scholarly journals Reliability and normative values of common adult radiographic parameters for hip preservation in the developing pelvis

2019 ◽  
Author(s):  
Patrick W Whitlock ◽  
Kamran F Salari ◽  
Gideon Blumstein ◽  
Bin Zhang ◽  
Alexandre Arkader ◽  
...  
Keyword(s):  
Femoral Head ◽  
Developmental Dysplasia ◽  
Categorical Variables ◽  
Normative Values ◽  
Crossover Sign ◽  
Good Reliability ◽  
Rater Reliability ◽  
Male And Female ◽  
Female Patients ◽  
Center Edge

AbstractAnterior–posterior (A/P) radiography of the pelvis is essential to the diagnosis and treatment of developmental dysplasia of the hip (DDH). Multiple well-defined parameters of adult hip morphology with good reliability are readily available. The purpose of this study was to determine normative values and observed reliability for 10 common adult hip parameters in the developing pelvis of male and female patients aged 6 months–16 years. One hundred and fifty-eight standardized A/P pelvic radiographs were randomly selected from an existing trauma patient database and stratified into five age groups. Mean values or presence of categorical values and the observed reliability of 10 adult hip parameters (acetabular index/angle, pelvic width index, lateral center edge angle, Tonnis angle, acetabular to femoral head distance, femoral head diameter, coxa profunda/protrusio, ischial spine sign, crossover sign and posterior wall sign) were determined. Minimal differences in all parameters were observed between male and female patients. The observed inter-rater reliability of continuous parameters was 0.77–0.99. The observed intra-rater reliability was 0.7–0.99 with a combined intra-rater reliability of 0.88–0.99. The observed inter-rater reliability of categorical variables was 0.64–1.0. The intra-rater reliability of categorical variables was 0.83–1.0. Normative values for 10 common adult hip parameters were determined for male and female patients in the developing pelvis. Reliable knowledge of these values and their relationship to the age of the patient and/or stage of pelvic development associated may provide additional information to aid the treatment of DDH.

scholarly journals A Newly Modified Salter Osteotomy Technique for Treatment of Developmental Dysplasia of Hip That Is Associated with Decrease in Pressure on Femoral Head and Triradiate Cartilage

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Seyed Mokhtar Esmaeilnejad-Ganji ◽  
Seyed Mohammad Reza Esmaeilnejad-Ganji ◽  
Mohammad Zamani ◽  
Hesam Alitaleshi
Keyword(s):  
Femoral Head ◽  
Developmental Dysplasia ◽  
Developmental Dysplasia Of Hip ◽  
Center Edge ◽  
Salter Osteotomy ◽  
Innominate Osteotomy ◽  
Femoral Shortening ◽  
Osteotomy Technique ◽  
The Mean

Background and Purpose. The Salter innominate osteotomy has been an effective method to treat the developmental dysplasia of hip (DDH) over the past decades; however, several postoperative complications and deficiencies were reported. In this study, we evaluated outcome of a newly modified Salter osteotomy in patients presenting with DDH. Methods. We reviewed retrospectively 76 patients (90 hips) with DDH aged ≥ 18 months, who underwent open reduction and a modified osteotomy by a single surgeon. The distal osteotomy segment of pelvis was shifted anterolaterally in the amount of osteotomy cross-section, but not downwards. The mean age at surgery was 2 years and 11 months (1.5 to 16 years). Femoral shortening was conducted when necessary. The duration of operation varied between 60 and 90 minutes. The mean follow-up was 4 years and one month (range 15 months to 7 years and 9 months). All patients were followed up both clinically (based on the modified MacKay criteria) and radiologically (based on the modified Severin criteria). Results. Clinically, 94.5% of hips had excellent and good results at final follow-up, and only 5.5% had a fair condition. Radiographically, at the final follow-up 77.8% of hips were grade IA (excellent), 12.2% were grade IB, 6.7% were grade II, and 3.3% were grade III (fair). The preoperative mean acetabular index was 47.85° (41° to 59), which decreased to 17.16° (13° to 22°) immediately after the surgery (p<0.0001) and progressed to 11.24° (7° to 19°) at the final follow-up (p<0.0001). The mean initial postoperative center-edge angle was 30.3° (25° to 42°) significantly improved to 39.1 (31° to 56°) at the final follow-up (p<0.0001). Avascular necrosis of femoral head occurred in 4.4% of hips (4 patients). Conclusion. The results show that our modified Salter osteotomy is safe and associated with significant benefit for the management of patients suffering from DDH.

