Congenital Anterior Radial Head Dislocation with Valgus Deformity: A Case Report

Congenital radial head dislocation is a rare anomaly of the pediatric musculoskeletal system. The most common type is posterior, with anterior and lateral dislocations being less common. Unilateral cases are even more uncommon and were earlier thought to be non-existent. Our case report describes a young girl with unilateral congenital anterior radial head dislocation with progressive development of cubitus valgus deformity, which is a very rare occurrence. On reviewing literature, only few such cases have been described. Our patient also had a history of developmental dysplasia of hip and a congenital intra-hepatic porto-systemic shunt, which in addition to the morphological appearances of the radial head and capitellum, suggested a congenital etiology.

Pelvic Obliquity, It Is Not a Neutral Angle in the Normal Population

Introduction: The definition of pelvic obliquity angle (PO) still unclear in the normal population. Several factors might cause the obliquity i.e. hip osteoarthritis, developmental dysplasia of hip, trauma, scoliosis and spine related factors. Perhaps, pelvic obliquity is expressed as a deviation of neutral alignment in the normal population. We developed present study to evaluate the distribution of pelvic obliquity angle in normal population.Method: present study retrospectively enrolled on 134 cases (70 female and 64 male) without any problem of spine, pelvic and lower extremity abnormality who referred to our institution from January 2017 to January 2018 for non-orthopedic problems. We retrospectively reviewed radiographs from institutional PACS and measured pelvic obliquity angle using mediCAD Classic software (version 3.50.0.1, Hectec, Landstuhl, Germany). Finally, all data were analyzed with SPSS software (version 24.0, USA).Result: present study show that all data has significant relationship in one sample T test. All PO angles were normally distributed in kurtosis and skewness test. The patients were aged with a mean of 39.6 ±16.8 in current study. The mean of PO angle was 2.18 ±1.6 in all patients and 0.13 standard error of mean. There was no significant differences between male and female genders (2.07 ±1.6 vs 2.27±1.6, P=0.47). This study reveal that age and PO angle had not any correlation (P=0.165).Conclusion: despite this fact, there was an attitude that PO angle normally is in neutral alignment, our result uncover that the normal range of PO angle was not neutral and ranged from 0.58 to 4.4 degrees with one standard deviation from mean in the normal population.

Are Hips Too Relaxed to Develop Healthy ?

Background: Developmental dysplasia of hip (DDH) etiology is still a controversial issue. While many factors involved in the etiology, one of which is the hormone relaxin. Relaxin concentrations in patients with DDH may lead to pathodynamic changes during hip development by altering the physiological nature of the ligament, as well as by long-term exposure to relaxin during pregnancy. Our objective in this study was to determine the quantity of relaxin receptors in the ligamentum teres and their part in causing DDH.Methods: We identified infants between birth and 3 years of age who had undergone open reduction for DDH between 2010 and 2012. 12 hips of 12 miss abortus fetus between 20 to 35 weeks of gestation were used as control group. Specimens obtained from two groups were stained with Relaxin-2 antibody and the amount of staining for relaxin receptors was determined using an ordinal H score. Results: The mean H scores of infants with DDH were significantly higher than those of controls (p=0.00). Conclusion: As a result, increased number of relaxin receptors in the ligamentum teres could be a risk factor for DDH and the number of relaxin receptors is an important clue in explaining the female:male ratio and clinical prognosis of early dysplastic hips.Level of Evidence: Level 2, Prospective comparative study