oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Differentiating subluxation from developmental dislocation of the hip  [cached]
Joao O. Tavares
Orthopedic Reviews , 2012, DOI: 10.4081/or.2012.e7
Abstract: The radiological and clinical picture of a developmental hip dislocation and a severe subluxation are identical. According to Leveuf and Wiberg the diagnosis can only be made by arthrography. The differential diagnosis is critical, as treatment differs dependent on the diagnosis. In this study, the diagnosis of subluxation was based on a plain radiograph of the pelvis. A radiograph of the pelvis with the hips abducted at least 45° and internally rotated (AIR view) was used to differentiate these two entities. In subluxations, the femoral head will relocate into the acetabulum with perfect or near perfect reconstitution of the Shenton’s line. It will fail to do so in true dislocations. Five patients, mean age 14.6 months (range 9 to 20 months), presented with delayed diagnosis of hip dysplasia. The examination revealed minimal or no limitation of hip abduction, a leg length discrepancy, and a Trendelenburg gait in the three walking age girls. The radiograph suggested a hip dislocation. The diagnosis of hip subluxation was based on the relocation of the femoral head with the abduction/internal rotation radiograph. All were successfully treated with an Ilfeld abduction splint. None had examination with general anesthesia, arthrograms, traction or immobilization in spica cast. Avoiding over diagnosis of hip dislocation in cases of subluxation is important. This is necessary to prevent overtreatment and to accurately assess the results of treatment. The abduction/internal rotation view may achieve this goal while avoiding diagnostic and therapeutic procedures, such as arthrograms, cast immobilization and surgery.
Developmental dislocation of the hip is still important problem: Therapeutic guidelines
Vuka?inovi? Z.,Vu?eti? ?.,?obelji? G.,Ba??arevi? Z.
Acta Chirurgica Iugoslavica , 2006, DOI: 10.2298/aci0604017v
Abstract: The authors are describing currently important problem - developmental dislocation of the hip. Guidelines for the treatment have been given according to literature date and upon their own experience. Therapeutic suggestions for the first twelve months of life are based on the ultrasound typing - it is advised to perform nonoperative treatment (abduction devices, "over head" traction, Pavlik harnesses). During the second year of life a pause in the treatment should be advised in order to avoid postreduction avascular hip necrosis as a very important complication. After that period surgical treatment has to be done (open reduction, pelvic and femoral osteotomies). Special suggestions have been given for the treatment of consecutive leg length inequality and the deformities caused by postreduction avascular hip necrosis.
Frequency of Developmental Dislocation of the Hip in Icteric Newborns Detected by Graf 's Ultrasonographic Method
Amin Foroughi,Reza Jalli,Mehrdad Mohammadhoseini
Iranian Journal of Radiology , 2009,
Abstract: "nIntroduction: A prospective detection of developmental dislocation of the hip (DDH) in icteric newborns and comparison with the frequency of DDH in other newborns. "nMaterials and Methods: During a one year period all icteric newborns who were referred to Nemazi hospital’s neonatal emergency room for bilirubin checking were screened by Graf"s ultrasonographic method for DDH.300 newborns (600 hips) were screened during this period. Any newborn with other problems such as congenital anomalies was excluded from this study. "nResults: Of the 600 hips a total of 20 newborns (3.3%) had a dysplastic hip (class IIa) that needed follow-up .A total of 11 from class IIa came back for a follow-up hip ultrasonography. All of them had become normal (class Ia) without treatment. Only 1 (16%) hip had sever dysplasia (class IIc) that needed treatment at the time of discovery "nConclusion: The rate of DDH seems to not increase in newborns how develop physiologic jaundice.
Role of the limbus in femoral-head deformation in developmental dislocation of the hip: findings of two-directional hip arthrography.
