V T Worrall | PubMed Health

PubMed1977

Paralytic instability of the hip in myelomengoceles.

The results of a Colonna type arthroplasty with several modifications were evaluated in 29 hips of 22 myelomeningocele children with subluxations or dislocations. The operations were performed only in children with high neurosegmental levels where no muscle transfers were possible or when previous surgical procedures failed to maintain hip stability. Improvement in radiographic and clinical stability was demonstrated in 79 per cent of the hips. Eighty-three per cent of the hips lost motion in the flexion-extension arch with a mean loss of 30 degrees. The arthroplasty improved hip stability but at the expense of some loss of flexion-extension. Favorable results are more likely when the neurosegmental level is T-12 or above, the hip has had no previous operative procedure and the arthroplasty is accomplished without capsular interposition. Improvement of ambulatory status was impossible to evaluate because in any one case, the level of ambulation was determined by influences and physical factors other than the operation.

Adolescent↗

PubMed1976

Sickle-cell dactylitis.

In order to define better the presentation, roentgenographic features, and clinical course of sickle-cell dactylitis, the records of nine children with sickle-cell anemia and acutely painful, swollen digits were reviewed. The average age of these children at the time of diagnosis was eighteen months, and in five instances the dactylitis occurred before the diagnosis of sickle-cell disease was established. The clinical signs, consisting of swelling, tenderness, fever, and leukocytosis, were self-limiting and resolved in five to thirty-one days. The roentgenographic features, characterized by periosteal new-bone formation or intramedullary densities, appeared in seven to fourteen days and resolved in two to three months. Incorrect diagnosis is frequent in this condition but can be avoided as familiarity with the syndrome increases.

Adult↗