The Hip - book

Pagets Disease

– Discussion: – a chronic progressive disease osteoblasts and osteoclasts which results in abnormal bone remodeling; – etiology, staging, and pathogenesis – prevalence: – uncommon in pts under age of 55 yrs but relatively common in later life, occurring in 3-4% of persons over 55 yrs & occurs in 10% in pts over age 80; – reference: – … Read more

Osteopetrosis

– Discussion: – osteopetrosis is failure of osteoclastic and chondroclastic resorption; – bones become exceedingly dense; – marrow space is filled w/ unresorbed dense bone; – disease results from lack of osteoclastic resorption, leading to thickened bones & exclusion of marrow cavity; – there is absence of marrow elements & these patients are susceptible to … Read more

Osteogenesis Imperfecta

(see also: Pyknodyostosis) Discussion disease characterized by failure of maturation and organization of collagen fibers; defect in collagen (procollagen to type I collagen sequence and abnormal cross linking) leading to decreased collagen secretion, bone fragility; there may be an inability to form normal bone due to a defect in osteoblastic function; with the formation of … Read more

Osteochondroma / Osteocartilaginous Exostosis

    – Discussion:     – a developmental dysplasia of peripheral growth plate which forms a cartilage capped projection of bone found near metaphyses of long bones;           – peripheral chondroblast grows outward from the metaphysis, acting as an ectopic growth plate, which ceases growth at skeletal maturation;     … Read more

Ortolani’s Test: for Congenital Hip Dislocation

– Discussion:     – early dx by postnatal screening w/ Ortolani or Barlow’s Test is essential to detect hip instability or dislocation;     – strictly interpreted, the Ortolani sign is the palpable sensation of the gliding of the femoral head in and out of the acetabulum;           – femoral … Read more

Orthopaedic Manifestations of Myelomeningocele

– Discussion of Myelodysplasia – Spinal Deformities: – vertebral column development: – scoliotic & kyphosis in myelomeningocele may be either congenital or paralytic, or combination of both; – scoliosis in myelomenigocele: – kyphosis in myelomenigocele: – need to distinguish between 2 distinct types of kyphosis both of which are centered over mid lumbar segment; – … Read more

Open Reduction for DDH

Open Reduction for DDH – Inidications:     – older age:          – attempts at closed reduction should be limited to children who are less than three years old;          – once children begin to walk, there is decreased chance for successful closed reduction & increased risk of AVN; … Read more