ABSTRACT
BACKGROUND AND PURPOSE: Avascular necrosis of the femoral head (AVN) is a complication in treatment of developmental dysplasia of the hip (DDH). We evaluated the risk of AVN after early treatment in the von Rosen splint and measured the diameter of the ossific nucleus at 1 year of age. CHILDREN AND METHODS: All children born in Malmö, Sweden, undergo clinical screening for neonatal instability of the hip (NIH). We reviewed 1-year radiographs of all children treated early for NIH in our department from 2003 through 2010. The diameter of the ossific nucleus was measured, and signs of AVN were classified according to Kalamchi-MacEwen. Subsequent radiographs, taken for any reason, were reviewed and a local registry of diagnoses was used to identify subsequent AVN. RESULTS: 229 of 586 children referred because of suspected NIH received early treatment (age ≤ 1 week) for NIH during the study period. 2 of the 229 treated children (0.9%, 95% CI: 0.1-3.1) had grade-1 AVN. Both had spontaneous resolution and were asymptomatic during the observation time (6 and 8 years). 466 children met the inclusion criteria for measurement of the ossific nucleus. Neonatally dislocated hips had significantly smaller ossific nuclei than neonatally stable hips: mean 9.4 mm (95% CI: 9.1-9.8) vs. 11.1 mm (95% CI: 10.9-11.3) at 1 year (p < 0.001). INTERPRETATION: Early treatment with the von Rosen splint for NIH is safe regarding AVN. The ossification of the femoral head is slower in children with NIH than in untreated children with neonatally stable hips.
Subject(s)
Femur Head Necrosis/etiology , Hip Dislocation, Congenital/surgery , Orthopedic Procedures/adverse effects , Osteogenesis/physiology , Postoperative Complications/etiology , Splints/adverse effects , Child , Child, Preschool , Female , Femur Head Necrosis/diagnostic imaging , Femur Head Necrosis/epidemiology , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Orthopedic Procedures/methods , Postoperative Complications/epidemiology , Radiography , Sweden/epidemiology , Treatment OutcomeABSTRACT
BACKGROUND: A set of face stimuli, called the Umeå University Database of Facial Expressions, is described. The set consists of 30 female and 30 male models aged 17-67 years (M = 30.19, SD = 10.66). Each model shows seven different facial expressions (angry, surprised, happy, sad, neutral, afraid, and disgusted). Most models are ethnic Swedes but models of Central European, Arabic, and Asian origin are also included. OBJECTIVE: Creating and validating a new database of facial expressions that can be used for scientific experiments. METHODS: The images, presented in random order one at a time, were validated by 526 volunteers rating on average 125 images on seven 10-point Likert-type scales ranging from "completely disagree" to "completely agree" for each emotion. RESULTS: The proportion of the aggregated results that were correctly classified was considered to be high (M = 88%). CONCLUSIONS: The results lend empirical support for the validity of this set of facial expressions. The set can be used freely by the scientific community.
