Three-dimensional computerized tomographic analysis of the deformity of lateral growth disturbance of proximal femoral physis.

Background: Lateral growth disturbance of the proximal femoral physis after treatment of developmental dysplasia of the hip, also known as type 2 avascular necrosis, has been described in a 2-dimensional (2D) plane with standard radiographs. It is not well described in the 3-dimensional plane using 3D computed tomography (CT) scan. The purpose of this study was to define the anatomy of the proximal femur after the lateral growth disturbance of the proximal femoral physis with 3D CT scans.

A radiological classification of lateral growth arrest of the proximal femoral physis after treatment for developmental dysplasia of the hip.

Background: After treatment of developmental dysplasia of the hip, lateral growth arrest of the physis of the proximal femur resulting in disturbance of the growth of the capital femoral epiphysis is not uncommon. The changes are usually not apparent until approximately the age of 9 years. The residual deformity has a variable prognosis at skeletal maturity.

The incidence of occult dysplasia of the contralateral hip in children with unilateral hip dysplasia.

Background: The purpose of this study is to determine the incidence of contralateral hip dysplasia in children with unilateral hip dysplasia.

Methods: We reviewed all patients with developmental dysplasia of the hip (DDH) who were evaluated at our institution until skeletal maturity (at least age 13 years). In the contralateral ("normal") hip, radiographic measurements of the acetabular angle >46 degrees, center edge angle <20 degrees, and migration index >20% were considered abnormal.

Hip arthroscopy for the treatment of children with hip dysplasia: a preliminary report.

The use of arthroscopic techniques to diagnose and treat hip disorders in children provides the potential to limit the morbidity of current techniques.

Prader-Willi Syndrome: clinical concerns for the orthopaedic surgeon.

Background: Prader-Willi Syndrome (PWS) is a chromosome 15 disorder characterized by hypotonia, hypogonadism, hyperphagia, and obesity. Musculoskeletal manifestations, including scoliosis, hip dysplasia, and lower limb alignment abnormalities, are well described in the orthopaedic literature. However, care of this patient population from the orthopaedic surgeon's perspective is complicated by other clinical manifestations of PWS.

Phase I study of liposome-DNA complexes encoding the interleukin-2 gene in dogs with osteosarcoma lung metastases.

Systemic gene delivery using cationic liposome-DNA complexes (LDCs) has been shown to elicit potent antitumor activity in mice with tumor metastases to the lungs. However, intravenous gene delivery for treatment of established cancer has not been evaluated previously in a spontaneous, large animal model. We therefore evaluated the safety, toxicity, and efficacy of intravenous gene delivery, using LDCs in dogs with established tumor metastases.

Operative treatment for type II avascular necrosis in developmental dysplasia of the hip.

Lateral growth disturbance of the proximal femur may occur after treatment of developmental dysplasia of the hip, although usually it is not recognized until the child is older. This resultant dysplasia is also known as Kalamchi and MacEwen Type II avascular necrosis. The valgus configuration of the proximal femur and associated acetabular dysplasia may need operative reconstruction.

Development of hip dysplasia in a child with perinatal contralateral high above-knee amputation.

The development of acetabular dysplasia in the growing child has been postulated to be due to abnormal forces on the acetabular rim, such as when the hip is in an adducted position. In this case report we document the development of acetabular dysplasia, as measured radiographically, in a child with a perinatal contralateral high above-knee amputation.

Management of leg length inequality.

Leg length inequality is common. Treatment objectives include obtaining leg length equality, producing a level pelvis, and improving function. Clinical assessment should include determination of a level pelvis with the patient standing using a set of blocks of various heights to estimate the amount of leg length inequality.

Fractures of the lateral humeral condyle: role of the cartilage hinge in fracture stability.

This study investigates the hypothesis that the integrity of the cartilage hinge at the distal humeral epiphysis determines the stability of fractures of the lateral humeral condyle. Sixteen patients with lateral humeral condyle fractures were studied with radiographs and magnetic resonance imaging (MRI). The clinical course of each patient was compared using these imaging studies to determine whether initial fracture displacement and the integrity of the cartilage hinge correlated with fracture stability.

Radiologic evaluation of juvenile tillaux fractures of the distal tibia.

This study evaluated the accuracy of plain radiographs and computerized tomography (CT) in assessing juvenile Tillaux fractures of the distal tibia. A simulated Tillaux fracture was made in four cadaver specimens and displaced 0, 1, 2, 3, and 5 mm. Plain radiographs and CT were performed on each specimen at each amount of displacement, and the results were compared with the actual amount of displacement present.

Development dysplasia of the hip from birth to six months.

The term "developmental dysplasia or dislocation of the hip" (DDH) refers to the complete spectrum of abnormalities involving the growing hip, with varied expression from dysplasia to subluxation to dislocation of the hip joint. Unlike the term "congenital dysplasia or dislocation of the hip," DDH is not restricted to congenital problems but also includes developmental problems of the hip. It is important to diagnose these conditions early to improve the results of treat- ment, decrease the risk of complications, and favorably alter the natural history.

Fibrous dysplasia of the proximal part of the femur. Long-term results of curettage and bone-grafting and mechanical realignment.

We reviewed the long-term outcomes of treatment of fibrous dysplasia of the proximal part of the femur in twenty-two patients (twenty-seven femora). There were fifteen male patients and seven female patients. Patients who had monostotic disease had no involvement of the calcar femorale, fewer microfractures, less deformity, and stronger bone that could support internal fixation.

Charcot-Marie-Tooth disease associated with hip dysplasia: a case report.

A 31-year-old woman with a known history of hip dysplasia was found to have Charcot-Marie-Tooth disease following abnormal conduction studies done at the time of surgery. Physical examination in this patient was otherwise normal, and the diagnosis of Charcot-Marie-Tooth disease had not been previously considered. This report demonstrates the importance of keeping in mind the association between hip dysplasia and Charcot-Marie-Tooth disease.