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Results for “HIP DISLOCATION”

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At least 19 recordsLinked to original sources
PubMed1987

The natural history of hip dislocations in ambulatory myelomeningoceles.

We studied 22 myelomeningocele patients with strong quadriceps and good ambulatory capability who had a dislocated hip. These patients did not have hip pain, had good to excellent hip motion and could sit with no difficulty. All but one was a good to excellent community ambulator with crutches and orthoses. Twenty-five percent had limb length inequality requiring shoe lifts but this combination did not impair functional capability. None owned wheelchairs. Seven had associated musculo-skeletal deformities which required treatment. We concluded that the hip dislocation in these patients was not significant. We evaluated a similar series of 11 patients who had open reduction of a dislocated hip an average of 18 months ago. Two patients were slightly improved and five patients were significantly worse after the open reductions. Serious complications related to the surgery ensued in half of the cases. The cost of the surgery and treatment of the complications in these 11 patients was $400,000. We concluded that surgical treatment of paralytic hip dislocations in ambulatory myelomeningocele patients offered no clear cut benefit.

Child↗
PubMed1988

[Osteotomy to lengthen the femur neck with distal adjustment of the trochanter major in coxa vara after hip dislocation].

Hip dysplasia and treated dislocations of the hip can lead to deformity of the proximal femur with shortening of the femoral neck and proximal displacement of the greater trochanter. Shortening the femoral neck causes a reduction in the leg length and insufficient performance of the abductors in the hip. Furthermore, the mechanical axis of the knee joint is lateralized. We used a technique involving lengthening the femoral neck and distal transfer of the greater trochanter to restore the normal anatomy and normal biomechanics of the hip joint. We used three osteotomies: one at the greater trochanter, one at the proximal, and the third an oblique osteotomy at the level of the distal femoral neck. In our group of 15 patients with 16 operated hip joints, the results were satisfactory in 14 of the 16 hips. This technique is recommended in young patients with little or no degenerative changes.

Adolescent↗
PubMed2002

Hip dislocation revealing hip tuberculosis. A case report.

Hip dislocation is an uncommon presentation of hip tuberculosis. We report a case in an 18-year-old woman with active hip tuberculosis. An attempt to reduce the dislocation 7 weeks into antituberculous therapy was followed by necrosis of the femoral head. Although severe forms of hip tuberculosis are common in endemic areas, dislocation is exceedingly rare. Capsule laxity and/or synovial hypertrophy probably contribute more to the occurrence of dislocation than does the accumulation of pus.

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↗
PubMedDate not supplied

Hip dislocation in spastic cerebral palsy: long-term consequences.

We evaluated 38 noninstitutionalized patients with spastic quadriplegic cerebral palsy with 51 dislocated hips. Nine hips had been reduced. The mean follow-up was 18 years, with an average age of 26 years. At follow-up, four were ambulatory with aids. Patients who could walk had normal intelligence and a level pelvis. In patients with 18 unreduced unilateral hip dislocations, pelvic obliquity and scoliosis were present in 12. In seven patients with reduced unilateral hip dislocations, similar findings were present in only two patients. Half of the dislocated hips were painful. Based on these findings, we recommend reduction of unilateral dislocations. Bilateral dislocations may benefit from reduction if treatment is undertaken before significant adaptive deformity of the femoral head occurs.

Adult↗
PubMedDate not supplied

Results of Pavlik harness treatment for neonatal hip dislocation as related to Graf's sonographic classification.

In this prospective study, 41 dislocated hips in 40 patients were classified according to Graf's sonographic classification. Of them, 29 hips were Graf type III and 12 hips Graf type IV. All were treated in a Pavlik harness to relocate the dislocated hip dynamically. In type III hips, this was successful in 97% and 50% in type IV hips. We conclude that Graf's classification in dislocated hips has prognostic significance in treatment with the Pavlik harness.

Female↗
PubMed1992

[Overhead extension in delayed diagnosis of congenital hip dislocations in children, following failure of treatment with the Pavlik harness].

Authors report, based on a retrospective examination of 103 dislocated hips of 85 children, on experiences with the overhead treatment of congenital hip dislocations, resistant to Pavlik harness or lately recognized. The results are compared with those of 23 hips of 20 children treated with Pavlik harness and plaster casts. Follow-up time was 3-15, in average 7 years. It is stated that the overhead extension treatment not followed by stiff fixation resulted in 92 per cent reduction in resistant and lately recognized hip dislocations. This procedure has caused in only 4 per cent severe necrosis of the femoral head with lasting consequences. Their experience with Pavlik harness combined with plaster cast are unfavourable as in 4 of 23 hips treated subtotal, in another 7 partial femoral head necrosis has developed.