Hara S,Akazawa H,Mitani S,Oda K
Acta Medica Okayama , 2002,
Abstract: Two-directional arthrographic findings made during conservative treatment of developmental dislocation of the hip were compared with the femoral-head configurations and radiological results obtained from long-term follow-up examinations in this retrospective study. Sixty hips were followed until at least age 14. Arthrography was carried out according to Terazawa's method. The shape of the superior, anterior, and posterior limbus was evaluated based on a modified Fujii's classification. The femoral-head configuration was classified into 4 groups, and the radiological results were evaluated using Severin's classification at the final observation. There was a statistically significant relationship between the shape of the anterior limbus, the number of portions of deformed limbus (superior, anterior, posterior), and the femoral-head configuration. Also, a statistically significant relationship between the shape of the limbus and Severin's classification was observed. These results suggest that the deformed limbus seems to play an important role in triggering femoral-head deformities, possibly via mechanical compression, and negatively affects development of the hip joint.
Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric
Mendon?a, Tania Maria da Silva;Silva, Carlos Henrique Martins da;Canto, Roberto Sérgio de Tavares;Morales, Nívea de Macedo Oliveira;Pinto, Rogério de Melo Costa;Morales, Rogério de Rizo;
Clinics , 2008, DOI: 10.1590/S1807-59322008000500007
Abstract: objective: to evaluate the effect the type of hip fracture (femoral neck or trochanteric) has on the health-related quality of life of elderly subjects. methods: forty-five patients with hip fractures (mean 74.30 ± 7.12 years), 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item short form health survey (sf-36) at baseline and four months after fracture. the health-related quality of life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. results: compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. the sf-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. conclusions: the mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. the negative impact on the health-related quality of life did not differ significantly according to fracture type.
Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy
Carvalho Filho, Guaracy;Chueire, Alceu Gomes;Ignácio, Helencar;Carneiro, Márcio de Oliveira;Francese Neto, Jo?o;Canesin, Augusto César;
Acta Ortopédica Brasileira , 2003, DOI: 10.1590/S1413-78522003000100006
Abstract: the congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (salter). in this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by salter's technique after open reduction. the age of the patients at the time of surgery ranged from 12 to 30 months (age after march), mean age of 19 months. fifteen were female and 3 were male, 4 patients had bilateral dislocation and in the remaining, 8 had their left hip dislocated and 6 had their right hip dislocated. the results were evaluated according to dutoit et al.(3) clinical criteria and to severin(12) radiological criteria, after a mean follow-up of 48 months. eighteen percent of excellent clinical results (4); 54% of good results (12); 14% of regular results (3) and 14% of bad results(3) were obtained. as to the radiologic criteria, 36% of the hips were classified as excellent (8); 45% as good (10); 5% regular (1) and 14% bad (3). there were 3 cases of re-dislocation which were treated by a different surgical technique. no cases of infection, graft fracture and vascular or nervous injury were reported.
Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy
Carvalho Filho Guaracy,Chueire Alceu Gomes,Ignácio Helencar,Carneiro Márcio de Oliveira
Acta Ortopédica Brasileira , 2003,
Abstract: The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter). In this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months (age after march), mean age of 19 months. Fifteen were female and 3 were male, 4 patients had bilateral dislocation and in the remaining, 8 had their left hip dislocated and 6 had their right hip dislocated. The results were evaluated according to Dutoit et al.(3) clinical criteria and to Severin(12) radiological criteria, after a mean follow-up of 48 months. Eighteen percent of excellent clinical results (4); 54% of good results (12); 14% of regular results (3) and 14% of bad results(3) were obtained. As to the radiologic criteria, 36% of the hips were classified as excellent (8); 45% as good (10); 5% regular (1) and 14% bad (3). There were 3 cases of re-dislocation which were treated by a different surgical technique. No cases of infection, graft fracture and vascular or nervous injury were reported.
