Establishing reference values for the pubofemoral distance in normal infant medial hips by ultrasound

2020 ◽  
pp. 028418512093324
Author(s):  
Yongguang Ban ◽  
Qinhua Luan ◽  
Miao Shi ◽  
Bo Sun ◽  
Tianyou Li ◽  
...  
Keyword(s):  
Age Groups ◽  
Developmental Dysplasia ◽  
Pubic Bone ◽  
Normal Infant ◽  
Male And Female ◽  
Type Ia ◽  
Hip Reduction ◽  
And Gender ◽  
Dysplasia Of The Hip

Background Measuring the pubofemoral distance (PFD) is important for evaluating the effectiveness of hip reduction in the treatment of developmental dysplasia of the hip (DDH). However, reference PFD values have not been established in normal infants. Purpose To investigate variations in PFD values measured in normal infant medial hips stratified by age, laterality, and gender. Material and Methods A total of 240 infants diagnosed with Graf type Ia and/or Graf type Ib hips by ultrasonography were stratified into eight age groups: 0–1 month; 1–2 months; 2–3 months; 3–4 months; 4–5 months; 5–6 months; 6–7 months; and 7–12 months. The bilateral medial hips were scanned with transinguinal ultrasound. The PFD was defined as the distance between the lateral edge of the superior ramus of pubic bone and the medial edge of the femoral head. Inter-observer reproducibility was assessed. Results Among the 240 infants, there were 371 Graf type Ia hips and 109 Graf type Ib hips. Mean ± SD bilateral PFD values of eight groups were measured separately. There were no significant differences in mean PFD values for left or right hips (t = 0.946, P = 0.345) or mean bilateral PFD values in male and female infants (t = 1.445, P = 0.149). Mean PFD values increased linearly with age (left: r = 0.680, P < 0.0001; right: r = 0.682, P < 0.0001). Inter-observer reproducibility was excellent. Conclusion This study established reference PFD values from the medial hip in infants aged 0–12 months. PFD values increased with age, but were not significantly influenced by laterality or gender. These data provide detailed information that can support follow-up of infants treated for DDH.

scholarly journals Treatment of the Developmental Dysplasia of the Hip with an Abduction Brace in Children up to 6 Months Old

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Raphaël Wahlen ◽  
Pierre-Yves Zambelli
Keyword(s):  
Femoral Head ◽  
Retrospective Analysis ◽  
Reduction Rate ◽  
Developmental Dysplasia ◽  
Pavlik Harness ◽  
Treatment Procedure ◽  
Hip Reduction ◽  
One Year ◽  
Dysplasia Of The Hip

Introduction. Use of Pavlik harness for the treatment of DDH can be complicated for parents. Any misuse or failure in the adjustments may lead to significant complications. An abduction brace was introduced in our institution, as it was thought to be easier to use.Aim. We assess the results for the treatment of DDH using our abduction brace in children of 0–6 months old and compare these results with data on treatments using the Pavlik harness.Method. Retrospective analysis of patients with DDH from 0 to 6 months old at diagnosis, performed from 2004 to 2009. Outcomes were rates of reduction of the hip and avascular necrosis of the femoral head (AVN). Follow-up was at one year and up to 4 years old.Results. Hip reduction was successful in 28 of 33 patients (85%), with no AVN.Conclusion. Our results in terms of hip reduction rate and AVN rate are similar to those found in literature assessing Pavlik harness use, with a simpler and comfortable treatment procedure.

scholarly journals Use of antidepressants among Finnish family caregivers: a nationwide register-based study

2021 ◽  
Author(s):  
Tuija M. Mikkola ◽  
Hannu Kautiainen ◽  
Minna Mänty ◽  
Mikaela B. von Bonsdorff ◽  
Hannu Koponen ◽  
...  
Keyword(s):  
Relative Risk ◽  
Family Caregivers ◽  
High Intensity ◽  
Matched Control ◽  
Age Groups ◽  
Control Population ◽  
Defined Daily Doses ◽  
Male Caregivers ◽  
And Gender