Adolescent↗
PubMed2003

Sciatic nerve injuries associated with traumatic posterior hip dislocations.

This study was undertaken to test the hypothesis that patients transferred between hospitals with a dislocated hip have a greater incidence of sciatic nerve injury than patients who have their hip reduced at the first facility. One hundred six dislocated hips were included in this 12-year retrospective study. Sixty-nine hips were relocated at the first hospital and 36 patients were transferred with the hip still dislocated to LDS Hospital. There was a higher incidence of major sciatic nerve injury (complete sciatic or peroneal motor deficit) in patients transferred with the hip still dislocated (P =.0453). Time to relocation was significantly longer in patients with major motor nerve injury (P =.016). The presence of an associated fracture had no influence on sciatic nerve injury rates. The length of time a hip remains dislocated influences the incidence and severity of major sciatic nerve injury.

Adolescent↗
PubMedDate not supplied

Guided abduction traction in the treatment of congenital hip dislocation.

Guided abduction is a form of overhead traction conceptually similar to the Pavlik harness. It is used in older children or in children in which the Pavlik harness has failed. The results of 27 congenitally dislocated hips treated by guided abduction traction from December 1979 to June 1989 were reviewed. Ages ranged from 1 month to 28 months. Twenty (74%) of the 27 hips underwent a gentle, often spontaneous, closed reduction, followed by abduction casting and bracing. Two hips developed radiographic evidence of avascular necrosis; five hips developed temporary irregular ossification. Closed reduction was unobtainable in any child older than 24 months. Two children needed additional reconstructive procedures, one an innominate pelvic osteotomy and the other a valgus derotation osteotomy. Both had had open reductions. Recent reports stated that preliminary traction in the treatment of congenitally dislocated hips is of no value. We consider guided abduction traction a valuable treatment modality resulting in a reduced incidence of open reduction. When comparing our results with those of a Salt Lake City study performed without preliminary traction, our incidence of open reduction is lower (26 versus 49%). Our study supports the use of preliminary traction to decrease the need for open reduction in congenitally dislocated hips.

Braces↗
PubMed1990

[Total hip prosthesis in coxarthrosis following congenital hip dislocation (65 hips reviewed at 5 years)].

In 45 patients, 65 hips with CDH were given a THR after 5 years or more, with an average follow up of 8.5 years. The results and the technical problems are discussed. Of those 65 hips, there were 46 anterior dislocations, 15 intermediate dislocations and 4 cases of posterior dislocation. The mean shortening was 58.3 mm. In all cases, the authors performed a total arthroplasty on the original acetabulum, after lowering and reconstruction of the acetabulum by grafts taken from the femoral head. There are some immediate postoperative complications: 12 thromboembolic complications, hematomas and 2 cases of paralysis of the peroneal nerve. There was loosening in 8 patients (12%), with 3 infections. The functional results were good in 85% and poor in 7.5%. Nevertheless, the limp was maintained in 49 patients. There was residual low back pain in 7 patients. In 14% a second operation on the homolateral knee was performed after an average time of 2 years. The technical problems are discussed: the cup should be placed in the original acetabulum and in evaluating the lowering of the acetabulum, the condition of the lumbar spine should be considered. Posterior luxation is discussed as well; the authors recommend prudence in the indication for THR operations with lowering of the acetabulum shell.

Adult↗
PubMedDate not supplied

Hip dislocation and subluxation in cerebral palsy.

Four hundred sixty-four patients with cerebral palsy were reviewed. They were placed in four function groups: independent ambulators (n = 76), dependent ambulators (n = 43), independent sitters (n = 41), and dependent sitters (n = 304). The percentage of subluxated or dislocated hips increased from 7% for independent ambulators to 60% for dependent sitters. In the dependent sitters, a level pelvis or different degrees of pelvic obliquity did not correlate with whether the hip was located, subluxated, or dislocated. The subluxated or dislocated hip did not correlate with the high side or the amount of pelvic obliquity. Muscle imbalance around the hip and not the pelvic obliquity is the cause of the hip subluxation or dislocation.

Adolescent↗