- Email: [email protected]
Acetabuloplasty in the treatment of congenital dislocation of the hip
282
ABSTRACTS
clinical picture, etiologic considerations as well as treatment possibilities. This material was based upon a review of one hundred cases.-Anthony H. Alrer A Study of the “Capsular” Shadow in Disorders of the Hip in Children. Ion Brown. J Bone J Surg 578: 175-l 79 (May), 1975.
This study was undertaken to discover if soft tissue radiologic shadows around the hip in various conditions are a true entity and worthy of consideration in diagnosis. Such shadows are described as “capsular swelling” in several conditions but particularly in transient synovitis, where distinction from more severe disease can often be difficult. Six children with normal hips were selected and the effects of all movements on the radiologic appearances of the hips were studied. It was shown that movements and appearances of the shadows was due to the position of the joint. A retrospective study of radiographs of patients with known transient synovitis was also done when it was again found that the position and presence of the radiologic shadows depended on the position of the limb. Twelve cases of Perthes’ disease were similarly examined, and again the shadows depended on limb position. The conclusion was reached that the x-ray appearance of “capsular swelling” is related to the position of the limb and seems to be a radiologic artefact and therefore probably of little help in diagnosis.--J. Aitken legg-perthes’ Disease in the Young:
Does It
Necessarily Do Well? Charles R. Snyder. J Bone J Surg 57:A6, 751-759 (September), 1975.
One-hundred and thirty-eight patients with Legg-Perthes’ disease were followed from 1937 through 1973. Follow-up was based upon questionnaire, so-geared as to conform to the Harris Assessment System. The study documents that many patients developing the disease before the age of five can go on to have poor roentgenographic results, contrary to initial information. Continued improvement was documented, however, as long as the capital femoral epiphysis was open. There was no way to correlate x-ray changes with the ultimate functional outcome.--/lnthony H. Alter Acetabuloplasty
in
the
Treatment
of
Con-
Eighty-six patients with a total of 102 acetabuloplastys were assessed after a minimum follow-up period of 5 yr. A “score” system was used which classified the patients into excellent, good, fair, and poor. Seventy-three per cent of the hips were found to be excellent or good. The operation performed on these patients consisted of levering the acetabular roof down over the femoral head and retaining it thus with a bone graft. Preserved holmologous rib graft was found to be the most’effective material for this purpose. An important feature appearing from the study was that concentric reduction of the femoral head was critical for a good result. There appeared to be no difference between the ages at which good and bad results were obtained and this was quite contrary to expectation. Coxa magna was the commonest abnormality and was often seen in an otherwise good result.--J. Aitken Surgical Prophylaxis of Subluxation and
Dis-
location of the Hip in Cerebral Palsy. W. J. Sher-
rard, J. M. H. Allen, S. H. Heovely, and G. R. S. Prendiville.
J Bone J Surg 578: 160-166 (May),
1975.
Two groups of children were examined and compared in this study. In group I there were 72 hips in 36 patients. All had been treated conservatively by splinting and physiotherapy, none had had surgical intervention. Average age was 7.5 yr. Group II consisted of 134 hips in 69 children. All the hips had been subjected to at least one surgical procedure. The average age of the children was 8.5 yr. Conclusions drawn from the survey were as follows: A planned regime of prophylactic surgical intervention can improve function and control the development of dislocation of the hip. Assessment and treatment should be started as soon as the diagnosis of cerebral palsy has been made. Surgical intervention should be considered when range of abduction becomes less than 45’ and when radiologic dysplastic changes occur. Restoration of muscle and tendon length to produce balanced muscle action at the hip can prevent progressive instability or can restore stability to an unstable joint. The authors conclude that the prevention of subluxation or dislocation diminishes the likelihood of developing a painful hip in later life.--J. Airken External Rotation Contmcture of the Extended
genital Dislocation of the Hip. D. Trevor, D. L.
Hip:
of
Infancy,
Johns, and J. A. Fixsen. J Bone J Surg 578:
Obscuring Femoral Neck Antevenion
and the
Most Frequent Cause of Out-Toeing
Gait
174 (May), 1975.
