Hip joint preserving osteotomy surgery is the treatment of choice for young patients with early symptomatic structural abnormalities of the acetabulum and proximal femur. This is true even in the absence of severe secondary degenerative changes. These disorders can include hip instability from classic developmental dysplasia, post-traumatic acetabular dysplasia, hip impingement from retrotorsional acetabular deformities, or, rarely, post-traumatic problems. During the past 20 years, various techniques of acetabular and proximal femoral reorientation have evolved, making the procedure reliable, reproducible, and durable. In this report, the current indications and results of acetabular and proximal femoral osteotomies in patients with symptomatic acetabular structural problems will be discussed.
Acetabulum ; Congenital Abnormalities ; Femur ; Hip ; Hip Joint ; Humans ; Osteotomy

Trichorhinophalangeal syndrome(TRPS) type I is characterized by sparse and slow-growing hairs, pear-shaped nose, elongated philtrum, thin upper lip, and bone deformities, especially, cone-shaped epiphyses of the phalanges. The syndrome is inherited in an autosomal dominant manner. We report a case of TRPS type I with alopecia like male pattern baldness and Perthes-like changes on the right hip joint.
Alopecia ; Congenital Abnormalities ; Epiphyses ; Hair ; Hip Joint ; Lip ; Nose

An evaluation of the acetabular cartilage was performed grossly and histologically in a patient who had a bipolar hemiarthroploasty, which had served satisfactorily for 2 years until the femoral prosthetic head had been separated from the acetabular assembly due to creep deformation of the inner bearing polyethylene cup. This study indicates that the double-bearing bipolar prosthesis dose not necessarily have an advantage over the classical single-piece prosthesis in the prevention of acetabular cartilage wear.
Acetabulum/abnormalities* ; Cartilage, Articular/abnormalities* ; Hip Joint/abnormalities ; Hip Prosthesis* ; Human ; Male ; Middle Age ; Postoperative Complications/etiology* ; Prosthesis Failure

The camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is characterized by congenital or early-onset camptodactyly, childhood-onset noninflammatory arthropathy associated with synovial hyperplasia. Some patients have pro-gressive coxa vara deformity and/or noninflammatory pericardial effusion. CACP is inherited as an autosomal recessive mode and the disease gene is assigned to a 1.9-cM interval on human chromosome 1q25-31. We describe a 10-yr-old boy who has typical features of CACP without familial association.
Adolescent ; Fingers/*abnormalities ; Hip Joint/*abnormalities ; Humans ; Joint Diseases/*congenital/*diagnosis ; Male ; Pericarditis/*congenital/*diagnosis ; Syndrome ; Toes/*abnormalities

The various implants used in total hip arthroplasty can be classified according to the design and the fixation type. In general, they can be divided into two groups; cemented and cementless types. The surgeon's decision regarding which type of implant to use should be based on the goal of the arthroplasty operation, the bony deformity of the patient, the function of the involved hip joint, and the experience of the operator. When using cementless implants, primary fixation, survival rate, and successful fixation on long-term follow-up depend on the material of the implant, the bone quality, and, ultimately, the interaction between the implant and the bone. Cementless implants have shown a high success rate in primary total hip arthroplasty and relatively fine outcomes on long-term follow-up. In comparison of the two implant types, superiority has yet to be determined, however, a choice made based on the objective of the surgery, the function of the joint, the quality of the bone, and the surgeon's experience will result in a good outcome. Therefore, we reviewed the qualities of cementless implants, the application, and the various procedures involving the implant.
Arthroplasty ; Congenital Abnormalities ; Follow-Up Studies ; Hip ; Hip Joint ; Humans ; Joints ; Survival Rate

Pelvic osteotomy is a surgery for correcting acetabular deformity, which causes incomplete coverage of the femoral head or biomechanically abnormal load to the hip joint. Pelvic osteotomy can be divided into two categories: reconstructive or realignment osteotomy and salvage osteotomy. Reconstructive osteotomy can be performed to correct the dysplastic hip with good congruency, and include most pelvic osteotomies, except Chiari osteotomy. Among these, Bernese osteotomy, rotational acetabular osteotomy, and periacetabular rotational osteotomy are commonly being used. Salvage osteotomy, which include Chiari osteotomy only, can be performed to increase the coverage of the femoral head of hip joint with joint incongruency due to the severely deformed femoral head and acetabulum or advanced osteoarthritis. Chiari osteotomy is a kind of arthroplasty reducing the pressure applied to the head, and increasing the bone coverage on the upper part of the femoral head. It is effective in reducing hip pain and slowing degenerative changes; however, as the surface is covered by fibrous cartilage, it is vulnerable to degenerative changes. The pelvic osteotomy is a very important and useful surgical technique to preserve joints, despite being a difficult procedure that is technically demanding.
Acetabulum ; Adult* ; Arthroplasty ; Cartilage ; Congenital Abnormalities ; Head ; Hip ; Hip Joint ; Humans ; Joints ; Osteoarthritis ; Osteotomy*

