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Results for “HIP CONTRACTURE”

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At least 73 records · Page 4Linked to original sources
PubMed2001

Congenital contractural arachnodactyly with neurogenic muscular atrophy: case report.

We report the case of a 3-(1/2)-year-old girl with hypotonia, multiple joint contractures, hip luxation, arachnodactyly, adducted thumbs, dolichostenomelia, and abnormal external ears suggesting the diagnosis of congenital contractural arachnodactyly (CCA). The serum muscle enzymes were normal and the needle electromyography showed active and chronic denervation. The muscle biopsy demonstrated active and chronic denervation compatible with spinal muscular atrophy. Analysis of exons 7 and 8 of survival motor neuron gene through polymerase chain reaction did not show deletions. Neurogenic muscular atrophy is a new abnormality associated with CCA, suggesting that CCA is clinically heterogeneous.

Child, Preschool↗
PubMedDate not supplied

Extension-abduction contracture of the spastic hip.

Patients with cerebral palsy and fixed hip extension are often unable to sit and therefore lose social and educational opportunities. At Texas Scottish Rite Hospital (Dallas, TX, U.S.A.), 29 patients had hip extension-abduction contractures. Eleven patients with mild involvement were managed with physical therapy. Six patients had moderate involvement and required wheelchair modification to maintain sitting. Twelve patients demonstrated severe contractures that required major soft tissue releases and often femoral shortening osteotomies to regain flexion. Patients with athetosis or rigidity were identified as those most likely to develop extension-abduction contractures either spontaneously or following adductor releases.

Adolescent↗
PubMedDate not supplied

Gait analysis in low lumbar myelomeningocele patients with unilateral hip dislocation or subluxation.

The surgical indications for the treatment of unilateral hip dislocations or subluxations in patients with low lumbar myelomeningocele remain highly debatable. This study examines the influence of unilateral hip dislocation or subluxation on the gait of these patients using three-dimensional gait analysis. Twenty patients with a diagnosis of low lumbar myelomeningocele underwent three-dimensional gait analysis. All patients were community ambulators with solid ankle-foot orthoses and crutches who presented with unilateral hip dislocation or subluxation and no scoliosis. The patients were divided in two groups. Group 1 comprised 10 patients who demonstrated either no evidence of hip flexion or adduction contractures or symmetric hip contractures. Group 2 comprised 10 patients with unilateral hip flexion and/or adduction contractures. Pelvic and hip kinematics were assessed to determine the symmetry of motion between the involved and the noninvolved side during walking. Seven patients from group 1 walked with a symmetric gait pattern; only two patients from group 2 walked with a symmetric pattern. Gait symmetry corresponded to the absence of hip contractures or bilateral symmetrical hip contractures and had no relation to the presence of hip dislocation. The authors concluded that reduction of the hip is unnecessary.

Adolescent↗
PubMed2000

[A problem with surgical treatment of ectopic ossification after total hip replacement].

The author presents the issue and the results of surgical treatment of ectopic (heterotopic) ossification following total hip replacement. Four patients (3 female patients aged 44, 52 and 59 years and one male patient aged 58 years) in whom ectopic ossification occurred as a late complication and who had major ROM limitation were treated surgically. The three female patients were from the risk group and the evolution of ossification had a typical course, in the male patient ossification occurred 6 years after hip replacement and was preceded by trauma and a haematoma proximal to the hip prostheses. ROM limitation was more dependent on the localisation of the ossification rather than it's extent. In all cases a major increase in ROM was noted, with intra-operatively and post-op. A good functional result was found in 3 cases 12 months after surgery. In one case, where the extent of the ossification was least, ROM decreased considerably when compared to the intra-operative result. Radiological follow-up at 3, 6 and 12 months after surgical treatment didn't reveal any signs of renewal of the ossification process. Routine prophylactics of ectopic ossification consisted of administration of NSAID (Metindol 1 g/24 h) and a low-calcium diet. The author believes that cases of ectopic ossification leading to hip contractures and major ROM limitations are best treated by surgical resection.

Adult↗
PubMed1993

[Investigation of activity of daily living performance in patients with Duchenne muscular dystrophy].

