Acetabular index values in healthy Turkish children between 6 months and 8 years of age: a cross-sectional radiological study.

Objective: The aim of this study was to determine the normal acetabular index values in children between 6 months and 8 years of age based on sex, age and side and to define the cutoff values for mild and severe acetabular dysplasia.

Methods: The records collected from the data pool that was gathered to define the prevalence of untreated congenital hip dislocation in Turkish children between 6 months and 14 years of age was used. The acetabular index was measured on pelvic and abdominal radiographs of children between 6 months and 8 years of age, taken in 19 different cities for non-dysplasia related causes.

Evaluation of experienced surgeons' decisions regarding the need for secondary surgery in developmental dysplasia of the hip.

Background: We aimed to evaluate experienced surgeons' decisions regarding the need for secondary surgery in developmental dysplasia of the hip (DDH) at 5 to 7 years of age.

Methods: We selected 21 hips from 17 patients who had mid-term and skeletally mature radiographs and who had neither had complications nor secondary surgery until skeletal maturity after having an initial soft tissue surgery for DDH before the age of 18 months. Twenty experienced orthopaedic surgeons evaluated the mid-term follow-up radiographs of these hips in terms of their need for secondary surgery.

Prevalence of untreated hip dislocation in Turkish children aged 6 months to 14 years.

Objective: In this study, our aim was to determine the prevalence of untreated hip dislocation and subluxation in Turkey.

Methods: Pelvic radiographs of 4,947 children, aged between 6 months and 14 years, taken for non-orthopedic purposes were requested from 23 provinces around the country. 3,723 radiographs met the study criteria and were evaluated.

Is Kalamchi and MacEwen Group I avascular necrosis of the femoral head harmless in developmental dysplasia of the hip?

The aim of this clinical study was to evaluate the influence of Kalamchi and MacEwen group I avascular necrosis of the femoral head (AVN) on the radiographic and clinical outcomes in developmental dysplasia of the hip (DDH). Preoperative and follow-up (at 2-3, 4-6, 7-9 and 10-15 years of age) Sharp's acetabular angles (AA) and the final Wiberg's center-edge angles (CEA) and proximal femoral center-trochanter distances (CTD) of 13 hips with group I AVN (AVN group) were compared with measurements of 22 hips without AVN (control group). All hips were initially treated by the same soft tissue surgical procedure (posteromedial limited surgery) under the age of 18 months and were completely followed up to at least 10 years of age.

Ipsilateral teratologic high hip dislocation, femoral hypoplasia and below-knee hemimelia associated with contralateral fibular hemimelia: report of a case with functional result.

In this case report, we present a patient with right teratologic high hip dislocation, femoral hypoplasia and below-knee hemimelia associated with left fibular hemimelia. Combined open reduction, proximal femoral osteotomy and a Dega acetabuloplasty were performed in the right hip. Closed tibial wedge osteotomy and centralization of the foot with lateral release and Achilles tendon lengthening were performed for the left side.

No detectable major changes in gait analysis after soft tissue release in DDH.

Unlabelled: The iliopsoas and adductor tendons are often soft tissue barriers obstructing relocation of the femoral head into the acetabulum and are frequently released to obtain reduction. We assessed whether posteromedial soft tissue release including sectioning of the adductor longus and iliopsoas tendons would lead to alterations in joint angles and moments of the hip joint or other major changes in the gait pattern. We conducted 3-D quantitative gait analysis of 10 patients (mean age, 8.

Posteromedial limited surgery in developmental dysplasia of the hip.

Unlabelled: We questioned whether our modified soft tissue surgical procedure can provide acceptable results with lower complication rates in developmental dysplasia of the hip (DDH). We retrospectively reviewed 143 patients (185 hips) with a mean age of 11.6 months at operation and a minimum followup of 5 years (mean, 7.

Acetabular development in developmental dysplasia of the hip. A radiographic study in anatomically reduced and uncomplicated hips.

The objective of this prospective, controlled study was to assess the radiographic course of acetabular develop- ment in developmental dysplasia of the hip (DDH). The study consisted of 14 patients (mean age at operation, 12 months; range, 6 to 18 months) from a large, prospective series diagnosed with unilateral DDH and treated by a soft tissue surgical procedure via the posteromedial approach. All patients had intraoperative radiographic anatomic reductions, did not have any type of complica- tion during follow-up, and were followed until at least 10 years of age.

[When should secondary procedures be performed in residual hip dysplasia?].

Residual hip dysplasia is one of the most important complications following treatment of developmental hip dysplasia. If untreated, this condition will cause problems during maturity. The acetabulum consists of the ilium, ischium, pubis, and the triradiate cartilage lying between them.

[Surgical treatment of hip dysplasia through the medial approach].

Open reduction of developmental hip dysplasia by the medial approach is one of the effective surgical treatment methods during early childhood. Although surgical approaches, fixation and follow-up methods may vary, successful results can be obtained by the algorithm involving the posteromedial approach and arthrographic evaluation. The aim of open reduction by the medial approach should be to obtain Tönnis grade I arthrographic reduction of the dysplastic hip and to maintain it.

A new, objective radiographic classification system for the assessment of treatment results in developmental dysplasia of the hip.

