scholarly journals Original positioning method to determine the clinical and radiographic parameters of the hip joint in patients with cerebral palsy

2021 ◽  
Vol 13 (4) ◽  
pp. 90-93
Author(s):  
Yatsulіak M ◽  
Nemesh M ◽  
Martsyniak S ◽  
Kabatsiy M ◽  
Filipchuk v
Keyword(s):  
Cerebral Palsy ◽  
Hip Joint ◽  
Developmental Disorders ◽  
Original Method ◽  
Hip Joints ◽  
Femoral Torsion ◽  
Neck Shaft Angle ◽  
Radiographic Parameters ◽  
Medical Institutions ◽  
Positioning Method

Relevance: Obtaining true radiographic parameters of the hip joint helps to choose therapeutic tactics for children with cerebral palsy. Goal of the study: Improvement of the diagnostic results in pathology of the hip joint among patients with cerebral palsy by using our original method. Materials and methods: The number of examined patients – 30 persons (60 joints), 15 boys and 15 girls, 26 joints were operated. The age of patients ranged between 3-15 years. All patients underwent a clinical evaluation – Ruwe's femoral torsion, as well as radiography of the hip joints using our original method (utility model patent №137567). The offered method is cheap, simple and accessible to all medical institutions with an X-ray room, for the diagnosis and screening of pathology of the hip joint. The our original method can be used to determine all the main parameters of the hip joint (femoral torsion, neck-shaft angle, Viberg angle, Reimers’ index, acetabular angle, Sharp’s angle) in patients with cerebral palsy. Making only single radiograph, one obtains true radiographic parameters of both hip joints, which significantly reduces the radiation load upon the patient. Our method can be used in the examination and screening of patients with developmental disorders and other diseases of the hip joint.

scholarly journals The Method of Determining Clinical and Roentgenogrammetric Indicators of Hip Joint in Patients with Cerebral Palsy

2020 ◽  
pp. 35-42
Author(s):  
V.Yu. Hoshko ◽  
N.O. Naumenko ◽  
M.B. Yatsuliak ◽  
A.I. Cheverda ◽  
M.M. Nemesh ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Hip Joint ◽  
Developmental Disorders ◽  
Hip Joints ◽  
Femoral Torsion ◽  
Neck Shaft Angle ◽  
Joint Pathology ◽  
Medical Institutions ◽  
Shaft Angle ◽  
The Subject

Summary. There is no doubt that obtaining the true parameters of the hip joint makes it possible to determine the tactics of treatment of patients with cerebral palsy and it is a relevant object of studying. Objective: to improve the results of diagnostics of pathology of the hip joint in patients with cerebral palsy by developing our own method. Materials and Methods. The study included 20 patients (40 joints): 10 boys and 10 girls. Sixteen joints were operated on. The patients were 3-15 years of age. Femoral torsion according to Ruwe was clinically determined in all the patients; also, our own method for determining the clinical and roentgenogrammetric parameters of the hip joint (utility model patent No. 137567) was used. Results. Our own method is simple, available and cheap; it may be used in all medical institutions with X-ray rooms for the diagnosis of hip joint pathology, as well as for screening. Conclusions. Our own method is simple and reliable for determining the parameters of the hip joint in patients with cerebral palsy (femoral torsion, neck shaft angle, Wiberg's angle, Reimer's index, vertical migration index, acetabular angle, the angle of inclination of the acetabulum) in patients with cerebral palsy. Obtaining radiographic parameters of both hip joints after only one radiograph also significantly reduce the radiation load on the patient, since patients with cerebral palsy are the subject of screening throughout the entire period of their development. This method can be also applied during the examination and screening the patients with developmental disorders and other diseases of the hip joint.

scholarly journals Substantiation of the method for determining the clinical and radiographic parameters of the hip joint in patients with cerebral palsy

