Late presentation of DDH continues to remain a major problem particularly in the developing countries. Femoro-Acetabular Zones (FAZ) system is created to find a relation between acetabular maturity and severity of dislocation, in one hand, and the success of closed reduction, on the other hand. We hypnosis that the lower the acetabular index and the closer the femoral head to the acetabulum, the more likely the success of treatment. Thus, a retrospective study was performed on late diagnosed DDH hips that underwent closed treatment at a particular hospital in the Middle East. FAZ are drawn on the AP view of the pelvic x-ray and is based on a perpendicular from the acetabular index at the lateral margin of the superior acetabular rim then another perpendicular to Perkin's line is drawn. This gives three zones, graded I-III. The center of femoral metaphysis is identified denoting the position of the femoral head in relation to the zone classification. FAZ system was applied on 65 pelvic radiographs; mean patient age was 24 months (range: 12 to 36 months) with a minimum follow up of 3 years. Overall, 37 of 65 hips (57%) achieved a satisfactory outcome (Severin I&II), while 22 hips (33%) were found to be unsatisfactory (Severin III). 6 hips (10%) needed an open reduction (
Improvements in the surgical technique of total
knee replacement (TKR) are continually being sought. There has recently
been interest in three-dimensional (3D) pre-operative planning using
magnetic resonance imaging (MRI) and CT. The 3D images are increasingly
used for the production of patient-specific models, surgical guides
and custom-made implants for TKR. The users of patient-specific instrumentation (PSI) claim that
they allow the optimum balance of technology and conventional surgery
by reducing the complexity of conventional alignment and sizing
tools. In this way the advantages of accuracy and precision claimed
by computer navigation techniques are achieved without the disadvantages
of additional intra-operative inventory, new skills or surgical
time. This review describes the terminology used in this area and debates
the advantages and disadvantages of PSI.