Herausgeber:
Springer Berlin Heidelberg
Erscheinungsdatum:
06.12.2012
For more than 100 years, congenital dislocation of the hip has been an area of concern in orthopedics. This publications on the subject are al most too numerous to count. Yet our knowledge of the basic principles of congenital hip dislocation and its management is constantly being expanded by new research. In Germanspeaking countries, Kaiser pub lished the last comprehensive textbook on congenital hip dislocation in 1958, and Schlegel followed with a comprehensive handbook in 1961. In the Angloamerican world, Coleman's monograph was pub lished in 1978, Somerville's in 1982, and Wilkinson's in 1985. In 1982 Tachdjian compiled a volume on congenital hip dislocation that con tained contributions from 44 authorities. The purpose of the present book is to provide an overview of our pre sent state of knowledge of congenital hip dislocation, covering basic principles, diagnosis, methods of closed and open treatment, and indi cations. In the process, an attempt is made to trace progress in the field from its beginnings to the present time. Many authors describe the diagnosis and treatment of congenital hip dysplasia and dislocation in terms of specific age groups. We believe it is more prudent to take an individualized approach based on arthro graphic findings and the degree of severity of pathologic changes. Less emphasis is placed here on the management of patients by age group.
Inhalt
1 Anatomic Aspects.- 1.1 Anatomy of the Hip Joint.- 1.1.1 The Acetabulum.- 1.1.2 Position of the Acetabulum.- 1.1.3 The Femoral Head.- 1.1.4 The Femoral Neck.- 1.1.5 Angle of Femoral Torsion.- 1.1.6 Femoral Shaft Axis, Mechanical Axis, and Knee Joint Axis.- 1.1.7 Tibial Torsion.- 1.1.8 The Role of the Acetabular Labrum and Atmospheric Pressure in Stabilizing the Hip.- 1.1.9 The Capsule and Ligaments of the Hip.- 1.1.10 The Muscles of the Hip.- 1.2 Vascular Supply of the Hip.- 1.2.1 Vascular Supply of the Femoral Head and Femoral Neck.- 1.2.2 Vascular Supply of the Acetabulum.- 1.3 Innervation of the Hip Joint.- 2 Development of the Hip Joint.- 2.1 Development of the Acetabulum.- 2.2 Principles of Pelvic Growth.- 2.2.1 External Apposition (Perichondrial and Periosteal).- 2.2.2 Internal, Proportional Resorption in the Pelvic Aperture.- 2.2.3 Chondral Growth Principle.- 2.2.4 Details of Growth.- 2.3 Development of the Proximal Femur.- 2.4 Factors Influencing the Growth and Shape of the Proximal Femur.- 2.4.1 Static Forces.- 2.4.2 Muscular Forces.- 2.5 Shape and Position of the Hip Joint During Development.- 2.6 Growth of the Juvenile Hip Joint as Established from Planimetric Measurements.- 3 Development of the Vascular System of the Hip Joint and Its Variations with Reference to Ischemia.- 3.1 Vascular Pattern at Birth.- 3.2 Infantile Phase (from About Four Months to Four Years).- 3.3 Intermediate Phase from About Four to Seven Years.- 3.4 Preadolescent Phase from 9 to 10 Years.- 3.5 Adolescent Phase.- 3.6 Variations of the Vascular Pattern.- 3.7 Clinical Implications.- 4 Introduction to the Biomechanics of the Hip.- 4.1 General.- 4.2 Loads and Stresses on the Hip.- 4.3 Current Knowledge on the Biomechanics of the Hip (Literature Survey).- 4.4 Anatomic Aspects.- 4.5 Radiographic Aspects.- 4.6 Principles of Biomechanical Analysis.- 4.7 The Load on the Hip.- 4.7.1 Load Model.- 4.7.2 Discussion of Geometric Parameters Used to Determine the Hip Load.- 4.7.3 Procedure for Calculating the Hip Load.- 4.7.4 Remarks on Load Calculations.- 4.8 The Stress on the Hip.- 4.8.1 Model for Calculating Joint Pressure (Maximum Pressure, Equal Pressure Distribution).- 4.8.2 Correction of the Pressure Calculation (Position of the Femoral Head Center C, Acetabular Anteversion).- 4.8.3 Calculation of Weight-Bearing Area with Allowance for the "Mean Inlet Plane".- 4.8.4 Pressure Distribution (Linear Pressure Rise, Hooke's Law).- 4.9 Explicit Calculation of Load and Stress.- 4.9.1 The Normal Hip.- 4.9.2 Illustrative Case.