Comparative assessment of average clinical smile parameters in male and female patients with orthognathic occlusion

2020 ◽  
Vol 25 (2) ◽  
pp. 121-126
Author(s):  
V. G. Galonsky ◽  
N. V. Tarasova ◽  
V. V. Aliamovskii ◽  
I. S. Leonovich
Keyword(s):  
Sexual Dimorphism ◽  
Male And Female ◽  
Young Males ◽  
Young Females ◽  
Female Patients ◽  
Evaluation Of Parameters ◽  
Distinguishing Features ◽  
Vertical Size ◽  
Relative Concept ◽  
The Ideal

Relevance. Separate issues in anthropomorphic sizes of relative norm of the ideal smile, its qualitative and qualitative parameters have not been addressed to sufficiently and are not properly reflected in scientific literature.Purpose. To determine distinguishing features in average smile parameters of the smile in male and female patients with orthognathic occlusion.Materials and methods. A clinical and anthropometric evaluation of parameters in main smile types was carried out for 150 young males and 150 young females aged 19-24 who had identical physiological development parameters.Results. It has been revealed that occurrence frequency of main smile types in patients with orthognathic occlusion has pronounced signs of sexual dimorphism which in over one half of the cases lies in predominance of the incisal smile type in males (52.7%) and the fascial type in females (55.3%). Occurence frequency of the cervical smile type totaled 25% among the studied patients of both genders. Average vertical size parameters in the incisal smile lies within the diapason of 3.91-4.91mm with surpassing by 1mm in males. Analogical data for the fascial smile type form the diapason of 6.21-6.73mm with surpassing by 0.52mm in females. The cervical smile type is characterised by larger vertical size forming the diapason of 7.94-8.91mm with surpassing by 0.97mm in males.Conclusion. The results of the study have shown that the “beautiful and ideal smile” is a relative concept having varied anthropometric characteristics and pronounced signs of sexual dimorphism lying in a broad spectrum of the dentofacial system norm notion with specific vectors for individual morphological deviations.

Feasibility of an iPhone-based application for knee joint goniometry during gait in a stroke patient (Preprint)

2018 ◽  
Author(s):  
Claudia Nava ◽  
Patrizio Sale ◽  
Vittorio Leggero ◽  
Simona Ferrante ◽  
Cira Fundaro' ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Stroke Patient ◽  
Reference Method ◽  
Flexion Angle ◽  
Good Reliability ◽  
Rater Reliability ◽  
Maximum Extension ◽  
Angle Measurements ◽  
Hemiparetic Gait ◽  
Flexion Extension

