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W Szulc

Publications and source records attributed to W Szulc.

At least 19 recordsLinked to original sources

The frequency of occurrence of congenital dysplasia of the hip in Poland.

In Poland, the number of newborn infants suffering from congenital dysplasia of the hip (CDH) is high. Its percentage has not changed during the past 30 years. The aim of this paper was (1) to find the frequency of occurrence of CDH based on the highest possible number of cases and to obtain the most objective data from examination performed by orthopedic surgeons; (2) to gather information about methods of treatment used; (3) to establish time of treatment (depending on how advanced the dysplastic process was); and (4) to determine the number of complications. The data are based on 17,094,000 inhabitants, or 46.2% of the Polish population. During the years 1980 to 1984, about 350,000 deliveries were annually registered. On the basis of the data, the following were concluded: (1) The frequency of CDH among children in Poland comes to 6.8%. (2) Cases of dysplasia with dislocation are 1.06%. (3) Almost half the number of children (46.2%) are being treated in outpatient departments run by orthopedic surgeons. The remainder are being cared by pediatric and general surgeons, or pediatricians. (4) Necrosis of the femoral head occurred in 10.4% of patients. (5) The most satisfactory therapeutic results (almost 100% cured) are obtained when treatment begins during the first week of the child's life.

Femur Head Necrosis

Coxa vara infantum, hip growth disturbances, etiopathogenesis, and long-term results of treatment.

The literature concerning coxa vara infantum (CVI) contains only a few long-term follow-up reports of the treatment. This study was performed to define the clinical and roentgenographic features of coxa vara infantum (CVI) in children and skeletally mature patients. Special attention was given in follow-up evaluations to the growth and impairment of the hip joint (acetabulum, femoral head, and neck) before and after operative treatment in different age groups. Because in difficult cases the results of subtrochanteric osteotomy have not been satisfactory and have led to recurrences, the use of overcorrecting of the neck-shaft angle value into valgus position has been adopted. To gain further insight into etiopathogenesis of CVI, histologic investigations were carried out. These investigations revealed growth and endochondral ossification disorders. Similar changes found in the growth zone of the iliac bone seem to indicate that the ossification disturbances are multifocal. Expansion of the fibrous connective and calluslike tissues is evidence of the overload syndrome in CVI.

Adolescent

Long-term results after Colonna's operation.

A long-term review of 82 patients (117 hips) who had Colonna's operation for congenital dislocation of the hip has been carried out. Although early assessments had shown a high proportion of good results these deteriorated with time. At our latest review of 61 hips, with an average follow-up of 30 years, 34% had moderate, and 66% severe, osteoarthrosis; many of these patients now need a total hip replacement. We conclude that Colonna's operation is only indicated in a small number of cases. It should never be carried out over the age of 6 years, and only in younger children when there is severe underdevelopment of the acetabulum or where procedures which preserve the articular cartilage are unlikely to be successful.

Child, Preschool