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Results for “HIP CONTRACTURE”

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At least 451 records · Page 25Linked to original sources
PubMed1985

Psoas abscess complicating Crohn's disease.

Psoas abscess classically was described as secondary to tubercular spondylitis but now more frequently is a complication of an intraabdominal process such as Crohn's disease. Less well recognized is that the fever, flexion contracture of the hip, and weight loss characterizing psoas abscess may be the first indications of Crohn's disease; in fact, gastrointestinal symptoms may be completely absent. Psoas abscess was the first sign of Crohn's disease in 11 of 46 reported patients. We present three additional patients; two were asymptomatic before psoas abscess formation. Only seven of 26 patients whose sole surgical procedure was drainage had subsequent resolution of the abscess. When drainage was combined with bowel resection, 14 of 18 patients (77.8%) were cured by the initial procedure. Thromboembolic complications occurred in four patients (8.3%). Effective therapy when psoas abscess complicates Crohn's disease, includes appropriate antibiotics, drainage, resection of fistulous intestine, and antithrombotic prophylaxis.

Abdominal Muscles↗
PubMed1979

Idiopathic scoliosis, scheurmann's disease and myopathy: two case reports.

2 cases of back curvature considered to be due to myopathy, but without associated limb weakness, are described. 1 case presented as infantile kyphosis with subsequent progression to scoliosis. There were some associated myopathic clinical features, including recurrent herniae and hip and knee contractures. The second case presented as an otherwise classical instance of Scheurmann's disease. Paraspinal muscle in both cases showed nonspecific abnormalities consistent with varieties of minimal change myopathy. EMG examination of limb muscles revealed myopathic abnormalities. These cases support the hypothesis that myopathy may underly some cases of apparently idiopathic scoliosis or kyphosis.

Adolescent↗
PubMed1994

[Experience in the conservative management of Scheuermann disease].

Authors analyse their 233 cases of Scheuermann's disease, treated 1980 through 1990 and followed in average until the age of 18.5 years. The material is classified according to the radiological appearance. The assessment of the results was based on the decrease of the dorsal kyphosis, the change of the complaints and of the Radiograms. The efficacity of the braces used in various radiological type. The brace, resting on 3 points, is in atypical form ineffective, in classical appearance success may be expected in 30 per cent from its application. In severe cases, or cases treated only late a brace, resting on 3 points is used for the day and a Milwauke brace in the night. Its efficacity could be increased by the physiotherapeutic ceasing of the flexion contracture of the hip and shoulder and of the ischiocrural tension.

Adolescent↗
PubMed1996

Techniques of psoas tenotomy and rectus femoris transfer: "new" operations for cerebral palsy diplegia--a description.

Two novel operations for cerebral palsy are described. Both procedures, originally proposed and performed by Gage, have been advocated as biomechanically more effective than previous procedures in achieving the objectives of eliminating hip and knee contractures in cerebral palsy. Description of the operative technique and the rationale of use are stated to assist the operator.

Cerebral Palsy↗
PubMed1997

Arthrogryposis multiplex congenita: perinatal and electromyographic findings, disability, and psychosocial outcome.

Fifty-two patients with arthrogryposis multiplex congenita were followed up for 1 to 36 years. There were six twin pregnancies, and delivery was complicated by breech position in 16 cases. In 19 cases the cause was atrophy of the alpha motoneurons of the spinal cord, detected by electromyography. Six patients did not achieve walking ability. Severe disability for other reasons was noted in two patients who had bilateral rigid extension contractures of the elbows and in six patients whose spinal deformities interfered with the balance of the trunk. Treatment of flexion contractures of the hips and knees seemed to be important in case it promotes the walking ability. Spinal deformities interfering with the balance of the trunk should be treated operatively. Restoration of elbow flexion was the main goal in operative treatment of the upper extremities. The intelligence of the patients was slightly above normal. The psychological analysis revealed significant diverging features compared with average population in testing situation. Socially the patients seemed to cope well.

Adolescent↗
PubMed2005

Prevention of severe contractures might replace multilevel surgery in cerebral palsy: results of a population-based health care programme and new techniques to reduce spasticity.

During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CP register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe contractures. The proportion of children treated with orthopaedic surgery for contracture or skeletal torsion deformity decreased from 40 to 15% (P = 0.0019). One-fifth of the children with spastic diplegia had been treated with selective dorsal rhizotomy. One-third of the children born 1994-1995 had been treated with botulinum toxin before 8 years of age. With early treatment of spasticity, early non-operative treatment of contracture and prevention of hip dislocation, the need for orthopaedic surgery for contracture or torsion deformity is reduced, and the need for multilevel procedures seems to be eliminated.

Anti-Dyskinesia Agents↗
PubMedDate not supplied

[Neurophysiologic aspects of the etiology and pathogenesis of congenital hip dislocation].

