摘要:

Summary:Although 59% of children with Perthes' disease have a good result without treatment, poor results are common when the disease has onset in older children. Femoral osteotomy at this age will control the disease but may leave shortening and a persisting limp if there is insufficient capacity for remodeling and growth. Twenty children aged >8 years with early disease were treated by lateral shelf acetabuloplasty. The results are compared with those in 14 children for whom no treatment had been advised. Lateral shelf acetabuloplasty has improved early outcome for these children as compared with untreated children for whom a poor prognosis has been confirmed.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:During an 18‐year period, 157 hips in 140 patients with hip dysplasia underwent a slotted acetabular augmentation (SAA or shelf) procedure. Indication for the procedure was pain in 71, progressive subluxation in 52, and acetabular insufficiency in 34 hips. Follow‐up of 24‐168 months (mean 60 months) was obtained in 108 hips in 98 patients. Good or excellent results were recorded in 83% of the hips. Unsatisfactory results were usually due to excessive breadth or insufficient thickness of the augmentation. The SAA is an alternative to the Chiari osteotomy when lateralization of the hip is not excessive.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:Eleven children with cerebral palsy were studied after shelf acetabular augmentation for progressive hip subluxation. Evaluation was based on computed tomography (CT) scans and radiographic measurements. We noted significant improvement in subluxation as measured by migration percentage, without increased subluxation of the nonoperated hip. Preoperatively, our patients had anterior acetabular deficiencies and increased acetabular anteversion, but no posterior deficiency by CT scanning. The acetabular shelves were positioned relatively more anteriorly than posteriorly. This appears to be appropriate owing to the relative anterior deficiencies of the acetabuli in our patients.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:We have observed that the acetabular tear‐drop figure provides extremely useful information about the development of the hip in young children. Normal development of the acetabulum is associated with progressive narrowing of the teardrop figure and development of a concave shape to its acetabular line. Anatomic and functional abnormalities of the hip can cause abnormalities of the teardrop figure, including absence of the acetabular line, persistent widening, and a V‐shaped tear‐drop figure. In young children, these abnormalities can be reversed to some degree by stabilizing operations, but it is unusual to observe substantial change in appearance of the teardrop figure after a child is aged 8 years.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:Arthroscopy was performed in five hips with slipped capital femoral epiphysis (SCFE) before pinning in situ. Arthroscopy disclosed erosion of acetabular cartilage in the anterosuperior region and damage to the posterolateral aspect of the acetabular labrum. Cartilaginous erosion and transverse cleft were identified on the anterior surface of the femoral head. These findings support the hypothesis that all pathomechanisms of SCFE are caused by traumatic factors. Arthroscopy for SCFE is also clinically useful in reducing hip pain. Arthroscopy performed simultaneously with pinning in situ can permit early exercise of the joint.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:A screening program was initiated and performed at five hospitals in Konya, Turkey from 1988 to 1990. Four thousand one hundred seventy‐three infants aged 3‐24 months were examined. With this study, we hoped to determine the incidence of and contributing factors to the etiology of congenital dislocation of the hip (CDH) in the central region of Turkey. The overall CDH incidence was 1.34%. CDH occurred about three times more often among girls than boys (40 girls vs. 16 boys). No infant with CDH had been delivered by Cesarean section or breech presentation. No teratologic CDH was detected. The relationship between CDH and swaddling (bundled in extension and adduction) was statistically significant.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:Long‐term results of Ludloff's open reduction of the hip were studied in 62 joints of 56 children with an average follow‐up of 11 years (range 5‐18 years). Results were considered good in 76% and poor in 24%. A decisive factor in assessing long‐term results was a proper centric reduction of the femoral head. The most frequent obstacles to proper reduction were a shortened inferomedial part of a joint capsule with the transverse ligament pulled into the joint cavity (14%), joint capsule contracture (100%), and an inverted limbus (92%), which was accompanied in 17% of patients by an impression of reflected head of the rectus femoris. Earlier nonoperative treatment affected the success of the reduction as well as longterm results.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:Delayed bone development is common in Perthes' disease, and affected children are usually smaller than normal. Somatosensory evoked potentials (SEP) studied in 25 cases of Perthes' disease were normal. Fifty‐four patients with active or healed Perthes' disease were examined. Every child aged <8 years showed failure of posterior lumbar and/or sacral fusion. With growth, fusion increased so that at age 14 years 50% had a normal fusion and 50% had spina bifida occulta. At age >16 years, the incidence was similar to that in the general population. In Perthes' disease, growth in fusion of the lumbosacral elements is delayed.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:Twenty‐six patients with progressive neuromuscular scoliosis underwent anterior/posterior (AP) spinal fusion. Thirteen of the patients underwent a one‐stage fusion, and 13 underwent a two‐stage fusion. Although one‐stage AP spinal fusion provides adequate correction of severe curves and allows a more expeditious recovery without increasing patient morbidity or mortality, current third‐party payor reimbursement policies provide little incentive for 1‐day operations. In addition, the procedure is mentally and physically demanding and the apparent benefits must be weighed against the potential harm that can result from surgeon fatigue or lack of appropriate planning.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Summary:Children with a narrowed canal secondary to spinal stenosis or congenital malformation may be predisposed to spinal cord concussion when the canal is further narrowed in hyperflexion or hyperextension. Review of the medical records of the Winnipeg and Ottawa Children's Hospitals disclosed 12 children who had been treated for transient sensory or motor loss after a spinal injury. Measurements of the spinal canal were compared with standard normal measurements, and the spinal canal width was expressed as a percentage of the vertebral width (the Torg ratio). This study shows that narrowing of the spinal canal is an inconsistent predisposing factor to spinal cord concussion in children. A poor correlation between the Torg ratio and comparison with a series of normal control canal widths was noted.

ISSN:0271-6798    

出版商:OVID    

年代:1992

数据来源: OVID