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At least 271 records · Page 15Linked to original sources
PubMed1981

Scoliosis in children with juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis (JRA) is an unusual causative factor of scoliosis in childhood. Among 320 patients with JRA in Sweden, 17 (5.3%) had structural scoliosis of thoracic and lumbar spine. This frequency is considerably higher than in the normal population. The mean age when scoliosis was first noted was 12.4 years, corresponding to a mean duration of the JRA of 7.4 years. A curvature exceeding 20 degrees was found in 12 out of the 17 patients. The scoliosis in our patients was associated with severe and protracted polyarthritis of early onset and involvement of hip joints and cervical spine. Contracture of the hip with pelvic tilt was found in 13 and torticollis in 3 of the patients. These factors, in addition to growth disturbances and probable inflammatory processes of spinal joints, may explain the development of the scoliosis.

Adolescent↗
PubMed1984

A long-term retrospective study of proximal hamstring release for hamstring contracture in cerebral palsy.

Proximal hamstring release was used exclusively for hamstring contracture in patients with spastic cerebral palsy. Average follow-up was 9 years 5 months. Thirty-two of 78 patients were examined retrospectively. Straight leg raising increased from 30 to 68 degrees. Knee flexion contracture decreased from 16 to 9 degrees. Knee flexion contractures of greater than 10 degrees were not permanently corrected. Only four of 64 knees were in mild (5-10 degrees) recurvatum at follow-up. Lumbar lordosis averaged 53 degrees at follow-up, and hip flexion contracture release apparently had little effect on lumbar lordosis. Proximal hamstring release can be used by this described technique without severe lumbar lordosis or devastating genu recurvatum.

Adolescent↗
PubMed2004

Prevention and management of iatrogenic flatback deformity.

The most common cause of iatrogenic flatback syndrome is Harrington distraction instrumentation extending into the lower lumbar spine. Other common causes and exacerbating factors include failure to enhance regional lordosis during lumbar fusion for degenerative spondylosis, development of pseudarthrosis or postoperative loss of correction, development of kyphosis at the thoracolumbar junction, development of degeneration and decompensation cephalad or caudad to a prior fusion, and hip flexion contractures. Prevention of flatback syndrome involves preoperative assessment of sagittal balance, avoidance of distraction instrumentation and extension of long fusions into the lower lumbar spine, enhancement of physiologic lordosis during lumbar fusions, and intraoperative positioning with the hips extended. Treatment of flatback syndrome involves corrective pedicle subtraction or Smith-Petersen osteotomies with segmental instrumentation. Polysegmental osteotomies and vertebral column resection may be utilized in cases of sloping global sagittal imbalance and related severe coronal imbalance, respectively. Following surgical treatment, sagittal balance is generally improved with fair-to-good clinical outcomes, high patient satisfaction, and moderately high perioperative complication rates.

Humans↗
PubMed2005

[Idiopathic chondrolysis of the hip].

Between 1993-2003 the authors treated 5 girls with idiopathic chondrolysis of the hip joint. Their mean age at first symptoms were 9 years (range 6-11 years). In all initial symptoms were pain and a hip flexion contracture of a mean 33 degrees (range 30-40 degrees). All were treated with multiple stationary rehabilitation including traction, range of motion exercises, analgetic physical therapy and longlasting walking with crutches. At the follow up examination only one hip was I 10 degree. Remaining 4 children were painfree. In 2 of them an acetabular protrusion, hip joint space narrowing and degenerative changes were observed on anteroposterior radiographs and clinically the hips were stiff in functional position. In the remaining 2 children, the hip range of motion was limited, with 30 and 90 degree of flexion, but joint space became wider on radiographs. Results were bad, because we do not know neither effective causative non symptomatic methods of treatment. Maybe the new technics of treatment, like arthrodiastasis, will bring better results.

Cartilage Diseases↗
PubMedDate not supplied

Hamstrings in cerebral palsy crouch gait.

After observing patients with increased anterior pelvic tilt following medial hamstring lengthening in cerebral palsy crouch gait, we became concerned that the hamstrings may be functionally important hip extensors. To evaluate this, we studied the three-dimensional motion of the hip and knee, calculated hamstring muscle length, and evaluated dynamic electromyography (EMG) of the medial hamstrings in 16 patients with diplegic cerebral palsy and crouch gait to determine if the hamstrings were extending the hip. Twelve of 16 patients exhibited marked prolongation of electrical activity in the medial hamstrings, and in eight of these 12, the hamstrings were contracting concentrically, thus aiding in hip extension during gait. Hamstrings may be important hip extensors in some cerebral palsy patients with crouch gait; however, other deformities contributing to crouch (such as hip flexion contracture) need to be considered before isolated hamstring lengthening is performed in these patients.

