[Symphysis rupture during partus]. / Symfyseruptuur durante partu.

A few hours after the birth of her first child a 36-year-old woman developed anterior pelvic pain. The pain worsened on walking. It proved that during the birth the patient had felt something 'give'. On X-ray a diastasis of 50 mm was seen in the symphysis and symphysis rupture was diagnosed. The patient was treated conservatively with bed rest and pelvic stabilisation. After 17 weeks she was symptom-free. Symphysis rupture during partus is rare. It is characterised by pain around the symphysis and/or the sacro-iliac joints during the first 24 hours post partum. Diagnosis can be made by X-ray. Treatment is predominantly conservative comprising pelvic stabilisation and bed rest.

Femoral fit predicts radiologic changes, but not clinical results, in Mallory-head total hip arthroplasties.

We prospectively studied the clinical and radiologic results of three groups of patients: 89 patients who had standard primary total hip replacements; 63 patients with hip dysplasia who had primary total hip replacements; and 48 patients who had revision total hip replacements. We studied the differences in clinical and radiologic behaviors of a titanium hydroxyapatite-coated stem with variations in the tightness of fit of the prosthesis in the femoral canal, operative group, stem size, grade of osteoporosis, and morphometric features of the femur. The clinical results in all three groups are slightly favorable for the standard primary group. Pain relief and stem survival in the three groups were similar to those reported in other studies regarding cementless prostheses. Nontight femoral fit significantly positively influenced the development of cancellous densification; however, the presence of osteoporosis also contributed to the formation of cancellous densification. Only tight femoral canal fit significantly positively influenced the development of cortical thickening independent of other parameters. There was no correlation between clinical parameters and the radiologic phenomena in either of the groups.

The "Oxford Heup Score": the translation and validation of a questionnaire into Dutch to evaluate the results of total hip arthroplasty.

BACKGROUND: The evaluation of a total hip prosthesis would be most complete if the opinion of the patient, surgeon and the radiographs are combined. Disease specific patient outcome questionnaires are scarce, especially in Dutch. METHODS: The disease-specific 12-item questionnaire on the perception of patients with total hip replacement was translated into Dutch. We also investigated the extra value of two specific hip items, "the need for walking aids" and "sexual problems because of the hip", four general items on overall satisfaction and one question about patient classification. The 14 hip-specific items were each scored from 1 (least difficulties) to 5 (most difficulties). The Dutch translation, the "Oxford Heup Score" (OHS) was tested on psychometric quality in a multicenter prospective study. RESULTS: The psychometric results of the OHS proved to be adequate. In the first postoperative year the score was very sensitive to changes, whereas in the second year it did not change significantly. The two added hip-specific questions were both filled out positively by more than 50% of the patients and thus fit perfectly into a hip-specific patient outcome questionnaire such as the OHS. INTERPRETATION: The OHS proves to be an appropriate instrument for assessment of the outcome of total hip replacement from the patient's perspective. Together with the judgement of the surgeon, it provides useful insights into the question of whether this operation has been a success or not.