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At least 37 records · Page 2Linked to original sources
PubMed1985

Open reduction of congenital hip dislocation. Advantages of the Ferguson medial approach.

Between 1974 and 1982, 56 hips of 51 children with congenital hip dislocation were treated by open reduction via the medial approach according to Ferguson. The mean age at operation was 7 (3-15) months. After 4 months of plaster cast immobilization, 41 hips had a normal acetabular index. Three hips required supplementary surgery: Salter's pelvic osteotomy in one case and a varus osteotomy in two cases. Of the remaining 53 hips, 26 received supplementary abduction treatment. During the first 2 years after reduction, 19 hips showed slight lateral displacement due to capsular laxity. The follow-up averaged 3 (0.5-8) years. All children older than 3 years now had stable, concentrically reduced hips without special treatment of the lateralization; in 9 of the 56 hips the acetabular roof was still dysplastic at follow-up. There was no difference in anteversion and neck-shaft angle between the treated and the contralateral hips. As vascular lesions were observed in only two hips and lateralization disappeared spontaneously, the Ferguson procedure seems safe.

Female↗
PubMed1988

Complex infantile and congenital hip dislocation: assessment with MR imaging.

Twenty-five magnetic resonance hip studies were performed on 19 infants with congenital hip dislocation. These patients had a poor initial treatment response, a teratologic dislocation, or a late presentation. Detailed images of single hips obtained with small surface coils resulted in excellent visualization of all the clinically important soft-tissue and cartilaginous structures of the hip. No other imaging modality demonstrates all of these structures simultaneously.

Acetabulum↗
PubMedDate not supplied

[The correction of the manifestations of the pathological alterations to the hip joints after the reduction of congenital hip dislocation in children].

The paper outlines mechanisms underlying the development and predetermining the forms of hip joint disorders consequent to setting of congenital hip dislocation, the results of a 3-8-year follow-up of relevant 75 cases in children. Individual treatment regimens combined appropriate exercise, biomechanical correction, physiotherapy, acupuncture, manual therapy.

Child↗
PubMedDate not supplied

Factors relating to hip joint arthritis following three childhood diseases--juvenile rheumatoid arthritis, Perthes disease, and postreduction avascular necrosis in congenital hip dislocation.

This article discusses factors that relate to the prognosis for development of hip joint arthritis following juvenile rheumatoid arthritis (JRA), Perthes disease, and postreduction avascular necrosis in congenital hip dislocation (CDH). In JRA, the integrity of the articular cartilage determines prognosis. In Perthes disease, prognosis is strictly related to the shape of the hip. In postreduction avascular necrosis in CDH, half the patients have a prognosis primarily related to hip joint shape, and half have a prognosis apparently more related to the integrity of the articular cartilage.

Adult↗
PubMed2000

[Clinical, radiological and personal condition of patients over 18 year of age with congenital hip dislocation treated conservatively].

The paper presents the clinical, radiological and personal condition of 121 patients (162 hip joints) age 18 to 32 years (mean age 24 years) treated during childhood because of congenital hip dislocation. In 34% of the cases slight and moderate pain was reported, but no other symptoms were found during follow-up. Radiological condition was assessed as very good in 34% of the cases, good in 48%, satisfactory in 6% and unsatisfactory in 5%. Structural changes in spongy bone, which may be early signs of degenerative disease were found in 3 hips. These changes were visible on X-ray films as a sign of increased density in the upper rim of the acetabulum. The assessed patients lead a normal life, work, often doing a job that is inappropriate for people who should take special care of their hip joints.

Acetabulum↗
PubMed2001

[Development and formation of the hip joint in children with surgically treated congenital hip dislocation].

The aim of this paper was to evaluate the development of different elements of the hip joint after surgical treatment, depending on age, anatomic conditions and degree of dysplasia at the time treatment was implemented. 100 hip joints were evaluated in 76 children treated because of congenital hip dislocation with the Dega or Chiari method in the years 1988-1993, according indication proposed during the XXVI Conference of the Polish Orthopedic Society. Age of patients at the time of surgery ranged from 2.5 to 7.5 years. There were 62 girls and 14 boys. The Dega method was implemented in 85 joints and the Salter method in 12 joints. Follow-up period ranged from 5 to 10 years. The best results were obtained in children who underwent surgery before 4 years of age.

Age Factors↗
PubMedDate not supplied

Postoperative computed tomographic evaluation of congenital hip dislocation.

The use of computed tomography (CT) in the postoperative evaluation of 19 congenitally dislocated hips is presented so that appropriate indications for reduction can be determined and radiologic criteria can be defined for judging whether reduction is satisfactory. The radiologic technique is presented. CT is an accurate and cost-effective modality that is capable of demonstrating subtle changes in femoral head position.

Female↗
PubMedDate not supplied

[Results of treatment of old congenital hip dislocations after the start of walking].

Between 1980 und 1986 32 patients with 42 longstanding congenitally dislocated hips were treated by operation. Age at surgery ranged from 13 months to 18 years (mean 4.5 years) with a follow up of 6.7 years. Surgery was done by open reduction mostly combined with innominate and femoral shortening osteotomy. Not in all cases this was done as a one stage procedure. Results were excellent in 20 hips, good in 11, and poor in 11 hips. Quality of results decreased with age at surgery. The best results could be achieved with the one stage combined operations (open reduction, capsuloraphy, femoral shortening osteotomy, iliac osteotomy). The rate of avascular necrosis of the femoral head was 7.14%. The poor results mostly depended on the operating technique and the indication of surgery in cases with no or with extremly flat acetabulum.