Adolescent↗
PubMedDate not supplied

Hip involvement in ankylosing spondylitis.

Hip involvement in ankylosing spondylitis (AS) is a common and disabling problem. The clinical and x-ray records of 87 patients with definite AS (Rome criteria) were examined to define and characterize their hip disease. Clinical hip disease was present in 33 cases (38%), was usually bilateral (91%), and tended to begin early in the disease course; it was the cause of 50% of the Class III and IV disability in the entire study group. Typical findings included regional pain, limitation of motion, muscle atrophy, and flexion contractures. Radiologic hip abnormalities occurred in 42 cases (48%). The radiographic pattern was distinctive when compared to that in two control groups and included axial migration of the femoral head (63%), concentric joint space narrowing (50%), rufflike femoral osteophytosis (36%), and protrusio acetabuli (30%). Eight patients required bilateral hip surgery. Para-articular ossification occurred in 8 of 16 replaced hips; in 5 of 8 hips it caused clinical immobility. This potentially serious complication may limit the usefulness of hip arthroplasty in some AS patients.

Adult↗
PubMed2004

Emergency hemipelvectomy as a result of uncontrolled infection after total hip arthroplasty: two case reports.

Described are 2 patients with sepsis caused by an infection of a total hip arthroplasty. In both cases, the infection involved spread to the ipsilateral retroperitonial and proximal femur soft tissues, and substantial parts of the osseous hemipelvis and proximal femur. Furthermore, the infection could not be controlled despite repeated surgical interventions. Progression of the infection of soft tissue and bone resulted in severe bone stock loss, contractures of hip and knee, and severe neurologic deficit of the involved limb. Hemipelvectomy was indicated as a life-saving procedure. Reluctance to perform vigorous debridement, including removal of the components, can lead to a local spread of the infection, resulting in an uncontrollable process leading to a life-threatening situation.

Aged↗
PubMed1994

Buttock augmentation with silicone prosthesis--a case report.

A 18-year-old male patient presented with small, flat buttock due to gluteus maximus contracture which caused psychological problem. Bilateral gluteal augmentation was achieved with tissue expanders followed by permanent silicone prosthesis replacement. A two year postoperative follow up revealed no capsular contracture of the prosthesis and no limitation of the patient's activities. The improved contour has improved the patient's outlook on his body image or confidence in his body image.

Adolescent↗
PubMed2005

[Surgical management of hip instabilities in children with spina bifida].

OBJECTIVES: We evaluated the results of surgical management of hip instability in children with spina bifida (SB). METHODS: Twenty-eight hips of 26 patients (16 girls, 10 boys; mean age 4.5 years; range 3 to 6 years) were surgically managed for hip instability (subluxation/dislocation) associated with SB. Twenty-four patients (2 bilateral dislocations) had low-level lesions (L4-sacral) and a potential to walk, of which 16 patients presented with unilateral dislocation with functional problems including significant (>2 cm) limb-length discrepancy and scoliosis. Two patients had high-level lesions (thoracic-L3) associated with unilateral dislocations and were unable to walk. Those with a high-level lesion and some patients (9/26 hips) with a low-level lesion also had hip flexion contractures. Treatment included open reduction, pelvic osteotomy, proximal femoral osteotomy when necessary, and a spica cast. The patients were clinically and radiographically monitored for a mean of 38 months (range 30 to 48 months). RESULTS: Of 16 patients with functional problems, 14 patients had improvement in their gait patterns, while limb-length discrepancy and scoliosis persisted in two. The remaining 10 patients maintained their preoperative functional statuses. The mean range of motion of the hips decreased postoperatively; however, none of them developed joint stiffness. Early postoperative complications included superficial wound infections in three patients, and distal femoral diaphyseal fractures in two patients. Three patients required removal of the implants in the sixth month due to subcutaneous prominence thereof. Late radiographs of three patients showed recurrent subluxations, which did not require any intervention. CONCLUSION: Although surgical treatment of hip problems associated with high-level lesions may be unrewarding in children with SB, those associated with low-level lesions can be successfully managed with proper surgical indications.