Abstract Purpose The purpose of this study was to compare the use of antidepressants over 6 years between family caregivers providing high-intensity care and a matched control population using register-based data. Methods The study includes all individuals, who received family caregiver’s allowance in Finland in 2012 (n = 29,846 females, mean age 66 years; n = 12,410 males, mean age 71 years) and a control population matched for age, sex, and municipality of residence (n = 59,141 females; n = 24,477 males). Information on purchases of antidepressants, including the number of defined daily doses (DDD) purchased, between 2012 and 2017 was obtained from the national drugs reimbursement register. Results During the follow-up, 28.5% of female caregivers and 23.5% of the female controls used antidepressants, while the numbers for males were 21.1% and 16.4%, respectively. Adjusted for socioeconomic status, female caregivers used 43.7 (95% confidence interval 42.4–45.0) and their controls used 36.2 (35.3–37.2) DDDs of antidepressants per person-year. Male caregivers used 29.6 (27.6–31.6) and their controls used 21.6 (20.2–23.0) DDDs of antidepressants per person-year. Among female caregivers, the relative risk for use of antidepressants was similar (about 1.3) from 20 to 70 years, after which the relative risk declined. In male caregivers, the relative risk was highest (about 1.4–1.5) between 45 and 65 years. Conclusions Family caregivers providing high-intensity care use more antidepressants and hence, are likely to have poorer mental health than the age-matched general population in virtually all age groups. However, the magnitude of the higher use varies as a function of age and gender.

The Relationship between Psychological Skills, Experience, and Practice Commitment among Collegiate Male and Female Skiers

1993 ◽  
Vol 7 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Sally A. White
Keyword(s):  
Psychometric Properties ◽  
Gender Effect ◽  
Psychological Skills ◽  
Internal Reliability ◽  
Male And Female ◽  
Mental Preparation ◽  
The Social ◽  
And Gender ◽  
The Relationship

The Psychological Skills Inventory for Sport (PSIS; Mahoney, 1988) identifies certain psychological skills or characteristics possessed by successful athletes. However, little has been done to connect the PSIS with other variables that may have an impact on the athletes’ psychological skills. Therefore the purpose of this study was twofold. First, the psychometric properties of the PSIS for all subjects and by gender were determined. Second, the relationship between the PSIS, experience, practice commitment, and gender of collegiate skiers was examined. A random sample of 131 male and female collegiate skiers responded to the 45-item PSIS. Overall, the six PSIS subscales (anxiety, concentration, confidence, mental preparation, motivation, and team emphasis) demonstrated acceptable internal reliability (coeff. alpha = .69−.84). Results of a 4 × 3 × 2 (Experience × Practice Commitment × Gender) MANOVA and follow-up univariate F tests revealed a significant gender effect on the team emphasis subscale. Female collegiate skiers were more team oriented than male collegiate skiers and placed more importance on the social and affiliative aspects of being on a team than did their male counterparts.

Outcomes of closed reduction in patients with developmental dysplasia of the hip incorporating open psoas and adductor release and using short leg cast

2021 ◽  
Vol 15 (5) ◽  
pp. 1529-1532
Author(s):  
M. S. Abdulqader ◽  
L. J. Khorsheed ◽  
Hwaizi .
Keyword(s):  
Soft Tissue ◽  
Closed Reduction ◽  
Case Series ◽  
Developmental Dysplasia ◽  
Soft Tissue Release ◽  
Plaster Of Paris ◽  
Dysplasia Of The Hip ◽  
Mid Term Results ◽  
Tönnis Grade

Background and objectives: Closed reduction and short leg spica casting are the preferred treatment options for children with developmental dysplasia of the hip. This study aimed to show the efficacy behind a standardized closed reduction for managing patients with developmental dysplasia of the hip with concomitant soft tissue releases when indicated and using a short leg plaster of Paris cast to maintain reduction and reporting mid-term results. Methods: A case series of 95 hips in 84 children aged 6-18 months who had closed reduction, with five years follow up or until next operation, involved in this study. The protocol defines acceptable concentric reduction criteria and the indications for an associated soft tissue release. All the patients were immobilized in a short leg cast for three months. Multiple follow-up radiographs were taken to assess Tönnis grade, Severin grade, acetabular index, and osteonecrosis signs. Results: A total of 48 hips were Tönnis grade 3/4 hips. At one year, 15 reductions couldn’t be maintained, and these patients needed open reduction. Of these 15 failed reductions, 7 patients were Severin 1; others were Severin 2. Of the 80 successful closed reductions, 70 hips were Severin 1. Surgical management for residual dysplasia was offered for 8 hips. Osteonecrosis was seen in 23 hips but was transient in 20. Bilateral hip dislocations and most Tönnis 4 hips were more likely to fail. Two children had severe osteonecrosis. Conclusions: Closed reduction, with subsequent adductor and psoas releases, when indicated and using a short leg plaster of Paris cast for three months, brings about good mid-term results in children with developmental dysplasia of the hip aged 6-18 months. Keywords: Developmental dysplasia of the hip, closed hip reduction, open psoas release, short leg cast.

scholarly journals Acetabular reaming and sartorius muscle pedicle iliac bone grafting in the treatment of developmental dysplasia of the hip in older children: a retrospective study of 15 patients with more than two years follow-up

