Recurrent dislocation of the hip in adult paraplegics

Gp, Graham; Cm, Dent; Pd, Evans; McKibbin, B

doi:10.1038/sc.1992.119

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…38,39 Furthermore, three cases of hip dislocation have been reported to be associated with AD reaction. 40 Sexual activity in both sexes may induce a dysre¯exia reaction. Manipulation of the vagina during investigations may be a triggering factor and induction of AD by ovarian cysts have been reported.…”

Section: Underlying Diseasementioning

confidence: 99%

Autonomic dysreflexia

1999

Spinal Cord

305

227

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Autonomic dysreflexia (AD) may complicate spinal cord injured (SCI) subjects with a lesion level above the sixth thoracic level. There are several ways to remove triggering factors and, furthermore, new trigger mechanisms may be added by the introduction of new treatments. New data about the pathogenic mechanisms have been suggested in recent years as well as signs of metabolic effects associated with the reaction. This review of the syndrome includes clinical aspects of the AD reaction; the known pathogenic mechanisms, the incidence and prevalence and triggering factors. AD is associated with some cases of severe morbidity, including cerebral haemorrhage, seizures and pulmonary oedema. Symptomatic as well as specific treatments are discussed. Finally, some further questions are raised by the necessity of a proper definition of the syndrome, the revealing of the underlying pathophysiology, and new investigations concerning incidence and prevalence.

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Section: Underlying Diseasementioning

confidence: 99%

Autonomic dysreflexia

1999

Spinal Cord

305

227

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“…Michaelis3 had good results with iliopsoas and obliquus externus myotomy; Graham et al 4. described 3 cases of recurrent dislocation of the hip in adult paraplegics successfully treated with open reduction and bone block augmentation of the acetabulum; Becker et al 5.…”

Section: Discussionmentioning

confidence: 99%

Paraplegic flexion contracture of hip joints: An unsolvable problem

Bhattacharyya

2016

IJOO

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Paraplegic flexion contracture of hip joints beyond 90° is a difficult condition to treat for any orthopedic surgeon. There is no fixed protocol of treatment described, by and large it is individualized. A 20 year old female presented with paraplegia for last 15 years due to irrecoverable spinal cord disease with complete sensory and motor loss of both lower extremities and was admitted with acute flexion contracture of both hip joints with trunk resting on thighs. She underwent bilateral proximal femoral resection. Both hip joints were straight immediately after surgery and patient could lie on her back. In a course of time, she started sitting on her buttocks, led a comfortable wheelchair life with a sitting balance. Proximal femoral resection is an effective method to treat long standing irrecoverable paraplegic acute flexion deformity of the hip joint.

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“…Michaelis [10] had good results with iliopsoas and obliquus externus myotomy; Graham et al [11] described 3 cases of recurrent dislocation of the hip in adult paraplegics successfully treated with open reduction and bone block augmentation of the acetabulum; Becker et al [12] focused on periarticular ossification in paraplegics, reporting the results of six patients treated with a total hip replacement. He recommends avoiding femoral head resection in favour of total hip arthroplasty even in complete paraplegia, as the former has the risk of posterior trochanteric dislocation and consequent formation of pressure sores.…”

Section: Discussionmentioning

confidence: 99%

Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

Nicodemo

Bersano

et al. 2014

Case Reports in Medicine

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Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

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Recurrent dislocation of the hip in adult paraplegics

Cited by 8 publications

References 9 publications

Autonomic dysreflexia

Autonomic dysreflexia

Paraplegic flexion contracture of hip joints: An unsolvable problem

Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

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