Many unsolved probIems still remain in these in management of trochanteric fracture of hip, especially unstable type of trochanteric fracture. Among many cases of the trochanteric fracture treated during period from Jan. 1963 to July, 1973 at Busan National University Hospital, six patient has severe sequelae such as coxa vara deformity, shortening of the affected limb and ankylosis of the hip joint, which were analyzed clinically and results obtained were as follow. 1. It is the most important factor that the medial and the posterior cortex is good alignment in reduction with internal fixation and maintainance of unstable trochanteric fracture. 2. It is dangerous for the unstable type of trochanteric fracture to be reducted and maintained with only screws or plates. Jewett nail is more effective than the S-P nail and Thornton plate in internal fixation of unstable type of trochanteric franture. 3. The posterior fragments can hardly be found in A-P view but easily in lateral view 4. In cases that had not good alignments between posterior fragments the distaI fragment displaced medially and migration of the naiI, distraction of the pIate, malunion have developed in spite of prolonged immobilization in cast. 5. In one case that the severe coxa vara deformity have been developed. we performed the transverse osteotomy & fixed with Blount-V-blade plate like device. The result was good but the shortening of the limb could not prevent.
Ankylosis ; Busan ; Congenital Abnormalities ; Coxa Vara ; Extremities ; Femur ; Hip Joint ; Hip ; Humans ; Immobilization ; Osteotomy

It is well known that early diagnosis and early treatment is very important for the patient with congenital dislocation of the hip joint to provide a favorable function in the whole life. The goal of treatment, which is either conservative or operative, is to replace the dislocated hip into the socketand restore its anatomical position. If the head is reduced lately, it may subluxate or redislocate. As a result, secondary osteoarthritis will be complicated in such hips at a laterdate The most cases of congenital dislocation of hip have a increased anteversion and vaglus deformity. It is known that these deformity are cause of redislocation or subluxation, and should be corrected by varus or derotational varus osteotomy to restore for normal cephalocotyloid relationship. We analized 18 residual subluxation of hips which had been treated by derotational varus osteotomy. The results obtained are as follows. 1. Regardless of the age at the time of osteotomy and the amount of varization, the neck-shaft angle corrected to nearly normal in all cases within 3 years after the osteotomy. 2. Acetabular development, indicated by acetabular index, was satisfactory when the osteotomy was done before 4 years, but unsatisfactory in the cases after 4 years of age. 3. Coxa valga epiphysialis of the subluxated head corrected spontaenously after osteotomy in all cases. 4. Subluxated head, indicated by C-E angle and migration percentage, reduced in the cases who had by the derotational varus osteotomy in patients below age of 4 years, but it persisted without further luxation in the cases over 4 years of age.
Acetabulum ; Congenital Abnormalities ; Coxa Valga ; Dislocations ; Early Diagnosis ; Head ; Hip Joint ; Hip ; Humans ; Osteoarthritis ; Osteotomy

PURPOSE: We investigated a statistical difference of tibial-articular surface (TAS) angles between radiographs of standing ankle anteroposterior (AP) and whole lower extremity view, and evaluated whether the tibial axis obtained from the standing ankle AP view reflects the original mechanical axis of lower extremity. MATERIALS AND METHODS: Both the standing ankle AP and whole lower extremity view were taken from 60 legs of 30 healthy volunteers without a history of ankle surgery or deformity of lower limb. To determine the tibial axis, Takakura's and Hintermann's method were employed in the standing ankle AP view. To compare these results with the original TAS angle, ANOVA and multiple comparison test were used. RESULTS: The mean TAS angle was 88.3 degrees(from hip joint to ankle), 89.5 degrees (from knee joint to ankle), 88.5 degrees (Takakura's method), and 90.2 degrees(Hintermann's method). Although there was a statistical significance (p=0.000) between these results, Takakura's method had no significant difference, compared to the results of whole extremity view by the multiple comparison test. CONCLUSION: The tibial axis obtained by Takakura's method reflects the original mechanical axis of lower extremity. When a surgical procedure is planned, however, it is necessary to consider that the ankle radiographs do not provide any information on the proximal deformity without the whole lower extremity view.
Animals ; Ankle ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Extremities ; Hip Joint ; Knee Joint ; Leg ; Lower Extremity

Larsen's syndrome is a very rare deformity, which is characterized by multiple congenital dislocations with a characteristic facial abnormality. The authors experienced a case of typical Larsen's syndrome that had saddle nose, hypertelorism, high-arched palate, dislocation of the hip joint, subluxation of the knee joint, dislocation of both radial heads, equinovarus deformities of both feet and winged scapulae of both shoulders. The dislocated left hip joint was reduced surgically and the result was excellent.
Clubfoot ; Congenital Abnormalities ; Dislocations ; Foot ; Head ; Hip Joint ; Hypertelorism ; Knee Joint ; Nose ; Palate ; Scapula ; Shoulder