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PubMed1989

[The role of exogenous factors in the etiology of congenital hip dislocation: a socio-epidemiologic study].

The authors present in their work the results of the analysis of the relation between congenital dislocation of vertebral joints and social factors which they have found out in 120 children singled out of 9516 live-born children in the Martin district (Slovakia) in the period 1979-1983. The investigation of social factors has been based on the analysis of socioeconomic and social conditions of the Martin district which has no regional particularities. According to their results the share of exogenous factors in the origin and development of this disease is manifested more frequently in the first-borns (having the highest representation in the examined group). On the top of the list of social indices, which they have examined in primiparae and multiparae respectively, there are unsuitable housing conditions (living in discord with mother-in-law in the same house-hold), high percentage of impregnation before marriage which can be considered a strain and longterm conflicting situation and can have together with other factors a sociopathogenetic effect.

Adult↗
PubMed1993

[Cooperation between the pediatrician and orthopedist in the diagnosis of congenital hip dislocation].

The author summarizes the principles of clinical diagnosis, referring to experience assembled in an investigation comprising more than 35,000 neonates during past years. The submitted pattern could be a practical instruction for examination of the hip joints by paediatricians--neonatologists. The author emphasizes the fact that the diagnosis of complete dislocation unless irreponible is very easy, and being a clinically very obvious defect, it should not be missed. In other countries the trend predominates to ensure examination of the hip joints of neonates by paediatricians-neonatologists for whom this examination is a matter of routine. The author outline possibilities of ultrasonographic examination, static as well as dynamic. In large towns it proved useful to establish an ultrasonographic examination room where some 4000 infants aged 2-3 weeks are examined. The hitherto used classification of ultrasonic examination is not quite reliable in view of "over-diagnosis" and thus to unnecessary therapy which can lead--as any abduction therapy--to complications such as avascular necrosis. Paediatricians-neonatologists should master the clinical problem and be aware of the responsibility for early clinical diagnosis to enable orthopaedists to specify indication for early treatment based on ultrasonographic examination.

Hip Dislocation, Congenital↗
PubMed2004

Implementing capsule representation in a total hip dislocation finite element model.

Previously validated hardware-only finite element models of THA dislocation h ave clarifiedhow various component design and surgical placement variables contribute to resisting the propensity for implant dislocation. This body of work has now been enhanced with the incorporation of experimentally based capsule representation, and with anatomic bone structures. The current form of this finite element model provides for large deformation multi-body contact (including capsule wrap-around on bone and/or implant), large displacement interfacial sliding, and large deformation (hyperelastic) capsule representation. In addition, the modular nature of this model now allows for rapid incorporation of current or future total hip implant designs, accepts complex multi-axial physiologic motion inputs, and outputs case-specific component/bone/soft-tissue impingement events. This soft-tissue-augmented finite element model is being used to investigate the performance of various implant designs for a range of clinically-representative soft tissue integrities and surgical techniques. Preliminary results show that capsule enhancement makes a substantial difference in stability, compared to an otherwise identical hardware-only model. This model is intended to help put implant design and surgical technique decisions on a firmer scientific basis, in terms of reducing the likelihood of dislocation.

Arthroplasty, Replacement, Hip↗
PubMed1994

Ipsilateral hip and knee dislocation.

Hip and knee dislocations individually are two of the relatively limited orthopaedic emergencies. Long-term results of treatment of these two types of injury are associated with avascular necrosis of the femoral head, knee instability, and knee stiffness. Correct early diagnosis, including arteriography in the case of knee dislocation, is crucial. Prompt treatment consisting of closed or open reduction of the dislocations is necessary. Additional treatment involving knee ligament reconstruction is warranted to maximize knee function in healthy, active patients. Simultaneous occurrence of ipsilateral hip and knee dislocations is a particularly morbid injury. We report such a case to emphasize that early, aggressive treatment and extensive physical therapy can result in a functional and painless lower extremity.

Adult↗
PubMed2005

Study of hip joint dislocation after total hip arthroplasty.

The present study was undertaken to identify the factors responsible for hip joint dislocation after total hip arthroplasty, laying emphasis on analysis of the background variables of the patients. Of the 317 hips included in the study, ten (3.2%) dislocated. Only the anteversion angle of the cup differed significantly between the dislocation group and the dislocation-free group. The safe zone of the anteversion angle seems to be between 20 and 30 degrees. but it is also essential to set the antetorsion angle of the stem to match the shape of individual bones to create a more stable hip joint. This safe zone may be expanded by the additive effect of antetorsion angle of the stem.

Adult↗
PubMed2005

[Ways of surgical technique optimization and prevention of hip endoprosthesis dislocation following total hip arthroplasty].

The article presents experience concerning intraoperative prevention of hip endoprosthesis dislocation, gained in the orthopedic surgical clinic of Moscow Regional Research Clinical Institute. The results of 1208 total articular replacements allowed the development of intraoperative dislocation-preventive measures, taking into account the approach to the hip joint, necessary mobilization of articular ends, the relative position of total endoprosthesis components. The cases of hip endoprosthesis dislocation were analyzed. The offered preventive measure system allowes reduction in total endoprosthesis dislocation rate down to 1.5%.

