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Osteocyte death and hip fracture.

The viability of osteocytes can be demonstrated in sawn decalcified sections of bone by their lactate dehydrogenase activity. In the cancellous bone of the femoral head, the proportion of lacunae containing viable osteocytes decreased from 88 +/- 7% (mean +/- SD) at 10-29 years to 58 +/- 12% (P < 0.001) by 70-89 years. Viability in the second lumbar vertebra was 88 +/- 3% in subjects aged 25-90 years and did not decrease with age. Mean osteocyte viability in the femoral head of 21 hip fracture patients aged 72-94 years was 58 +/- 21%, similar to controls of a similar age, though there was grea…

Pediatric hip and pelvis disorders.

Significant advances in the management of hip and pelvic disorders have occurred during 1992. Developmental dysplasia of the hip or congenital dislocation of the hip has continued to provoke innovative thinking regarding preoperative planning for hip and pelvic reconstruction. "New" osteotomies are proposed but will require long-term follow-up to confirm their appropriateness. A new classification for Perthes' disease has been proposed, and further clues for the basic understanding of the etiology of Perthes' disease add to the already voluminous literature on the subject. For chronic slipped …

Bone remodeling in hip fracture.

Hip fracture incidence has shown strong upward secular trends in many societies with wide differences in age adjusted incidence between nations. Falls and reduced physical activity have emerged as the strongest risk factors in epidemiological studies, while clinical investigations have pointed to secondary hyperparathyroidism as an important candidate cause of the loss of femoral cortical bone in old age. Until recently there have been few studies performed directly on the region of interest in the proximal femur. Non-invasive methodology using 85Sr has now been developed by our group for meas…

[Arthrography in congenital hip dislocation].

The paper is concerned with the results of contrast arthrography in 73 children with hip joint dysplasia, among which true dislocations prevailed (70 patients). In addition to bone alterations, arthrography revealed various soft tissue changes like hypertrophy and deformity of limbus, soft tissue interposition, separation of the articular sac with the presence of an isthmus, disintegration of articular cartilages. These findings are used to define indications for surgical intervention as well as for planning the area of operation.

Rhabdomyolysis following total hip arthroplasty.

We report six cases of contralateral limb involvement during total hip arthroplasty including swelling of the gluteal muscle compartments, rhabdomyolysis, myoglobinuria, and sciatic nerve palsy. The risk factors for such complications include obesity, prolonged operative time, and positioning in the lateral decubitus position. The laboratory and clinical findings are consistent with a gluteal muscle crush-injury with consequent compartment syndrome. The patients should be treated conservatively as symptoms can be expected to resolve.

Total hip arthroplasty for osteonecrosis.

The success of Charnley cemented total hip arthroplasty for osteonecrosis of the femoral head was assessed using survival analysis. Eighty-seven total hip arthroplasties were followed up for an average of 5.7 years (range, 1.4-13.0 years). There were 59 women and 28 men. The average age was 60 years (range, 30-84 years). Using Charnley hip scores, all patients showed significant progress. The survival analysis showed that using femoral loosening, revision, and pain scores less than 5 as end points, survival was 0.61, 0.94, and 0.81, respectively. With revision as an end point, there were no di…

Septic arthritis complicating hip osteoarthritis.

Four patients with osteoarthritis of the hip, who developed septic arthritis of the affected joint, are reported. The septic arthritis developed insidiously and was diagnosed with difficulty. One patient died, two required subsequent joint excision, and one arthrodesis despite antibiotics. The presence of a recognised predisposing factor to septic arthritis, such as rheumatoid arthritis or a surgically replaced joint, can provide a diagnostic pointer. These cases suggest that osteoarthritis, similarly, is a predisposing factor. It is concluded that joint sepsis should be considered if a patien…

Переломы гипсов в хроническом остеомиелите.

Мы представляем два случая спонтанного смещения бедренного сустава из-за хронического остеомиелита верхней части бедра. Спонтанное смещение бедра происходит в некоторых патологических условиях, таких, как полиомиелит (Инграм, 1980 год), церебральный паралич (Howard et al., 1985 год), остеомиелит и нейрофиброматоз.

Совпадение в аннотации оригинала
We present two cases of spontaneous dislocation of the hip joint due to chronic osteomyelitis of the upper femur. Spontaneous hip dislocations occur in certain pathological conditions such as poliomyelitis (Ingram, 1980), cerebral palsy (Howard et al., 1985), osteomyelitis and neurofibromatosis.

[Hip prosthesis: idea, indications, development].

The authors describe the evolution and the successive stages that were necessary until the present total substitution of the hip joint could be worked out. The earliest attempts were made in 1923, but only in 1953, professor Marino Zuco, of Rome University Orthopedic Department started to carry out operations of arthroplasty, after 3 years of experimental research. In 1960, Charnley introduced the use of cement (methyl methacrylate), thus initiating the practice of total hip substitution. This surgery is indicated in a variety of joint pathologies of which osteoarthritis is the most frequent o…

Irritable hip and Perthes' disease.

One hundred fifty patients with 160 irritable hip episodes and 120 patients with Perthes' disease who were treated between 1976 and 1986 were compared. The ratio of males to females was 2.1:1 for patients with irritable hip and 3:1 for patients with Perthes' disease. On the average, patients with irritable hip were aged 3 years and patients with Perthes' disease were aged 7 years. The duration of symptoms in patients with irritable hip averaged 6 days and 6 weeks in patients with Perthes' disease. One patient developed Perthes' disease 2 months after the irritable hip episode. The mean intraar…

Management of congenital hip dysplasia.

In summary, congenital hip dysplasia remains a worldwide health problem, which has not been resolved by neonatal screening programs. The primary care physician's role is critical for early diagnosis. An understanding of the need for repeated examinations, the age related signs, and continued diligence is essential. The common use of the triple diaper treatment is not recommended.

[Traumatic hip dislocation in childhood].

The article reports on eight cases of traumatic dislocation of the hip in children. Six of these were genuine dislocations and two dislocation fractures. The children were between 5 and 13 years of age at the time of injury. Seven of these 8 children could be followed up one to 21 years after the accident. All 7 children were free from complaints at the time of follow-up examination; in one case only we found a moderate loss of function in the injured hip joint. In this patient the x-ray film showed deformation of the head of the femur after partial necrosis of the femoral head, as well as ini…

Irritable hip and campylobacter infection.

Three cases are reported which presented as "irritable" or "observation" hips and failed to respond to rest at home and in hospital. In each case a campylobacter organism was grown from the faeces; none were found in a group of 20 patients in the paediatric ward for other reasons. The patients responded to a course of erythromycin. It is postulated that they may have had a reactive arthropathy of the hip and suggested that cultures for Campylobacter be made as part of the investigation of irritable hip.

Sonography in pediatric hip disorders.

Real-time ultrasonography of the infant hip has proven to be a reliable and safe method of evaluating the joint for dislocation or instability. A number of techniques for diagnosing and quantifying these disorders have been developed. Several other applications of ultrasound in pediatric hip disorders have also been described, most notably the detection of joint fluid.

Namaqualand hip dysplasia. Orthopedic implications.

Namaqualand hip dysplasia (NHD) is an inherited skeletal disorder that has been identified in 45 persons in five generations of a large family in South Africa. Involvement of the femoral capital epiphyses, which was present in all cases, led to significant orthopedic complications. Hip pain developed between three and 20 years of age and heralded the onset and gradual progression of premature degenerative arthropathy. The patients who were examined were all over 35 years of age; four had been treated by total hip arthroplasty. For appropriate and effective management of this uncommon but well-…