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At least 235 records · Page 13Linked to original sources
PubMed1991

[Complete surgical correction of congenital hip dislocation (one-stage surgery)].

A 3-10 years follow-up and the evaluation of the 55 cases operated 1980 through 1988 on the Orthopaedic University Hospital in Pécs is presented. The age of the patients at operation was 4.5-10 years, in average 4 years. The operation consisted of four components: operative reduction, varus derotation femoral osteotomy, acetabular plasty and transposition of the iliopsoas muscle. In 53 cases excellent or good Roentgen anatomical and functional results were found. In one case after the operation complete femoral head necrosis has developed, in two cases a transient ischaemic state was observed that healed however without functional deficiency.

Arthroplasty↗
PubMed2006

[An unusual cause of hip pain: pelvic granulocytic sarcoma].

A 27-year-old male patient presented with right-sided hip pain. Magnetic resonance imaging of the hip joint revealed an extensive intrapelvic mass adjacent to the iliopsoas muscle. Laboratory tests showed severe leukocytosis and a differential WBC count enabled the diagnosis of chronic myeloid leukemia (CML). The pelvic mass was then assessed as granulocytic sarcoma developing from CML. It should be kept in mind that the initial presenting feature of hematological diseases such as CML may be hip pain arising from CML-associated granulocytic sarcoma.

Adult↗
PubMed1991

Anticoagulants, iliopsoas hematoma and femoral nerve compression.

A case of bilateral compression femoral neuropathy due to iliopsoas muscle hematomas during anticoagulant therapy is described. Diagnosis was confirmed with computed tomographic scan. The right hematoma was larger than the left and caused a more severe femoral neuropathy. The hematoma on the right side was surgically evacuated, and the left-sided one was treated conservatively. The patient had a complete recovery.

Anticoagulants↗
PubMedDate not supplied

Lumbosciatic pain and coagulopathies.

Three cases of nerve compression causing lumbosciatic pain and/or cruralgia due to hematoma secondary to coagulopathies of varying etiology are described. The cases involved a multiple nerve root syndrome of the cauda equina due to extradural hematoma in coagulopathy resulting from the administration of dicumarol drugs, a neuropathy of the crural nerve caused by hematoma of the iliopsoas muscle in hemophilia B, and a neuropathy of the sciatic nerve caused by hematoma in the gluteus and thigh in coagulopathy resulting from the administration of dicumarol drugs. In all three of the cases the clinical picture resembled that of lumbar disc herniation, but a careful evaluation of each patient's history, objective picture, and laboratory and radiological testing allowed us to make a correct diagnosis. Medical therapy is based on the correction of the coagulopathy by means of suitable drugs or hemoderivates. Surgical treatment is reserved for the most severe cases.

Acute Disease↗
PubMed1990

Surgical treatment of congenital dislocation of the hip.

The results of two collective studies on congenital dislocation of the hip (CDH) from a number of hospitals are reported here, including general trends in the Federal Republic of Germany and the author's personal methods and preferences. In the first collective study group, the rate of ischemic necrosis in open reductions was 8.2% for anterolateral approaches, 9.6% for inguinal, 16.7% for Ludloff's operation, and only 5.5% when shortening osteotomy was combined with open reduction. A simultaneous Salter osteotomy or acetabuloplasty increased the rate to 10.3% and a concomitant varus osteotomy to 22.2%. The author prefers an inguinal approach to the hip joint, first laterally and then medially of the iliopsoas muscle and femoral nerve, for optimal visualization of the acetabulum. Stability of the joint is increased by a girdle-like flap from the dorsolateral capsule, which is drawn anteriorly and prevents dorsal redislocation. Acetabuloplasty should also be used, even during the first year of life, in joints in which stability may only be guaranteed by extreme abduction and internal rotation. Salter's and Pemberton's osteotomies are used in Germany with good results. However, the author prefers a lateral Albee-Lance acetabuloplasty modified to a complete osteotomy for lateral levering of the acetabular roof. Long-term results show measurements between 82% and 93% of normal and slightly pathologic values. Simultaneous or single varus osteotomies lead to subcapital coxa valga and should no longer be used routinely. In adolescents and adults up to 45 years of age, as long as osteoarthritis is not too advanced and the femoral head is not too deformed, triple pelvic osteotomy with the author's type of modification has a number of advantages.

Adolescent↗
PubMed1990

[Open reduction with pelvic osteotomy and femoral shortening].