TRAUMA ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 42-46
Author(s):  
V.Yu. Hoshko ◽  
N.O. Naumenko ◽  
M.B. Yatsuliak ◽  
A.I. Cheverda ◽  
M.M. Nemesh ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Hip Joint ◽  
Neuromuscular Disorders ◽  
Neck Shaft Angle ◽  
Standard Position ◽  
Radiographic Parameters ◽  
Acetabular Angle ◽  
Number Of Patients ◽  
Shaft Angle ◽  
Student’S T

Background. The difficulties of diagnosis that arise when choosing therapeutic measures aimed at preventing sublu-xation, dislocation, and contractures of the hip joint in patients with cerebral palsy are a topical object of the research. The purpose was to improve the results of the diagnosis of the hip joint pathology by establishing objective radiographic parameters. Materials and methods. The total number of patients was 20 (40 joints), 10 boys and 10 girls aged 3 to 15 years. Sixteen joints were operated. Radiographically, we have determined neck-shaft angle and torsion of the thigh, projection and true according to Koval (using tables), acetabular angle, angle of inclination (Sharpe’s angle). Hip torsion was determined clinically according to Ruwe. Torsion was evaluated intraoperatively in our own way (patent No. a200512793). All patients were examined using our method (patent No. 137567). Results. Using the Student’s t-test for independent samples, the parameters of the hip joints were compared and significant differences were found between the neck-shaft angle in the standard position and the neck-shaft angle in our own position (p < 0.05), as well as between the neck-shaft angle in the standard position and the neck-shaft angle true according to Koval (p < 0.05). According to Fisher’s test, it was found that the torsion according to Ruwe and the torsion according to Koval are significantly different (p < 0.05): Femp 1.87 > Fkr 1.7. Using the method of odds ratio (OR), we determined that the sensitivity of torsion measurement by Ruwe was 0.7, the specificity of torsion measurement by Ruwe was 0.83 (OR = 11.67, confidence interval [1.94–70.18]) indicating that the chance of getting a coincidence by measuring torsion by Ruwe is 11.67 times higher than accor-ding to Koval, compared with intraoperative data. A well-defined amount of torsion of the thigh according to Ruwe provides true indicators of the hip joint using our own method. Conclusions. The own method provides the determination of objective clinical and radiographic (diagnostic) parameters in patients with patho-logy of the hip joint. When performing one roentgenogram, it is possible to define all basic parameters of the hip joint (torsion of the hip, neck-shaft angle, Wiberg’s angle, Reimers’ index, index of vertical migration, acetabular angle, angle of inclination) and to standardize examinations of patients with cerebral palsy who are subject to screening throughout the whole period of their development. In this way, you can get radiographic indicators of patients with severe neuromuscular disorders (Gross Motor Function Classification System levels III and IV).

Virtual Model and Simulation of the Normal and Affected Human Hip Joint

2016 ◽  
Vol 823 ◽  
pp. 167-172 ◽  
Author(s):  
Daniel Calin ◽  
Daniela Tarniţă ◽  
Dragos Popa ◽  
Dan Calafeteanu ◽  
Dan Tarnita
Keyword(s):  
Hip Joint ◽  
Ct Scanning ◽  
Original Method ◽  
Ansys Software ◽  
Hip Joints ◽  
Element Analysis ◽  
Model And Simulation ◽  
Mechanical Assemblies ◽  
3D Software ◽  
Anatomical Information

To generate a virtual human hip is a main goal for our research team. Also, starting from the normal virtual hip joint and using the important orthopedics information was defined the affected hip joint. All these models were generated in a 3D virtual environment starting with CT scanning images. Using an original method all the scanned CT images were re-defined and re-drawn and transferred to the 3D software. The resulted curves were used to generate the bones and the virtual complex system of both hip joints. With motion and geometric constrains the bio-mechanical assemblies were defined, starting from anatomical information. The normal hip joint and the model of the affected hip were defined and exported to ANSYS, software based on Finite element analysis.

scholarly journals 8-Year-Old Child with Cerebral Palsy Treated with Pelvic Osteotomies Using 3.5 MM Blade Plate Having Subsequent Bilateral Implant Aseptic Loosening: A Case Report

