BackgroundTwo-dimensional (2D) measurements of acetabular morphology and orientation are well known; there is less information on these acetabular characteristics in three dimensions. One important reason is the lack of standardized reference planes for the pelvis, especially in relation to the spinopelvic unit; another is that no method precisely assesses the acetabulum in three-dimensional (3D) orientation based on its axis rather than on the directions of the edges of the acetabular rim. We present an objective, highly reliable and accurate, axis-based approach to acetabular anthropometry in the measurement of acetabular volume and spatial orientation in both normal and pathologic hips. This was done using reference planes based on the sacral base (SB) and true acetabular axis in 3D computed tomography (CT) pelvic reconstruction.MethodsRadiological examinations of 30 physiologic pelves (60 acetabula) were included in the study. Reliability and accuracy of the method were verified by comparing acetabular angles in 2D pelvic scans with 3D reconstructions. We also applied the method to two pathologic acetabula.ResultsComparison of axis position in the horizontal plane revealed significant positive correlations between 2D angle measurements (acetabular anteversion angle [AAA] and anterior acetabular index [AAI]) and 3D measurement of anteversion angle (p < 0.001 and p = 0.012, respectively). In the frontal plane, there was no difference between abduction angle, measured on topogram, and inclination angle, obtained from a 3D model (p = 0.517). In the sagittal plane, there was a significant negative correlation between AAA and acetabular tilt (p < 0.001). Inter- and intra-observer reproducibility was excellent for determination of the sacral-base plane and assessment of volume, with Fleiss κ coefficients of 0.850 and 0.783, respectively, and intraclass correlation coefficients of 0.900 and 0.950, respectively. Inter-observer reproducibility for evaluation of acetabular axis ranged from 0.783 to 0.883, and intra-rater reliability ranged from 0.850 to 0.900 for all 3D angles.ConclusionsOur method is a new, reliable diagnostic tool for assessing the acetabula in both normal and pathologic hip joints. The sacral-base plane can be used as a stable reference that takes the relationship of the acetabulum to the spinopelvic unit into consideration.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0503-8) contains supplementary material, which is available to authorized users.

We investigated the incidence and risk factors for the development of avascular necrosis (AVN) of the femoral head in the course of treatment of children with cerebral palsy (CP) and dislocation of the hip. All underwent open reduction, proximal femoral and Dega pelvic osteotomy. The inclusion criteria were: a predominantly spastic form of CP, dislocation of the hip (migration percentage, MP > 80%), Gross Motor Function Classification System, (GMFCS) grade IV to V, a primary surgical procedure and follow-up of > one year. There were 81 consecutive children (40 girls and 41 boys) in the study. Their mean age was nine years (3.5 to 13.8) and mean follow-up was 5.5 years (1.6 to 15.1). Radiological evaluation included measurement of the MP, the acetabular index (AI), the epiphyseal shaft angle (ESA) and the pelvic femoral angle (PFA). The presence and grade of AVN were assessed radiologically according to the Kruczynski classification. Signs of AVN (grades I to V) were seen in 79 hips (68.7%). A total of 23 hips (18%) were classified between grades III and V. Although open reduction of the hip combined with femoral and Dega osteotomy is an effective form of treatment for children with CP and dislocation of the hip, there were signs of avascular necrosis in about two-thirds of the children. There was a strong correlation between post-operative pain and the severity of the grade of AVN.

There is no consensus on the definition of dysplasia of the hip (DH). Past and present concepts used to describe DH do not form a complete view of the pathology. Moreover, some authors still present the disease as congenital, not developmental. This prompted authors to analyze the evolution of the definition of DH. Based on the biomedical databases 500 articles and books in the field of hip dysplasia were found and analyzed. Fifteen definitions of hip dysplasia met inclusion criteria, subsequently were analyzed and presented in chronological order. The analysis revealed that currently there is no single, universal definition of hip dysplasia in the aspect of morphological, clinical, and radiological studies. Despite the widely-used term of DH, it is described imprecisely and in different ways. Therefore, it is necessary to develop a multidisciplinary definition of this pathology covering all aspects of hip disorders considered valid in modern orthopaedics.