The combined procedure of femoral shortening, reduction of the hip, iliac osteotomy, transfer of the iliopsoas muscle, and redirection of the femoral head, applied in 225 hips of children over the age of 7, gave good results in two-thirds of the cases, and poor in one-tenth. The quality of the outcome diminished with increasing age at surgery.

Adolescent↗
PubMed1985

[Iliopsoas hemorrhage in hemophilic children].

Sixty-nine children with hemophilia were treated in our center between 1968 and 1983. About 1 per cent of hemorrhagic complications were bleedings localized in the iliopsoas muscle of 12 patients ranging in age from 9 to 15 years. The typical sign of the bleeding is a tight, palpable tumour above the inguinal fold. Today mass bleedings of the muscle with retroperitoneal localization are diagnosed safely by help of computer tomography or sonography. Psoas muscle bleedings in children are characterized by a high recurrence rate (41.5%) and often by an associated damage of the femoral nerve. Surgery was necessary only in 1 patient where a huge psoas hematoma with cystic transformations had to be removed. High substitution doses led to a complete recovery within 3 weeks in all other children.

Adolescent↗
PubMed1989

[Multifocal tuberculosis of bone. Apropos of an exceptional case].

Multifocal tuberculosis of bones (MTB) is exceptional in Europe. To the few cases found in the literature the authors add another case well documented by computerized tomography and nuclear magnetic resonance and remarkable for the number of bone lesions and their coexistence with extra-skeletal lesions. The patient was a 28-year old man native of the Ivory Coast in whom the imaging techniques demonstrated no less than 19 different bone lesions plus an abscess of the iliopsoas muscle and a prevertebral pus collection. The diagnosis of MTB was confirmed by the finding of alcohol- and acid-fast bacilli at needle aspiration of the bone lesions and by the presence of folliculo-caseous Ziehl-stained granuloma on bronchial biopsies. Fourteen months after treatment with specific 4-drug therapy, the outcome is favourable. This case is exceptional by the diffusion of bone lesions and by their association with bronchial lesions due to lymph node fistulization. Modern imaging techniques (CT, NMR), clearly demonstrated the bone lesions and their extent.

Adult↗
PubMed1989

[Percutaneous treatment of abscess of the kidney and retroperitoneum].

Twenty eight abscesses or infected liquid collections located in the kidney or in the retroperitoneum were drained percutaneously. The abscesses were located in the renal parenchyma in most cases (14 cases), in the anterior pararenal space in 3 cases and in the iliopsoas muscle in 9 cases. In all cases, the drain was inserted under TV monitoring after needle puncture, which was most often guided by ultrasound. The percutaneous treatment was successful in 82% of all cases. Among the 5 unsuccessful attempts, 1 case of duodenal fistula required surgical treatment while the anterior pararenal abscess was effectively evacuated by the inserted drain, and 1 case of infected hydatid cyst was treated surgically immediately after the percutaneous needle puncture. Drainage is the first-line method for the treatment of abscesse of the kidney and retroperitoneum. It requires an appropriate technique and strict follow-up, which allow healing the lesion in most cases.

Abscess↗
PubMed1989

Giant prosthetic reinforcement of the visceral sac.

One hundred and seventy-nine patients with 237 hernias of the groin who were at high risk for recurrence after classic hernioplasty were operated upon; the procedure of giant prosthetic reinforcement of the visceral sac (GPRVS) was used. The patients in this series had predominantly recurrent and re-recurrent hernias. However, a few were obese with bilateral primary direct hernias and some had associated connective tissue disorders, such as Marfan and Ehlers-Danlos syndromes. GPRVS eliminates hernias of the groin by rendering the peritoneum inextensible by placing, in the preperitoneal space, a large prosthesis that extends far beyond the borders of the myopectineal orifice. The myopectineal orifice is the weak spot at which all hernias of the groin begin and is bounded by the rectus, oblique abdominal and iliopsoas muscles and the pectin of the pubis. In bilateral GPRVS, the peritoneum of both groins is reinforced with a single prosthesis inserted in the preperitoneal space through the midline. In unilateral GPRVS, the mesh envelops the peritoneum of a single groin. This simplifies the operation and makes it suitable for surgical centers that perform outpatient operations. The prosthesis with the best physical characteristics for GPRVS is Mersilene (polyester fiber). Unsutured prostheses of polypropylene and Teflon (polytetrafluoroethylene) may not adhere at the far edges, leading to a failure and recurrence. The over-all recurrence rate in this series of problem hernias was 3.7 per cent, which is extremely good. However, the rate becomes outstanding if recurrences resulting from meshes unsuitable for GPRVS are excluded.

