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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↗
PubMed2000

Clinical practice guideline: early detection of developmental dysplasia of the hip. Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip. American Academy of Pediatrics.

Developmental dysplasia of the hip is the preferred term to describe the condition in which the femoral head has an abnormal relationship to the acetabulum. Developmental dysplasia of the hip includes frank dislocation (luxation), partial dislocation (subluxation), instability wherein the femoral head comes in and out of the socket, and an array of radiographic abnormalities that reflect inadequate formation of the acetabulum. Because many of these findings may not be present at birth, the term developmental more accurately reflects the biologic features than does the term congenital. The disorder is uncommon. The earlier a dislocated hip is detected, the simpler and more effective is the treatment. Despite newborn screening programs, dislocated hips continue to be diagnosed later in infancy and childhood,(1-11) in some instances delaying appropriate therapy and leading to a substantial number of malpractice claims. The objective of this guideline is to reduce the number of dislocated hips detected later in infancy and childhood. The target audience is the primary care provider. The target patient is the healthy newborn up to 18 months of age, excluding those with neuromuscular disorders, myelodysplasia, or arthrogryposis.

Algorithms↗
PubMed2006

[The significance of ultrasonic investigation of the hip joint with dysplasia and congenital hip joint dislocation].

The paper presents results of ultrasonography of the hip joint of 56 newborns with pathology of the hip joint detected by a clinical and ultrasonic screening, and 56 children aged from 1 through 6 months with dysplasia of the hip joint and a congenital hip dislocation. The ultrasonic examination gives an exact evaluation of the development of the joint. Measures of treatment were chosen with special reference to the patient's age and severity of the pathology. The terms of treatment depended on the age of the child and severity of the disease.

Female↗
PubMed2006

Late presenting dislocation of sonographically stable hips.

We report on seven developmental hip dislocations in five babies (age 6-22 months) in whom ultrasound had demonstrated reduced and stable hips. Four hips in three babies had been diagnosed as having clinical instability (Barlow positive) at birth, which had stabilized by the time of the scan (16-45 days). Femoral head coverage ranged from 36 to 56%. One hip had minimal sonographic laxity on stress examination. Hips that are reduced and stable sonographically at 2-6 weeks of age can subsequently dislocate. Any child with instability at birth should be reviewed with a pelvic radiograph at 4-6 months, even if an ultrasound scan appears to be normal.

Female↗
PubMed1976

Congenital dislocation of the hip.

Congenital dislocation or subluxation of the hip (congenital acetabular dysplasia) is a complete or partial displacement of the femoral head out of the acetabulum. The physical signs essential for diagnosis are age related. In newborns the tests for instability are the most sensitive. After the neonatal period, and until the age of walking, tightness of the adductor muscles is the most reliable sign. Early diagnosis is vital for successful treatment of this partially genetically determined condition. Various therapeutic measures, ranging from abduction splinting to open reduction and osteotomy, may be required. Following diagnosis in the first month of life, the average treatment time in one recent series was only 2.3 months from initiation of therapy to attainment of a normal hip. When the diagnosis was not made until 3 to 6 months of age, ten months of treatment was required to achieve the same outcome. When the diagnosis is not made, or the treatment is not begun until after the age of 6, a normal hip will probably not develop in any patient.

Age Factors↗
PubMed2001

Experimental and computational simulation of total hip arthroplasty dislocation.

Other than fatal pulmonary embolism and deep infection, dislocation following total hip replacement remains probably the most vexing complication to patient and surgeon. Subluxation and dislocation are complex, poorly understood phenomena. Many important questions in this area unfortunately do not lend themselves well to clinical or registry study. Appropriate realistic laboratory models have been lacking. This article synthesizes new work undertaken independently by two groups of biomechanical investigators using very different, but complimentary, methodologies to study the mechanisms of dislocation, and especially the influence of specific design and surgical variables.

Arthroplasty, Replacement, Hip↗