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Biomedical subjects

D Hendel

Publications and source records attributed to D Hendel.

63 records · Page 4Linked to original sources
PubMed1980

Arthrography as an aid to diagnosis, prognosis and therapy in Legg-Calvé-Perthes' disease.

Measurements of head diameter and acetabulum-head quotient (AHQ) were made on the plain radiographs and corresponding arthrograms of 37 consecutive patients with unilateral Legg-Calvé-Perthes' Disease (L.C.P.D.). Although on plain radiographs the affected osseous femoral capital epiphysis was slightly larger (22) the same size (9) or smaller (6) than that on the normal side, on arthrography the osteochondral head was much larger in 34 and the same size in 3 instances. In 35 cases the arthrograms revealed flattening of the osteochondral head. The AHQ computed from the arthrograms was almost invariably less than that computed from the plain radiographs. Thus the AHQ computed on arthrograms more realistically assessed the almost invariably poor head coverage in L.C.P.D. This, together with signs of flattening, diagnoses the severity of the disease process and helps to differentiate the "head at risk" which requires treatment. During arthrography the degree of abduction-medial rotation of the leg necessary for containment of the flattened protruding head within the acetabulum can be determined, allowing accurate therapy to be planned, be it operative or orthotic.

Acetabulum↗
PubMed1978

Arthrographic findings in Legg-Calvé-Perthes disease and transient synovitis of the hip.

Bilateral arthrography of the hip was performed in thirty-seven patients with unilateral Legg-Calvé-Perthes disease. Measurements made on the plain roentgenograms and on the arthrograms of the diameter of the femoral head, the width of the medial joint space, and the thickness of the acetabular cartilage were compared. The acetabulum-head quotients also were calculated. When present, evidence of flattening of the femoral head cartilage and of pooling of the contrast material also was noted. These data showed that in the early stages of Legg-Calvé-Perthes disease the articular cartilage is thickened, and that the cartilaginous femoral head is deformed and protrudes from the acetabulum. Arthrograms made with the hip in different positions also indicated the extent and location of collapse of the (osteochondroal) femoral head and therefore proved useful as a means to determine the best therapeutic position of the hip to provide coverage of the head. In three patients with severe transient synovitis, thickening of the articular cartilage resembling that seen in Legg-Calvé-Perthes disease was demonstrated.

Cartilage, Articular↗
PubMedDate not supplied

Recurrent Legg - Calve - Perthes' disease. A case report.

This is a report of the fifth known case of recurrent Legg--Calve--Perthes' disease. Roentgenograms of the hips after the first avascular episode, at the age of 3 years and 6 months resemble to a certain extent, Dysplasia Epiphysealis Capitis Femoris.

Child↗
PubMedDate not supplied

Indications for femoral osteotomy in Legg-Calvé-Perthes disease.

A group of children with Legg-Calvé-Perthes disease (LCPD) who underwent femoral osteotomy were analyzed to define further those most likely to respond favorably to this procedure. Treatment was directed to removal of the protruded, flattened, and damaged osteochondral head segment--as delineated by arthrography--from the damaging influence of the lateral acetabular lip and to expose the head to the molding influence of the acetabulum during weight-bearing and motion. This containment of the head was achieved by employing femoral varus-derotation (and sometimes extension) osteotomy. "Reversed" and "open" wedge techniques were also used to minimize limb shortening. Overall results were 83% satisfactory and 17% unsatisfactory according to Mose's criteria. Operation is recommended in the early clinical and radiologic stage of the disease, when favorable biologic and biomechanical effects may be anticipated. In the late stages of LCPD, osteotomy may be used as a salvage procedure in painful and deformed hips, while still maintaining a passive range of motion. An expectant approach can be adopted in children less than 4 years of age, but undue delay in operation, if femoral head protrusion is demonstrated by arthrography, may compromise the final results.

Child↗