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At least 19 recordsLinked to original sources
PubMed1995

Hip contracture as the presenting sign in children with HLA-B27 arthritis.

Five pediatric patients who presented with hip contractures are described. There were 3 boys and 2 girls ranging in age from 7 to 14. None had morning stiffness and one complained of no pain at all. Each had undergone several diagnostic procedures and had seen an average of 2.5 doctors before receiving the diagnosis of arthritis. All were antinuclear antibody negative and HLA-B27 positive, and they had excellent responses to treatment with nonsteroidals and physical therapy. HLA-B27 positive arthritis should be considered in the differential diagnosis of otherwise unexplained hip contractures in children.

Adolescent↗
PubMedDate not supplied

Dynamic implications of hip flexion contractures.

Hip flexion contractures are a common complication in disabled patients. However, no previous study has examined reduced hip motion during gait. This retrospective analysis evaluates the relationship between the degree of hip flexion contracture found on static testing and the degree found during gait and also assesses the strength of the association between hip flexion contractures and compensatory mechanisms such as anterior pelvic tilting, increased knee flexion, and decreased contralateral step length. Clinical and quantitative gait laboratory data were obtained from 41 consecutive patients with mostly neurologically based impairments who presented with bilateral hip flexion contractures on Thomas testing (82 limbs). Correlation studies demonstrated a relatively weak association between the degree of peak hip extension during gait and hip flexion contracture by Thomas testing (r = 0.41, P < 0.0001). Limited hip extension was most closely associated with anterior pelvic tilting (r = 0.60, P < 0.0001), whereas Thomas test measurements yielded a correlation with anterior pelvic tilt of only r = 0.36 (P < 0.001) and were insignificant predictor variables of anterior pelvic tilting in regression analysis. Thus, peak hip extension and anterior pelvic tilting assessed during gait were poorly associated with the static Thomas test measurements, and anterior pelvic tilt was most strongly correlated with reduced hip extension during gait compared with the other compensatory mechanisms.

Adolescent↗
PubMed1996

Factors affecting appearance patterns of hip-flexion contractures and their effects on postural and gait abnormalities.

Hip flexion contractures accompanying various orthopedic and neurologic conditions not only limits the physical activities of the patients but also distorts their postures and gait patterns. The purposes of this study were to characterize the appearance patterns of flexion contracture at the hip joints and to elucidate how this disability affects their postural and gait abnormalities. Seventy-eight patients (mean age of 68.1 +/- 10.5 years) with hemiplegia, femoral neck fractures, osteoarthritis of the hip and other conditions causing hip flexion contractures were studied. The presence and degree of hip flexion contracture were estimated in the supine position using the Thomas maneuver with a goniometer. Relationship between appearance patterns and 12-survey variables was also analyzed statistically. As a result, it was revealed that whether lack of mobility caused by hip flexion contracture was compensated for by pelvic tilt an an increase of lumbar lordosis or not was affected by four factors. It was also revealed that whether it appeared unilaterally or bilaterally was affected by five factors. In addition, some postural and gait abnormalities caused by hip flexion contracture were observed in many patients. These results suggest that clinical pictures of the patient's posture and gait abnormality depend on his ability to regulate the position of the trunk and knees as well as the mobility of his spine.

Adolescent↗
PubMedDate not supplied

[Relationship of an increased internal rotation of the hip with pelvic tilt, spinal alignment and posture - does the so-called antetorsion syndrome exist?].

AIM: A cross-sectional study of pupils should show a possible relation between hip movement, posture and spinal alignment. METHODS: 143 children aged 6 to 17 years were clinically examined with particular respect to internal rotation and extension of the hip, spinal alignment and posture to determine if the so-called antetorsion syndrome exists in children as a remnant of the uprising of man. RESULTS: Internal hip rotation decreased with age without any difference regarding the age between children with and without hip contracture. Children with hip flexion deformity had a significantly higher ability for internal hip rotation (p = 0.0471), but both hip extension and internal rotation were not related to spinal alignment (p = 0.5585/0.5612). On the other hand a normal posture is related with a "normal" back and age (p = 0.0004). The spinal alignment itself did not differ in the age groups. 30 % of the children with sufficient posture and 38 % of the ones with insufficient posture had a hip contracture. The latter showed an increased internal hip rotation by 12 degrees (p = 0.0079). CONCLUSION: On the basis of these results, a relationship between muscular performance, neuromuscular maturity, decreased hip extension and increased internal hip rotation can be assumed. This so-called antetorsion syndrome exists in 20 % of the examined children. A relation to the spinal alignment especially the hollow-round back, cannot be found.

