Traumatic Hip Dislocation in Childhood

ISBN-13: 9783642828942 / Angielski / Miękka / 2012 / 146 str.

Antonio Barquet; Roberto Masliah

Opis

Although the number of published papers on traumatic hip disloca tion in childhood is large, our actual current knowledge on this inju ry in this age group is still full of obscure points and unsolved prob lems. Luxation of the hip of traumatic origin in children is infrequent, and the small number of cases reported by authors and institutions, as well as the usually short follow-up in many cases, are responsible for the many doubts and questions, especially related to complications and outcome following the injury. Consequently the treatment, especially the postreduction management, has not been adequately defined. Dr. Antonio Barquet has made the great effort to analyze the ex perience gained from 38 cases in Uruguay and to review more than 500 references related to the subject, covering more than 1400 cases. He began to study this topic in 1976. It was the subject of his postgraduate monograph in 1979, which was followed by a statisti cal analysis of the major complication, i. e., avascular necrosis of the proximal femoral extremity, which was presented as his doctoral thesis in 1981. In addition, he has published numerous papers deal ing with several aspects of traumatic hip dislocation in children."

Spis treści

1 Introduction.- 1.1 General Considerations and Purpose.- 1.2 Hip Development.- 1.2.1 Acetabulum.- 1.2.2 Proximal End of Femur.- 1.3 Hip Vascularity.- 2 Etiopathogenesis.- 2.1 Incidence.- 2.1.1 General Considerations.- 2.1.2 Incidence of THDC Relative to THDA.- 2.1.3 Incidence of THD Relative to Traumatic Separation of the Proximal Femoral Epiphysis and to Femoral Neck Fractures in Children.- 2.2 Age.- 2.3 Sex.- 2.4 Side.- 2.5 Mechanisms of Injury.- 2.6 Severity of Injury.- 3 Pathoanatomical Classifications.- 3.1 By Dislocation.- 3.1.1 Posterior Dislocations.- 3.1.2 Anterior Dislocations.- 3.1.3 Inferior Dislocations.- 3.1.4 Bilateral Dislocations.- 3.1.5 Incidence of Varieties.- 3.2 By Associated Lesions.- 3.2.1 Simple Dislocations and Fracture Dislocations….- 3.2.1.1 Simple Dislocations.- 3.2.1.2 Fracture Dislocations.- 3.2.2 Dislocations with Nerve Injuries.- 3.2.2.1 Pathoanatomical Basis.- 3.2.3 Dislocations with Vascular Injuries.- 3.2.4 Dislocations with Ipsilateral Femoral Shaft Fracture.- 3.2.5 Open Dislocations.- 4 Recent Dislocations.- 4.1 Clinical Features.- 4.1.1 Symptoms and Signs.- 4.1.2 Special Circumstances.- 4.1.3 Associated Nerve Injuries.- 4.1.4 Associated Vascular Injuries.- 4.2 Roentgenographs Diagnosis.- 4.3 Initial Therapeutic Protocol.- 4.3.1 Simple Dislocations.- 4.3.1.1 Reduction Procedures.- 4.3.1.2 Postreduction Clinical and Radiological Tests.- 4.3.1.3 Irreducible Recent Simple Dislocations.- 4.3.2 Fracture Dislocations.- 4.3.2.1 Dislocations with Acetabular Fracture.- 4.3.2.2 Dislocations with Femoral Head Fracture.- 4.3.2.3 Dislocations with Separation of the Capital Femoral Epiphysis.- 4.3.2.4 Dislocations with Femoral Neck Fracture.- 4.3.2.5 Dislocations with Separation of the Greater Trochanter.- 4.3.3 Dislocations with Ipsilateral Femoral Shaft Fracture.- 4.3.4 Dislocations with Nerve Injuries.- 4.3.5 Dislocations with Vascular Injuries.- 4.3.6 Open Dislocations.- 5 Complications, Prognosis, and Postreduction Therapeutic Protocol.- 5.1 Complications.- 5.1.1 Avascular Necrosis.- 5.1.1.1 Interval Before Diagnosis.- 5.1.1.2 Symptoms and Signs.- 5.1.1.3 Roentgenographic Patterns — Physiopathological Basis.- 5.1.1.4 Bone Scintiscan.- 5.1.1.5 AN — THDC and other AN of the PFE in Children.- 5.1.1.6 Etiopathogenesis.- 5.1.1.7 Other Factors.- 5.1.1.8 Incidence.- 5.1.1.9 Outcome and Prognosis.- 5.1.1.10 Treatment.- 5.1.2 Recurrent Dislocation.- 5.1.2.1 Etiopathogenesis.- 5.1.2.2 Pathoanatomical Considerations.- 5.1.2.3 Clinical Aspects.- 5.1.2.4 Roentgenographic Signs.- 5.1.2.5 Outcome and Prognosis.- 5.1.2.6 Treatment.- 5.1.3 Premature Fusion of Growth Plates of Traumatic Origin.- 5.1.3.1 Premature Fusion of the Longitudinal Growth Plate.- 5.1.3.2 Premature Fusion of the Trochanteric Growth Plate.- 5.1.3.3 Premature Fusion of the Acetabular Triradiate Cartilage.- 5.1.4 Heterotopic Ossification.- 5.1.4.1 Incidence.- 5.1.4.2 Etiopathogenesis.- 5.1.4.3 Symptoms and Signs.- 5.1.4.4 Radiological Signs.- 5.1.4.5 Treatment and Prognosis.- 5.1.5 Traumatic Arthritis.- 5.1.5.1 Clinical and Radiological Signs.- 5.1.5.2 Treatment.- 5.2 Prognosis.- 5.2.1 Factors of Influence.- 5.2.2 Incidence of Normal and Abnormal Results.- 5.3 Postreduction Therapeutic Protocol.- 6 Unreduced Dislocations.- 6.1 Introduction.- 6.2 Etiologic Circumstances.- 6.3 Pathoanatomy.- 6.4 Clinical and Radiological Features.- 6.5 Treatment.- References.