2020 ◽  
Vol 14 (3) ◽  
pp. 201-207
Author(s):  
Zhang Fan ◽  
Luo Cong ◽  
Liu Hang ◽  
Li Ming ◽  
Wu Jun ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bone Grafting ◽  
Developmental Dysplasia ◽  
Iliac Bone ◽  
Sartorius Muscle ◽  
Acetabular Defect ◽  
Older Children ◽  
Short Term ◽  
Dysplasia Of The Hip

Purpose Despite the early diagnosis and treatment of developmental dysplasia of the hip (DDH), some older children still need open reduction. It is usually difficult to get a satisfactory reduction particularly in patients with acetabular defect. The purpose of this study was to evaluate the short-term outcomes of acetabulum reaming and sartorius muscle pedicle iliac bone grafting in the treatment of older children with DDH and acetabular defect. Methods The records of 15 patients with DDH (mean age 113.9 months (sd 29); 17 hips) who were treated with the reported technique between February 2015 and January 2017 were retrospectively reviewed. All patients acquired regular clinical and radiographic follow-ups, and alterations in the acetabular index, centre-edge angle and acetabular head index were measured. Joint function and radiographic results were evaluated with McKay and Severin modified criteria, respectively. Results A total of 15 patients were followed up for mean 32.4 months (sd 6.9). The percentages of excellent and good conditions were 94.1% (16/17) according to the Severin modified criteria and 88.2% (15/17) according to the McKay modified criteria. Avascular necrosis of the femoral head and redislocation only occurred in one hip. No cases of ankylosis or bone graft absorption occurred during the follow-up. Conclusion Reaming the acetabulum and sartorius muscle pedicle iliac bone grafting for repairing the acetabular defect can recover the arcuate structure by increasing the volume of the acetabulum, which is beneficial for achieving a concentric reduction. The short-term outcome was satisfactory, while the long-term results need to be further observed. Level of Evidence IV – retrospective study

scholarly journals Developmental dysplasia of the hip: update of management

2019 ◽  
Vol 4 (9) ◽  
pp. 548-556 ◽  
Author(s):  
Alfonso Vaquero-Picado ◽  
Gaspar González-Morán ◽  
Enrique Gil Garay ◽  
Luis Moraleda
Keyword(s):  
Physical Examination ◽  
Open Reduction ◽  
Acetabular Dysplasia ◽  
Wide Spectrum ◽  
Positive Family History ◽  
Developmental Dysplasia ◽  
Ultrasound Screening ◽  
Spontaneous Correction ◽  
Hip Reduction ◽  
Dysplasia Of The Hip

The term ‘developmental dysplasia of the hip’ (DDH) includes a wide spectrum of hip alterations: neonatal instability; acetabular dysplasia; hip subluxation; and true dislocation of the hip. DDH alters hip biomechanics, overloading the articular cartilage and leading to early osteoarthritis. DDH is the main cause of total hip replacement in young people (about 21% to 29%). Development of the acetabular cavity is determined by the presence of a concentrically reduced femoral head. Hip subluxation or dislocation in a child will cause an inadequate development of the acetabulum during the remaining growth. Clinical screening (instability manoeuvres) should be done universally as a part of the physical examination of the newborn. After two or three months of life, limited hip abduction is the most important clinical sign. Selective ultrasound screening should be performed in any child with abnormal physical examination or in those with high-risk factors (breech presentation and positive family history). Universal ultrasound screening has not demonstrated its utility in diminishing the incidence of late dysplasia. Almost 90% of patients with mild hip instability at birth are resolved spontaneously within the first eight weeks and 96% of pathologic changes observed in echography are resolved spontaneously within the first six weeks of life. However, an Ortolani-positive hip requires immediate treatment. When the hip is dislocated or subluxated, a concentric and stable reduction without forceful abduction needs to be obtained by closed or open means. Pavlik harness is usually the first line of treatment under the age of six months. Hip arthrogram is useful for guiding the decision of performing a closed or open reduction when needed. Acetabular dysplasia improves in the majority due to the stimulus provoked by hip reduction. The best parameter to predict persistent acetabular dysplasia at maturity is the evolution of the acetabular index. Pelvic or femoral osteotomies should be performed when residual acetabular dysplasia is present or in older children when a spontaneous correction after hip reduction is not expected. Avascular necrosis is the most serious complication and is related to: an excessive abduction of the hip; a force closed reduction when obstacles for reduction are present; a maintained dislocated hip within the harness or spica cast; and a surgical open reduction.Cite this article: EFORT Open Rev 2019;4:548-556. DOI: 10.1302/2058-5241.4.180019

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