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D Lazović

Publications and source records attributed to D Lazović.

10 recordsLinked to original sources
PubMed2000

Ultrasound examination of neonatal hip: correlation of twin pregnancy and congenital dysplasia.

Twin pregnancy is considered to be a risk factor for congenital dysplasia of the hip. From 1987 until 1996, the hips of 4476 (2260 male, 2216 female) newborn babies were examined by ultrasound according to Graf's technique and classification in our hospital. In this study, we compare the results of twins and singletons for this risk factor. Of the newborns, 97 (2.2%) were twins (40 male, 57 female); 39 pairs of twins (10 male/male, 19 female/female, 10 male/female) and 19 individual twins (6 male, 13 female) were investigated. Hips of type Ia, Ib and IIa (alpha > or = 55 degrees) are not pathologic; hips of type IIa (alpha <55 degrees ) need an early control examination; and hips of type IIc, D, IIIa, IIIb and IV require therapy. Types Ia, Ib, and IIa (alpha > or =55 degrees ) were found in 4207 (94.0%) of all newborns, in 4112 (93.9%) of the singletons, and in 95 (97.9%) of the twins. Early control examination and/or therapy (indicated for types IIa (alpha <55 degrees ), IIc, D, IIIa, IIIb, and IV) were necessary in 269 (6.0%) of all cases, in 267 (6.1%) of singletons and two (2.1%) of twins. Twins with additional factors such as breech position birth, hip dysplasia in the family or premature birth did not show the types of hip IIa (alpha <55 degrees ), IIc, D, IIIa, IIIb, IV. We did find these hips in two (3.5%) of the female twins, but not at all in the male twins. Statistically, twins with or without other risk factors that are known before birth did not show significantly more of type hip IIa (alpha <55 degrees ), IIc, D, IIIa, IIIb, IV (P>0.05).

Breech Presentation↗
PubMed1998

[Ultrasound hip joint screening in newborn infants. Is twin pregnancy a risk factor for dysplasia?].

PURPOSE: This study aimed at investigating whether twin pregnancy is a risk factor for congenital dysplasia of the hip. METHOD: From 1987 until 1994 the hips of 3739 (1902 male, 1837 female) newborn were examined by ultrasound (screening) according to Graf's technique. We compared the results of twins and the other newborn (non-twins). The examinations were performed by 19 physicians. 73 (2%) of the newborn were twins (29 male, 44 female). RESULTS: In the group of 3666 non-twins we found the types of hip IIa (alpha < 55 degrees) to IV (Graf's classification) in 237 (6.5%) newborn: 136 (3.7%) right side/183 (5.0%) left side. Only 2 (2.7%) of the 73 twins showed these types of hip. We found 4% (149/3739) breech presentations at birth in the entire group. 3.9% (141/3666) in the group of non-twins and 11% (8/73) cases in the twin group. 5.2% (190/3666) of the non-twins and 2.7% (2/73) of the twins required a treatment with abduction orthosis or Pavlik harness. CONCLUSION: This report shows that the types of hip IIa (alpha < 55 degrees); IIc; D; IIa, IIb and IV according to Graf and a required treatment in twins was significantly not more frequent than in the other newborn (non-twins), although twins showed more often a breech presentation at birth. The different kind of breech position in twins (hips and knees in flexion, legs and feet parallel) and non-twins (hips in flexion, knees in extension) could be one reason for these results. Besides, non-twins assume their breech position earlier than twins with a consecutively longer period of time of mechanical stress on the hips.

Breech Presentation↗
PubMed1997

[Effect of surgical technique on meniscus transplants. A histological, animal experiment study].

After transplantation, a meniscus undergoes alterations in mechanical loading, which causes changes in its histological structure. We studied the degenerative effects on meniscus and tibial cartilage resulting from variations in the congruity or the isometric fixation of medial meniscus transplants. In three groups of five sheep each, the menisci were transplanted in three different ways, using the same operative approach. The menisci were evaluated 24 weeks after operation. In group 1, the meniscus was totally detached from its base at the capsule and refixed without changes in the congruity or isometry. This group provided the basic data. In group 2, the contralateral medial meniscus was turned upside down and transplanted. The reattachment was performed according to isometric conditions. With this technique the congruity of the tibial and femoral surface was modified. In group 3, the medial meniscus was reimplanted by choosing defined non-isometric fixation points for the anterior and posterior meniscal ligaments without changing the position of the corpus. For evaluation, the morphological alterations of meniscus and tibial cartilage were assessed by the Jackson score. The more distinct changes of the meniscus were assessed histologically by three criteria: surface cells, surface fibers and changes in the meniscus center. The highest degree of degenerative changes occurred in group 3 (score 4.5); however, considerable changes were also found in group 2 (score 3.5). Incongruous or non-isometric placement of a meniscal graft will lead to degeneration and failure of the graft.