STRESZCZENIEWstęp. U dzie ci opóź nio nych w roz wo ju ru cho wym udo wod nio no po zy tyw ny wpływ hi po te ra pii na po pra wę naj trud niej szych funk cji ru cho wych, ta kich jak: bie ga nie, ska ka nie, po pra wę rów no wa gi i ko or dy na cji. Ce lem pra cy by ła oce na wpły wu hi po te ra pii na wy bra ne pa ra me try cza so wo -prze strzen ne cy ku cho du u cho dzą ce go dziec ka z mó -zgo wym po ra że niem.Ma te riał i me to dy . Ma te riał ba dań sta no wi ło 16 cho dzą cych dzie ci z mó zgo wym po ra że niem dzie cię cym (10 dziew czy nek i 6 chłop ców), w wie ku od 5,7 lat do 17,5 (śred nia: 13,2), za kwa li fi ko wa nych na hi po te ra pię. Ana li zie pod da no pod sta wo we pa ra me try cza so wo -prze strzen ne cho du (szyb kość cho du, czę sto tli wość, dłu gość kro ku, czas je go trwa nia, oraz sy me tria) zbie ra ne przy po mo cy ak ce le ro me tru Dy na Port. Ba da nie wy ko na ne zo sta ło dwu krot nie: przed i bez po śred nio po se sji hi po te ra peu tycz nej. Do we ry fi ka cji ró żnic mię dzy wy ni ka mi po mia rów, uzy ska ny mi pod czas ba dań wstęp nych i koń co wych, za sto so wa no test ko lej no ści par Wil co xo na.Wy ni ki. Po se sji hi po te ra peu tycz nej stwier dzo no istot ną sta ty stycz nie zmia nę pręd ko ści cho du. Za ob ser wo wa no zbli że nie po zo sta łych ba da nych pa ra me trów do war to ści re fe ren cyj nych dla wie ku; je dy nie pa ra metr opi su ją cy dłu -gość kro ku uległ po gor sze niu -zmia ny te nie by ły istot ne sta ty stycz nie.Wnio sek. Jed no ra zo wa se sja hi po te ra peu tycz na mo że mieć istot ny wpływ na nor ma li za cję pręd ko ści cho du u dziec ka z mó zgo wym po ra że niem.Słowa kluczowe: analiza chodu, akcelerometr, fizjoterapia SUMMARY Background. Hippotherapy has been shown to produce beneficial effects by improving the most difficult motor functions, such as sitting, running, jumping, coordination, as well as balance and muscle strength in children with motor developmental delays. The aim of this study was to analyze the effect of hippotherapy on spatiotemporal parameters of gait in cerebrally palsied children.Material and methods. 16 ambulatory cerebrally palsied children (GMFCS Level I-III; Female: 10, Male: 6; Age: 5.7-17.5 years old) qualified for hippotherapy were investigated. Basic spatiotemporal parameters of gait, including walking speed, cadence, step length, stride length and the left-right symmetry, were collected using a threedimensional accelerometer device (DynaPort MiniMod) before and immediately after a hippotherapy session. The Wilcoxon test was used to verify the differences between pre-and post-session results.Results. Changes of walking speed were statistically significant. With the exception of step length, all spatiotemporal parameters improved, i.e. were closer to the respective reference ranges after the session. However, these changes were not statistically significant.Conclusion. One session of hippotherapy may have a significant effect on the spatiotemporal parameters of gait in cerebrally palsied children.

The paper presents the results of real road emission measurements performed under real traffic conditions in the city of Poznan. The tests were carried out in the morning and afternoon hours. The conditions were pre-selected so as to ensure the highest possible reflection of the actual traffic conditions: passenger count on a given bus route that would reflect typical parameters for the Poznan routes. The tests were carried out over a period of two days (Friday, Saturday) characteristic of a very small and very high passenger count and high and medium traffic congestion. The objects of the tests were the buses manufactured by Solaris: one of the vehicles was fitted with a hybrid engine (Hybrid H18) and the other operated on a conventional drive train. The buses were selected based on their similarities in terms of passenger capacity and length. They were selected to enable a comparison of their functionality and environment friendliness under real road conditions (the engines complied with the Euro V standard).