scholarly journals Triple Curve Scoliosis Presented with Developmental Dysplasia of the Left Hip in Marfan Syndrome

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Lukas Widhiyanto ◽  
Tri Wahyu Martanto ◽  
Febrian Brahmana
Keyword(s):  
Marfan Syndrome ◽  
Open Reduction ◽  
Developmental Dysplasia ◽  
Scoliosis Surgery ◽  
Cast Immobilization ◽  
Autosomal Dominant Disorder ◽  
Major Curve ◽  
Ponte Osteotomy ◽  
Coronal Imbalance ◽  
Dysplasia Of The Hip

Introduction: Marfan syndrome is an autosomal dominant disorder of connective tissue, and skeletal system involvements are the cardinal features.  Triple rigid large major curve in conjunction with developmental dysplasia of the hip in Marfan syndrome is rare then sagittal and coronal imbalance correction on this case is challengingCase Presentation: We reported a case of 12 years old female with Marfan syndrome presented triple rigid large Major curve scoliosis on left cervico-thoracal, right main  thoracal and left thorakolumbal, also developmental dysplasia of the left hip has been done correction surgery consist of open reduction following cast immobilization of the left hip, multiple ponte osteotomy and asymetrical pedicle substraction osteotomy to correct sagittal and coronal imbalance.Discussion: the treatment of scoliosis in patients with Marfan syndrome parallels that in patients with idiopathic scoliosis and spinal fusion and instrumentation should be considered for curves greater than 45 to 50 degrees. Posterior technique, Ponte osteotomy correct 10 to 20 degrees and pedicle substraction osteotomy correct 30 to 40 degrees at each segment are effective for managing sagittal and coronal imbalance in scoliosis. Open reduction developmental dysplasia of the hip to overcome complicated coronal balance correction.Conclusion : Detailed planning scoliosis surgery is needed to correct a rare the sagittal and coronal imbalance due to scoliosis complicated with developmental dysplasia of the hip in Marfan syndrome.

scholarly journals Prediction of the requirement of open reduction for developmental dysplasia of the hip

2017 ◽  
Vol 46 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Nabil Alassaf
Keyword(s):  
Open Reduction ◽  
Area Under The Curve ◽  
Internal Validity ◽  
Developmental Dysplasia ◽  
Estimation Model ◽  
Cross Sectional ◽  
Noninvasive Treatment ◽  
Dysplasia Of The Hip ◽  
Logistic Regression Equation ◽  
Objective Tool

Objective Closed reduction (CR) is a noninvasive treatment for developmental dysplasia of the hip (DDH), and this treatment is confirmed intraoperatively. This study aimed to develop a preoperative estimation model of the probability of requiring open reduction (OR) for DDH. Methods The study design was cross-sectional by screening all patients younger than 2 years who had attempted CR between October 2012 and July 2016 by a single surgeon. Potential diagnostic determinants were sex, age, side, bilaterality, International Hip Dysplasia Institute (IHDI) grade, and acetabular index (AI). An intraoperative arthrogram was the reference standard. A logistic regression equation was built from a reduced model. Bootstrapping was performed for internal validity. Results A total of 164 hips in 104 patients who met the inclusion criteria were analysed. The prevalence of CR was 72.2%. Independent factors for OR were older age, higher IHDI grade, and lower AI. The probability of OR = 1/[1 + exp − (−2.753 + 0.112 × age (months) + 1.965 × IHDI grade III (0 or 1) + 3.515 × IHDI grade IV (0 or 1) − 0.058 × AI (degrees)]. The area under the curve was 0.79. Conclusion This equation is an objective tool that can be used to estimate the requirement for OR.

Secondary Surgery and Residual Dysplasia Following Late Closed or Open Reduction of Developmental Dysplasia of the Hip

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
William Z. Morris ◽  
Sean Hinds ◽  
Hannah Worrall ◽  
Chan-Hee Jo ◽  
Harry K.W. Kim
Keyword(s):  
Open Reduction ◽  
Developmental Dysplasia ◽  
Secondary Surgery ◽  
Dysplasia Of The Hip

Treatment of developmental dysplasia of the hip in infants aged between 12 and 18 months with open reduction surgery

2014 ◽  
Vol 49 (4) ◽  
pp. 335
Author(s):  
FathyH Salama ◽  
Mohamed Abdallah ◽  
OsmanAbd Ellah ◽  
SamirA Elshora
Keyword(s):  
Open Reduction ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

Kickstand Rod Technique for Correcting Coronal Imbalance in Adult Scoliosis: 2-Dimensional Operative Video

2019 ◽  
Vol 19 (2) ◽  
pp. E163-E164 ◽  
Author(s):  
Thomas J Buell ◽  
Avery L Buchholz ◽  
Marcus D Mazur ◽  
Jeffrey P Mullin ◽  
Ching-Jen Chen ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Adult Scoliosis ◽  
Scoliosis Surgery ◽  
Major Curve ◽  
Coronal Imbalance ◽  
Medical Publication ◽  
Alignment Correction ◽  
Iliac Screw ◽  
Coronal Malalignment ◽  
The Impact

Abstract Restoration of spinal alignment and balance is a major goal of adult scoliosis surgery. In the past, sagittal alignment has been emphasized and was shown to have the greatest impact on functional outcomes. However, recent evidence suggests the impact of coronal imbalance on pain and functional outcomes has likely been underestimated.1,2 In addition, iatrogenic coronal imbalance may be common and frequently results from inadequate correction of the lumbosacral fractional curve.2,3 The “kickstand rod” is a recently described technique to achieve and maintain significant coronal-plane correction.4 Also, of secondary benefit, the kickstand rod may function as an accessory supplemental rod to offload stress and bolster primary instrumentation. This may reduce occurrence of rod fracture (RF) or pseudarthrosis (PA).5  Briefly, this technique involves positioning the kickstand rod on the side of coronal imbalance (along the major curve concavity or fractional curve convexity in our video demonstration). The kickstand rod spans the thoracolumbar junction proximally to the pelvis distally and is secured with an additional iliac screw placed just superior to the primary iliac screw. By using the iliac wing as a base, powerful distraction forces can reduce the major curve to achieve more normal coronal balance. This operative video illustrates the technical nuances of utilizing the kickstand rod technique for correction of severe lumbar scoliosis and coronal malalignment in a 60-yr-old male patient. Alignment correction was achieved and maintained without evidence of RF/PA after nearly 6 mo postoperatively. The patient gave informed consent for surgery and to use imaging for medical publication.

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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