- 4.9.3 Published Reports on Biomechanical Data in the Normal Hip.- 4.10 Standard Treatments of Hip Dysplasia in Adults and Their Biomechanical Efficacy.- 4.10.1 Intertrochanteric Osteotomies.- 4.10.2 Trochanteric Transfer.- 4.10.3 Pelvic Operations.- 4.11 Questions Relating to the Planning of Operative Tactics.- 4.12 Conclusion.- 5 Etiology of Congenital Dislocation of the Hip.- 5.1 Older Causation Theories.- 5.2 Anatomic and Racial Predisposition.- 5.3 Prevalence and Geographic Distribution.- 5.4 Sex Incidence and Ratio of Affected Sides.- 5.5 Inheritance.- 5.6 Exogenous, Mechanical Causative Factors.- 5.7 The Study of P. M.Dunn.- 5.8 Further Studies on Mechanical Causative Factors.- 5.9 Hormonal Effects on the Hip Capsule.- 5.10 Capsular and Ligament Laxity.- 5.11 Seasonal Influences.- 5.12 Summary and Conclusion.- 6 Pathologic Anatomy of Congenital Dislocation of the Hip.- 6.1 Grade 1 Dislocation of the Hip.- 6.2 Grade 2 Dislocation of the Hip.- 6.3 Grade 3 Dislocation of the Hip.- 6.4 Direction of Dislocation and Orientation of the Acetabulum.- 6.5 The Proximal Femur.- 6.5.1 Coxa Valga.- 6.5.2 Femoral Antetorsion.- 6.5.3 The Femoral Head.- 6.6 Vascular Supply in High Dislocations.- 6.7 The Muscles in Congential Dislocation of the Hip.- 7 Nomenclature and Classification of Congenital Hip Dislocation.- 7.1 Nomenclature.- 7.2 Classification of Congenital Hip Dislocation and Anatomic Findings.- 7.3 Grades of Dislocation According to Howorth and Dunn.- 7.4 Grades of Dislocation According to the CSHD.- 7.5 Graf's Classification by Sonographic Appearance.- 8 Clinical Examination of the Hip.- 8.1 History.- 8.1.1 Newborns and Infants.- 8.1.2 Older Children and Adults.- 8.2 Examination During Walking and Standing.- 8.2.1 Limp with a Positive Trendelenburg Sign.- 8.2.2 Limp Due to Shortening.- 8.2.3 Limp Due to Pain.- 8.2.4 Limp Due to Ankylosis.- 8.2.5 Examination in Stance.- 8.3 Testing the Range of Hip Motion in Older Children and Adults.- 8.3.1 Flexion and Extension.- 8.3.2 Abduction and Adduction.- 8.3.3 Internal and External Rotation.- 8.4 Testing the Range of Hip Motion in Newborns.- 8.5 Limitations of Hip Motion in Congenital Hip Dysplasia and Dislocation.- 8.6 Further Tests for Exclusion of Hip Dysplasia and Dislocation in Infants.- 8.6.1 Leg Length Examination in Infants.- 8.6.2 Skin Relief and Skin Folds.- 8.6.3 Manual Examination of the Hip.- 8.6.4 Expanded Classification of Palpatory Findings.- 8.6.5 Techniques of Manual Examination.- a) Ortolani's Examination.- b) Examination of Coleman and Palmén.- c) Barlow's Examination.- d) Dislocation and Reduction Sign of Klopfer.- e) Our Examination Technique.- 8.7 Anatomic Basis of the Roser-Ortolani Sign.- 8.8 DryHipClick.- 8.9 Naming the Roser-Ortolani Sign.- 8.10 Definition of the Roser-Ortolani Sign.- 8.11 Ludloff's Sign.- 9 General Radiography of the Hip Joint.- 9.1 Radiographic Evaluation of the Acetabulum.- 9.1.1 AP Pelvic Film for Evaluating the Lateral Acetabular Roof.- 9.1.2 Faux Profil View for Demonstrating the Anterior Acetabular Roof.- 9.1.3 View of Chassard and Lapiné for Evaluating the Posterior Acetabular Rim and Acetabular Anteversion.- 9.1.4 View of Dunlap et al. for Evaluating the Posterior Acetabular Rim and Acetabular Anteversion.- 9.2 Radiographic Evaluation of the Femoral Neck.- 9.2.1 Frontal (Anteroposterior) View.- 9.2.2 Lateral Views of the Femoral Neck.- a) Axial Hip Views of Dunn, Rippstein and Müller for Evaluating Femoral Antetorsion.- b) Axial Orthograde View of the Hip for Evaluating the Second Plane of the Femoral Head and Neck.- c) Axial Views of the Hip in the Vertical Projection (Lauenstein's View) and in the Horizontal Projection (Sven Johansson's View).- 9.3 Functional Views of the Hip Joint.- 9.3.1 View of Andrén and von Rosen for the Diagnosis of Hip Dislocation.- 9.3.2 Abduction-Medial Rotation View (Lange's Position) in Small Children.- 9.3.3 Functional Views in Older Children and Adults.- 9.4 Commonly Used Reference Lines for the Diagnosis of Hip Disloc…
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