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PubMedDate not supplied

[The problem of comparability of results of the treatment of congenital hip dislocation--exemplified by the Severin scheme and the classification system of the Work Group Hip Dysplasia].

The comparison of the results obtained by conservative or operative treatment of hip dysplasia shows that the consideration of absolute roentgenologic hip parameters is of little use. Classification principles for numerous hip parameters have been developed for this reason by Tönnis. In the Angloamerican and Scandinavian countries, on the other hand, it is predominantly the Severin classification that is employed for an evaluation of the methods of treatment. We examined in our study the differences in the evaluation of the results obtained in 117 hip joints treated by pelvic osteotomy according to Salter by application of the AKH and the Severin classification scheme. There were evident differences in all groups of these classifications. In the application of the Severin scheme the groups I, II and III contained 9.5% less, 24.8% more, and 18.8% less hip joints, respectively than in the respective groups of the Tönnis classification. In the groups IV, V and VI of the Severin classification there were altogether 3.5% less hip joints than in the respective groups of the Tönnis classification. Our study thus showed that a comparison of the operative results of hip dysplasia as presented in the Angloamerican and Scandinavian literature and those presented in the German literature is not possible. We conclude from this result that an evaluation according to a unified classification scheme would be most desirable.

Adolescent↗
PubMedDate not supplied

[Preliminary treatment of congenital hip dislocation using physical therapy based on neurophysiology].

Adductor tightness is a typical symptom in CDH. In cases of subluxation and complete dislocation even a rigid abduction contracture can occur, preventing reduction and favouring redislocation. The contracture of the hip joint is the result of neurophysiological disorders, which can be treated by an exercise program on a neurophysiological basis. 62 children with 73 severely contracted and 5 hypotonic hip dislocations have been treated by the so-called "Vojta-program" before reduction. In a prospective study over 5 years this kind of treatment has been very successful: the incidence of necrosis of the femoral head could be reduced to 4%, long-lasting traction was not necessary anymore and the rigid hip joints required open reduction only in 2 cases.

Cerebral Palsy↗
PubMedDate not supplied

[Results of the follow-up of Ludloff open hip repositions and closed repositions in congenital hip dislocations].

Three combinations of therapy of CDH (closed and open reduction, with and without foregoing so called "functional" conservative treatment, and with and without retention in the frog position) have been evaluated among 82 children with 100 dislocated hips. They had been operated on 71 times by Ludloffs open reduction and 29 times by gentle closed reduction in anaesthesia. If following a test-x-ray in 130 degrees flexion of the hips and 50 degrees of abduction no spontaneous reduction occurs, an attempt at careful closed reduction under anaesthesia seems to be justified. If it is not successful with lack of a deep position of the head, an immediate open reduction after Ludloff with retention in hip flexion of about 130 degrees and slight abduction was in our hands less frequently followed by an avascular necrosis of the femoral head than following conservative treatment. The latter and the inhuman frog position are according to our statistics probably more responsible for the avascular necroses than the open reduction as such. Every treatment of CDH has to be evaluated in regard to the frequency of irreversible avascular necrosis of the femoral head.

Casts, Surgical↗