondary ossification in the acetabular rim. Our findings emphasise the importance of continuing the follow-up of patients treated for congenital dislocation of the hip until full skeletal maturity.

Acetabulum↗