By Professor Dr. Dietrich Tönnis (auth.)
For greater than a hundred years, congenital dislocation of the hip has been a space of shock in orthopedics. This courses at the topic are al so much too quite a few to count number. but our wisdom of the elemental rules of congenital hip dislocation and its administration is continually being improved by means of new study. In Germanspeaking nations, Kaiser pub lished the final complete textbook on congenital hip dislocation in 1958, and Schlegel with a entire guide in 1961. within the Angloamerican international, Coleman's monograph was once pub lished in 1978, Somerville's in 1982, and Wilkinson's in 1985. In 1982 Tachdjian compiled a quantity on congenital hip dislocation that con tained contributions from forty four experts. the aim of the current publication is to supply an summary of our pre despatched country of data of congenital hip dislocation, overlaying uncomplicated ideas, analysis, tools of closed and open therapy, and indi cations. within the strategy, an try out is made to track growth within the box from its beginnings to the current time. Many authors describe the analysis and remedy of congenital hip dysplasia and dislocation by way of particular age teams. We think it truly is extra prudent to take an individualized technique in response to arthro photograph findings and the measure of severity of pathologic adjustments. much less emphasis is positioned the following at the administration of sufferers via age group.
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Extra resources for Congenital Dysplasia and Dislocation of the Hip in Children and Adults
13). Of interest in this context is a study by Dvonsch and Bunch (1983) which indicates that ossification of the sub capital growth plate normally begins on the lateral side and progresses medially. 4 Factors Influencing the Growth and Shape of the Proximal Femur The growth and shape of the proximal femur are critically influenced by the static and muscular forces acting on the hip joint. 1 Static Forces Roux, in 1895, advanced the theory of the functional adaptation of bone through periosteal growth.
An example is the "disuse coxa valga" described by Lindemann (1930, 1936). In an effort to explain the development of a valgus neck angle in patients with congenital muscular atonias, Lindemann related the condition to an absence of weight bearing on the femur as a result of disease and prolonged bed rest. The opposite phenomenon, a decrease in the neck-shaft angle, is observed in small children who have just started to walk and gain weight. Clinical examples of changes in the neck-shaft angle in response to unilateral changes in muscular action are coxa valga in spastics and coxa valga following surgical resection of the greater trochanter (Brandes 1924; Brandes and Horeyseck 1951).
Dysplastic hips do not show the growth spurts which characterize the normal hip. Also, closure of the triradiate cartilage takes place considerably earlier in the dysplastic hip. Marked differences also exist in the development of the acetabular floor (Imhauser 1947, 1952) and the teardrop figure (Peic 1975), although these differences are no longer apparent once anatomic recovery has been achieved. Another interesting observation in our study pertained to cases in which acetabular dysplasia was present on one side and coxa valga on the other.