ABSTRACT
The survivorship method of analysis has been used to evaluate retrospectively the outcome of 1166 total hip arthroplasties performed in Taranaki between 1970 and 1989. There were 867 cemented Charnley, 105 Harris Galante and 92 cemented Muller prostheses. Outcome was determined in 99.1% of the cases. There were 72 failures in the Charnley group, resulting in an annual failure rate of 1.78% and a 15 year survival rate of 73%. There were 26 failures in the Muller group, an annual failure of 6.93% and an 11 year survival of 63%. At review none of the Harris Galante group had failed. Survival was affected by age, sex, hospital and surgeon.
Subject(s)
Hip Prosthesis/statistics & numerical data , Age Factors , Aged , Female , Follow-Up Studies , Hospitals, Private , Hospitals, Public , Humans , Life Expectancy , Male , Multivariate Analysis , New Zealand/epidemiology , Osteoarthritis/surgery , Prosthesis Design , Prosthesis Failure , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
A prospective neonatal screening programme for congenital dislocation of the hip is reported. This covered over 20,000 live births including all the babies born in one area, with a virtually complete follow-up. All babies were examined within the first seven days of life and all hips which were dislocated or unstable after four days (1.6%) were splinted. Only two screened cases were "missed" and subsequently detected at 15 and 18 months. No later cases were discovered, and patients between 10 and 20 years of age had apparently remained asymptomatic. The detailed results show that neonatal screening is effective in detecting and preventing a crippling disorder in otherwise normal people. The examination, though brief, is difficult to perform well; it is considered that failure of the method lies with the examiner and not with the tests.
Subject(s)
Hip Dislocation, Congenital/prevention & control , Mass Screening , Female , Hip Dislocation, Congenital/diagnosis , Hip Dislocation, Congenital/therapy , Humans , Infant, Newborn , Longitudinal Studies , Male , New Zealand , Prospective Studies , SplintsABSTRACT
A Malmo type neonatal screening programme for congenital dislocation of the hip has been conducted in New Plymouth by orthopaedic surgeons from 1964 to 1975 including 10 103 births. Follow-up for the 11-year period appears complete. Treatment by a Von Rosen type splint for six weeks instituted within seven days of birth appears to prevent established late CDH. Subluxation at six months, however, occurred twice and a longer period of splintage might be advisable. Fourteen cases of "walking" CDH have been prevented, with a 92% success rate, with five and 10-year x-ray follow-up demonstrating good hip development in treated cases.
Subject(s)
Hip Dislocation, Congenital/therapy , Child , Child, Preschool , Female , Follow-Up Studies , Hip Dislocation, Congenital/epidemiology , Humans , Infant , Infant, Newborn , Male , Mass Screening , New Zealand , SplintsABSTRACT
A case of congenital pseudarthrosis of the ulna is described. The inevitability of dislocation of the radial head in the early years of life, is pointed out. Following dislocation of the radial head, creation of a stable single-bone forearm is necessary to prevent loss of hand function due to effective shortening of the long flexors. A method of radioulnar fusion is described. Following such fusion good hand function can be anticipated, as the vital humeroulna radiocarpal joints are intact.
