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human position for cast in ddh

Abdul Monem Mohamed Alsiddiky, Khalid Abdulla Bakarman, Kholoud Omar Alzain, Fawzi Fahad Aljassir, Abdulaziz Suliman Al-Ahaideb, Mamoun Khalid Kremli, Mohammed Medhat Zamzam, Robert Mervyn Letts
BACKGROUND: In some infants with developmental dysplasia of the hip, concentric closed reduction, although initially achievable, cannot be maintained even by casting because of a deficient posterior acetabular wall. Usually, these hips will redislocate in the cast and a rereduction will be necessary, often requiring an open reduction subsequently. METHODS: A 3-year retrospective review of 88 infants, (M/F; 14/74) 6 to 12 months of age with 124 dislocated hips, was conducted to assess the efficacy of percutaneous Kirschner wire fixation in achieving permanent hip stability...
January 2012: Journal of Pediatric Orthopedics
O Eberhardt, M Zieger, T Wirth, F F Fernandez
AIM: Determination of the femoral head position after closed or open reduction and application of a spica cast is possible by X-ray, MRI, CT or transinguinal ultrasound. In this study we compared the efficacy of transinguinal ultrasound and radiography. Further options with transinguinal ultrasound such as the determination of soft tissue and intraoperative possibilities are also described. MATERIAL AND METHODS: In a first cohort of 25 patients with 33 affected hips ultrasound and radiography were compared...
November 2009: Zeitschrift Für Orthopädie und Unfallchirurgie
Hakan Senaran, M Nazim Karalezli, Sezgin Simşek, Mehmet Arazi, M I Safa Kapicioğlu
OBJECTIVES: We compared the stability of K-wire fixation methods used in Salter iliac osteotomies in developmental dysplasia of the hip (DDH) to determine the most appropriate method for stabilization of the acetabular fragment. METHODS: The study included 425 hips of 331 patients (63 boys, 268 girls; mean age 23.3 months; range 17 to 35 months) who underwent iliac osteotomies for DDH with appropriate indications described by Salter. Fixation of the graft was made with the use of one or two K-wires...
2007: Acta Orthopaedica et Traumatologica Turcica
Marcin Sibińiski, Andrzej Grzegorzewski, Marek Synder
Despite the fact that ultrasound of children's hips is widely used for screening, late diagnosed cases of developmental dislocation of the hip are still a common problem in the orthopaedic practice. The aim of the study is to review final clinical and radiological outcomes of treatment of DDH with overhead traction and closed reduction after skeletal growth. Clinical records and radiograms of 107 hips (81 children) were retrospectively reviewed. All of them were treated according to the same program: overhead traction (about 2 weeks), followed by closed reduction, modified Lorenz cast (2 months) and finally cast in Lange position (3 months)...
2006: Chirurgia Narzadów Ruchu i Ortopedia Polska
B Westhoff, A Wild, K Seller, R Krauspe
BACKGROUND: Reliable concentric reduction of the femoral head and subsequent retention in a centred position are indispensable preconditions for the remodelling of the acetabulum in developmental dysplasia of the hip (DDH) and to prevent damage to the hip joint, i.e. avascular necrosis. The objective of this study is to evaluate the necessity of verifying the reduced position of the articulation in the plaster cast. METHOD: MRI was carried out in 15 infants with 21 unstable hip joints after reduction under arthrographic control and fixation in a plaster cast in the 'human' position with the hips flexed above 90 degrees and abducted to 50 degrees or 60 degrees...
July 2003: Archives of Orthopaedic and Trauma Surgery
P Koczewski, M Napiontek
We studied 10 patients treated because of late avascular necrosis (AVN) mimicking Legg-Calvé-Perthes' disease (LCPD) after developmental dislocation of the hip (DDH). DDH was recognized late at an average age of 5.4 months and in all children it was treated without surgery. In 4 children, the treatment was complicated by mild AVN of the femoral head, which had disappeared before 3 years of age. The first clinical signs of LCPD were noted at a mean age of 5.8 years. They all had Catterall's type III or IV of LCPD...
August 2001: Acta Orthopaedica Scandinavica
R Graf
Therapy for hip dysplasia and DDH by means of sonography. Numerous methods are available for treating "congenital" dysplasia of the hip (CDH). The important point seems to be the differentiation between dysplastic hip joints with and without displaced femoral heads. A historical review of the diagnosis of so-called "congenital dysplasia" and dislocation of the hip and different indications for therapeutic maneuvers is given. Generally, a three-step plan of treatment is recommended: dislocated heads must be reduced, after which retention is needed until the hip joint is stable...
January 1997: Der Orthopäde
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