Aims. To determine the normal values and usefulness of the C1/4 space
available for spinal cord (SAC) ratio and C1 inclination angle,
which are new radiological parameters for assessing atlantoaxial
instability in children with
Significant hip osteoarthritis has been reported in 8–28% of patients with
Significant hip osteoarthritis has been reported in 8–28% of patients with
The best algorithm, measurements, and criteria for screening children with
The life expectancy of patients with
There is an increased incidence of dislocation, dysplasia, slipped epiphysis, Perthes’ disease, and avascular necrosis leading to degenerative arthritis which occurs in up to 28% of
We treated eight dysplastic acetabula in six skeletally mature patients with
Hip osteoarthritis is prevalent in 8%–28% of patients with
Hip disease occurs in between 8% and 28% of patients with
The purpose of this study was to describe the clinical course of patients with
Dysplasia of the hip, hypotonia, osteopenia,
ligamentous laxity, and mental retardation increase the complexity
of performing and managing patients with
Introduction and Aims: The aim of this paper is to review C1-C2 facet screw use in paediatric patients and to demonstrate that the technique plays an important role in patients with underlying anatomic abnormalities, which are common in children with cervical instability. Method: A chart review was conducted of all patients managed with C1-C2 facet screws from January 1, 1996 until July 30, 2003 present in the case database. All radiographs were obtained and reviewed. Post-operative and follow-up films were assessed for acceptable screw position and evidence of fusion. Results: C1-C2 facet screws were utilised in nine patients at British Columbia’s Children’s Hospital. The youngest patient treated was five years of age with a mean age for the group of 12. The group consisted of three
The February 2015 Hip &
Pelvis Roundup. 360 . looks at: Hip arthroplasty in
Background: Congenital dislocation of the patella can cause significant functional disability and is often associated with limb deformity in childhood. Two types or clinical manifestations of this condition have been previously described, namely the fixed lateral dislocation and the habitual or obligatory dislocation of the patella. Few surgical procedures have been suggested for the treatment of the complex condition. Objective: We reviewed our surgical approach in ten knees (seven children) with both types of patellar dislocation, and evaluated the clinical and functional outcomes. Methods: All our patients underwent an extensive sub-periosteal mobilization of the extensor mechanism from the lateral side of the thigh combined anteriorly with plication of the medial patellar retinaculum. This procedure was supplemented by medialization of half of patellar tendon in the skeletally immature patients, and by tibial tuberosity transfer that was performed in one skeletally mature patient. Results: In six children, patellar dislocation was a part of a diagnosed
We believe that soft tissue release and articulated hip distraction distinguishes itself in the short term as a good salvage procedure for late onset severe Perthes disease of the hip. Our series is made of 10 patients with late onset Perthes disease. All 10 patients were above 9 years of age at diagnosis (average = 11 years). There were 7 boys and 3 girls in the series. All patients had significant limp and pain with positive Trendelenburg sign. All patients used crutches or wheelchairs and had symptoms for a period of 0.5 to 3 years before the operation; all hips had limited ROM. Two patients had previous soft tissue release. There were 2 children with
The advent of modular porous metal augments has ushered in a new form of treatment for acetabular bone loss. The function of an augment can be seen as reducing the size of a defect or reconstituting the anterosuperior/posteroinferior columns and/or allowing supplementary fixation. Depending on the function of the augment, the surgeon can decide on the sequence of introduction of the hemispherical shell, before or after the augment. Augments should always, however, be used with cement to form a unit with the acetabular component. Given their versatility, augments also allow the use of a hemispherical shell in a position that restores the centre of rotation and biomechanics of the hip. Progressive shedding or the appearance of metal debris is a particular finding with augments and, with other radiological signs of failure, should be recognized on serial radiographs. Mid- to long-term outcomes in studies reporting the use of augments with hemispherical shells in revision total hip arthroplasty have shown rates of survival of > 90%. However, a higher risk of failure has been reported when augments have been used for patients with chronic pelvic discontinuity. Cite this article:
The aims of this study were to characterize the incidence and risk factors associated with stress fractures following periacetabular osteotomy, and to determine their effect on osteotomy union. We retrospectively reviewed all periacetabular osteotomies (PAOs) performed for developmental dysplasia of the hip (DDH) at one institution over a six-year period between 2012 and 2017. Perioperative factors were recorded, and included demographic and surgical data. Postoperatively, patients were followed for a minimum of one year with anteroposterior and false profile radiographs of the pelvis to monitor for evidence of stress fracture and union of osteotomies. We characterized the incidence and locations of stress fractures, and used univariate and multivariable analysis to identify factors predictive of stress fracture and the association of stress fracture on osteotomy union.Aims
Methods
In primary total hip replacements there are numerous options available for providing hip stability in difficult situations (i.e.