Biomedical subjects
Publications and source records attributed to D Uyttendaele.
After several round table discussions between the members of the Belgian Association of Pediatric Orthopedics (BAPO) a plan of treatment of congenital dislocation of the hip was adopted. The purpose of this publication, is to propose this plan as a basis for a general approach to the problem of congenital dislocation of the hip (CDH).
In our department, sixteen patients with CDH (17 hips) have been treated with open reduction and innominate osteotomy. The children were between 15 and 18 months old at the moment of surgery and the follow-up period ranged from two to eight years. Fourteen hips had an excellent or good radiological evaluation. About 50% showed signs of minor growth disturbances or partial avascular necrosis. Clinical evaluation showed 7 excellent, 3 good and one fair result. There is a short period of treatment with this procedure and technical difficulties or major complications did not occur. One additional surgical intervention had to be carried out (a varus derotation osteotomy) after a mean follow-up of five years.
Simultaneous Achilles and tibialis posterior lengthening was used to correct equinovarus foot deformity in 9 patients with cerebral palsy. In 7 cases, heel-to-ball gait became possible. There were no significant recurrences that required re-operation. Two overcorrections necessitated a subtalar arthrodesis.
En-bloc resection, extracorporeal irradiation and re-implantation of the irradiated bone have been used to treat 15 patients suffering from primary malignant tumours of bone or cartilage and two with benign lesions. This treatment is an alternative to replacement by prosthesis or allograft bridging techniques. After a mean follow-up of over five years results are encouraging, despite some complications and the relatively long period before weight-bearing is allowed.
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Two hundred seventy schoolchildren attending Belgian town schools were screened for trunk asymmetries. The present investigation confirms a wide prevalence of clinically evident asymmetries of the trunk. In the large majority of cases, the asymmetries were accompanied by a measurable rib hump and/or lumbar prominence, which have to be considered in scoliosis screenings. Age and sex do not have a clinically demonstrable influence on the degree and laterality of asymmetry in the school population examined. A height discrepancy of shoulders, scapulae, and iliac crests not exceeding 1 cm and a discrepancy in the depth of the waist triangles not exceeding 1.5 cm are so frequency that they must be considered as physiologic. The same applies to the rib hump (not exceeding 8 mm) and the lumbar prominence (not exceeding 5 mm). As in idiopathic scoliosis, the rib hump is predominantly situated on the right, especially in girls in the prepubertal period.
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