The purpose of this study was to reach a better understanding the deficits of activity of daily living (ADL) skills in patients with Duchenne muscular dystrophy (DMD), and their influencing factors. Our samples consisted of 35 male DMD patients, aged 3-24 years. The Barthel index was used to assess daily living abilities. Besides ten different motor abilities, muscle strengths of both upper and lower extremities and joint contractures were also included in each patient's evaluation. The results of degree of severity in ADL performance showed that 21.1% of patients were classified as totally dependent, 48.5% were severely dependent, 12.1% moderately dependent, 9.1% mildly dependent and 9.1% totally independent. Among the ADL skills, the bathing needed most assistance whereas feeding required the least. Two of the sixteen factors influencing ADL performance was calculated to be significant after stepwise multiple regression analysis. They were hip contracture and static sitting balance. In conclusion, we find that DMD patients are highly dependent in carrying out ADL tasks. Therefore, it is very important to avoid contracture, to increase static sitting balance and to use appropriate devices to improve their daily living abilities. Finally, the Barthel index proved acceptable in evaluating Taiwanese children over six years of age.

Activities of Daily Living↗
PubMedDate not supplied

Proximal rectus femoris release surgery is not effective in normalizing hip and pelvic variables during gait in children with cerebral palsy.

The purpose of this study was to determine the efficacy of the proximal rectus femoris release to treat hip flexor contractures and hip and pelvic gait deviations in children with spastic cerebral palsy. This study was a retrospective repeated-measures analysis of data collected on two matched groups of patients, those with and without proximal rectus femoris release surgery, seen in our Motion Analysis Laboratory. Proximal rectus release surgery did not improve hip extension, did not decrease anterior pelvic tilt, and did not improve temporal-distance measures of gait in children with cerebral palsy. A multivariate measure, the Hip Flexor Index, was also unchanged. The group of patients without any hip flexor surgery was not different from the rectus femoris release group on hip or pelvic variables before or after surgery. The findings of this study offer no evidence that the proximal rectus femoris release is successful in achieving desired gait outcomes at the hip and pelvis in children with cerebral palsy.

Adolescent↗
PubMed1991

Intraoperative defect in haemostasis in a child receiving valproic acid.

This report describes the development of an intraoperative defect in haemostasis which occurred during surgery for lengthening of the heel cords and release of hip contractures in a patient receiving valproic acid. A review of the literature failed to find any other cases of a valproic acid-induced bleeding disorder occurring under anaesthesia and surgery. While recognized in the non-surgical literature, this case reports the first in which the development of a valproic acid-induced haemostatic defect occurred under anaesthesia. The subsequent course is discussed and some pathophysiological mechanisms are presented. It is suggested that for patients receiving valproic acid preoperative education should include PT/PTT, platelet and fibrinogen counts and bleeding time so that abnormal coagulation states can be recognized.

Child↗
PubMed1998

Predicting the outcome of adductor tenotomy.

This study reviewed 57 hips in 30 children (18 girls and 12 boys) with cerebral palsy who had undergone an adductor tenotomy alone or in combination with an anterior obturator neurectomy (23 hips). Results were evaluated by the Reimers migration percentage (MP). The hips were split into three groups: group A (12 hips) a preoperative MP of less than 20%, group B (25 hips) between 20 and 40%, and group C (20 hips) more than 40%. The mean age at the time of surgery was 6 years and 1 month (range: 2.5-13 years). The mean period of review was 6 years and 3 months (2-20 years). The results were considered as "good" when radiographs at the longest follow-up showed a decrease of > 10% of the MP, as "bad" when they showed an increase of > 10%, and as "stable" when the MPs varied less than 10%. At the latest review of group A, 11 were stable (92%) and 1 was bad. In group B, 12 were stable (48%), 7 were good (28%), and 6 were bad (24%). In group C, 7 were stable (35%), and 13 were bad (65%). The preoperative migration percentage provided to be the only predictor of outcome. Age at the time of surgery had no constant significant effect on the outcome, neither had the addition of an anterior neurectomy.

Age Factors↗
PubMed2003

Use of a prone transfer technique in patients with severe hip-flexion restrictions: a report of 3 cases.

We report 3 cases in which the prone transfer technique improved the functional status of patients with postoperative restriction of hip flexion. All 3 patients, who had undergone a different type of surgery, were unable to get out of bed without a tilt table, and therefore could not be discharged home. The prone transfer technique enables patients to move from a lying to a standing position with or without the use of a flat board. All 3 patients were discharged home when they could perform this transfer without assistance. It required 10 to 18 sessions of therapy training, which took place in 5 to 9 days. With advancements in surgical techniques, postoperative joint-motion restriction may be seen more frequently in community settings. Prone transfer may provide a low-cost, low-technologic way to mobilize patients with hip-flexion restriction.

Adult↗