Type of Surgery
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Last updated: 11/24/2009
A physical examination performed by a pediatrician or an orthopaedic surgeon is the best method for diagnosing developmental dysplasia of the hip. Other aids to diagnosis include ultrasound examination of the hips during the first six months...
of life. An ultrasound study is better than an x ray for evaluating hip dysplasia in an infant because much of the hip is made of cartilage at this age and does not show up clearly on x rays. Ultrasound imaging can accurately determine the location of the femoral head in the acetabulum, as well as the depth of the baby's hip socket. An x-ray examination of the pelvis can be performed after six months of age when the child's bones are better developed. Diagnosis in adults also relies on x ray studies.
To prepare for a hip osteotomy, the patient should come to the clinic or hospital one to seven days prior to surgery. The physician will review the proposed surgery with the patient and answer any questions. He or she will also review the patient's medical evaluation, laboratory test results, and x-ray findings, and schedule any other tests that are required. Patients are instructed not to eat or drink anything after midnight the night before surgery to prevent nausea and vomiting during the operation.
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An osteotomy is a surgical operation whereby a bone is cut to shorten, lengthen, or change its alignment. It is sometimes performed to correct a hallux valgus, or to straighten a bone that has healed crookedly following a fracture. It is also used to correct a coxa vara, genu valgum, and genu varum. The operation is done under a general anaesthetic.
Two main types of osteotomies are used in the correction of hip dysplasias and deformities to improve alignment/interaction of acetabulum - (socket) - and femoral head (femur head) - (ball), innominate osteotomies and femoral osteotomies. The bones are cut, reshaped or partially removed to realign the load bearing surfaces of the joint.
Adjustments are made to part of the hip-bone. Many operating methods and variations have been developed. They are defined by the type of cut and adjustment made Some acetabular procedures are named after the surgeons who first described them as Salter (R. Salter), Dega (W. Dega), Sutherland (D.H. Sutherland), Chiari (K. Chiari): other names one may encounter are Ludlov, P. Pemberton, and James B. Steele. Some are named after the shape of cut (e.g. Chevron, Wedge) or the way the bones are aligned (Dial=old style rotary dial phone).
Femoral osteotomies, as the name indicates, involves adjustments made to the femur head and/or the femur.
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New procedures like minimally invasive procedures are often subject to scrutiny, but I think that one of the biggest problems facing these innovative procedures is for people to understand exactly what we do.
-Dr. Michael Perry, Laser Spine institute
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