Total hip replacement in congenital dislocation and dysplasia of the hip.

The results of thirty-one total hip replacements in twenty-four patients with either severe congenital dysplasia or dislocation, after an average follow-up of four years, were excellent in eleven, good in sixteen, fair in one, and poor in one. The operative technique included superolateral bone grafts to increase the acetabular coverage in six hips. Twenty-seven hips required smaller and straighter femoral components than normal. The incidence of major complications was 19 per cent.

Subluxation of the sacroiliac joints in a black female with ankylosing spondylitis.

A 55-year-old black female with ankylosing spondylitis (AS) is described. The patient had a severe flexion attitude secondary to a rotational subluxation at the sacroiliac joints with subsequent bony ankylosis. The sacroiliac abnormality has not been reported in AS patients. Sacroiliac joint laxity during multiple pregnancies might have contributed to the subluxation. The importance of this anatomic site in evaluating the surgical correction of the postural deformities of AS is stressed.

Clinical heterogeneity of skeletal dysplasia in Roberts syndrome: a review.

Roberts syndrome is a rare autosomal recessive disorder with highly variable clinical features. The most notable manifestations include pre- and postnatal growth retardation, craniofacial anomalies and improper development of all four extremities. We reviewed 50 cases whose clinical evaluation has been vigorously pursued. A relationship of deformities exists between humerus versus femur, and radius and ulna versus tibia and fibula. Only six cases had clubfoot. The number of fingers and toes was variable. The sex ratio was 1:1. Most individuals died in early infancy, although the longest follow-up survival was 13 years in one case. Premature centromere separation, centromere splitting and puffing were common chromosomal abnormalities. An annotated bibliography on notable cases is also provided which should serve as an aid for clinicians who wish to further understand the genetic and clinical heterogeneity noted in their cases.

Stress-riser fractures of the hip after sliding screw plate fixation.

Fractures occurring after fixation of intertrochanteric femur fractures have been described previously in the literature. Terms such as "stress-riser fracture" and "Young's modulus fracture" have been applied. The prevalence of these fracture types has increased, and so has use of the sliding screw plate device for fixation of intertrochanteric hip fractures. The object of this paper is to describe, by case examples, types of stress-related fractures of the proximal femur in association with the sliding screw plate and to define each biomechanical type in review.