Radiographic Prediction of the Results of Long-term Treatment with the Pavlik Harness for Developmental Dislocation of the Hip  [PDF]
Ohmori,Takao,Endo,Hirosuke,Mitani,Shigeru,Minagawa,Hiroshi
Acta Medica Okayama , 2009,
Abstract: In 1957, Pavlik introduced the Pavlik harness as a useful treatment for developmental dislocation of the hip (DDH), and subsequent studies have documented favorable outcomes among patients treated with this device. However, there are only a few articles reporting how early radiographic measurements can be used to determine the prognosis after treatment with the Pavlik harness. In this study, 217 hips from 192 patients whose DDH treatment with the Pavlik harness was initiated before they were 6 months old and whose follow-up lasted at least 14 years (rate, 63.8%) were analyzed using measurements from radiographs taken immediately before and after harness treatment, and at 1, 2, and 3 years of age. Severin's classification at the final follow-up was I or II in 71.9% and III or IV in 28.1% of the hips, respectively. Avascular necrosis of the femoral head (AVN) was seen in 10% of the hips. Stepwise multiple regression analysis was performed to retrospectively determine whether any radiographic factors were related to the final classification as Severin I/II or III/IV. Receiver opera-ting characteristic (ROC) curves were drawn for these factors, and a Wiberg OE angle (Point O was the middle point of the proximal metaphyseal border of the femur) of 2 degrees on the 3-year radiographs was found to be the most useful screening value for judging the acetabular development of DDH cases after treatment with a Pavlik harness, with a sensitivity of 71% a specificity of 93%, and a likelihood ratio of 10.1.
Arthroscopic removal of intraarticular fragments following fracture dislocation of the hip  [cached]
Bagaria Vaibhav,Sapre Vikram
Indian Journal of Orthopaedics , 2008,
Abstract: We report here a case of posterior dislocation of hip with fracture of posterior lip of acetabulum, with retained fracture fragments after a successful closed reduction. The fractured fragments were removed by arthroscopy of the hip. The technique of hip arthroscopy used in removing the fragments is discussed.
人工全髋关节置换术治疗CroweⅣ型先天性髋关节发育不良截骨术的研究进展
RESEARCH PROGRESS OF OSTEOTOMY IN TOTAL HIP ARTHROPLASTY TO TREAT CROWE TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP
 [PDF]

陈涛,杨春喜
- , 2015, DOI: 10.7507/1002-1892.20150096
Abstract: 目的总结Crowe Ⅳ型先天性髋关节发育不良(developmental dysplasia of the hip,DDH)行人工全髋关节置换术(total hip arthroplasty,THA)截骨方法以及相关并发症,旨在为临床选择术式提供参考。 方法广泛查阅国内外有关THA治疗DDH的研究报道,并进行总结分析。 结果THA治疗DDH常用截骨术包括转子间截骨、粗隆下截骨、小转子水平截骨与远端截骨。其中粗隆下截骨与转子间截骨能有效调整患肢长度,纠正前倾角,避免神经损伤,但转子间截骨易发生骨折和损伤外展肌。小转子水平截骨术后效果较差,临床应用较少;远端截骨主要用于伴膝关节畸形的患者。 结论对于股骨严重脱位伴周围软组织严重痉挛的CroweⅣ型DDH患者,建议选择粗隆下截骨,但在切口形状与截骨长度方面尚无确切标准,有待进一步研究明确。
ObjectiveTo summarize the methods and complications of osteotomy in total hip arthroplasty (THA) to treat Crowe type ⅠV developmental dysplasia of the hip (DDH) so as to provide the reference for selection of surgical procedures. MethodsThe literature concerning THA for DDH was reviewed, and the effectiveness and complications were summarized in different methods. ResultsAt present, four osteotomies are commonly used in DDH, including transtrochanteric osteotomy, subtrochanteric osteotomy, lesser trochanteric osteotomy, and distal femoral osteotomy. Transtrochanteric osteotomy and subtrochanteric osteotomy can effectively adjust leg length, correct femoral anteversion and avoid nerve injury, but transtrochanteric osteotomy may cause bone fracture and abductor injury. Lesser trochanteric osteotomy is scarcely used because of its poor effectiveness. Distal femoral osteotomy is usually used in patients with knee deformity. ConclusionFor patients with Crowe type ⅠV DDH complicated by severe femoral dislocation and soft tissue spasm, subtrochanteric osteotomy should be selected, whereas it needs an associated standard focusing on how to select the osteotomy shape and length in subtrochanteric ostetomy, which needs an advanced research.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.