Hernia, Inguinal↗
PubMed1989

[An unusual expression of a complication following hysterectomy; the patient kneels in front of the doctor].

During operation of a woman aged 54 years for inguinal hernias, abdominal hysterectomy was carried out as well. A severe wound infection occurred. Subsequently, the patient was unable to sit down because she could not flex the left upper leg. Laparotomy revealed thrombosis and sclerosis of the left ovarian vein which impaired contraction of the iliopsoas muscle. Adverse effects of hysterectomy are briefly discussed.

Female↗
PubMed1986

[Synovial cysts of unusual localization. 2 cases and review of the literature].

Two patients with true synovial cysts in atypical sites (internal compartment of knee and inguinal hollow) were investigated by radioarthrography, ultrasound and computed tomography imaging. The cyst in the hip region originated from a dilated serous bursa of the iliopsoas muscle that did not communicate or was no longer in communication with the joint. In contrast, the cyst of the knee appeared to be a lateral synovial capsule hernia. Positive diagnosis in both cases was dependent on combined ultrasound-CT scan imaging, this eliminating a tumor (sarcoma) of soft tissues. However, affirmation of the synovial origin (mesothelial covering of the wall) of the lesion was obtained by histology only, this allowing differentiation from a "capsular" (fibrous wall) cyst, which probably provokes similar ultrasound and CT scan images.

Aged↗
PubMed1986

[Diagnosis of renal trauma].

We experienced 25 cases of renal trauma in our hospitals during the past 5 years, 20 cases were male and 5 cases were female, ranging in age 10 to 51 years old with average 26 years old, and the chief complaints were gross-hematuria and pain of renal region. We studied the IVP and CT patterns of these cases. IVP revealed 13 cases of renal contusion, 11 cases of renal lacerated wound and 1 case of renal fragmentation. The CT scan of 14 cases showed that it was useful for the diagnosis of the degree of renal trauma, especially, for hematoma surroundings the kidneys. The hematoma surrounding the kidneys was clearly noted in 7 cases by CT scan, but the unclearness of renal contours and iliopsoas muscle was considered to suggest the existence of hematoma surrounding the kidneys by IVP. All of the hematoma surrounding the kidneys was absorbed by conservative therapy, but 5 of the 7 cases were treated within 3 months.

Adolescent↗
PubMed1985

Tuberculosis of the spine. CT demonstration of paravertebral abscess.

Two surgically proven cases of tuberculous psoas abscess are presented. The common findings on CT were low-density paraspinal masses and extension of the lesions which followed the typical distribution of iliopsoas muscle in both cases. The skeletal findings from the spine are also discussed. Our cases indicate the complementary use of plain radiography and CT in the investigation of tuberculous spondylitis.

Abscess↗
PubMed1984

A pathological study in cynomolgus monkeys infected with Edesonfilaria malayensis.

The host response to natural infection with Edesonfilaria malayensis in six female adult cynomolgus monkeys (Macaca fascicularis) imported from Indonesia was examined retrospectively by histopathology and clinical investigations. Reduced values of hemoglobin and hematocrit, an increased number of eosinophils, an elevated level of total protein and a decrease in A/G ratio were noted in hematological and blood chemical examinations of the infected animals. The filarial worms inhabited subserosal connective tissues of the abdominal and the thoracic cavities but not the lumina of the body cavities. There was thickening of the connective tissues, hemorrhage and adhesion of the serosa in the site occupied by the worms and the cysts. Histopathologically, proliferation of the connective tissues and/or granulation tissues, infiltration of eosinophils, lymphocytes and other cells associated with inflammation and hemorrhage were observed. The worms occasionally caused mechanical damage in nearby tissues such as the pancreas and the iliopsoas muscle. In addition, splenic nodules were found in five of the six infected monkeys as a secondary lesion specifically related to the infection with Edesonfilaria malayensis.

Animals↗
PubMedDate not supplied

Femoral neuropathy secondary to anticoagulant therapy.

Two patients with femoral neuropathy resulting from compression by spontaneous hematoma of the iliopsoas muscle while on anticoagulant therapy, were definitively diagnosed preoperatively by CT scan. Early decompression of the femoral nerve, after correcting the coagulopathy, is recommended to assure optimal chances for relief of pain and recovery of neurological function.

Female↗