2021 ◽  
Author(s):  
Ahmed Nahian ◽  
Julieanne P. Sees
Keyword(s):  
Cerebral Palsy ◽  
Aseptic Loosening ◽  
Hip Joints ◽  
Neck Shaft Angle ◽  
Blade Plate ◽  
Muscle Balance ◽  
Blade System ◽  
Shaft Angle ◽  
Neurological Insult ◽  
The Brain

Background: Cerebral palsy (CP) is a central problem of the brain due to neurological insult that affects muscle posture, tone, and movement, resulting in poor motor control and dysfunctional muscle balance affecting hip joints in the growing child. Surgical treatment of hip and, if present, acetabular dysplasia addresses the femoral neck-shaft angle, appropriate muscle lengthening, and deficiency of acetabular coverage, as necessary. The surgeons perform proximal femoral osteotomies (PFOs) mostly with fixed angled blade plates (ABP) with proven success. The technique using an ABP is common and requires detailed attention to perform and to teach. The Case: In this case, an eight-year-old ambulatory patient with CP underwent bilateral proximal varus femoral derotational and pelvic osteotomies for the neuromuscular hip condition with a 3.5 mm Locking Cannulated Blade System (OP-LCP) by OrthoPediatrics Corp instead of the use of the conventional 4.5 mm ABP procedure, resulting in aseptic loosening. Conclusion: Due to the child’s underdeveloped posture, the surgeon utilized the 3.5 mm instrumentation for a child-size implant, which worked sufficiently for the surgery but may not have loosened if a similar child-size blade plate system of 4.5 mm screws was implanted. While the ABP and OP-LCP systems are fruitful and safe for internal corrections of PFOs, the OP-LCP system may aid the residents in learning the procedure with higher confidence, fewer technical inaccuracies, and refined outcomes. Both systems are safer and viable for the treatment of neuromuscular hip conditions.

scholarly journals Reconstruction of the Hip in Multiple Hereditary Exostoses

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 490
Author(s):  
Dong Hoon Lee ◽  
Dror Paley
Keyword(s):  
Hip Joint ◽  
Joint Involvement ◽  
Neck Shaft Angle ◽  
Multiple Hereditary Exostoses ◽  
Femur Neck ◽  
Radiographic Outcomes ◽  
Surgical Dislocation ◽  
Center Edge ◽  
Shaft Angle ◽  
Coxa Valga

The hip joint involvement in multiple hereditary exostoses (MHE) occurs in 30–90%, causing pain and limitation of motion by femoroacetabular impingement, coxa valga, acetabular dysplasia, hip joint subluxation, and osteoarthritis. The purpose of this study was to investigate the clinical and radiographic outcomes of ten hips in seven patients treated by surgical dislocation and corrective osteotomies between 2004 and 2009. Surgical dislocation and excision of the osteochondromas and varus intertrochanteric osteotomies were performed in all cases when the neck–shaft angle was > 150°. Common sites of osteochondromas were medial, posterior, and anterior neck of the femur. Neck–shaft angle of the femur was improved from a mean of 157° to 139°, postoperatively. On an average, the center-edge angle improved from 20° to 30° postoperatively. We believe that Ganz’s safe surgical dislocation technique is the preferred treatment of MHE. This safeguards the circulation of the femoral head and the osteochondromas can be resected under direct vision. It can be combined with additional corrective osteotomies because the hip affected by MHE is frequently associated with dysplastic changes which can result in premature osteoarthritis.

Morphological patterns of the hip joint structure in students of choreography schools and young athletes involved in sports associated with the art of movement

2020 ◽  
Vol 15 (6) ◽  
pp. 90-93
Author(s):  
O.S. Vasiliev ◽  
◽  
S.P. Levushkin ◽  
E.E. Achkasov ◽  
◽  
...  
Keyword(s):  
Hip Joint ◽  
Young Athletes ◽  
Hip Joints ◽  
Joint Structure ◽  
Normal Limits ◽  
Rhythmic Gymnastics ◽  
Key Words Hip ◽  
Coxa Valga ◽  
Key Words Hip Dysplasia ◽  
Morphological Patterns

