Arthrography of the Hip Joint

Tönnis, Dietrich

doi:10.1007/978-3-642-71038-4_10

Cited by 3 publications

(2 citation statements)

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“… 7 All clinical and radiological data were recorded in the patient’s medical charts and then collected after permission. The patient’s hip joints are then classified according to Tönnis measurements of the acetabular angles into 4 grades 8 ( Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

Late-presenting developmental dysplasia of the hip in Jordanian males

Samarah

Hadidi

Hamdan

et al. 2016

SMJ

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Objectives:To describe the pattern of developmental dysplasia of the hip (DDH) in late presenting Jordanian male patients and identify the risk factors and associated findings.Methods:This is a retrospective study of 1145 male patients who attended the Pediatric Orthopedic Clinic for a DDH check up. This study was carried out in the Orthopedic Section, Special Surgery Department, Faculty of Medicine, The University of Jordan, Amman, Jordan between March 2011 and October 2014. Data was collected from medical records, and x-ray measurements were evaluated.Results:Of the 1145 male patients, 43 (3.75%) with 70 involved hips were diagnosed with late- presenting DDH. Being a first-born baby resulted in 41.9% increased risk for DDH. Cesarian delivery was significantly associated with an increased risk of hip dislocation (p=0.004) while normal delivery was significantly associated with acetabular dysplasia (p=0.004). No predictable risk factors were found in 44.2% patients with DDH. Bilateral cases were more common than unilateral cases: (26 [60.5%] versus 17 [39.5%]). Limited abduction was a constant finding in all dislocated hips (p<0.001). Associated conditions, such as club foot and congenital muscular torticollis were not observed.Conclusion:Cesarian section is a significant risk for dislocated hips while normal delivery is significantly associated with acetabular dysplasia. Bilateral DDH is more common than the unilateral. Club foot and torticollis were not observed in this series.

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Section: Methodsmentioning

confidence: 99%

Late-presenting developmental dysplasia of the hip in Jordanian males

Samarah

Hadidi

Hamdan

et al. 2016

SMJ

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“…Other authors classify it as a subluxation. 7 In subluxation, this soft tissue interposition does not exist. 4 , 5 This is the reason for the relocation of the femoral head in the abduction/internal rotation (AIR) view in case of subluxation.…”

Section: Discussionmentioning

confidence: 99%

Differentiating subluxation from developmental dislocation of the hip

2012

Orthop Rev

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The radiological and clinical picture of a developmental hip dislocation and a severe subluxation are identical. According to Leveuf and Wiberg the diagnosis can only be made by arthrography. The differential diagnosis is critical, as treatment differs dependent on the diagnosis. In this study, the diagnosis of subluxation was based on a plain radiograph of the pelvis. A radiograph of the pelvis with the hips abducted at least 45° and internally rotated (AIR view) was used to differentiate these two entities. In subluxations, the femoral head will relocate into the acetabulum with perfect or near perfect reconstitution of the Shenton's line. It will fail to do so in true dislocations. Five patients, mean age 14.6 months (range 9 to 20 months), presented with delayed diagnosis of hip dysplasia. The examination revealed minimal or no limitation of hip abduction, a leg length discrepancy, and a Trendelenburg gait in the three walking age girls. The radiograph suggested a hip dislocation. The diagnosis of hip subluxation was based on the relocation of the femoral head with the abduction/internal rotation radiograph. All were successfully treated with an Ilfeld abduction splint. None had examination with general anesthesia, arthrograms, traction or immobilization in spica cast. Avoiding over diagnosis of hip dislocation in cases of subluxation is important. This is necessary to prevent overtreatment and to accurately assess the results of treatment. The abduction/internal rotation view may achieve this goal while avoiding diagnostic and therapeutic procedures, such as arthrograms, cast immobilization and surgery.

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Developmental dysplasia of the hip: A computational biomechanical model of the path of least energy for closed reduction

Zwawi¹,

Moslehy²,

Rose³

et al. 2016

J. Orthop. Res.

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This study utilized a computational biomechanical model and applied the least energy path principle to investigate two pathways for closed reduction of high grade infantile hip dislocation. The principle of least energy when applied to moving the femoral head from an initial to a final position considers all possible paths that connect them and identifies the path of least resistance. Clinical reports of severe hip dysplasia have concluded that reduction of the femoral head into the acetabulum may occur by a direct pathway over the posterior rim of the acetabulum when using the Pavlik harness, or by an indirect pathway with reduction through the acetabular notch when using the modified Hoffman–Daimler method. This computational study also compared the energy requirements for both pathways. The anatomical and muscular aspects of the model were derived using a combination of MRI and OpenSim data. Results of this study indicate that the path of least energy closely approximates the indirect pathway of the modified Hoffman–Daimler method. The direct pathway over the posterior rim of the acetabulum required more energy for reduction. This biomechanical analysis confirms the clinical observations of the two pathways for closed reduction of severe hip dysplasia. The path of least energy closely approximated the modified Hoffman–Daimler method. Further study of the modified Hoffman–Daimler method for reduction of severe hip dysplasia may be warranted based on this computational biomechanical analysis. © 2016 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 35:1799–1805, 2017.

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Arthrography of the Hip Joint

Cited by 3 publications

References 84 publications

Late-presenting developmental dysplasia of the hip in Jordanian males

Late-presenting developmental dysplasia of the hip in Jordanian males

Differentiating subluxation from developmental dislocation of the hip

Developmental dysplasia of the hip: A computational biomechanical model of the path of least energy for closed reduction

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