RESUMO
Three cases of acetabular dysplasia associated with failed ossification of the ischiopubic synchondrosis are presented. The patients are second-degree relatives and all skeletally mature with no evidence of other pathological process to delay ossification. A summary of the development of the inferior pubic ramus is presented and the literature of this unusual condition is reviewed.
Assuntos
Acetábulo/patologia , Doenças do Desenvolvimento Ósseo/complicações , Ísquio/patologia , Dor/etiologia , Osso Púbico/patologia , Acetábulo/diagnóstico por imagem , Acetábulo/cirurgia , Adolescente , Adulto , Artrografia , Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , Doenças do Desenvolvimento Ósseo/genética , Doenças do Desenvolvimento Ósseo/cirurgia , Feminino , Articulação do Quadril/patologia , Articulação do Quadril/cirurgia , Humanos , Ísquio/diagnóstico por imagem , Ísquio/cirurgia , Osteotomia , Linhagem , Osso Púbico/diagnóstico por imagem , Osso Púbico/cirurgiaRESUMO
We have evaluated the reliability of the measurement of radiological indicators in developmental dysplasia of the hip. Three observers each independently assessed 60 pelvic radiographs from infants aged from 3 to 36 months. Errors from the true value of a single measurement made by a single observer (E1), of the average of two measurements by a single observer (E2), and of the average of two single measurements by two different observers (E3) were established for the acetabular index of Hilgenreiner, for the assessment of superior and lateral femoral displacement and for indicators of pelvic alignment. The errors for the assessment of the acetabular index were E1 +/- 5 degrees, E2 +/- 5 degrees, and E3 +/- 3.5 degrees. There was a significant correlation between the presence of an acetabular notch on the radiograph and an increased error in measurement (p = 0.01). Yamamuro's measurement of lateral femoral displacement was more reliable than the Hilgenreiner distance. The errors of indicators of pelvic alignment showed a correlation with the age of the infant; the quotient of pelvic rotation was more reliable after seven months of age (p < 0.0001). The errors of the measurement of the symphysis os-ischium angle tended to increase with age and those of the measurement of the index of pelvic tilt decreased with skeletal maturation (p = 0.002).
Assuntos
Luxação do Quadril/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Pré-Escolar , Luxação do Quadril/patologia , Humanos , Lactente , Ossos Pélvicos/patologia , Radiografia , Reprodutibilidade dos TestesRESUMO
In a prospective study, 63 tibial shaft fractures were managed by intramedullary nailing with a solid nail inserted without reaming. The patients were followed to union or a definitive outcome (non-union or death). Three patients died early in the post operative course as a result of other injuries. This left 60 nails in the series for complete follow up. Eighty-two per cent of the fractures were the result of motor vehicle accidents, 44 nails were inserted within 72 h of injury. Fifty-six fractures united (93%) at a mean of 21.1 weeks (8-52). There were 4 non-unions among this population of multiply injured patients. All closed fractures united at a mean of 19.5 weeks. Those nailed acutely united at a mean of 16.8 weeks. The open fracture group (classified according to Gustilo and Anderson) included the 4 non-unions (2 type II, 1 type IIIa and 1 type IIIb). A union rate of 86.2% was achieved in these fractures. All type I fractures united. One deep infection occurred in the series. The major complication identified in the current series was failure of the distal cross bolts.