167-
A
Common
Phenomenon
in
ABSTRACTS
clinical picture, etiologic considerations as well as treatment possibilities. This material was based upon a review of one hundred cases.-Anthony H. Alrer A Study of the “Capsular” Shadow in Disorders of the Hip in Children. Ion Brown. J Bone J Surg 578: 175-l 79 (May), 1975.
This study was undertaken to discover if soft tissue radiologic shadows around the hip in various conditions are a true entity and worthy of consideration in diagnosis. Such shadows are described as “capsular swelling” in several conditions but particularly in transient synovitis, where distinction from more severe disease can often be difficult. Six children with normal hips were selected and the effects of all movements on the radiologic appearances of the hips were studied. It was shown that movements and appearances of the shadows was due to the position of the joint. A retrospective study of radiographs of patients with known transient synovitis was also done when it was again found that the position and presence of the radiologic shadows depended on the position of the limb. Twelve cases of Perthes’ disease were similarly examined, and again the shadows depended on limb position. The conclusion was reached that the x-ray appearance of “capsular swelling” is related to the position of the limb and seems to be a radiologic artefact and therefore probably of little help in diagnosis.--J. Aitken legg-perthes’ Disease in the Young:
Does It
Necessarily Do Well? Charles R. Snyder. J Bone J Surg 57:A6, 751-759 (September), 1975.
One-hundred and thirty-eight patients with Legg-Perthes’ disease were followed from 1937 through 1973. Follow-up was based upon questionnaire, so-geared as to conform to the Harris Assessment System. The study documents that many patients developing the disease before the age of five can go on to have poor roentgenographic results, contrary to initial information. Continued improvement was documented, however, as long as the capital femoral epiphysis was open. There was no way to correlate x-ray changes with the ultimate functional outcome.--/lnthony H. Alter Acetabuloplasty
in
the
Treatment
of
Con-
Eighty-six patients with a total of 102 acetabuloplastys were assessed after a minimum follow-up period of 5 yr. A “score” system was used which classified the patients into excellent, good, fair, and poor. Seventy-three per cent of the hips were found to be excellent or good. The operation performed on these patients consisted of levering the acetabular roof down over the femoral head and retaining it thus with a bone graft. Preserved holmologous rib graft was found to be the most’effective material for this purpose. An important feature appearing from the study was that concentric reduction of the femoral head was critical for a good result. There appeared to be no difference between the ages at which good and bad results were obtained and this was quite contrary to expectation. Coxa magna was the commonest abnormality and was often seen in an otherwise good result.--J. Aitken Surgical Prophylaxis of Subluxation and
Dis-
location of the Hip in Cerebral Palsy. W. J. Sher-
rard, J. M. H. Allen, S. H. Heovely, and G. R. S. Prendiville.
J Bone J Surg 578: 160-166 (May),
1975.
Two groups of children were examined and compared in this study. In group I there were 72 hips in 36 patients. All had been treated conservatively by splinting and physiotherapy, none had had surgical intervention. Average age was 7.5 yr. Group II consisted of 134 hips in 69 children. All the hips had been subjected to at least one surgical procedure. The average age of the children was 8.5 yr. Conclusions drawn from the survey were as follows: A planned regime of prophylactic surgical intervention can improve function and control the development of dislocation of the hip. Assessment and treatment should be started as soon as the diagnosis of cerebral palsy has been made. Surgical intervention should be considered when range of abduction becomes less than 45’ and when radiologic dysplastic changes occur. Restoration of muscle and tendon length to produce balanced muscle action at the hip can prevent progressive instability or can restore stability to an unstable joint. The authors conclude that the prevention of subluxation or dislocation diminishes the likelihood of developing a painful hip in later life.--J. Airken External Rotation Contmcture of the Extended
genital Dislocation of the Hip. D. Trevor, D. L.
Hip:
of
Infancy,
Johns, and J. A. Fixsen. J Bone J Surg 578:
Obscuring Femoral Neck Antevenion
and the
Most Frequent Cause of Out-Toeing
Gait
174 (May), 1975.
167-
A
Common
Phenomenon
in