摘要:

Summary:We attempted to clarify experimentally the effect of hip joint incongruity on the necrotic femoral head. Twenty‐four immature rabbits were divided into three groups: group I (12 rabbits), interruption of the epiphyseal artery and immobilization of the knee in extension for inducing subluxation of the hip; group II (six rabbits), interruption of the epiphyseal artery; group III (six rabbits), opening of the capsule (with preservation of the epiphyseal artery) and immobilization of the knee in extension. Radiographic examination of the hips of the rabbits in group I showed severe deformation of the necrotic femoral head with subluxation. These radiographic findings appeared similar to those of human hip joints affected with Perthes' disease.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:One hundred forty‐two consecutive patients treated at the Portland Shriners Hospital from 1975 through 1984 for congenital hip dysplasia were reviewed. Fourteen patients (10%) with 18 lateral physeal tethers were identified; three tethers occurred in the uninvolved hip. The lateral bridge was apparent at an average of 8 years. Age at initial treatment averaged 10 months and, at follow‐up, 10 years. Fourteen of the tethers occurred in the treated hip, five after open reductions, and seven after closed reductions. Lateral physeal tethering is an iatrogenic entity. Knowledge of this condition should lead to early recognition and prevention of the secondary deformities.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:An angle within the femoral arch is defined, and its line is described in selecting the osteotomy site and the position of the fixation device in performing a femoral varus osteotomy. This neck metaphyseal angle was measured with varying degrees of rotation on seven pediatric femurs; it was also studied on 283 randomly selected hip radiographs. The angle varied 25‐40° in 90% of the patients and was not age related. The angle is stable within 5° as long as the landmarks, base of the great trochanter, and medial metaphysis of the femoral neck are definable (0‐30° of rotation).

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:Seventeen patients underwent open bone graft epiphyseodesis for slipped capital femoral epiphysis (SCFE); physeal fusion was achieved in 12 patients. Eight grafts either resorbed, moved, or fractured postoperatively (graft insufficiency). Graft insufficiency was statistically associated with failure of physeal fusion. (p = 0.009). Radiographic examination, using three different measurements, corroborated postoperative changes in femoral head position. One case of joint space narrowing and three cases of significant myositis ossificans occurred. Ten patients had anterolateral thigh hypesthesia. We conclude that fracture, movement, or resorption of a single bone graft is common, leading to an increase in slip severity and failure of physeal fusion.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:We evaluated 104 osteotomies of the pelvis after an average of 18 years: 48% of patients had hip joint pain, 15% had low back pain, 41% had restricted movement, 74% had a positive Trendelenburg sign, and 77% had limb length discrepancy > 1 cm. We also followed the anti‐Chiari effect, the influence of the osteotomy on narrowing the birth canal, and deterioration of the opposite acetabulum. We showed that the optimum indications for Chiari osteotomy are severe instability of the hip joint and an irregular femoral head.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:A review of hip radiographs of patients with severe hemophilia showed Legg‐Calvé‐Perthes disease in four of 63 patients examined before the era of specific treatment. In another series of 44 patients receiving prophylactic treatment, there was no evidence of Legg‐Calvé‐Perthes disease. A case report of a boy with severe hemophilia with hip joint bleeding that caused joint capsule distention and greatly increased intracapsular pressure is presented. Based on our findings, and previously published results, we suggest that Legg‐Calvé‐Perthes disease in hemophilia is caused by increased intracapsular pressure secondary to hemarthrosis.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:The three‐dimensional relationship between the acetabulum and femoral head was evaluated using three‐dimensional computed tomography (CT) reconstruction before and after rotational acetabular osteotomy. This method provides exact anatomic information on acetabular coverage so that precise operative planning is more easily made. Evaluation of six dysplastic hips indicated the possible dangers of anterolateral rotational shift of the acetabulum when there is marked posterior deficiency, such as in the case of a high decree of subluxated femoral head covered by a shallow false acetabulum. In these circumstances, it may be safer and preferable to plan a lateral shift instead of an anterolateral shift.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:We evaluated curve progression after completion of Wilmington brace treatment for adolescent idiopathic scoliosis in 67 patients. Follow‐up ranged from 5 to 13 years. Pretreatment curve magnitudes ranged from 20 to 39°, with a Risser sign of 0 or 1. Sixteen patients (21%) experienced 5‐16° of curve progression after brace treatment was discontinued. For nine of these patients, the final curve magnitude was within 5° of the pretreatment Cobb angle, reflecting a loss of correction achieved during brace treatment. The remaining seven patients had final curve magnitudes measuring 8‐32° greater than the pretreatment Cobb angle.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:An analysis of the efficacy of two techniques of posterior spinal instrumentation in patients with idiopathic scoliosis was performed. Thirty‐two consecutive patients treated with Cotrel‐Dubousset instrumentation and no external bracing were compared with 30 consecutive patients treated with Harrington rod instrumentation supplemented by Bobechko hooks, sublaminar wires, and postoperative bracing. The groups were similar in age, curve magnitude, and type. Cotrel‐Dubousset instrumentation demonstrated significantly improved immediate frontal plane correction. It was also more effective in improving thoracic kyphosis, particularly in patients with preoperative hypokyphosis. Both procedures were performed with similar operative time, blood loss, and minimal complication rates.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Summary:In a retrospective study, 217 patients with conservatively treated adolescent idiopathic scoliosis (AIS) were investigated. Forty‐nine cases were operated and 168 were treated only conservatively and had been out of the brace for at least 4 years at the time of the investigation. The progression between cessation of brace treatment and follow‐up (a mean of 6.9 years later) was 5.1°. Almost all progression (4.5°) occurred within 2 years of the end of weaning, however. The incidence of failure with regard to the length of follow‐up was also studied. A follow‐up of 2 years was sufficient to predict with great accuracy (97%) all incidences of failure.

ISSN:0271-6798    

出版商:OVID    

年代:1990

数据来源: OVID