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Acetabular Dysplasia: Skeletal Dysplasias in Childhood by J. A. Ogden, H. L. Moss (auth.), U. H. Weil (eds.)

By J. A. Ogden, H. L. Moss (auth.), U. H. Weil (eds.)

Readers of the 1st quantity of development in Orthopaedic surgical procedure could bear in mind the introductory feedback of Drs. Wagner and Hungerford. it's the goal of the editors of this book to familiarize English - talking orthopaedists with articles released within the eu literature which, due to language boundaries, might rather be inaccessible to them. such a lot articles during this moment quantity are also translations of papers initially published in Der Orthopiide. the aim of this German clinical magazine is to disseminate the latest reports of orthopaedic difficulties in a kind that's of specific price to the practicing orthopaedic health professional. In 1973 8 articles have been released on acetabular dysplasia. In his fore­ be aware to this factor Dr. Wagner said a number of the the explanation why such an indepth learn was once deemed beneficial. He was once of the opinion that the self-love and elevate in acclivity of the acetabulum was once of such imperative significance within the improvement and remedy of hip dysplasias quantity facing this topic used to be absolutely justified. one more reason for this selection of papers used to be the advances made in correcting the result of a dysplastic acetabulum by means of surgical capacity and thereby enhancing hip joint functionality in later years, or a minimum of pre­ venting its early deterioration.

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Moss ig. 17. (a) - deformity of c nt ur of femoral head. (b) - irregular def rmity f margin between true and fal acetabula howing area f ever i nand inv r i n femur brought the lesser trochanter closer to the pubic ramus, and the iliopsoas tendon had a longer course over bone, both factors increasing the risk of vascular compromise. The femur was twisted into extreme anteversion (beyond 90°) and valgus (beyond 180°). These deformities obviously occurred over an extended period of time in response to biologic plasticity.

Although the child tries to fight against this contracture by kicking movements, his extremities are not sufficiently developed to accept the specific functions provided for them. Portmann (cited in F. Becker) speaks of an additional "extra-uterine fetal period" which lasts about 9 months. H. Biischelberger points out that the maternal abdomen clasped by the small legs of the infant, is the proper place for his further development. As a matter of fact, those countries where it is custom for the mother to tie the child to her body during her daily occupations show the lowest incidence of hip dislocations.

A mature stillborn fetus with massive internal hydrocephalus (complete obstruction of the cerebral aqueduct) is shown in Figure 4: The head of the fetus (Fig. 4a) was so large that its body was squeezed into the minor pelvis. In the lateral view (Fig. 4 b) one observes hyperflexion of the hips, clubfeet, and necrotic areas of skin indicating abnormal effects of pressure. Radiography of the hip showed bilateral dislocations (Fig. 4c). The anatomic specimen (Fig. 4d) showed a clear depression in the anteriosuperior acetabular rim, caused by the pressure of the neck of the femur.

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