The new, objective radiographic classification system for the assessment of treatment results in developmental dysplasia of the hip includes three quantitative parameters: centre-edge angle of Wiberg, acetabular angle of Sharp and the centre-trochanter distance. Each parameter is divided into three subgroups and assigned a point score (0, 1 and 2) according to their previously determined values. Besides this, three corrective items on the existence of middle/posterior acetabular deficiency, secondary operation and resubluxation/redislocation are added to the classification system and in the presence of any of these items, one point for each item is extracted from the total points.

Is concomitant bone surgery necessary at the time of open reduction in developmental dislocation of the hip in children 12-18 months old? Comparison of open reduction in patients younger than 12 months old and those 12-18 months old.

It is controversial to perform bone surgery at the time of open reduction in developmental dislocation of the hip in children 12-18 months old. The purpose of this study is to investigate whether concomitant bone surgery is necessary in patients treated with medial open reduction in this age range. Patients that were under 12 months of age at the time of open reduction were compared with patients that were 12-18 months old.

[A new measurement method for the radiographic assessment of the proximal femur: the center-trochanter distance].

Objectives: We developed a new method --measuring the perpendicular distance between the center of the femur head and the tip of the trochanter-- for radiographic assessment of the proximal femur.

Methods: The "center-trochanter distance" (CTD) refers to the perpendicular line drawn to the femoral shaft axis between two parallel lines that pass through the center of the femoral head (C) and the tip of the greater trochanter (T). The measured distance in millimeters is expressed as a positive or negative value depending on the location of the point C, that is, above or below the point T, respectively.

The accuracy and reliability of estimation of lateral pillar height in determining the herring grade in Legg-Calvé-Perthes disease.

The amount of the preserved lateral pillar height (LPH) for assigning Herring grades is estimated during daily practice in Perthes disease. Despite this estimation, Herring classification has been reported to have a good interobserver agreement. The purpose of this study was to investigate whether the amount of preserved LPH has an effect on interobserver agreement.

Open reduction through a medial approach in developmental dislocation of the hip: a follow-up study to skeletal maturity.

Forty-four developmentally dislocated hips occurring in 30 patients with an average age at initial surgery of 10.7 (range 2-19) months underwent medial open reduction by Ferguson's approach. All patients were skeletally mature at most recent evaluation.

Treatment of developmental dysplasia of the hip with Pavlik harness: prospective study in Graf type IIc or more severe hips.

Successful treatment of developmental dysplasia of the hip (DDH) is associated with early diagnosis and appropriate treatment. In this prospective study, the results of the treatment with Pavlik harness followed by an abduction brace in patients with severe DDH were presented. Twenty-two hips of 18 patients with a mean age of 14.

[The effects of arthrographically detected femoral head lateralization and soft tissue interposition during closed reduction of developmental dislocation of the hip on mid-term results].

Objectives: In a prospective, non-randomized evaluation of patients who underwent surgery under general anesthesia for developmental dislocation of the hip (DDH) at or below 18 months of age, we assessed the mid-term effects of arthrographically documented femoral head lateralization and soft tissue interposition under the acetabular labrum during reduction without opening the hip joint capsule.

Methods: The study included 31 unstable hips of 21 children (mean age 12 months; range 4 to 18 months). After the iliopsoas and adductor longus tendons were sectioned by a medial approach, hip joint arthrography was performed.

Six years of experience with a new surgical algorithm in developmental dysplasia of the hip in children under 18 months of age.

One hundred thirty-seven developmentally dysplastic hips of 107 children with a mean age of 11 months were treated by the same surgical algorithm. Following iliopsoas and adductor longus tenotomies by the Ferguson posteromedial approach, the operation was ended in case of arthrographically documented concentric reduction (Tönnis grade 1 reduction) and an open reduction was performed in case of nonanatomic arthrographic reduction (Tönnis grade 2 or 3 reduction). Mean follow-up was 4.

[Treatment of stiff-knee gait by distal rectus femoris transfer].

Objectives: We evaluated the preliminary results of distal rectus femoris transfer in patients with stiff-knee gait due to cerebral palsy.

Methods: Eight knees of four patients who had stiff-knee gait due to cerebral palsy were treated by distal rectus femoris transfer. All the patients were females with a mean age of 11 years (range 9.

Analysis of a radiographic assessment method of acetabular cover in developmental dysplasia of the hip.

The aim of this study was to analyse a radiographic assessment method of acetabular cover (Ogata et al.) in developmental dysplasia of the hip (DDH). Intraobserver and interobserver reliabilities of the method were found to be 'substantial' (agreement ratio 85%, kappa coefficient 0.

How should the acetabular angle of Sharp be measured on a pelvic radiograph?

Four experienced orthopaedic surgeons measured the acetabular angle of Sharp (AA) in 66 hips by using two methods. In the classic method (AA-c), the lateral margin of the acetabular roof was used as the landmark. In the modified method (AA-m), the lateral margin of the sourcil (subchondral bony condensation in the acetabular roof) was used as the landmark.

Measurement of center-edge angle in developmental dysplasia of the hip: a comparison of two methods in patients under 20 years of age.

Objective: To analyse in detail the two methods for the measurement of the center-edge (CE) angle in developmental dysplasia of the hip (DDH) in children and adolescents.

Design: Four observers independently interpreted the radiographs of 51 surgically treated and 15 unaffected hips on two occasions. CE angle was measured by using two methods: classic (Wiberg) and refined (Ogata et al.