MRI evaluation of hip containment and congruency after closed reduction in congenital hip dislocation

Druschel, Claudia; Placzek, Richard; Selka, Lina; Seidl, Tamara; Funk, Julia F.

doi:10.5301/hipint.5000070

Cited by 16 publications

(13 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In der vorliegenden Studie wurde das bisher größte Kollektiv kongenitalermittels primärer geschlossener Reposition therapierter und MR-tomografisch nachuntersuchter -Hüftluxationen beschrieben. Bisher vorliegende Studien beinhalten entweder wesentlich geringere Fallzahlen oder nutzen keine MR-Bildgebung zur direkten postinterventionellen Erfolgskontrolle [8,13]. Zudem sind die dort beschriebenen Patientenkollektive bez.…”

Section: Diskussionunclassified

“…Die in dieser Studie verwendeten radiologischen Indizes stellen durch ihre hohe Inter-und Intraobserver-Reliabilität über diverse Studien hinweg entscheidende Kriterien für die Erfolgsbewertung der Reposition dar [8,14,15]. Natürlich sind diese Kriterien auch in anderen Kontexten anwendbar, wenngleich dies im klinischen Alltag bei Narkosenotwendigkeit für MR-Untersuchungen bei Säuglingen nur selten der Fall sein wird.…”

Section: Diskussionunclassified

“…Daher ist die Beurteilung der transversalen Ebene von großer Bedeutung, da der Beobachter geneigt sein könnte, durch alleinige Betrachtung der koronaren Gelenkstellung zu falsch positiven Ergebnissen zu gelangen. In der vorliegenden Studie stellten sich die Hüftköpfe kleiner dar als in einer Studie von Druschel und Kollegen [8]. Dies mag in einem jüngeren Patientenkollektiv begründet sein oder in der Tatsache, dass in der vorliegenden Studie die Fläche der Hüftköpfe in der transversalen Ebene nicht approximativ bestimmt wurde.…”

Section: Diskussionunclassified

“…Für die schwere Form der Hüftdysplasiedie kongenitale Hüftluxationzählten in der Vergangenheit insbesondere Repositionsorthosen nach Pavlik, Abduktionskissen nach Frejka oder Traktionsbehandlungen zu den Verfahren der Wahl. Im Verlauf des vergangenen Jahrzehnts hat sich in der Literatur, aber auch im klinischen Alltag zunehmend die arthrografisch gestützte, geschlossene Reposition mit anschließender Becken-Bein-Gips-Anlage verbreitet, die den Vorteil geringerer Komplikationsraten und einer unmittelbaren Erfolgskontrolle mittels eines postinterventionellen MRTs erlaubt [7,8].…”

Section: Introductionunclassified

See 3 more Smart Citations

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Congenital hip dislocation (luxation) has an incidence of 0.4 – 0.7% and is regarded as a prearthrotic deformity. Thus, if not being diagnosed and treated at a very early age, extensive surgical measures are inevitable in childhood and early adulthood. Methods In the time between 01/2013 and 02/2019 we performed 28 600 hips sonographies in babies as part of general screening measures at U2 or U3. There were 71 instable, dysplastic or dislocated hips diagnosed that were treated by arthrographic, closed reduction. After a hip spica cast was applied, reposition was controlled by MRI, estimating the acetabular head index (ACI), the head coverage index (HCI) as well as the femoral headʼs sphericity or by sonography using the Graf method. Results Overall success rate was 91.6% for primary closed reduction. Patients with primarily irreducible hips were significantly older (p < 0.003) than patients with primarily successful reducible hips. Congenital dislocated hips had significantly higher ACIs (p < 0.001) and HCIs (p = 0.03) as well as significantly less well rounded femoral heads (sphericity; p < 0.001) compared to stable hips. Conclusion Early diagnosis and treatment of congenital dislocated hips by closed reduction is essential for a sufficient and regular maturation of the hips without further surgical interventions.

show abstract

Section: Diskussionunclassified

Section: Introductionunclassified

See 2 more Smart Citations

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…[20–24] To children older than 6 months, manipulative reduction and spica cast are used generally. According to the report by Druschel et al, [25] magnetic resonance imaging scanning used to examine the femoral head containment after the close reduction showed that 22 hips were stable and 27 hips were not. For irreducible children who failed in traditional therapy and with poor containment, open reduction is the only way; whereas open reduction has effects of operation trauma and complications, especially femoral avascular necrosis and limited joint mobility.…”

Section: Discussionmentioning

confidence: 99%

Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up

Yan

et al. 2016

Medicine

View full text Add to dashboard Cite

The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation.

show abstract

Sonographic-Based Treatment

Kolovos

Maizen

Pellegrin

et al. 2022

Developmental Dysplasia of the Hip

View full text Add to dashboard Cite

MRI evaluation of hip containment and congruency after closed reduction in congenital hip dislocation

Abstract: Dislocated hips showed significantly lower values for all of the evaluated parameters concerning congruency and containment. MRI is not only useful to confirm successful reduction but may also help to predict outcome by evaluating following dislocation.

Cited by 16 publications

References 18 publications

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up

Sonographic-Based Treatment

Contact Info

Product

Resources

About