Till today the meaning of neuromuscular factors in etiology and treatment of congenital dislocation of the hip is not quite clear. Our observation in 62 children with 78 dislocated hips show that neurophysiological mechanisms play of very important role in the development and upkeep of CDH. The neurological examination in 17 children pointed to the typical asymmetries of the children which correlated with the side of the dislocated hip. The knowledge of neurophysiological disturbances on the dislocated hip is of great value for the diagnosis of CDH and even more for the exercise treatment in hips with severe adduction contracture.

Cerebral Palsy↗
PubMed1990

Congenital dislocation of the hip: the indications and technique of open reduction.

Open reduction will be indicated in three circumstances: failure to correct the soft tissue contracture; failure of the hip to reduce concentrically following a "Trial of Closed Reduction"; and when closed reduction is contra-indicated in a child over two and a half years or with an associated condition such as Arthrogryposis Multiplex Congenita.

Arthrogryposis↗
PubMedDate not supplied

Musculoskeletal deformities in Behr syndrome.

SUMMARY: Seventeen children with Behr syndrome were investigated, focusing on the musculoskeletal deformities and long-term outcome. Behr syndrome is characterized by optic atrophy beginning in early childhood associated with ataxia, spasticity, mental retardation, and posterior column sensory loss. The ataxia, spasticity, and muscle contractures, mainly of the hip adductors, hamstrings, and soleus, are progressive and become more prominent in the second decade. In 70% of the patients, contractures developed in the lower limbs, requiring surgery mainly for the Achilles tendon, hamstrings, and adductor longus. At last follow-up at an average age of 21.7 years (range, 8-31 years), 13 of the patients are housebound walkers, 2 are nonfunctional walkers, and 2 are nonwalkers.

Achilles Tendon↗
PubMedDate not supplied

Focal scleroderma in children: an orthopaedic perspective.

Focal scleroderma is a connective-tissue disorder manifested by fibrosis of the skin and subcutaneous tissues. Consequently, it may be associated with joint contractures, extremity deformity, and impairment of extremity function. It has a variable clinical course, with both remissions and recurrences. In resistant cases of extremity involvement, treatment considerations should include physical and occupational therapy, medical treatment, bracing, serial casting, and surgical intervention. We reviewed seven patients treated between 1960 and 1990 with significant joint contractures secondary to focal scleroderma. Serial casting was found to be useful for contractures about the wrist, knee, and ankle. Soft-tissue release was an effective treatment for contractures at the wrist, hip, and ankle. Knee disarticulation was performed on one patient with a severe knee-flexion contracture. Epiphysiodesis and femoral shortening osteotomy were effective treatments for leg-length equalization in a case of hemiatrophy.

Adolescent↗
PubMed1983

Clinical investigation in Duchenne dystrophy: 2. Determination of the "power" of therapeutic trials based on the natural history.

A prospective study of 114 patients with DMD provided data for "power" calculations for future therapeutic trials. There was a decline in strength of 0.4 units per year (on a 0-10 scale). Contractures of the iliotibial bands, hip flexors, and heel cords developed before 6 years. Contractures of other joints accompanied the increased use of wheelchairs. All children walked until 8 years with functional "improvement" between 3-6 years. Children of the same age varied widely in their strength, degree of contracture, and functional abilities. Fifteen percent of the patients appear to have a milder variety of the disease and are termed "outliers." To test a drug which might slow the disease to 25% of its original rate of progression, two groups (placebo and treatment) of 40 patients each would have to be followed for one year.

Adolescent↗
PubMedDate not supplied

Proximal hamstring lengthening in the sitting cerebral palsy patient.

We retrospectively studied 62 nonambulatory children with spastic quadriplegic cerebral palsy who underwent proximal hamstring lengthening to improve hip and spine positioning. Preoperatively, all had hamstring contracture, with difficulty sitting due to hip extensor thrust and increased kyphosis. Thirty-five patients with follow-up greater than or equal to 2 years were studied using a modified Reimer scale to assess sitting ability. Sitting ability improved significantly (p less than 0.01) postoperatively, along with popliteal angle (p less than 0.001) and straight leg raising (p less than 0.001). Proximal hamstring lengthening is effective in treating severe hamstring contractures in the wheelchair-bound child with cerebral palsy.

Adolescent↗
PubMedDate not supplied

Idiopathic chondrolysis of the hip: management by subtotal capsulectomy and aggressive rehabilitation.

Three cases of idiopathic chondrolysis were treated by a subtotal circumferential capsulectomy with follow-up for 3 years and 1 month. Concomitant muscle releases were performed as necessary to relieve joint contractures. Surgery was followed by an aggressive rehabilitation effort. All patients were symptom-free and displayed an extremely satisfactory range of motion. Radiographs revealed reconstitution of the joint space in all cases. We believe that this aggressive management is well justified when one considers the results of previous published reports.

Adolescent↗
PubMed1989

Congenital gluteus maximus contracture.

Muscle contractures are infrequent in Israel. This report discusses one case of a congenital contracture associated with a skin dimple treated in Israel. A 3-year-old boy presented with difficulty in running, riding a bicycle, and squatting. Flexion of the right hip in adduction was impossible. The hip could be fully flexed in abduction. Congenital contracture of the right gluteus maximus muscle was successfully treated by surgical release.

Buttocks↗