ABSTRACT
For the research here presented, a total of 15 femoral heads with idiopathic necrosis in 15 patients, ranging in the age from 28 to 59 years, were available. In 7 of the histologically examined, in the occasion of endoprosthetic obtained femoral heads, a singular necrosis was to be discovered. In 6 items two attacks of necrosis, in 2 even three attacks could be confined. The comparison of these results with the clinically obtained case history showed that the second as well as the third attack of necrosis occurred during the first two years of the disease and partly obvious due to the increase of subjective symptoms. With the knowledge of these facts, it may be assumed that by means of exact observation of the patients concerned, even after diagnosis has been made, valuable tips to solve the up to now still unknown etiology of idiopathic avascular necrosis could be won.
Subject(s)
Femur Head Necrosis/pathology , Adult , Female , Femur Head/pathology , Femur Head Necrosis/surgery , Follow-Up Studies , Hip Prosthesis , Humans , Male , Middle AgedABSTRACT
The question whether disturbances of hormonal regulation influence the development of the hip joint, is examined on the basis of roentgenographs in 25 patients with epiphyseolysis. We can conclude from the numerous collected data that gross anatomy (especially the harmonic development between head and acetabulum) is largely normal. A change of the abductor angle of Debrunner in the sense of a reduction may exercise an unfavorable influence on the load which the entire hip joint has to bear (due to reduction of the lever arm of the musculature with an abductor effect). Besides, hormonal dysregulation produces a very minimal enlargement of the head radius and of the load area as well as of the length of the neck of the femur c, which may possibly become biomechanically manifest. The slight change in shape of the entire pelvic girdle is reminiscent of the late form of osteoarthrosis of the hip (coxarthrosis) on the basis of a so-called enchondral dysostosis. The working hypothesis according to which this normal dysostosis would in fact be a late form of epiphyseolysis, remains unconfirmed.
Subject(s)
Epiphyses, Slipped/diagnostic imaging , Hip Joint/diagnostic imaging , Osteoarthritis/etiology , Adolescent , Age Factors , Aged , Biomechanical Phenomena , Child , Endocrine System Diseases/complications , Epiphyses, Slipped/etiology , Epiphyses, Slipped/physiopathology , Female , Humans , Male , Middle Aged , RadiographyABSTRACT
Osteoarthrosis of the hip (also known as coxarthrosis) as a result of a high-region dislocation of the hip, presents a difficult task for the orthopaedic surgeon, the solution of which is still under frequent and intense discussion. Total hip replacemnt (hip endoprosthesis) involves technical difficulties which result on the one hand, from the underdeveloped anatomic conditions (underdeveloped primary acetabulum with soft spongiosa on valgus position of the highly sclerosed secondary acetabulum associated with underdeveloped shaft of the femur); on the other hand, a repositioning is difficult if anchoring of the prosthesis is effected at the level of the primary acetabulum. For this reason, we developed an original operation method requiring two sessions: in a first operation, an extended arthrolysis is performed via an anterior access, whereas at the same time an extension is carried out by means of the distraction apparatus according to Wagner. After this first session, distraction is performed during 3 to 4 weeks until the head of the femur has attained the level of the primary acetabulum. The prosthesis is inserted in a second session, where anchoring at the level of the primary acetabulum becomes possible and repositioning can be affected without undue difficulties. An example of such total hip replacement by endoprosthesis, requiring 2 sessions, is demonstrated.
Subject(s)
Hip Joint/surgery , Hip Prosthesis/methods , Osteoarthritis/surgery , Female , Hip Dislocation/complications , Hip Prosthesis/instrumentation , Humans , Middle Aged , Osteoarthritis/etiologySubject(s)
Hip Dislocation/surgery , Adolescent , Adult , Age Factors , Child , Child, Preschool , Female , Hip Prosthesis , Humans , Infant , Infant, Newborn , Infant, Newborn, Diseases/surgery , Male , Middle Aged , Osteoarthritis/surgerySubject(s)
Ankylosis/surgery , Elbow Injuries , Elbow Joint , Ankylosis/etiology , Arthroplasty , Elbow Joint/surgery , Humans , Time Factors , Tissue AdhesionsABSTRACT
76 operated metastatic tumors of bone are reviewed. In the past 10 years modern methods (such as endoprothesis and the use of acrylic cement in the replacement of excised bone or for stabilisation of the spine) gave new possibilities to palliative surgery. Operative indication so that toleration of material are discussed.