Adolescent↗
PubMed1992

Hip flexion contracture in cerebral palsy. The association between clinical and radiologic measurement methods.

Hip flexion contracture was examined in 51 spastic cerebral palsy patients by three clinical methods and two radiologic methods. An extremely low association was found between the clinical and radiologic methods with no particular method, clinical or radiologic, showing a higher association. The method of clinical examination should be chosen by convenience. Radiologic measurements by the methods used did not add useful information.

Adolescent↗
PubMedDate not supplied

[Scoliosis and hip flexion contracture in Duchenne muscular dystrophy].

UNLABELLED: Spinal deformity is common in muscular dystrophy and usually occurs after loss of walking ability. Unlike in idiopathic and other scoliosis forms, there seems to be no side preference of the convexity. Aim of the study was to analyse, if there is any relation between incidence and extent of walking ability, lower limb contractures and development of scoliosis. METHODS: In a retrospective study, 45 patients with Duchenne muscular dystrophy who underwent surgery were analysed, concerning walking ability, contractures of lower extremities and scoliosis. RESULTS: 1: No scoliosis was observed in ambulatory patients. 2: 96% of the wheelchair bound patients suffered from scoliosis. 3: 96% of the scoliosis patients had hip flexion or abduction contractures. 4: In 12 of 15 cases with side-different contractures, scoliosis tended to the side with the greater contracture. CONCLUSIONS: The influence of hip contracture and pelvic obliquity on scoliosis is discussed controversially. Concerning muscular dystrophy, there seems to be a positive correlation between convexity and hip contracture. If this is a causal relation or if there is a faster progression of structural alteration of the muscles on one side has to be further investigated.

Adolescent↗
PubMedDate not supplied

Residual poliomyelitis of lower limb-pattern and deformities.

The pattern of muscle paralysis and paresis in the lower limbs has been studied in 1356 children with 1800 poliomyelitic limbs, revealed that more than two-third (68 = 55%) muscles were affected, with the ratio of paresis and paralysed muscles were 1.89:1.00. The muscles most frequently affected were tibialis anterior (1516), quadriceps (1465) and tibialis posterior (1435) while tibialis anterior (1070), tibialis posterior (820) and quadriceps (766) were most commonly paralysed in descending order. The tibialis anterior which leads in paralysis group, has come last in order of frequency of paresis. The highest segmental incidence of affection of muscles found in second to fourth lumbar segments while muscle paralysis is found in fourth lumbar spinal segment. The commonest deformities encountered in residual poliomyelitis are flexion-abduction contracture hip, flexion contracture knee and valgus deformity foot.

Child, Preschool↗
PubMed1986

Pelvic obliquity. Its causes and its treatment.

Pelvic obliquity can be caused by leg length inequality, contractures about the hips, as part of a structural scoliosis, or as a combination of two or more of these causes. Careful physical and radiologic evaluations are necessary to establish the correct diagnosis. Treatment is then directed toward the specific cause, ie, leg length balancing, release of hip contractures, or scoliosis correction. Structural scolioses with pelvic obliquity may be either congenital or paralytic. If a traction roentgenogram reveals the curve to be flexible enough that the pelvis can be fully leveled, then a posterior fusion only is necessary. If the pelvis will not level with traction, then anterior convex wedge excisions (discectomies for the paralytic, hemivertebra excision for the congenital) are necessary for achieving adequate correction. Posterior instrumentation and fusion must follow the anterior procedure. Various forms of internal correction and fixation devices are now available, and there is no single best procedure. Anterior internal fixation devices are being used less and less, while posterior segmental fixation with Luque rods are wires is being used more and more.

Adolescent↗