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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↗
PubMedDate not supplied

Coxa magna following surgical treatment of congenital hip dislocation.

We studied coxa magna after operative treatment of congenital dislocation of the hip, including incidence, relationship to treatment, and influence of coxa magna on the acetabulum. Coxa magna was defined as a femoral head with a horizontal diameter at least 15% greater than the symmetrical position on the opposite side. Coxa magna developed in 16 hips (33%). The mean increase was 20.9% (range 15-30%). Three factors correlated with coxa magna: femoral osteotomy (100%), open reduction (75%), and operation at a younger age (mean 15.6 vs. 35.8 months). Four of the 16 hips developed coxa magna following Type 1 avascular necrosis; no other growth deformities appeared. At follow-up, the acetabular indices and the center edge angles were not statistically different between the coxa magna and the control groups. One must avoid confusing coxa magna with hip subluxation or inadequate reduction, of which the latter requires appropriate treatment. Coxa magna gives a good hip if a concentric, congruous reduction is obtained, providing the acetabulum has enough growth potential for remodeling.

Child↗
PubMed1994

[Unreduced congenital hip dislocation in adults].

Thirty-four cases of unreduced congenital dislocation of the hip were reviewed. The hips were completely dislocated and rode high with the femoral head supported by gluteal muscles, but not by a false acetabulum. The mean Harris hip score was 64 points. Twenty-four patients (80%) had mild or severe low backache, and this was associated with increased lumbar lordosis or functional scoliosis. Seven patients (20%) had valgus malalignment and dysfunction of the knee joint. In older patients over 50 years old, there were many significant problems in the hip, lumbar spine and knee.

Adult↗
PubMed1984

[Radiologic detection of congenital hip dislocation at the 4th month].

For the systematic detection of the congenital dislocation of the hip the roentgen examination must be performed at the beginning of the fourth month. At birth, only are X rayed the dislocations clinically detected in order to have a picture for the follow-up and to check the beneficial effect of the treatment by an abduction device. At the fourth month, for radiological detection, an ordinary frontal film of the pelvis is performed with a strict technique. The criteria of a well performed radiograph are given. For the diagnosis of dislocation the roentgen signs are quite precise. Among them, the high-value of the acetabular angles is not longer considered as a good criterion for detection at this age. It has been shown that radiological mass screening is beneficial from the socio-economic and radiation risk point of view. Nevertheless such a mass screening, in our opinion, is not advisable. Radiological screening must be restricted to infants at risk (infant born after breech presentation, infant with pes talus, genu recurvatum, torticollis, infant with other cases in the family, first born in a family, mainly if of important birthweight).

Hip Dislocation, Congenital↗
PubMed1989

[Radiological study of the development of the hip joint in children with congenital hip dislocation treated by the Frejka cushion].

The changes in the radiological state of the hip joints between the 2-nd and the 21-st year of age in persons treated for congenital dysplasia of the hip with dislocation have been determined on the basis of the analysis of 3.005 X-razy pictures of 4 or 6 radiological parameters of 916 hip joints in 708 children and the total point evaluation. On comparing the rate of excellent, good and poor results in individual years of life, it has been concluded that marked and quick rebuilding occurs between the 2-nd and the 7-th year of age, and on the other hand, after 10 years of age the radiological state of the hip joint stabilizes.

Adolescent↗
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↗
PubMed1996

[The results of operations for open reduction with capsular hip joint arthroplasty in congenital hip dislocation in children].

The authors make an analysis of results of operations for open setting with capsular arthroplasty of the hip joint, derotational supratrochanteric denticulate osteotomy and resection of the femur with creation of iliofemoral, ischiofemoral and pubofemoral ligaments from the residual proximal part of the capsule in 56 children with congenital dislocation of the femur. Long-term results were studied in 46 children, 35 of them having good results and 8 having satisfactory results.

Anesthesia, Endotracheal↗
PubMed1987

Natural history of congenital hip dislocation (CDH) and hip dysplasia.

For normal development of the hip joint to occur, there must be a delicate, genetically determined balance between growth of the acetabular and triradiate cartilages and a well-centered femoral head. This balance may be profoundly affected by the intrauterine environment. Without treatment, it is uncertain how many dysplastic, unstable hips will retain their dysplastic features throughout life. The natural history of untreated complete dislocation varies considerably and is affected by societal considerations. There may be little, if any, functional disability in many cases. Significant roentgenographic degenerative disease and poor clinical results, however, may develop in completely dislocated hips with well developed false acetabulae. In unilateral cases, ipsilateral knee deformity and pain may develop. Congenital subluxations have a particularly poor long-term outcome. A significant percentage of these patients have roentgenographic degenerative joint disease and clinical disability. The age of symptom onset and roentgenographic degenerative joint disease is related to the amount of subluxation and dysplasia. The natural history of acetabular dysplasia in the absence of subluxation is difficult to predict. Physical signs may be absent, and the diagnosis only established with symptom onset or as an incidental roentgenographic finding. While degenerative joint disease may ensue, current roentgenographic parameters are not predictive.

Adult↗
PubMed1990

[Neonatal treatment of congenital hip dislocation using an abduction pillow].

Numerous and various devices are being used in the treatment of congenital dislocation of the hip before the age of 1 year. We prefer the abduction pillow of Becker, owing to the simple design and use; there is also an economical factor: everybody can afford it. The abduction pillow can in no way be used for prevention. Only pathological hips with clinical signs confirmed by X-ray or sonography justify this treatment. Because of the good tolerance and efficacity of the pillow, it is the first choice treatment for unstable and luxated hips before the age of 4 months. If hips are not centered, other procedures should be used, in particular the Pavlik harness.

Hip Dislocation, Congenital↗