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Trace Minerals
Published in Luke R. Bucci, Nutrition Applied to Injury Rehabilitation and Sports Medicine, 2020
In 1981, Fincham and others, of the Division of Nutritional Pathology of the National Research Institute for Nutritional Diseases in Parowvallei, South Africa, proposed that Mseleni hip disease was actually a manganese deficiency.991 Mseleni disease occurs sporadically (39% of females and 11% of males) in the KwaZulu area of South Africa, especially near Lake Sibaya. Symptoms include osteoarthritis of multiple joints which progresses to a crippling hip dislocation. Most adults in the region are smaller than usual in stature, suggesting mild dwarfism (shortened and thickened bones). Epiphyseal dysplasia and disturbances of bone mineralization are evident upon closer examination of Mseleni disease subjects. An early finding is an increase in serum alkaline phosphatase,991 similar to findings in animals. All these symptoms are identical to manganese deficiency symptoms in animals. Fish from Lake Sibaya are severely and uniformly stunted, unlike their counterparts in other nearby lakes.992 However, the few livestock in the region range freely and eat selectively, and exhibit few signs of manganese deficiency.
History of osteotomies around the hip joint and their classification
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
An osteotomy is a surgical corrective procedure used to obtain the correct biomechanical alignment of the lower extremity so as to achieve equivocal and uniform load transmission, which may be done with or without removal of a portion of the bone from either cortex calculated by radiological estimation.5 A clear understanding is obtained by the appreciation of the imaging techniques available and their correct application. A number of indices give a good idea of its severity and of the degree of congruency, instability, and degenerative change that have been defined on these radiographs to facilitate surgical planning and to evaluate surgical outcomes. It is important to realize that plain radiographs or fluoroscopy are usually the only diagnostic means available pre-operatively. The imaging modalities of projection radiography, computerized tomography (CT), and magnetic resonance imaging (MRI), including direct magnetic resonance-arthrography, are discussed with regard to their diagnostic capability in the postoperative assessment of the hip joint.6 Consolidation of osteotomies and position of implants should be assessed in postoperative radiography. MRI is useful for confirming correct articulation after treatment of congenital hip dislocation.
Breech presentation
Published in David M. Luesley, Mark D. Kilby, Obstetrics & Gynaecology, 2016
For the extended breech climbing the perineum (once the umbilicus has delivered), two fingers can be slid along the posterior surface of the fetal thigh towards the popliteal fossa. Gentle pressure along the thigh causes slight abduction of the hips along with gentle pressure on each popliteal fossa to allow flexion of the knee in its natural plane of movement which brings the foot down, expediting delivery (Pinard’s manoeuvre). Gentleness and natural planes of movement will help avoid femoral fracture and hip dislocation.
Development and calibration of a probabilistic finite element hip capsule representation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Casey A. Myers, Clare K. Fitzpatrick, Daniel N. Huff, Peter J. Laz, Paul J. Rullkoetter
Hips that have experienced some sort of mechanical compromise of the capsule are at heightened risk of instability (Woo and Morrey 1982; Wetters et al. 2013). This is demonstrated most directly in terms of the increased incidence of dislocation in hips that have had a prior surgery, particularly a previous THA (Alberton et al. 2002). In the United States, instability/dislocation is the most common indication for revision THA, accounting for 22.5% of all revisions (Bozic et al. 2009). Hip dislocation often happens early, with approximately 60% occurring within the first five weeks to three months postoperatively (Bourne and Mehin 2004) and more than 80% of dislocations with the first year (Ali Khan et al. 1981; D’Angelo et al. 2008; Van Sikes et al. 2008). Dislocations occur more often in the posterior direction, approximately 65.6% of the time, compared to the anterior direction at 34.4% (Fessy et al. 2017). Many studies have demonstrated that meticulous capsular repair can reduce the risk of dislocation and improve stability (Goldstein et al. 2001; White et al. 2001; Patel et al. 2007; McLawhorn et al. 2015).
Crescent Technique with Dual C-Shaped Reconstruction Plates for Posterior Acetabular Wall Fractures
Published in Journal of Investigative Surgery, 2020
Cem Yalın Kılınc, Ahmet Emrah Acan, Emre Gultac, Rabia Mihriban Kılınc, Sancar Serbest, Ugur Tiftikci, Nevres Hurriyet Aydogan
Fractures of the posterior wall of the acetabulum are the most common acetabular fractures. In Letournel’s series of 940 acetabular fractures, 24% were isolated and 26% involved a fracture of the posterior wall as part of a more complex fracture pattern [1,2]. Since these are usually high-energy fractures, there is often concomitant hip dislocation. In an unstable hip and/or when a large part of the posterior wall is involved, an open reduction and internal fixation are required [3–5]. Most of these fractures are comminuted; therefore, the reduction and stabilization are extremely difficult [2]. Moreover, the clinical results are directly affected by the reduction quality [3,6,7]. The main goal of surgery is to obtain a stable hip with an anatomical reduction and no step or gap formation [3,8–10]. In addition, the reduction must be protected until solid union is complete. Saterbak et al. emphasized the importance of this in a study reporting a 33% reduction loss rate at the end of a 1-year follow-up [6].
Predicting Hip Dysplasia in Teenagers with Cerebral Palsy in order to Optimize Prevention and Rehabilitation. A Longitudinal Descriptive Study
Published in Developmental Neurorehabilitation, 2021
Carlo Bertoncelli, Paola Altamura, Edgar Ramos Vieira, Domenico Bertoncelli, Federico Solla
Cerebral Palsy (CP) is a term used for a group of non-progressive motor and postural control and postural disorders as a result of damage during the early stages of brain development.1 Hip dysplasia and dislocation are common and severe problems2,3 in patients with CP (figure 1); the risk of neuromuscular hip dysplasia (NHD) is highest in patients with the most severe forms of CP, especially in those who cannot walk.4 Hip dysplasia occurs in more than 1/3 of children with CP, and it is typically progressive. Hip dislocation can result in pain and difficulty with sitting and perineal care.5 When early diagnosis is made, non-operative treatments may prevent or delay progression, maintain pelvic symmetry, and prolong pain-free hip mobility.6 Early identification and rehabilitation with conservative or less invasive measures (abduction posture, physical therapy, botulinum toxin injection, and/or abductor muscle tenotomies) instead of more complex surgery (i.e. pelvic and/or femur osteotomy) is important to help manage NHD in children with CP.7 Screening programs help identify the risk of NHD and prevent dislocation.8 However, high-quality evidence on NHD risk factors and prediction in teenagers with CP is lacking.9 The variability in incidence, diagnosis, and treatment outcomes of NHD reported in the literature highlights the lack of standardized screening and management protocols and emphasizes the need for stronger supporting evidence.10,11