Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 1982
Growth of the proximal femur after varus-derotation osteotomy in the treatment of congenital dislocation of the hip.
The growth of the upper end of the femur was studied in 50 children with congenital dislocation of the hip in whom a femoral osteotomy had been carried out. All children had unilateral dislocations and had been treated by a proximal femoral varus-derotation osteotomy after closed reduction, excision of the limbus, or open reduction. The average age at osteotomy was 2.3 years. ⋯ Although no cases of avascular necrosis of the capital epiphysis occurred, 21 children developed deformities of the femoral head, of whom eight showed an abnormal angulation of the capital-epiphyseal plate. The neck-epiphysis angle is described as an alternative to the shaft-epiphysis angle in assessing the orientation of the capital-epiphyseal plate. The best radiographic outcome was obtained when the neck-shaft angle measured 100 degrees to 110 degrees immediately after osteotomy.
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Clin. Orthop. Relat. Res. · Jan 1982
The development of the spinal deformities in osteogenesis imperfecta.
Evaluations were made of the spinal deformities in 22 of 30 patients (osteogenesis imperfecta congenita, eight; osteogenesis imperfecta tarda I, 13; osteogenesis imperfecta tarda II, one) treated at Hamagumi Gakuen Children's Hospital from 1959 to 1980. Seven of the congenital type patients were in the severe curve group (greater than 50 degrees), four of whom showed more than 100 degrees of curvature. ⋯ The complications of the spinal deformities included disability on ambulation, inactivity in daily living, and possibly respiratory dysfunction. Progression of the spinal curvature should be prevented by functional bracing or surgical treatment before severe complications arise.