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The Journal of Bone & Joint Surgery British Volume
Vol. 65-B, Issue 2 | Pages 148 - 149
1 Mar 1983
Fiddian N Grace D

Fracture separation of the capital femoral epiphysis occurring during attempted closed reduction of a traumatic dislocation of the hip is described in two adolescents. Although this complication is extremely rare, the prognosis of fracture separation with dislocation of the epiphysis is known to be poor. Avascular necrosis subsequently developed in both cases. The importance of gentle manipulative reduction under general anaesthesia with complete muscle relaxation is emphasised


The Journal of Bone & Joint Surgery British Volume
Vol. 56-B, Issue 4 | Pages 688 - 697
1 Nov 1974
Kemp HBS Lloyd-Roberts GC

1. Attention is drawn to the danger of avascular necrosis developing in the capital femoral epiphysis as a complication of osteomyelitis in the intertrochanteric region. 2. This necrosis is commonly aseptic. It is believed to be caused by compression or thrombosis of the epiphysial vessels. 3. The situation will be aggravated if infection spreads to involve the joint. 4. We believe that prompt decompression of both the joint and the bone is indicated in order to reduce the incidence and severity of these complications


The Journal of Bone & Joint Surgery British Volume
Vol. 78-B, Issue 3 | Pages 471 - 476
1 May 1996
Haidar RK Jones RS Vergroesen DA Evans GA

We have studied retrospectively 37 hips in 36 children at an average of 91 months after simultaneous open reduction and Salter innominate osteotomy for developmental hip dysplasia. At the latest review 97.3% were clinically and 83.8% radiologically good or excellent. In three hips (8%) there were signs of avascular necrosis, but only one had been symptomatic. There were no cases of recurrent posterior displacement


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 2 | Pages 175 - 180
1 Mar 1990
Dhar S Taylor J Jones W Owen R

We have reviewed 82 children with congenital dislocation of the hip, after treatment by anterior open reduction followed by derotation femoral osteotomy. The clinical and radiological results were significantly better in the group that had open reduction before the appearance of the capital femoral epiphysis; this group also had a lower incidence of avascular necrosis. We conclude that, when it is clearly indicated, the earlier an open reduction is carried out the better the results


The Journal of Bone & Joint Surgery British Volume
Vol. 56-B, Issue 3 | Pages 438 - 447
1 Aug 1974
McKibbin B Ráliš Z

1. The findings in a femoral head obtained at necropsy on a boy aged nine suffering from Perthes' disease are described. 2. The findings revealed that there had been avascular necrosis of the epiphysis followed by revascularisation and healing, and there was evidence to suggest a second episode of infarction. 3. The findings provide strong support for the suggestion that Perthes' disease is the result not of one but of more than one episode of major infarction


The Journal of Bone & Joint Surgery British Volume
Vol. 43-B, Issue 1 | Pages 38 - 42
1 Feb 1961
Piggot J

1. Nine cases of traumatic dislocation of the hip in children have been reviewed. 2. There was one instance of avascular necrosis of the femoral head, which became apparent six months after injury. 3. In one case fracture of the femur on the same side led to four days' delay in recognition and treatment of the dislocation. 4. At the time of review all patients were free from symptoms


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 5 | Pages 854 - 858
1 Sep 1990
Clarke H Wilkinson J

We have used a modified technique of cervical osteotomy to treat a consecutive series of 23 patients with chronic slip of the upper femoral epiphysis. It has been successful in correcting both moderate and severe deformities with a low incidence of avascular necrosis, comparable to that seen after subtrochanteric osteotomies. We describe the operative details and discuss the features which make cervical osteotomy technically superior to intertrochanteric and subtrochanteric procedures


The Journal of Bone & Joint Surgery British Volume
Vol. 70-B, Issue 3 | Pages 423 - 427
1 May 1988
McKibbin B Freedman L Howard C Williams L

We describe the results of a policy of highly selective splintage for CDH, using knee plasters. No child suffered because splintage was withheld. In those who were treated the results were satisfactory and the proportion who required a subsequent operation was extremely low. Avascular necrosis was not a significant problem. The method, although a little more time consuming, appears to offer significant advantages over current alternatives


The Bone & Joint Journal
Vol. 102-B, Issue 1 | Pages 64 - 71
1 Jan 2020
Tsuda Y Fujiwara T Stevenson JD Parry MC Tillman R Abudu A

Aims

The purpose of this study was to report the long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma.

Methods

A total of 35 consecutive patients treated with extendable endoprosthetic replacement of the humerus in children were included. There were 17 boys and 18 girls in the series with a median age at the time of initial surgery of nine years (interquartile range (IQR) 7 to 11).


The Journal of Bone & Joint Surgery British Volume
Vol. 84-B, Issue 8 | Pages 1176 - 1179
1 Nov 2002
Ballard J Cosgrove AP

A study of 78 children (110 hips) was undertaken in an attempt to assess the risk of avascular necrosis (AVN) after slipped capital femoral epiphysis based on the radiological appearances of the hip at the time of presentation. Physeal separation, which was defined as the amount of separation of the anterior lip of the epiphysis from the metaphysis on the frog lateral view, was assessed. Of the eight hips which developed AVN, seven had anterior physeal separation. We conclude that anterior physeal separation is associated with a high incidence of subsequent AVN after slipped capital femoral epiphysis and that screw fixation may not be appropriate in these patients


The Journal of Bone & Joint Surgery British Volume
Vol. 68-B, Issue 1 | Pages 61 - 64
1 Jan 1986
Quain S Catterall A