Students of choreography schools and young athletes involved in sports associated with the art of movement usually have dysplastic hip joints with normal acetabular coverage and femoral Coxa valga, whose normal limits require further discussion. We have identified 5 X-Ray morphological patterns of the hip joint structure typical of such individuals, and analyzed their association with professional qualities. Key words: hip dysplasia, dysplastic constitution, Coxa valga, young athletes, rhythmic gymnastics, choreography, ballet

scholarly journals Risk factors for venous thrombosis in patients with endoprosthetics of hip joints

2021 ◽  
Vol 11 (9) ◽  
pp. 875-885
Author(s):  
Ihor Venher ◽  
Sviatoslav Kostiv ◽  
Dymytrii Khvalyboha
Keyword(s):  
Connective Tissue ◽  
Femoral Neck ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Hip Joint ◽  
Hip Replacement ◽  
Inferior Vena ◽  
Vena Cava ◽  
Hip Joints ◽  
Connective Tissue Dysplasia

Background. Important part of orthopaedic surgery is endoprosthetics of hip joints, which eliminates pain syndrome, restores the amplitude of movements and the support ability of the lower limb. But there is a number of complications; venous thromboembolism among them occupies a leading place. Material and methods. 219 patients with a mean age of 64.7 ± 3.8 years were operated. In 137 (62.1%) observations, total cement hip replacement was performed for osteoarthritis. 82 (37.4%) patients received total and unipolar cement hip replacement for cervical femoral neck fractures. Results. Clinical manifestations of non-specific connective tissue dysplasia were detected in 83 (37.9%) patients, which were confirmed by the laboratory determination of the level of general, bound and free oxyproline. In the postoperative period, the thrombotic process in the venous system of the inferior vena cava was diagnosed in 23 (10.5%) observations. Operative intervention on the hip joint in patients with nonspecific dysplasia of connective tissue in 11 (13.3%) cases was complicated by the development of venous thrombosis. In patients without non-specific connective tissue dysplasia, postoperative thrombosis in the system of the inferior vena cava was diagnosed in 12 (8.8%) observations. Conclusions. Patients with osteoarthrosis of the hip joint and the femoral neck fracture accompanied by the non-specific dysplasia of the connective tissue are characterized by expressed levels of endothelial dysfunction and increased activity of the blood-coagulation system.

scholarly journals The functional use of the reciprocal hip mechanism during gait for paraplegic patients walking in the Louisiana State University reciprocating gait orthosis

1999 ◽  
Vol 23 (2) ◽  
pp. 152-162 ◽  
Author(s):  
P. M. Dall ◽  
B. Müller ◽  
I. Stallard ◽  
J. Edwards ◽  
M. H. Granat
Keyword(s):  
Hip Joint ◽  
Swing Phase ◽  
Spinal Injuries ◽  
Small Contribution ◽  
State University ◽  
Hip Joints ◽  
Cable Tension ◽  
Louisiana State University ◽  
Hip Flexion ◽  
Limb Flexion

Reciprocally linked orthoses used for paraplegic walking have some form of linkage between the two hip joints. It has been assumed that flexion of the swinging leg is driven by extension of the stance leg. The aims of this study were to investigate the moments generated around the hip joint by the two cables in a Louisiana State University Reciprocating Gait Orthosis (LSU-RGO). Six (6) subjects were recruited from the Regional Spinal Injuries Centre at Southport, who were experienced RGO users. The cables were fitted with strain gauged transducers to measure cable tension. Foot switches were used to divide the gait into swing and stance phases. A minimum of 20 steps were analysed for each subject. Moments about the hip joint for each phase of gait were calculated. There were no moments generated by the front cable in 4 of the subjects. In only 2 subjects did the cable generate a moment that could assist hip flexion during the swing phase. These moments were very low and at best could only have made a small contribution to limb flexion. The back cable generated moments that clearly prevented bilateral flexion. It was concluded that the front cable, as used by these experienced RGO users, did not aid flexion of the swinging limb.

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