There is much confusion in orthopedic literature regarding the nature and significance of the so-called acetabular labrum in congenital dislocation of the hip. This experiment describes an animal model in which the relationship between eversion of the acetabular labrum and acetabular dysplasia with degeneration of the articular cartilage was studied. The acetabulum gradually become shallower and more vertically oriented and the femoral head gradually subluxed, but never dislocated. The radiographic appearance of the hip dysplasia was very similar to that seen in human beings. The animals remained asymptomatic without clinically visible signs of hip abnormality throughout the study. It was clearly demonstrated that there was substantial amounts of degenerative change in the articular cartilages of the subluxed hip with no evidence of degenerative change radiologically. It could be concluded that excision of the acetabular labrum should be avoided during open reduction of congenital dislocation of the hip.
Acetabulum/pathology* ; Animal ; Bone Diseases, Developmental/etiology* ; Dogs ; Hip Dislocation/complications* ; Osteoarthritis/etiology*

Lower extremity deep venous thrombosis (LDVT) is one of the most common complications in orthopedic surgery, and it often occurs in the first 24 h after operation. We report a case of delayed LDVT, which occurred on d 16 after operation for osteofibrous dysplasia on the left femur. Upon the diagnosis confirmed, thrombolysis and anticoagulation therapy was conducted. The symptoms disappeared 3 weeks later and lower limb vascular ultrasound examination showed no remnant thrombosis.
Adult ; Bone Diseases, Developmental ; surgery ; Female ; Femur ; surgery ; Humans ; Leg ; pathology ; Orthopedic Procedures ; adverse effects ; Venous Thrombosis ; etiology

OBJECTIVESTo investigate clinical appearance and radiological characteristics of high grade developmental spondylolisthesis and their significance.

METHODSIn a retrospective study, a group of 6 female patients, who were diagnosed as high grade developmental spondylolisthesis and treated in Peking University third hospital from March 2007 to December 2008 were included. Clinical and radiological characteristics of the 6 patients were investigated and the following parameters were measured on standing lateral X-ray: PI (pelvic incidence), SK (sacral kyphosis) and LL (Lumbar lordosis). A series of 44 patients who came to out-patient department due to LBP and had no positive findings on lateral lumbar X-ray were selected as the control group. The four parameters were compared between study group and control group. Clinical meanings of significant difference were discussed.

RESULTSClinical findings of high grade developmental spondylolisthesis included bending of knees, deformity of trunk and sciatica. Radiological appearances were characterized with kyphosis of lumbo-sacral joint, retroverted pelvis and domed sacrum. Spondylolisthesis patients has an average PI of (52 +/- 7) degrees which was significant higher than the control group [(43 +/- 8) degrees ] (P < 0.01). LL of study group [(51 +/- 10) degrees ] was higher than that of the control group [(18 +/- 9) degrees ] (P < 0.01) and SK of the study group [(12 +/- 11) degrees ] were lower than that of the control group [(21 +/- 10) degrees ] (P < 0.05).

CONCLUSIONSCharacteristics of clinical findings of spondylolisthesis patients have obvious cosmetic appearance, significant pain and lower neurological deficits. Radiological characteristics display deformity of lumbo-sacral joint. PI, LL and SK are significant parameters for high grade spondylolisthesis.

Bone Diseases, Developmental ; complications ; diagnostic imaging ; Child ; Female ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; Radiography ; Retrospective Studies ; Spondylolisthesis ; diagnostic imaging ; etiology

OBJECTIVETo retrospectively compare the therapeutic effects of simple Pemberton's ilium osteotomy and combined unter-trochanter derotation-varisation osteotomy for developmental dysplasia of the hip (DDH).

METHODSClinical data of 141 DDH patients who received either simple Pemberton's ilium osteotomy (n=57; 12 male and 45 female; age range 3-8 years) or combined unter-trochanter derotation-varisation osteotomy (n=84; 15 male and 69 female; age range 4-9 years) from January 2004 to January 2009 were collected. Postoperative complications, Severin's radiological outcomes and therapeutic outcomes as evaluated by Mcay criteria were compared between the two groups 2 years after operation.

RESULTSThe patients in simple Pemberton group were followed-up for 30-52 months (mean 38 months) and the patients in the combination group were followed-up for 32-51 months (mean 37 months). There were 7 cases of dislocation, 4 cases of avescular necrosis of femoral head and 5 cases of joint stiffness in simple Pemberton group vs 0 case of dislocation, contraction of the limb and ANFH,2 cases of joint stiffness in the combination group. Two years after surgery, the result as evaluated by McKay criteria was excellent in 27 cases, good in 18 cases and fair in 12 cases in simple Pemberton group vs. 52, 25 and 7 cases in the combination group. The overall clinical outcome in the combination group was better than that in simple Pemberton group. Severin X-ray evaluation showed excellent in 27 cases, good in 15 cases and fair in 15 cases in simple Pemberton group vs. 53, 22 and 9 cases in the combination group,indicating that the overall result in the combination group was better than that in simple Pemberton group.

CONCLUSIONThe overall clinical outcome of the combination group is better than that of simple Pemberton group in the treatment of pediatric DDH, especially in reducing postoperative complications and functional recovery. The patients in the combination group reported a higher postoperative satisfaction as compared with those in simple Pemberton group.

Bone Diseases, Developmental ; etiology ; surgery ; Child ; Child, Preschool ; Female ; Femur ; surgery ; Hip Dislocation, Congenital ; complications ; surgery ; Humans ; Ilium ; surgery ; Male ; Osteotomy ; methods

Scurvy is very rare disease in industrialized societies. Nevertheless, it still exists in higher risk groups including economically disadvantaged populations with poor nutrition, such as the elderly and chronic alcoholics. The incidence of scurvy in the pediatric population is very low. This study reports a case of scurvy in a 5-year-old girl with cerebral palsy and developmental delay based on MRI findings.
Ascorbic Acid/blood/therapeutic use ; Bone Diseases, Metabolic/etiology ; Cerebral Palsy/complications ; Child, Preschool ; Cholecalciferol/blood ; Developmental Disabilities/complications ; Drainage ; Female ; Femur/pathology/radionuclide imaging/surgery ; Fever/etiology ; Follow-Up Studies ; Hematoma/diagnosis/etiology/surgery ; Humans ; Knee/radiography ; Magnetic Resonance Imaging/*methods ; Muscle Weakness/etiology ; Rare Diseases ; Scurvy/complications/*diagnosis/drug therapy ; Thigh/pathology ; Vitamins/therapeutic use