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PubMedDate not supplied

The Altdorf hip clamp.

Forty-one osteotomies internally fixed with the Altdorf hip clamp were reviewed at Nemours Children's Hospital (Jacksonville, FL). They were divided according to pathology: cerebral palsy, 19 patients; congenital dislocated hip, 2 patients; Legg-Calvé-Perthes disease, 8 patients; and other, 2 patients. There were 15 boys and 18 girls, with an average age of 6.9 years (range 2.6-12 years). No intraoperative complications have been reported. Long-term complications are as follows: nonunion, one patient; superficial wound infection, one patient; and loss of position of greater than 15 degrees, two patients.

Cerebral Palsy↗
PubMed1990

Avascular necrosis in patients treated with the Pavlik harness for congenital dislocation of the hip.

Two hundred and seventy hips of 220 patients were treated with the Pavlik harness for congenital dislocation. Two hundred and thirty-three hips were dislocated, and thirty-seven hips had acetabular dysplasia. Of the 233 dislocated hips, thirteen (6 per cent) were not reduced. In one hundred and eighty-four hips that were successfully reduced, avascular necrosis did not develop. Avascular necrosis was observed in thirty-six (16 per cent) of the 220 reduced hips. Of these, twenty-seven hips were followed for five to twenty years (average, nine years). The result was excellent or good in eighteen hips (67 per cent), fair in three (11 per cent), and a failure in six (22 per cent). Avascular necrosis was seen in one of the thirty-seven hips that had acetabular dysplasia, and it was found even in the normal hip of a patient who had unilateral dislocation. In this study, the amount of displacement was represented by distances a and b, as defined by Yamamuro and Chene. Distance a is the length from the middle point of the proximal metaphyseal border of the femur to the Y-line, and distance b is the distance from the same point to the lateral margin of the ischium. When distance a was more than four millimeters, the over-all rate of reduction was 97 per cent (209 of 215 hips), ranging from 96 per cent (eighty-two of eighty-five hips) when distance a was eight to ten millimeters to 100 per cent (twenty-nine hips) when distance a was more than ten millimeters.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMedDate not supplied

Developmental dysplasia of the hip.

Developmental dysplasia of the hip (DDH), formerly known as congenital dislocation of the hip (CDH), is a term used to describe a variety of abnormalities of the hip in development. The treatment options are diverse depending on etiology, degree of dislocation, and age of the child when diagnosis is made. This article provides the reader with a knowledge base to assist with early diagnosis, treatment, and nursing care of the client with dislocations and subluxations of the hip. Presented are the definitions, diagnostic techniques, treatments, and nursing diagnoses and interventions for the client with DDH and for the child's family.

Braces↗
PubMed1992

[Hip diseases in children].

In the orthopedic practice, the hip joint is of special importance at all ages. For the general practitioner and the pediatrician are those disorders of the hip of high importance, for which early diagnosis and initiation of treatment is critical for prognosis. The following disorders should be looked for in priority, if symptoms indicate a possible affection of hip: congenital dysplasia and dislocation of the hip, coxitis, slipped capital femoral epiphysis, and tumors. One should always be aware that especially in children disease of the hip need not necessarily present with symptoms directly located within the region of the hip. Especially the child often complains only about knee or vague leg pain, while having a disorder of the hip; therefore, the cause of any pain should always also be looked for proximal to the structure, where the pain may be localized by the patient.

Bone Neoplasms↗
PubMed1980

Intra-articular volume and hip joint instability in dogs with hip dysplasia.

UNLABELLED: The nature of the instability of the hip joint in dogs with dysplasia of the hip was investigated. In the experimental canine model, instability of the joint, as shown by subluxation of the femoral head on a roentgenogram, was accompanied by an increase in the volume of the synovial fluid and of the ligamentum teres and, therefore, an increase in the intra-articular volume. Injection of a buffered solution of hyaluronic acid into non-subluxated hip joints in situ increased subluxation, whereas withdrawal of synovial fluid from one joint with severe subluxation reduced the degree of subluxation. The withdrawal of varying amounts of synovial fluid from excised but intact joints resulted in a decrease in the lateral displacement of the femoral heads. Injection of the hyaluronic acid solution into excised joints resulted in increased lateral displacement of the femoral heads. The results suggest that the joint instability associated with canine hip dysplasia is related to increased intra-articular volume. CLINICAL RELEVANCE: Instability of the hip joint (abnormal laxity) is a feature of hip dysplasia in dogs and congenital dislocation of the hip in children. The canine disease can provide a valuable model in which to examine the pathogenesis of hip instability. The model may be useful to test prophylactic procedures to prevent joint instability and thus ameliorate disease.

Animals↗
PubMed1988

The predictability of acetabular development after closed reduction for congenital dislocation of the hip.

We have reviewed the serial radiographs of 63 hips in 53 children treated by closed reduction for congenital dislocation with a view to finding a radiological measurement which can predict subsequent acetabular development. All had been followed for more than seven years, and at latest review, 34 hips were dysplastic. Failure to obtain concentric reduction or its loss by migration of the femoral head within one year of reduction were the best predictors of persisting acetabular dysplasia and were best quantitated by the h/b ratio (Smith et al. 1968). The acetabular index at reduction or its decrease in the first year were not reliable predictors. Late treatment was less likely to lead to normal acetabular development, but avascular necrosis did not appear to have a significant influence. The average age at which the acetabulum stopped developing was five years, but ranged from 17 months to eight years. The failure of a dysplastic acetabulum to improve in each annual radiograph after closed reduction should lead to consideration of operation on the acetabulum.

Acetabulum↗
PubMed1980

Detection of congenital dislocation of the hip by an early screening program, with particular reference to false negatives.

The incidence of hip abnormality was investigated in 11,980 children born at Hope Hospital, Salford, between 1975 and 1978. Of 179 neonates (14.9/1,000 livebirths) found to have an abnormal hip, only 22 (1.8/1,000 livebirths) required treatment with an abduction splint. Despite this high detection rate of hip abnormalities, 10 children (0.83/1,000 livebirths) presented with late congenital dislocation of the hip, i.e., CDH diagnosed after the age of six weeks. It is suggested that the hips should be reexamined in all children at the age of six to seven months.

England↗