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Results for “HIP DISLOCATION, CONGENITAL”

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PubMedDate not supplied

[Early therapy of congenital hip dislocation and ultrasonic studies of clinically positive cases--results of a prospective epidemiological study in Brünn].

The early diagnosis of CDH in CSFR an in other countries is discussed from different views. To our opinion only the orthopaedic surgeons are able to ensure the high sensitivity and specificity of the clinical tests. In the Brno-prospective epidemiologic study we have examined 19,879 neonates. The frequency of dislocation and instability was 368 cases (18%). The early treatment with Frejka pillow or Pavlik harness has failed only in one case. The systematic second (6 weeks) and third examination (3 months) discovered 19 late diagnosed cases (0.95%). In the era of conventional diagnosis the usual frequency of CDH in CSFR was 20-30%. The ultrasonographic examination of all neonates is not yet possible in our country; we have examined only clinically positive cases.

Czechoslovakia↗
PubMedDate not supplied

[Results of the treatment of congenital hip dislocation using Salter's open repositioning and pelvic osteotomy].

In this paper the results of Salter's innominate osteotomy combined with an open reduction are shown on the basis of radiographic and clinical investigations. From 1969-1976 43 hips up to the age of 3.11 years had been treated after Salter's method. At the follow-up 65.6% of the hips were found to have normal or slightly pathological AC angles. 63.4% of the hips show good and fair results concerning the ACM angle. The results of the CE angle and the 'hip value' are disappointing: only just 34.1% of the hips can be considered good or fair. This is a consequence of the high rate of preoperative avascular necrosis on the one hand, on the other hand it is based on the fact that most of the cases had had a previous non-operative or operative treatment.

Child↗
PubMedDate not supplied

[Magnetic resonance tomography in therapy follow-up after repositioning treatment of congenital hip dislocation].

INTRODUCTION: After treatment of infantile hip dislocation in terms of reduction and retention in plaster casts or splints a problem of therapy controlling exists. To assess if the femoral head is in correct position centered in the socket ultrasound is not possible, because one cannot achieve the necessary standard position. Computertomograms are associated with a hereditary taint of radiation and plain roentgenograms lack of presentation of the important cartilaginous structures. METHOD: To control infantile hips after open or closed reduction from 1990 until 1996, 43 examinations by MR imaging were performed in 34 children. RESULTS: In our series MRI was able to provide exact information about the position of the femoral head independently of its state of ossification. Also, a clearly visualisation of the different structures of the acetabular fossa, particular acetabulum, pulvinar, bony and cartilaginous acetabular rim and limbus was possible. Furthermore the MR images showed interpositioned soft tissue, intraarticular effusion and displayed cartilaginous parts of the acetabular rim. CONCLUSIONS: MRI is an exact method to assess the anatomical and pathological conditions of the childlike hip joint. Because of the disadvantages of CT and X-ray, MRI is superior in terms of controlling the results after treatment of infantile hip dislocation.

Acetabulum↗
PubMed2005

Successful treatment of high congenital dislocated hips in older children by open reduction, pelvic and femoral osteotomy with external fixator stabilization (average 8.2 years of age).

A new technique using a hinged external fixator to stabilize an open reduction with pelvic and femoral osteotomies has been developed for treating high-dislocated hips in older children with developmental dislocated hip (DDH). This technique was performed in 11 patients (12 hips) at a mean age of 8.2 years. At follow up, radiographic results showed no redislocation/subluxation and clinical results demonstrated 11 hips as excellent/good and only one hip as poor from persistent stiffness. In conclusion, this new technique produces acceptable results in the treatment of older children with high dislocation of the hip from DDH.

Child↗
PubMed1989

Arthroplasty for congenital hip dislocation. Techniques for acetabular reconstruction.

We investigated a series of 63 arthroplasties for chronically dislocated hips or severe dysplasia with at least two thirds of the femoral head uncovered. Direct cementation into the neoacetabulum at the pelvic wing was followed by 6/20 revision arthroplasties and 3/20 impending failures. Cups supported by cortical bone grafts were revised in 8/16 and found loose in 2/12 arthroplasties. The best technique was restoration of the rotational center of the hip joint and roof reconstruction with a femoral head graft with 2/25 revisions and signs of loosening in 2/25.

Acetabulum↗
PubMed2001

Treatment of dysplastic and congenitally dislocated hips with the Zweymueller total hip prosthesis.

Uncemented Zweymueller total hip prostheses were implanted in 35 dysplastic or dislocated hips in 33 patients. Sixteen hips were dislocated and 19 hips were dysplastic; in 12 hips, an intertrochanteric or pelvic osteotomy was performed in early childhood. In all cases, the titanium screw socket was implanted at the level of the original cotyloid cavity. Osteotomy of the greater trochanter, shortening osteotomy, or roof acetabuloplasty were not performed. In cases in which the femoral cavity was too narrow for the Zweymueller stem, an anterolateral longitudinal window-shaped osteotomy was performed. In cases of severe dysplasia, cotyloid cavity bone grafts from the resected femoral head were placed medially to reinforce the acetabular bottom. Clinical and radiographic follow-up ranged from 3-8 years. Average Harris hip score improved from 47 points preoperatively to 86.2 points postoperatively. Complications included two primary anterior dislocations, two temporary femoral nerve pareses, and two deep vein thromboses. At longest follow-up evaluation, no revision was indicated in any of the hips. Satisfactory results in this series were attributed to careful patient selection, precise preoperative radiographic planning, and an operative technique that included implantation of the socket at the primary acetabulum and achievement of primary stability using press-fit fixation.

Adult↗