Child↗
PubMed1976

Juvenile hyalin fibromatosis.

A boy had multiple large tumors on the scalp, whitish nodules on the nape and both sides of the neck, hypertrophic gingiva, and severe flexural contractures of hip and knee joints. The histopathologic structure of the tumor was characteristic of juvenile hyalin fibromatosis. The tumor cells were embedded in an amorphous eosinophillic ground substance. X-ray films revealed numerous osteolytic and osteociastic lesions that are important findings in the study of this disease.

Child↗
PubMed1992

Paraplegia and congenital contractures as a consequence of intrauterine trauma.

We present a newborn infant with paraplegia and contractures of the lower limbs, consistent with neurologic injury rather than malformation. The mother was involved in a severe motor vehicle accident during the sixth month of pregnancy. We propose that this infant's injuries are a result of that accident.

Accidents, Traffic↗
PubMedDate not supplied

Range of knee motion in normal neonates.

Fifty-seven normal neonates were examined at birth and at 3 and 6 months (to within 7 days). Range of knee motion and of hip flexion contracture were measured. Mean knee flexion contracture was 21.4 degrees at birth, reducing to 10.7 degrees at 3 months and 3.3 degrees at 6 months. Decreasing range of knee flexion was noted in the same period. The natural history of normal knee motion is important in interpreting findings in patients with neuromuscular disorders.

Hip Joint↗
PubMedDate not supplied

Fibrous myopathy. A rheumatic complication of drug abuse.

A progressive fibrous myopathy may result from chronic intramuscular drug abuse. This complication may mimic other rheumatic disorders and early recognition may prevent disability. The patient described here presented with fixed flexion and extension contracture of hips and knees, respectively, after abusing meperidine and other agents for 3 years. Soft tissues of thighs and buttocks were "wood hard," EMG showed absence of action potentials in affected muscles, and biopsy revealed extensive replacement of muscle with dense, acellular fibrous tissue. Possible mechanisms are discussed.

Biopsy↗
PubMed1987

Olivo-ponto-cerebellar atrophy with muscular atrophy, joint contractures and pulmonary hypoplasia of prenatal onset.

The clinical and pathological features of a female neonate with congenital joint contractures and pulmonary hypoplasia are described. Neuropathological examination revealed a widespread neuronal degeneration with a predominantly olivo-ponto-cerebellar distribution and muscle pathology consistent with neurogenic atrophy. This is the first reported case of congenital joint contractures and pulmonary hypoplasia with pathologically documented olivo-ponto-cerebellar degeneration. The observation further illustrates that the so-called fetal akinesia sequence or Pena-Shokeir I syndrome is an aetiologically non-specific symptom complex that can be caused by a number of underlying mechanisms.

Atrophy↗
PubMed2006

A new distal arthrogryposis syndrome characterized by plantar flexion contractures.

The distal arthrogryposis (DA) syndromes are a distinct group of disorders characterized by contractures of two or more different body areas. More than a decade ago, we revised the classification of DAs and distinguished several new syndromes. This revision has facilitated the identification of five genes (i.e., TNNI2, TNNT3, MYH3, MYH8, and TPM2) that encode components of the contractile apparatus of fast-twitch myofibers and cause DA syndromes. We now report on the phenotypic features of a novel DA disorder characterized primarily by plantar flexion contractures in a large five-generation Utah family. Contractures of hips, elbows, wrists, and fingers were much milder though they varied in severity among affected individuals. All affected individuals had normal neurological examinations; electromyography and creatinine kinase levels were normal on selected individuals. We have tentatively labeled this condition distal arthrogryposis type 10 (DA10).

Adolescent↗
PubMedDate not supplied

[Hip joint changes in meningomyelocele].

With an incidence of approx. 2% among newborns, meningomyelocele is a rarely encountered condition. Its clinical manifestations vary within very wide limits, ranging from minor disability to extremely severe limitation of physical function. The function of the trunk muscles and of the lower extremities, and especially that of the hip joints, is impaired to different degrees in the patients affected, depending on the severity of the paralysis. The changes associated with meningomyelocele are typical, and the therapeutic principles adopted will usually depend on individual findings. Taking the disability into account, the primary goal must be to achieve optimal function. The value of imaging procedures is secondary to this consideration. In recent years a number of conventional therapeutic principles have undergone substantial modifications.

Child↗