BACKGROUND In recent years, different smartphone apps have been validated for joint goniometry, but none for goniometric assessment of gait after stroke. OBJECTIVE The aims of our work were to assess:1) to assess intra-rater reliability of an image-based goniometric app – DrGoniometer- in the measurement of the extension, flexion angles and range of motion of the knee during the hemiparetic gait of a stroke patient; (2) its validity comparing to the reference method (electrogoniometer) for flexion-extension excursion measurements; and the intra-rater agreement in the choice of the video frames. METHODS An left-hemiparetic inpatient following haemorrhagic stroke was filmed using the app while walking on a linear path. An electrogoniometer was fixed on the medial face of the affected knee in order to record the dynamic goniometry during gait. Twenty-one raters, blinded to measurements, were recruited to rate knee angle measurements from video acquired with DrGoniometer. Each rater repeated the same procedure twice, the second one at least one day after the first measure. RESULTS Results showed that flexion angle measurements are reliable (ICC95%=0.66, 0.34;0.85; SEM=4°), and adequately precise (CV=14%). Extension angles measurements demonstrated moderate reliability and higher degree of variation (ICC=0.51, 0.09;0.77; SEM 4°; CV=53%). ROM values were: ICC=0.23 (-0.21;0.60); CV=20%. Accuracy of DrGoniometer compared to the electrogoniometer was 7.3±4.7°. The selection of maximum extension frame revealed an accordance of 58% and 72% within a range of ±5 or ±10 frames, respectively; while the best flexion frame reported 86% of agreement for both range of 5 and 10 frames. CONCLUSIONS The results demonstrated moderate to good reliability concerning the maximum extension and flexion angles, while assessing ROM DrGoniometer showed poor intra-rater reliability. Flexion angle measurements seemed to be reliable according to ICC and SEM values and more precise with a limited dispersion of results DrGoniometer revealed a good accuracy in the measurement of range of motion. The agreement of the maximal extension frame was anyway adequate within 5 frames (59%) and noticeably increased within 10 frames (72%). In conclusion, DrGoniometer was found to be a valid and reliable method for assessing knee angles during hemiparetic gait. Further studies are necessary to investigate inter-rater reliability and confirm our results.

scholarly journals Prevalence of Morphological Variations Associated With Femoroacetabular Impingement According to Age and Sex: A Study of 1878 Asymptomatic Hips in Nonprofessional Athletes

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097789
Author(s):  
Rodolfo Morales-Avalos ◽  
Adriana Tapia-Náñez ◽  
Mario Simental-Mendía ◽  
Guillermo Elizondo-Riojas ◽  
Michelle Morcos-Sandino ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Alpha Angle ◽  
Cross Sectional Study ◽  
Level Of Evidence ◽  
Crossover Sign ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Morphological Variations ◽  
Pelvic Radiographs ◽  
Center Edge

Background: Radiographic findings related to the cam and pincer variants of femoroacetabular impingement (FAI) include measurements of the alpha angle and lateral center-edge angle (LCEA). The function of these radiographic findings has been put into question because of high heterogeneity in reported studies. Purpose: The aim of this study was 3-fold: (1) to determine the prevalence of cam and pincer variants according to sex and age on anteroposterior (AP) pelvic radiographs from an asymptomatic nonathletic population, (2) to identify the most common radiographic signs of cam- and pincer-type variants, and (3) to determine if there are variations in the prevalence of these radiographic signs according to sex and age. Study Design: Cross-sectional study; Level of evidence, 3. Methods: There were 3 independent observers who retrospectively analyzed the 939 AP pelvic radiographs (1878 hips) of patients aged 18 to 50 years who did not have hip symptoms and who were not professional athletes. The prevalence of the cam and pincer variants according to the alpha angle and LCEA, respectively, and the presence of other radiographic signs commonly associated with these variables were determined in the overall population and by subgroup according to sex and age group (18-30, 31-40, and 41-50 years). Descriptive and inferential statistics were used to analyze the study sample. Results: The mean age of the included population was 31.0 ± 9.2 years, and 68.2% were male. The prevalence of the cam-type variant was 29.7% (558/1878), and that of the pincer-type variant was 24.3% (456/1878). The radiographic signs that were most associated with the cam and pincer variants were a pistol-grip deformity and the crossover sign, respectively. Significant differences ( P < .001) in the prevalence of these variants were identified between men and women in both variants. No differences were observed in the alpha angle or LCEA according to sex or age. Conclusion: Radiographic findings suggestive of FAI had significant variations with respect to sex and age in this study sample. This study provides information to determine the prevalence of these anatomic variants in the general population.

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