Animals↗
PubMed1996

Ultrasound for diagnosis of apophyseal injuries.

Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable diagnostic tool for these cases. From June 1988 to June 1993, 243 young athletes were seen with an anamnestic and clinically suspected apophyseal injury of the lower extremity. In all cases X-ray examination and ultrasound examination were performed. In 80 cases the diagnosis was confirmed by X-ray examination and in 97 by ultrasonography. Four criteria were defined for the sonographic examination: (a) a hypoechogenic zone, (b) increased distance to the apophysis, (c) dislocation of the apophysis, and (d) mobility of the apophysis on dynamic examination. These criteria are correlated to (a) edema, (b) lysis, (c) avulsion, and (d) unstable avulsion of the apophysis. Ultrasonography is a proven technique for the detection of apophyseal injuries. In comparison to X-ray examination, it has the advantages of no radiation exposure, early detection even without ossification center, and dynamic examination.

Adolescent↗
PubMedDate not supplied

[Perthes disease--results of a containment-oriented therapy concept].

INTRODUCTION: In a retrospective study a treatment concept for Perthes' disease dependent on the containment was applied. PATIENTS/METHODS: 49 hips of 41 children (9 female, 32 male) were treated between 01. 01. 1990 and 31. 12. 1995. In our concept of treatment a varus femoral osteotomy was performed in 28 cases with not contained hips or less than 4/5 coverage of the femoral head (X-ray/MRI). The other 21 well contained hips with 4/5 coverage or more were treated conservatively with physiotherapy and in case of joint effusion and pain additionally with the use of crutches (partial weight bearing) and anti-inflammatory medication. The average age in the non-operative group at the time of first investigation was 4 years and 9 months (3 y./1 m. to 7 y./1 m.) and 6 years and 3 months (4 y/2 m. to 10 y/0 m.) at our last examination (mean follow up 17.7 months, range of 6 to 72 months). At the time of indication for a varus femoral osteotomy the patients had an average age 6 years and 1 month (3 y./6 m. to 10 y./2 m.), the mean age at the last postoperative examination was 7 years and 11 months (4 y./8 m. to 12 y./5 m.) with an average follow up of 21.5 months (6 to 77 months). RESULTS: For the conservatively treated children we achieved good results (still well contained hips with 4/5 coverage, no decrease of function, no increase of pain) in 85.7% (18 of 21 cases). In 85.7% (24 of 28 cases) we found good results (well contained hips, increase of coverage, no decrease of function, no increase of pain) in the operation group. CONCLUSIONS: The presented concept of therapy in Perthes' disease was practicable for all patients and included the possibility of decision for operative or non-operative treatment. In both groups we achieved good results in 85.7% of the cases.

Child↗
PubMedDate not supplied

[Ultrasound hip joint screening in newborn infants. Correlation of anamnestic risk factors and hip dysplasia].

BACKGROUND: Congenital dysplasia of the hip (CDH) is the most frequent inborn deformity of the locomotor apparatus. Hereditary, pelvic respectively breech presentation or abdominal delivery, premature as well as post-term birth and twin pregnancy are considered to be anamnestic risk factors for congenital dysplasia of the hip. The results of ultrasound hip screening from July 87 until December 94 are presented with special regard to the correlation of these risk factors and the occurrence of pathologic hips. PATIENTS: 19 different orthopaedic surgeons examined the hips of 3739 newborns (female: 1837-49.1%; male: 1902-50.9%) by ultrasound (screening). 96% of the examinations were performed within a period of 5 days after birth, in a few cases the babies were up to 19 days old. METHOD: The ultrasound examinations, the assessment of the echograms and classification into types of hip were performed according to Graf's technique. Two types of ultrasonographs were used: SL-1, Siemens--5 MHz scanner; LSC 7500, Picker--7.5 MHz scanner). All investigations were assessed retrospectively over the period of time with the help of documentation forms (data of newborn baby, case history, clinical and sonographical findings, kind of therapy and procedure) and statistically checked (program SPSS 7.5, Chi-Quadrate-Test, logistic regression). RESULTS: In 239 children (6.4%) we found hips required therapy respectively control investigations (type IIa, alpha < 55 degrees or worse; Graf's classification). For the entire group we achieved the following types of hips (right/left side): Ia--214 (5.7%)/224 (6.0%); Ib--2069 (55.3%)/2008 (53.7%); IIa (> or = 55 degrees)--1318 (35.3%)/1322 (35.4%); IIa (< 55 degrees)--65 (1.7%)/74 (2.0%); IIc--45 (1.2%)/71 (1.9%); D--18 (0.5%)/30 (0.8%); IIIa--8 (0.2%)/7 (0.2%); IIIb--1 (< 0.1%)/2 (0.1%); IV--1 (< 0.1%)/1 (< 0.1%). With regard to the risk factors the distribution was as follows: hereditary--302 babies (8.1%), pelvic respectively breech presentation--149 (4%), abdominal delivery--359 (6.5%), premature birth--188 (5.0%), post-term birth--164 (4.4%), twin pregnancy--73 (2%). CONCLUSIONS: In newborn babies with cases of hip dysplasia in their family (heredity) and pelvic respectively breech presentation at birth we found a significant higher rate (p < 0.05) of hips required therapy respectively control investigations (type IIa, alpha < 55 degrees or worse; Graf's classification). Also, for girls and the left hip a significant higher rate was achieved. A correlation of the other mentioned risk factors abdominal delivery, premature and post-term birth as well as twin pregnancy was not evident.

