Three cases of developmental dysplasia of the hip on partially mummified human remains (Roccapelago, Modena, 18th Century): a study of palaeopathological indicators through direct analysis and 3D virtual models

2016 ◽  
Vol 28 (3-4) ◽  
pp. 202-212 ◽  
Author(s):  
M. Traversari ◽  
F. Feletti ◽  
A. Vazzana ◽  
G. Gruppioni ◽  
M. A. Frelat
Keyword(s):  
Femoral Head ◽  
Birth Order ◽  
18Th Century ◽  
Human Remains ◽  
Direct Analysis ◽  
Developmental Dysplasia ◽  
Current Data ◽  
Acetabular Roof ◽  
Mechanical Factors ◽  
Dysplasia Of The Hip

Developmental dysplasia of the hip (DDH) is caused by a delay in the development of the acetabular cavity, leading to an anomaly in the angle of the acetabular roof. As a result, the femoral head and the acetabular cavity do not interact normally. The identification of three cases of DDH among the remains discovered in the most recent unit from the crypt at Roccapelago (Modena, Italy) enabled us to discuss the presence of DDH in this region during the 18th century. All three cases are bilateral and Dunn class I, two have been identified as male and one as female. These DDH cases are very likely mainly due to mechanical factors such as the breech position of the foetus, perhaps associated with birth order. But given their overall similarity, they may also have resulted from the practice of swaddling new-borns. In addition, current data from the Italian Ministry of Health suggests that the incidence of DDH has remained stable in this region from the 18th century to the present. The ongoing study of remains from earlier units should bring a better understanding of the particular prevalence of DDH at Roccapelago.

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

Developmental dysplasia of the hip

2011 ◽  
Author(s):  
Anish Sanghrajka ◽  
Deborah M Eastwood
Keyword(s):  
Femoral Head ◽  
Early Diagnosis ◽  
Surgical Approach ◽  
Developmental Dysplasia ◽  
Ultrasound Screening ◽  
Hip Instability ◽  
Appropriate Treatment ◽  
Aggressive Surgical Approach ◽  
Dysplasia Of The Hip ◽  
All Treatment

♦ Developmental dysplasia of the hip represents a spectrum of hip pathology with or without hip instability♦ Controversy continues regarding the relative roles of clinical and ultrasound screening programmes♦ Early diagnosis and prompt, appropriate treatment is important♦ All treatment methods risk compromising the vascularity of the developing femoral head♦ Residual dysplasia may require an aggressive surgical approach.

scholarly journals Irreducible developmental dysplasia of the hip due to acetabular roof cartilage hypertrophy. Diagnostic sonography in 15 hips

2011 ◽  
Vol 97 (6) ◽  
pp. 629-633 ◽  
Author(s):  
C. Tréguier ◽  
C. Baud ◽  
M. Ferry ◽  
J.-L. Ferran ◽  
P. Darnault ◽  
...  
Keyword(s):  
Developmental Dysplasia ◽  
Acetabular Roof ◽  
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 What are the significant factors affecting pain in patients with Hartofilakidis type Ι developmental dysplasia of the hip?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yange Gu ◽  
Wenshu Jin ◽  
Han Zhang ◽  
Zhiwei Shi ◽  
Yaohui Yue ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Femoral Head ◽  
Influencing Factors ◽  
Severe Pain ◽  
Cox Regression ◽  
Age At Onset ◽  
Developmental Dysplasia ◽  
Cox Regression Analysis ◽  
Sharp Angle ◽  
Dysplasia Of The Hip

Abstract Objective To explore the influencing factors of age at onset of pain and severe pain in patients with Hartofilakidis type I developmental dysplasia of the hip (DDH). Methods A retrospective study of 83 patients with DDH treated at our hospital from January 2017 to June 2021 was conducted. The age at onset of pain, patients’ demographic data, and radiographic parameters were collected. Multiple linear regression was used to determine the influencing factors of age at onset of pain. Cox regression analysis was used to determine the influencing factors of severe pain attacks. Results According to the results of multiple linear regression analysis, when the distance between the medial femoral head and the ilioischial line increased by one millimetre, the age at onset of pain decreased by 1.7 years (β = − 1.738, 95% CI − 1.914–[− 1.561], p < 0.001). When the sharp angle increases by one degree, the age at onset of pain decreases by 0.3 years (β = − 0.334, 95% CI − 0.496–[− 0.171], p < 0.001). According to the results of the Cox regression analysis, for each additional degree of the lateral centre-edge angle (LCEA), the probability of severe pain was reduced by 5% (Exp [β]: = 0.947, 95% CI 0.898–0.999, p = 0.044). For each additional millimetre in the distance between the medial femoral head and the ilioischial line, the likelihood of severe pain increased by 2.4 times (Exp [β]: 2.417, 95% CI 1.653–3.533, p < 0.001). Conclusion Larger distances between the medial femoral head and the ilioischial line and sharp angle can lead to an earlier age at onset of pain in patients with DDH. Small LCEA and excessive distance between the medial femoral head and the ilioischial line are risk factors for severe pain.

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