Adolescent↗
PubMed1990

[Computed tomography in untreated congenital hip dislocation in adolescence].

Untreated cases of congenital dislocation of the hip (CDH) in the adolescent age are rarely encountered in the western world but are not uncommon in our clinical practice. The pathoanatomy has not been well studied. Previously poor results of operative treatment are partially related to this lack of understanding of the true pathoanatomy and the failure to select the appropriate modality of treatment. Computed tomography (CT) has the capability to show the three-dimensional structure and was used in this study. From September 1985 to July 1988, we had 15 patients (18 dislocated hips) for CT study. Their ages ranged from 8 years 6 months to 22 years 5 months. The patients were divided into 4 types according to the position of dislocation, formation of pseudojoint and size of the true acetabulum: (1) high dislocation without pseudojoint formation; (2) high dislocation with pseudojoint formation; (3) low dislocation with pseudojoint formation; and (4) wide acetabulum. By measuring the diameter of the true acetabulum and femoral head, and the anteversion of the true acetabulum and proximal femur, we had the following results: (1) the size of the acetabulum and femoral head in dislocated hips were smaller than the normal side; (2) most of the acetabula in the dislocated hips were still large enough to accommodate the corresponding femoral heads, even up to the age of 22 years; and (3) the degree of anteversion was similar between the acetabula in normal and dislocated hips, but was more prominent in the proximal femur of a dislocated hip than the normal side.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗
PubMed1988

Vascular disorders of the proximal femur following treatment of congenital hip dislocation.

Early diagnosis of congenital dislocation of the hip entails treating patients in a very young age-group. These patients present a high risk of vascular disorder in the femoral capital epiphysis in the course of either surgical or nonsurgical treatment. Thirty-five cases of anomalies in the proximal femur of vascular origin were observed, corresponding to 3% of hips treated for congenital dislocation. Roentgenographic diagnostic elements are included in an evolutive classification. In recent cases, radionuclide bone scans were used to obtain supplementary information. Based on bone scans, two distinct groups of patients can be identified: in the first group, vascular disorders of the proximal femur (VDPF) are iatrogenic in origin; in the second, VDPF are due either to the precariousness of prereductional blood flow to the epiphysis or to the summation of risk factors.

Epiphyses↗
PubMed1981

Incidence of avascular necrosis of the femoral head in congenital hip dislocation related to the degree of abduction during preliminary traction.

Two-hundred and twenty-two congenitally dislocated hips of 173 patients had been abducted in one of two fashions, prior to closed reduction under general anaesthesia. In both forms of treatment, the hips were in 90 degrees of flexion while they were abducted. Group 1 included those who were abducted up to 90 degrees and Group 2 those who were abducted to not more than 60 degrees. The incidence of total avascular necrosis was 90% when the limbs were abducted to no more than 60 degrees and 17% in those abducted up to 90 degrees. The incidence of partial avascular necrosis was not affected by the degree of abduction of the hips. The incidence of avascular necrosis in Group 2 patients is comparable to that in recent reports of patients who received their traction with the hips in extension; this suggests that the flexed position is not harmful, and it is certainly effective and convenient.

Child, Preschool↗
PubMed1982

Congenital hip dislocation after walking age.

Between 1940 and 1970, 107 patients more than 1 year of age with 134 congenitally dislocated hips were treated at the Alfred I. duPont Institute. It was found that after initial reduction 66% of hips reduced closed and approximately 30% of hips reduced open required further surgery. Good acetabular development was seen in 19% of hips reduced between 2 and 3 years, but only in 7% reduced after 3 years of age. The best results in the correction of residual dysplasia or subluxation were seen if correction was done before 6 years of age. Avascular necrosis was highest after simple open reduction and was responsible for most of the fair and poor results, with late development of poor femoral head coverage after an initial concentric reduction with good coverage.

Age Factors↗
PubMed1990

[Experience with open reduction of congenital hip dislocation by the Ludloff method].

The authors have performed simple open reduction of congenital dislocation of the hip after Ludloff in 54 children aged 3 months to 3 years. The total number of the operated joints was 79. The authors believe that this method provides favourable development of the acetabulum in the children operated before 1-2 years of age with the initial acetabular index below 30-40 degrees. In the children aged 2-3 years it should be regarded as one of the stages in the treatment of congenital dislocation of the hip.

Acetabulum↗
PubMed1992

Radiographic screening at four months of infants at risk for congenital hip dislocation.

We report on a radiographic screening programme at four months of age for infants who were clinically normal at neonatal examination but were considered to be 'at risk' for congenital dislocation of the hip because of their family history, breech presentation, or a persistent click. From a total population of 13,662 live births over a two-year period, 357 (2.6%) infants at risk were identified. Of these 46 had abnormal radiographs (six subluxations, 40 acetabular dysplasia). In 12 infants treatment resulted in a normal hip; 34 required no treatment but were followed up until their radiographs were normal and walking had begun. Of the 311 infants with normal radiographs, 256 (82%) were examined after 15 months of age; none had any detectable abnormality. We suggest that radiography of the hip at four months is a valuable adjunct to neonatal screening for infants at increased risk of congenital dislocation of the hip.

Acetabulum↗