摘要:

Summary:Acetabular growth and development in the axial plane was evaluated by computed tomography (CT) scan. One hundred seventy normal hips of children ranging in age from 6 months to 17 years were evaluated for axial acetabular index, anterior and posterior center-edge angles (CEA), and acetabular anteversion. The acetabulum deepens and becomes increasingly spherical with time until the age of 13 years. Little further change in acetabular shape occurs once the triradiate cartilage closes. Closure ensues between the ages of 11 and 13 years, occurring slightly earlier in girls. Posterior bony coverage of the femoral head is greater than anterior coverage at all times. Acetabular anteversion showed little change as the acetabulum developed. Establishing normal values for axial development of the hip and acetabulum allows a better three-dimensional concept of the different pathologic conditions and aids in treatment planning.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Fifty-six hips in 44 patients that underwent triple innominate osteotomy were reviewed. Average follow-up was 7 years (range 2–12 years). Patients were evaluated with regard to any postoperative pain and any improvement in function and as to whether they would recommend the procedure. Improvement in pain and function was considered good in 53 hips. Three hips were considered failures. Forty-two of 44 patients strongly recommended the procedure. Two patients would not recommend the procedure. In all, 94% of patients had improvement in both pain and function and recommended the operation.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:A two-dimensional biomechanical model of the juvenile hip joint was developed to describe the forces acting on the capital epiphysis and the greater trochanter apophysis in the one-legged stance. Based on anatomic femur specimens of 16 children, ranging from toddlers to teenagers, and radiographic studies of 1,350 hip joints of healthy children, we showed that the apophysis of the greater trochanter is a pressure apophysis. If the muscular forces acting on the apophysis of the greater trochanter are added, the unit sum may be considered a resultant force acting from a craniolateral direction. The trochanteric resultant force near the end of the growth period is equivalent to ∼1.7 times body weight. The trochanteric resultant force stimulates craniolateral growth of the greater trochanteric apophysis. This mechanism is responsible for the direction of the forces exerted by the hip abductors and thus the direction and magnitude of Pauwels' hip-joint resultant, and finally influences the neck-shaft angle.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:The utility of ultrasound in the primary examination of patients with Perthes disease was evaluated. Nineteen patients were examined with a longitudinal lateral and an anterior scan. Ultrasound was reliable in diagnosing Perthes disease when the surface of the ossified epiphysis was irregular and when fragmentation had occurred. There was good correspondence between ultrasound and radiography in assessment of femoral head coverage. Twelve patients had an increased anterior joint space, indicating accompanying synovitis. Femoral anteversion (AV) angles, measured by ultrasound, were significantly greater in the affected hips, but mean side difference (3°) was moderate. Ultrasound provided useful information. Like conventional radiography, ultrasound showed the irregular structure of the bony epiphysis and the lateral coverage of the femoral head. In addition, the anterior coverage, an accompanying synovitis, and the degree of femoral AV were obtained. In the very early stage, the femoral head may look normal by ultrasound, but a persisting joint effusion arouses the suspicion of Perthes disease.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Since 1987, nine cases of septic arthritis of the hip joint in children were treated by arthroscopic lavage. The technique of arthroscopic hip examination is described. This treatment, when combined with standard medical therapy, was effective in ablating septic disease in all patients. No complications were attributable to the surgical procedure. We emphasize the value of large bore, large-volume lavage, direct suction to remove joint debris, and postoperative suction drainage. The technique is an attractive alternative to arthrotomy and offers low surgical morbidity, effective joint cleansing, and early return of joint mobility.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Technetium bone scintigraphy was performed in four patients with fulminant meningococcemia and extensive peripheral gangrene. The bone scans showed variable levels of absent uptake in all extremities of the four patients who subsequently required quadrimembral amputations. In 13 limbs, the level of amputation was determined primarily by the bone scan findings, and operation was successful in 84% of those limbs. These findings suggest that bone scanning is a useful adjunct in differentiating viable from nonviable tissues in patients with extensive peripheral gangrene secondary to fulminant meningococcemia and thus helps determine the appropriate level of amputation in such patients.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Pyomyositis is rarely reported in the United States and is not easily recognized. In a 4–year period, we treated three adolescents from our vicinity with muscle infection resulting from Staphylococcus aureus. One was an insulin-dependent diabetic patient. Two patients had deep infections about their pelvis, one of which resulted in acute loss of bowel and bladder function. In all three cases, the patient did not recover until the abscess was operatively drained. Diagnosis was delayed because of lack of awareness of the condition, the deep muscles involved, and clinical presentation before formation of a localized abscess. Indium scan may be a very useful initial diagnostic test.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Cutis marmorata telangiectatica congenita (CMTC), a rare benign condition usually present at birth, is characterized by areas of cutaneous marbling that often become more pronounced with low temperatures. The skin lesions typically become less prominent with age, but may be associated with a variety of abnormalities. Reported are three patients with vivid cutis marmorata who had leg length discrepancies (LLD) which, unlike most limb discrepancies caused by vascular malformations, involved relative growth retardation of the affected leg.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Twenty-eight patients with limb overgrowth and the diagnosis of Klippel-Trenaunay-Weber or Proteus syndromes were evaluated retrospectively. These disorders are part of the phakomatosis spectrum of syndromes. The orthopedic problems consisted of asymmetric limb overgrowth, localized gigantism, angular deformities, scoliosis, vascular malformations, and skin anomalies. Systemic abnormalities are common and de serve full evaluation before treatment. Surgical treatment consisted of epiphysiodesis, osteotomies, debulking procedures, and amputation. Mixed results were obtained with surgery, and conservative or supportive treatment should be the primary mode of orthopedic care.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Twenty-three patients who underwent femoral lengthening had proximal fixation with two Shanz screws; however, the type of distal fixation and site of the osteotomy differed. One group had distal fixation with two Shanz screws attached to a Wagner device and had a midshaft osteotomy; the other group had distal fixation with an Ilizarov ring attached to a modified Wagner device and underwent metaphyseal osteotomy. Patients were compared with regard to callus formation, presence of knee subluxation, and range of motion (ROM) at the knee. The average lengthening achieved was 9.9 cm. The type of bone healing was superior when the osteotomy was performed in the metaphysis rather than to the diaphysis. Knee ROM was poorer in the group with the distal fixation by the Ilizarov wires than the group with the Shanz pins. Multiple adhesions caused by Ilizarov wire impalement of muscles appeared to have caused the excessive stiffness. In instances of simultaneous ipsilateral lengthening of the femur and tibia, interconnection of the Ilizarov ring by means of hinges was successful in reducing the incidence of knee subluxation.

ISSN:0271-6798    

出版商:OVID    

年代:1993

数据来源: OVID