Arthroplasty, Replacement, Hip↗
PubMed2002

Posterior fracture dislocation of the hip joint: the value of the obturator-oblique view with the hip still dislocated.

OBJECTIVES: To determine the value of the Judet oblique views taken while the hip is still dislocated. STUDY DESIGN: Radiological review. SETTING: Level I trauma center. METHOD: In addition to the traditional views in fifty of 110 fracture-dislocations, Judet views were carried out with the hip still dislocated. Each of the respective views was viewed with the reviewer blinded to diagnosis and the fracture classified according to the information available on that view. The percent accuracy of each view was then calculated by comparing radiologic with intraoperative classification. Under the pretext that if any view enabled a more accurate classification of the fracture, it must be providing more information, we assessed the quantitative value of each radiologic view according to our ability to accurately classify the fracture. RESULTS: Using the CT scan alone, classification was accurate in 82 percent of cases because the CT often overdemonstrated the degree of comminution. When the added information available from the traditional radiographs was included, there was only a slight improvement (82 percent versus 84 percent). This was increased to 96 percent when the obturator-oblique dislocated view was included. CONCLUSION: Because it provides an uninterrupted view of the posterior wall, demonstrates the displacements of fragments, and provides a comparison for the reduced view, which greatly augments the available information, the obturator-oblique dislocated view should be done routinely in the assessment of all posterior fracture dislocations of the hip joint.

Hip Dislocation↗
PubMed1976

Radiologic classification of posterior dislocations of the hip: refinements and pitfalls.

Seventeen traumatic hip dislocations seen during a 15-month period were evaluated. In 10 of the 14 cases of posterior hip dislocation, the final Thompson-Epstein classification differed from the initial radiographic classification. Dislocations of the hip often result in radiographically obscure femoral head and acetabular damage. High quality radiographs with oblique and coned-down views are of substantial aid in evaluating the dislocated hip. After closed reduction of a dislocated hip, further views and tomography are helpful but diagnostic pitfalls exist. A persistently widened hip joint, even with negative plain films and tomography, indicates possible intra-osteochondral debris or incompletely reduced femoral head fragments.

Adolescent↗
PubMed1975

Neonatal septic "dislocation" of the hip: true dislocation or pathological epiphyseal separation?

The clinical and roentgenologic appearance of septic dislocation of the hip may be caused by either a true dislocation or a pathological epiphyseal separation due to osteomyelitis. Arthrography of the hip permits differentiation in the neonate. The significance of these two anatomical possibilites is discussed in terms of follow-up and results of neonatal infections about the hip, and a case of pathological epiphyseal separation at the hip diagnosed in the neonatal period by aspiration and arthrography and followed up for 3 years is presented.

Child, Preschool↗
PubMed2005

Traumatic anterior dislocation of the hip joint with posterior acetabular wall fracture.

The incidence of traumatic hip dislocation has increased in recent years as a result of high-energy trauma. Anterior hip dislocation forms less than 10-15% of all traumatic hip dislocations. Only a few case reports describe anterior dislocation along with acetabular fractures. The acetabular fracture involved the anterior wall or column in all such cases. We describe a rare case in which anterior superior dislocation of the hip was associated with a large fracture fragment of theposterior acetabular rim and adjacent wall.

Accidents, Traffic↗
PubMed1990

[Experimental study on the etiology of pathogenesis of acetabular dysplasia in congenital dislocation of the hip].

In order to investigate the etiology of pathogenesis of congenital hip dislocation and acetabular dysplasia, experiments using fetuses of pregnant rabbits were conducted. The following findings were obtained. (1) Dislocation occurred in approximately 40% of total animals used. The earliest dislocation was seen 2 days after birth. (2) The hip dislocation could be relatively and easily generated by exogenous factors during the perinatal period, even without such primary cause, as hip joint dysplasia. The acetabular dysplasia could be generated secondarily to dislocation. (3) There was a difference in the cause of acetabular dysplasia between areas of the acetabulum with and without load. (4) The acetabular depth growth in the dislocated hip was more seriously impaired than the longitudinal and transverse diameters of the acetabular entrance. These results have indicated that endochondral ossification of the epiphyseal cartilage of the acetabulum in the dislocated hip was more markedly impaired than that of Y epiphyseal cartilage.

Acetabulum↗
PubMed1979

Congenital dislocation of the hip.

From January 1970 to December 1976, seventeen patients with twenty-two congenital hip dislocations were treated by open reduction through a medial approach. The average follow-up was 42.2 months. The patients were evaluated for acetabular development, aseptic necrosis, and intraoperative findings. The incidence of aseptic necrosis was 10 per cent. The acetabular index improved rapidly during the first year after reduction. After the first year the rate of development was decreased, but the acetabular index continued to improve throughout the period of study. The medial approach provides a safe, effective way to reduce a dislocated hip in infancy. This procedure is advocated when closed reduction cannot be obtained by gentle manipulation or maintained by positioning once reduction is done.

Acetabulum↗