Exostoses or osteochondromas are the most common benign bone tumors in children. The proximal femur is affected in approximately 30% of individuals and may lead to growth disturbances, acetabular dysplasia, and possible subluxation. Intraarticular lesions may also occur but are rarer. We present 2 cases of intraarticular exostoses that were successfully treated by surgical dislocation of the hip and complete excision of the lesion. However, despite successful excision, both hips are still abnormal because of the long standing inherent growth disturbance and residual acetabular dysplasia and may still require further surgery.
Many ways of detecting hip instability in the newborn infant exist, including a history of risk factors, clinical examination and ultrasound. We investigated our practice of 'at risk' screening using subjective, dynamic and static, ultrasound, followed by radiographic evaluation at 12 months. We found that the average age at presentation was 71 days, with the most common reason for referral being a clicking hip. None of the hips deemed stable under review deteriorated, and all those considered normal at first visit had a normal radiograph at 12 months. Abnormal radiographs were found in all the other groups.
In patients with severe glenohumeral dysplasia, glenoid realignment osteotomy in conjunction with soft-tissue rebalancing permits maintenance of joint reduction and functional improvement in the short term. In our view, external rotation osteotomy of the humerus is no longer the only surgical option for these cases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.