Preliminary traction and the use of under-thigh pillows to prevent avascular necrosis of the femoral head in Pavlik harness treatment of developmental dysplasia of the hip

2000 ◽  
Vol 5 (6) ◽  
pp. 540-545 ◽  
Author(s):  
Shigeo Suzuki ◽  
Yoichi Seto ◽  
Tohru Futami ◽  
Naoya Kashiwagi
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Developmental Dysplasia ◽  
Pavlik Harness ◽  
Dysplasia Of The Hip

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

2010 ◽  
Vol 20 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Haluk Ağuş ◽  
Hakan Ömeroğlu ◽  
Ali Biçimoğlu ◽  
Yücel Tümer
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Developmental Dysplasia ◽  
Group I ◽  
Dysplasia Of The Hip

scholarly journals Contact Pressure Distribution of the Hip Joint During Closed Reduction of Developmental Dysplasia of the Hip

2020 ◽  
Author(s):  
Zhiqiang Zhang ◽  
Hai Li ◽  
Dashan Sui ◽  
Haiyi Qin ◽  
Ziming Zhang
Keyword(s):  
Finite Element ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Contact Pressure ◽  
Closed Reduction ◽  
Treatment Success ◽  
Developmental Dysplasia ◽  
Abduction Angle ◽  
Lateral Part ◽  
Dysplasia Of The Hip

Abstract Background: Developmental dysplasia of the hip (DDH) is the most common deformity of the lower extremity in children, and the etiology remains unclear. The biomechanical change during closed reduction (CR) focused on cartilage contact pressure (CCP) has not been studied. Thereby, we try to provide insight into biomechanical factors potentially responsible for CR treatment success and complications by using finite element analysis (FEA) for the first time.Methods: Finite element models of one patient with DDH were established based on the data of MRI scan on which cartilage contact pressure was measured. During CR, CCP between the femoral head and acetabulum in different abduction and flexion angles were tested to estimate the efficacy and potential risk factors of avascular necrosis (AVN) following CR.Results: A 3D reconstruction by the FEA method was performed on a sixteen-month-old girl with DDH on the right side. The acetabulum of the involved side showed a long, narrow, and "plate-shaped" deformity, whereas the femoral head was smaller and irregular compared with the contralateral side. With increased abduction angle, the stress of the posterior acetabulum increased significantly, and the stress on the lateral part of the femoral head increased as well. The changes of CCP in the superior acetabulum were not apparent during CR. There were no detectable differences in terms of pressure on the femoral head.Conclusions: Severe dislocation (IHDI grade III and IV) in children showed a high mismatch between the femoral head and acetabulum. Increased abduction angle corresponded with high contact pressure, which might relate to avascular necrosis, whereas increased flexion angle was not. Enhanced pressure on the lateral part of the femoral head might increase the risk of AVN.

scholarly journals Does the vascular development of the femoral head correlate with the incidence of avascular necrosis of the proximal femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction?

2021 ◽  
pp. 1-7
Author(s):  
JianPing Wu ◽  
Zhe Yuan ◽  
JingChun Li ◽  
MingWei Zhu ◽  
Federico Canavese ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Vascular Development ◽  
Contralateral Side ◽  
Developmental Dysplasia ◽  
Level Of Evidence ◽  
Class B ◽  
Class C ◽  
Dysplasia Of The Hip

Purpose The purpose of this study was to identify the correlation between the vascular development of the femoral head and avascular necrosis (AVN) in patients with developmental dysplasia of the hip (DDH) treated by closed reduction (CR). Methods We retrospectively reviewed 78 patients with DDH treated by CR (83 hips). The vascular maturity, number of vessels and perfusion changes of the femoral head were assessed on perfusion MRI (pMRI) before and after CR. Results The number of vessels (mean 4.2 sd 1.4) of the femoral head and the ratio (36.1%) of mature vessels (type III) on the dislocated side were significantly less than those at contralateral side (mean 6.0 sd 1.2; 82.2%) (p < 0.001). Of the included 83 hips, 39 hips (61.5%) showed decreased perfusion of the femoral head, including partial decreased (Class B, 47.0%) and global decreased (Class C, 14.5%), at the dislocated side, which was significantly more than those at contralateral side (0.0%) (p < 0.001). In total, 32 out of 83 hips (38.5%) developed AVN. The rate of AVN with Class A (18.8%) which perfusion of the femoral head was normal (unchanged or enhanced) was significantly less than those with Class C (66.7%) (p = 0.006). Conclusion The vascular development and perfusion changes of the femoral head on the dislocated side are significantly worse than those at contralateral side. Immature vascularity of the femoral head before CR and poor perfusion of the femoral head after CR may be risk factors for AVN in patients with DDH. Level of evidence III

Three-dimensional MRI analyses of prereduced femoral head sphericity in patients with developmental dysplasia of the hip after Pavlik harness failure

2018 ◽  
Vol 27 (5) ◽  
pp. 394-398
Author(s):  
Yuta Tsukagoshi ◽  
Hiroshi Kamada ◽  
Ryoko Takeuchi ◽  
Shogo Nakagawa ◽  
Yohei Tomaru ◽  
...  
Keyword(s):  
Femoral Head ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Pavlik Harness ◽  
Dysplasia Of The Hip
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