Equipment Design↗
PubMedDate not supplied

[Ultrasound neonatal screening: the effect of anamnestic risk factors on hip dysplasia].

INTRODUCTION: Hereditary, pelvic respectively breech presentation or abdominal delivery, premature as well as post-term birth and twin pregnancy are considered to be anamnestic risk factors for congenital dysplasia of the hip. The results of ultrasound hip screening of two University hospitals are presented with special regard to the correlation of these risk factors and the occurrence of pathologic hips. PATIENTS/METHODS: 24 different physicians of the orthopaedic departments examined the hips of 6617 newborns (female: 3253--49.2%; male: 3364--50.8%) by ultrasound (screening). 94.6% of the examinations were performed within a period of 5 days after birth. The ultrasound examinations, the assessment of the echograms and classification into types of hip were performed according to Graf's technique. All investigations were assessed retrospectively over the period of time with the help of documentation forms (data of newborn baby, case history, clinical and sonographical findings, kind of therapy and procedure) and statistically checked (Chi-Quadrate-test). RESULTS: In 436 children (6.6%) we found hips required therapy respectively control investigations (type IIa, a < 55 degrees or worse; Graf's classification). For the entire group we achieved the following types of hips (right/left side): Ia--724 (10.9%)/645 (9.8%); Ib--3931 (59.4%)/3892 (58.8%); IIa (> or = 55 degrees)--1733 (26.2%)/1768 (26.7%); IIa (< 55 degrees)--143 (2.2%)/181 (2.7%); IIc--55 (0.8%)/77 (1.2%); D--20 (0.3%)/39 (0.6%); IIIa--9 (0.1%)/11 (0.2%); IIIb--1 (< 0.1%)/3 (0.1%); IV--1 (< 0.1%)/1 (< 0.1%). CONCLUSIONS: In newborn babies with cases of hip dysplasia in their family (heredity) and pelvic respectively breech presentation at birth, as well as for girls and the left side we found a significant higher rate (p < 0.05) of hips required therapy respectively control investigations (type IIa, alpha < 55 degrees or worse; Graf's classification). A correlation of the other mentioned risk factors premature respectively post-term birth, twin pregnancy and cases of abdominal delivery without breech presentation was not evident.

Female↗
PubMedDate not supplied

[Meniscus replacement using incongruent transplants--an experimental study].

The effect of incongruous medial meniscal grafts on the articular surface was studied. We compared the cartilage degeneration in 4 Groups of 25 sheep knees. The histological changes were graded according to the score of Mankin, the morphological alterations by the score of Jackson. In Group 1 no surgery was performed. In group 2, the meniscus was totally detached from its base at the capsule and refixed without changes in the congruity or isometry. This group provided the basic data. In group 3, the contralateral medial meniscus was used as a transplant by reversing it. The reattachment was done according to isometric conditions. With this technique only the congruity of the tibial and femoral surface was modified. In group 4, the medial meniscus was completely removed. The results of group 1 (Mankin grade 0.58; Jackson grade 0.00) and group 2 (grade 0.50 and 0.47) showed no difference. The highest degree of degenerative changes occurred in the meniscectomized knees (group 4, grade 4.47 and 1.73), however considerable changes were also found in the knees with an incongruous meniscal graft (group 3, grade 3.37 and 1.27). The results suggest that incongruous grafts will lead to degeneration of the articular surface but still have a chondroprotective effect.

Animals↗