PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “HIP CONTRACTURE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed1989

Iliopsoas myofascial dysfunction: a treatable cause of "failed" low back syndrome.

Most patients with low back pain experience loss of spinal and hip extension range of motion. The limitation appears to involve significant iliopsoas myofascial dysfunction manifested in tenderness, as shown by deep abdominal palpation of the psoas muscle, hip flexor contracture, pain elicited by the stretch maneuver of the spine and hip, and relative weakness of the psoas muscle when tested manually. These signs assisted in identifying the source of low back pain in six patients who had failed to respond to prior treatment. Therapy consisted of iliopsoas trigger point treatment using a dry needling technique, followed by self-administered postisometric relaxation exercise of the iliopsoas. In all cases, marked improvement of hip and spine extension, dramatic reduction of pain, and return to normal activity resulted. Given the low risk-to-benefit ratio, trigger point treatment is indicated in "failed back syndrome" and chronic low back pain after conservative therapy or surgery have been tried without success.

Abdominal Muscles↗
PubMedDate not supplied

Anterior hip dislocation in children with cerebral palsy.

This is a report of 27 hips with anterior dislocation in 17 children with cerebral palsy. Type 1 consists of patients with extension-external rotation and adduction contracture of the hip and extension contracture of the knee; type 2 consists of patients with extension-external rotation and abduction contracture of the hip and flexion contracture of the knee; and type 3 consists of patients without contractures. All children with types 1 and 2 were unable to sit and were forced into an almost full-time lying position. No child with type 3 pattern had sitting troubles. Hip pain was present in 50% of patients. All children with type 1 pattern and half of children with types 2 and 3 developed a thoracolumbar kyphosis. Standard radiographic hip measurements were inconsistent, and only three-dimensional computed tomography scans were useful in fully assessing the deformity. Indications for hip surgery were inability to sit or hip pain or both. Reconstruction was performed by anterior superior acetabular reconstruction and varus-shortening femoral osteotomy or proximal femur resection as a salvage procedure. Although three of the 13 children required two procedures, 11 of 13 children who underwent 16 hip procedures had stable and painless hips at the time of follow-up.

Adolescent↗
PubMed2004

Neuro-orthopedic management of the dysfunctional extremity in upper motor neuron syndromes.

Orthopedic surgery can help restore extremity function to many patients with upper motor neuron syndromes (UMN). Impairments are divided into those that cause problems with the active function of the extremity versus those that impede passive function. Limb deformities commonly result from both dynamic (spastic) and static (contractural) components. Clinical examination supplemented with dynamic electromyographic studies provides the optimal information for planning the most effective surgical procedures. In the upper extremity, selective lengthening of the shoulder adductors and extensors combined with elbow flexor lengthening can improve forward reach. Lengthening of the forearm pronators and finger flexors will improve hand use. In the lower extremity, standing balance is improved with widening the base of support by correcting hip adduction contractures and equinovarus foot deformities. Improvement of knee flexion during swing phase by a rectus femoris to gracilis transfer will enhance the fluidity and efficiency of walking. Correction of hip and knee flexion contractures will allow a upright posture and dramatically decrease the energy requirement of walking.

Journal Article↗
PubMed1982

Distal hamstring tendon release in knee flexion deformity.

Hamstring tendon release was performed in thirty-one children for correction of true knee flexion deformity due to neurological disease. The long-term results in the thirty cases (55 knees) available for review were encouraging. Functional walking capacity and independence improved in nearly all cases. No complication occurred and there was no recurrence of the deformity despite an average follow-up period of five years. The results suggest that distal hamstring tendon release can be recommended in the management of true knee flexion deformity in selected cases of cerebral palsy and meningomyelocele.

Adolescent↗
PubMedDate not supplied

Ambulation in patients with myelomeningocele: a 12-year follow-up.

Factors determining change in ambulatory status were studied over a 12-year observation time in 60 ambulating patients with myelomeningocele. There were 26 female and 34 male subjects with a median age of 22 years (range, 12-54). We used the method of Lindseth to define the neurologic level of the lesion and classified walking ability according to the criteria of Hoffer. The prevalence of spasticity and spine and lower-limb deformities was assessed. Orthopedic and neurosurgical interventions and other medical events were registered, as well as occurrence of pressure sores, musculoskeletal pain, and use of orthoses. There were 19 patients with downward transitions in ambulatory level during the follow-up time. Factors explaining deterioration in these 19 patients included deterioration of the neurologic level of lesion, spasticity, knee and hip flexion contractures, low-back pain, lack of motivation, as well as those of major medical events like stroke, recurrent septicemia, lower limb edema, and invasive surgical interventions.

Adolescent↗
PubMedDate not supplied

Medial spinal aplasia--a rare manifestation of congenital paraplegia: report of six cases and review of the literature.

Medial aplasia of the spine is a rarely recognized malformation characterized by isolated absence of spinal segments, with vertebrae present cranially and caudally. We analyzed six patients and the five cases described in the relevant literature. The extent of defect ranges from one to 11 segments and leads to spinal instability with resulting kyphosis. All patients have a thoracic or high lumbar level of paralysis and, in varying degrees, typical contractures of hips, knees, and feet. The differentiation between medial aplasia of the spine and the syndrome of caudal regression is discussed.

Abnormalities, Multiple↗
PubMed1989

Cerebrovascular accidents.