Hinge abduction is an abnormal movement of the hip which occurs when a femoral head, deformed as a result of avascular necrosis or Perthes' disease, fails to slide within the acetabulum. Patients with this condition present with pain and shortening and in some cases arthrodesis has been recommended. We report 27 cases in which the diagnosis had been established by arthrography. The satisfactory results of abduction-extension osteotomy of the femur in 26 hips with this condition are reported


The Journal of Bone & Joint Surgery British Volume
Vol. 43-B, Issue 1 | Pages 43 - 46
1 Feb 1961
Haliburton RA Brockenshire FA Barber JR

1. The case history of a seven and a half-year-old boy who developed increased radiographic density of the femoral capital epiphysis after traumatic dislocation of the hip is presented. 2. The authors have been able to examine the case reports of thirteen similar cases presented in the literature. 3. The case presented is felt to be of interest because avascular necrosis was diagnosed early, and the radiographic appearance of the hip became normal five months after the injury


The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 7 | Pages 1046 - 1049
1 Sep 2001
Phillips SA Griffiths WEG Clarke NMP

We reviewed the management of 100 cases of slipped upper femoral epiphysis treated over a period of 26 years. A total of 14 slips was identified as unstable on admission. These underwent reduction and stabilisation within 24 hours of the onset of severe symptoms. Of the 86 stable slips four progressed to avascular necrosis (AVN), which was not seen in the unstable slips. The literature on slipped upper femoral epiphysis suggests that the acute unstable slip is at higher risk of developing AVN. We recommend reduction and stabilisation of unstable slips within 24 hours of the onset of symptoms in order to reduce the risk of AVN


The Journal of Bone & Joint Surgery British Volume
Vol. 83-B, Issue 5 | Pages 721 - 725
1 Jul 2001
Sokolovsky AM Sokolovsky OA

We describe a method of intertrochanteric osteotomy with posterior rotation of the femoral head and neck. We analysed 45 hips in 44 children and adolescents aged from six to 18 years with residual dysplasia after conservative (35) and operative (10) treatment of developmental dysplasia of the hip complicated by avascular necrosis of the femoral head. In ten, femoral osteotomy was combined with a variety of pelvic procedures. Thirty-seven hips (36 patients) were available for follow-up at a mean of 4 years 5 months (2 to 15 years). Excellent results were obtained in nine, good in 17, fair in seven and poor in four


Bone & Joint 360
Vol. 8, Issue 4 | Pages 39 - 42
1 Aug 2019


The Journal of Bone & Joint Surgery British Volume
Vol. 36-B, Issue 4 | Pages 630 - 632
1 Nov 1954
Mason ML

1. The literature of dislocation of the hip in childhood from 1922 to 1954 is reviewed. A total of eighty-eight cases have been recorded. 2. A further case, in a child of one year and eleven months, is described. 3. Nine of the children whose cases have been recorded developed Perthes' disease of the hip after the dislocation, an incidence of 10 per cent. A similar incidence of avascular necrosis of the femoral head has been reported after dislocation of the hip in adults


The Journal of Bone & Joint Surgery British Volume
Vol. 80-B, Issue 5 | Pages 757 - 761
1 Sep 1998
Fixsen JA Li PLS

Subluxation of the hip presenting for the first time in a child over the age of four years is rare. We report ten cases treated over nearly 11 years by the senior author (JAF). We describe the surgical procedures and the results, at maturity, of nine of the ten patients. At a mean follow-up of nearly nine years, the clinical outcome was good in all ten children by the criteria of Ponseti. Radiological assessment showed that three hips remained subluxed, and that four had avascular necrosis of the physis. We advise a one-stage procedure, correcting both the femur and acetabulum


The Journal of Bone & Joint Surgery British Volume
Vol. 88-B, Issue 6 | Pages 740 - 746
1 Jun 2006
Marulanda G Seyler TM Sheikh NH Mont MA

Osteonecrosis of the knee comprises two separate disorders, primary spontaneous osteonecrosis which is often a self-limiting condition and secondary osteonecrosis which is associated with risk factors and a poor prognosis. In a series of 61 knees (38 patients) we analysed secondary osteonecrosis of the knee treated by a new technique using multiple small percutaneous 3 mm drillings. Total knee replacement was avoided in 59 knees (97%) at a mean follow-up of 3 years (2 to 4). Of the 61 knees, 56 (92%) had a successful clinical outcome, defined as a Knee Society score greater than 80 points. The procedure was successful in all 24 knees with small lesions compared with 32 of 37 knees (86%) with large lesions. All the procedures were performed as day cases and there were no complications. This technique appears to have a low morbidity, relieves symptoms and delays more invasive surgery


The Journal of Bone & Joint Surgery British Volume
Vol. 68-B, Issue 2 | Pages 260 - 265
1 Mar 1986
Angus P Cowell H

The results of triple arthrodesis performed in 80 feet and followed for an average of 13 years are reviewed. Although the majority of patients were very pleased, the results of objective assessment were less favourable. There was a high incidence of degenerative joint changes in the ankle and midfoot and also of pseudarthrosis, avascular necrosis of the talus and residual deformity. Pre-operative rigid equinovarus deformity produced the majority of the poor results. It is suggested that bony resection alone might not be the best means of correcting severe equinus


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 4 | Pages 554 - 556
1 Jul 1990
Gopalakrishnan K Lewis J

We report seven children in whom traumatic haemarthrosis of the hip had produced lateral subluxation of the femoral head, which is different from the apparent displacement seen in Perthes' disease. In all seven cases, aspiration of the haemarthrosis allowed reduction of the femoral head, and follow-up for a mean of 14 months revealed no evidence of avascular necrosis of the proximal femoral epiphysis. Traumatic haemarthrosis of the hip in children appears to be a clinical entity which can produce femoral head subluxation. Aspiration and traction is the treatment of choice and can cure the condition