By Robert Bourne
The needs of this e-book is to offer an summary of controversies that orthopaedic surgeons may have to contemplate whilst undertaking all degrees of hip surgery.Contributions conceal such vital paediatric difficulties comparable to developmental dysplasia of the hip, Perthes ailment, slipped capital femoral epiphysis and hip difficulties linked to neurological ailments. hectic stipulations of the hip, together with acetabular fractures and femoral neck fractures are lined intimately. enormous emphasis is given to the sphere of either basically and revision overall hip alternative, with distinctive emphasis at the distinction which take place in Europe and North the United States. like any different element of hip affliction, the sphere of overall hip anthroplasty is continually altering to enhance either the standard and sturdiness of the medical end result. eventually, post-operative problems and their avoidance are coated, fairly within the fields of deep vein thrombosis prophylaxis and administration of the contaminated overall hip arhtroplasty. The contributions during this quantity are from a world array of specialists within the box of hip surgical procedure.
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Extra resources for Controversies in Hip Surgery
Sample text
427–35. Churchill Livingstone, New York, 1982. Tasnavites A, Murray DW, Benson MKD: Improvement in acetabular index after reduction of hips with developmental. Journal of Bone and Joint Surgery [Br] 75: 755–9, 1993. Tonnis D: Normal values of the hip joint for evaluation of X-rays in children and adults. Clinical Orthopaedics and Related Research 119: 39– 47, 1976. Weinstein SL: Congenital dislocation of the hip. Long-range problems, residual signs, and symptoms after successful treatment. Clinical Orthopaedics and Related Research 281: 69–74, 1992.
In almost all cases, the patients will be obese, with more than 50 per cent above the 95th percentile for weight for their age. All these factors should raise a high index of suspicion and call for appropriate radiographs (Fig. 4). Radiographic examination The radiographic signs of a slipped epiphysis are numerous and easy to recognize if the slip has progressed beyond a mild degree and comparative radiographs of the opposite hip are obtained. If a slipped epiphysis is suspected, an anteroposterior radiograph of the pelvis (including both hips) and a frog lateral radiograph of both hips should be requested.
Group B hips have a good prognosis in children with a bone age of 6 years or less. Those with a bone age between 6 and 9 years have an intermediate prognosis, while those over 10 years have a higher incidence of poor results. Hips in group C risk a poor outcome at any age, even 4 or 5 years, with the older hips faring the worst. As we move forward, greater use of more physiological studies such as bone scan and MRI may add to our prognostic armamentarium. Results of treatment Now for the real controversy.