CVA comprises a large number of clinical entities, depending on the site of infarction in the brain. Accurate evaluation of deficits in the patient's sensory and/or motor systems and the patient's intellectual status are paramount in establishing realistic rehabilitation goals. With respect to the motor system, two types of voluntary movement may occur. These include synergistic or pattern movement and selective movement. Spasticity in the affected lower extremity may result in a variety of lower-extremity deformities and contractures. Those most commonly encountered include hip flexion and adduction contracture, inadequate knee flexion and knee flexion contracture, and ankle equinus, varus, and equinovarus. Correct evaluation of deformities may be aided by the use of poly-EMG analysis and evaluation after nerve block or motor point blocks. In hemiplegic gait dysfunction, the basic requirements for functional ambulation include (1) ability to maintain standing balance; (2) voluntary hip flexion; (3) leg stability; and (4) ability to follow instructions and adequate motivation. Often a hemiplegic patient can be trained to ambulate if an adequate extensor synergy pattern develops, since mass extension can provide stability of the leg for weight bearing. Medical rehabilitative management of the CVA patient includes early mobilization, restorative exercises (including neuromuscular facilitation techniques), measures to prevent or correct contractures, the use of AFOs, and occasionally functional electrical stimulation. Orthopedic management of deformities in CVA is indicated where conservative measures fail. Surgical procedures seek to alter the forces causing shortening of the muscles and tendons. Hence, the most commonly performed surgical procedures include (1) tendon lengthening or release; (2) soft-tissue release; and (3) tendon transfer. Surgery for hip contractures is not common; however, occasional release of hip flexors is indicated when hip flexion contracture impedes ambulation or prone lying. Inadequate knee flexion, caused by dysphasic quadriceps contraction, can be corrected by release of the vastus medialis and rectus femoris muscles. Distal hamstring tendon release with or without knee joint capsule release is the surgical procedure of choice for severe knee flexion contractures. Surgical correction of an equinus deformity is by TAL, with or without neurectomy of tibial nerve branches to the gastrocsoleus muscles. Severe ankle varus may require a SPLATT procedure. Surgery for equinovarus includes the combined surgery for both equinus and varus (that is, TAL and SPLATT procedures). Toe curling is corrected by toe flexor releases.(ABSTRACT TRUNCATED AT 400 WORDS)

Cerebrovascular Disorders↗
PubMed1975

[Deterioration of the ileo-sacral joints through serious unilateral hip joint diseases (author's transl)].

Based on the clinical and radiological examinations of 95 patients with unilateral restricted movement of the hip, the deformities of ileosacral joint and symphysis are described. The pathological changes of ileosacral joints and symphysis could be demonstrated in cases with severe contractures of the hip. Low grade contractures under 15 degrees have been tolerated over many years.

Adult↗
PubMedDate not supplied

Total hip and total knee arthroplasty in juvenile rheumatoid arthritis.

Total hip arthroplasty (THA) or total knee arthroplasty (TKA) is indicated for patients with juvenile rheumatoid arthritis (JRA) when marked joint destruction is present and pain or deformity compromises function despite optimal medical therapy. Relief of pain, reduction of the deformity, and dramatic improvement in functional status and quality of life can be achieved in most patients. Functional impairment and deformity rather than pain are usually the primary indications for THA or TKA. When there is both hip and knee involvement, hip arthroplasty should probably be done first. Regional anesthetic appears to be the anesthetic of choice. Careful preoperative planning and the availability of custom and minisized components are essential. Small bone size, osteoporosis, and severe soft tissue disease make the surgery technically demanding. Skeletal immaturity may not contraindicate surgery if the patient is otherwise bedridden with progressive deformity. In the hip trochanteric osteotomy is often necessary for adequate exposure, with the possible exception being a patient with juvenile ankylosing spondylitis who is subject to heterotopic bone formation. Although complete capsulectomy and psoas tenotomy may be necessary to relieve a hip flexion contracture, a soft tissue release that produces leg lengthening may lead to nerve palsy. In the hip component loosening has been less common in patients with JRA than in other young patients who have undergone THA, but it is still the most frequent cause of failure. In the knee preoperative and postoperative serial casts can aid in the correction of severe flexion contracture. Secondary patellar pain has been the most common cause of late failure. Patellar resurfacing should probably be performed at the time of the original knee arthroplasty in all patients with JRA.

Adolescent↗
PubMed1989

[A study on the prevalence and risk factors of muscular fibrotic contracture in Jia-Dong Township, Pingtung County, Taiwan].

In order to examine the prevalence and risk factors of muscular fibrotic contracture (MFC) among school children in Jia-Dong Township, Pingtung County, a prevalence survey combined case-control study was carried out from January to April, 1988. All the school children aged from 6 to 19 years old were first screened at schools and then referred to the Provincial Pingtung Hospital for confirmatory diagnosis based on the non-invasion criteria. A total of 83 MFC cases were identified including 79 gluteal fibrotic contracture (GFC) patients, 3 deltoid fibrotic contracture (DFC) patients, and 1 affected both GFC and DFC. The prevalence was significantly higher in males (17.3 per 1,000) than in females (10.5 per 1,000). The prevalence was found to increase with age after 6 years of age, peaked at the age group of 13-15 years, and decline thereafter. Most MFC cases clustered in both Wen-Fon and Yuan-Wen villages locate in the southern coast of Taiwan Island. Among 83 MFC patients, 65 were further interviewed to obtain information on the risk factors of MFC. A total of 65 healthy classmates one-to-one matched with MFC cases on aged, sex, and living villages were selected as the control group which was also interviewed. The case-control study showed a positive association between the frequency of injection and the MFC in a dose-response relationship. The injection site also correlated with the development of the GFC and DFC. It was reasoned that the injection might be the most important risk factor of MFC. Follow-up study of 65 operated MFC cases indicated a high percentage (89.2%) of hyperscar formation in the incision region.

Adolescent↗