Since developmental dysplasia of the hip (DDH) represents one of the most common congenital deformations of the musculoskeletal system and the most common deformation of the hip joint, the aim is to emphasize the importance of early recognition and diagnosis of DDH as well as comprehensive screening among newborns. DDH represents a dynamic process that results in the action of a number of exogenous and endogenous factors, physiological and mechanical, exerted to the mother and to the child during pregnancy and after delivery. Summary of all current knowledge about the origin of this deformity suggests that the most important factors in the development are hard abdominal muscles and uterine muscles, as limiting factors for fetal movement, which prevents its physiological turn, and reinforces the pelvic presentation of the fetus in uterus. Considering the fact that developmental dysplasia of the hip demands multidisciplinary approach and cooperation among gynecologists, neonatologists, pediatricians, radiologists, and orthopedic surgeons, the goal of this chapter is to make a consensus about early conservative treatment among clinicians, time of commencement, and its efficacy.
Part of the book: Developmental Diseases of the Hip
Every long bone fracture in orthopedic surgery represents a possible scenario for development of embolism complication, especially the fat embolism. There is no scientific explanation why fat embolism occurs and what are the hypotheses for development of fat embolism or the proper way of prevention, but just speculations and possible theories in the evolution of the clinical picture of fat embolism syndrome. Throughout this chapter, the authors will explain the possible theories of development of fat embolism, risk factors, pathology, and pathophysiology during progress of the clinical picture and signs of the fat embolism syndrome and therapy.
Part of the book: Embolic Diseases
Blood vessel branching of the proximal femur by its scheme differs from all other major joints. This scheme changes during the individual's development, dynamically depending on age. Namely, the caliber, blood flow rate, and dominance of certain arteries from the entire network of blood vessels that participate in the vascular supply of the hip are not equally expressed in all stages of development. In each successive stage, blood supply is dominated by a different artery that, after a certain period of time, shifts its major role to another artery. Anastomoses between individual arteries are not constant in all stages of development, and they represent a great importance for compensatory mechanisms. The disturbance of local arterial blood vessels, at a time when they dominate the blood supply and affect the quality of hip development and maturation, leads to reduced perfusion, and consequently, to the lack of development, ossification, and possible osteonecrosis.
Part of the book: Osteonecrosis