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• W1890352893 abstract "Many technics to determine the anterior-posterior position of the femoral head in the congenitally abnormal hip have seemed to work well for their proponents but have not received universal favor, since calculations (3) or special mechanical devices (6) are needed. The purpose of this paper is to again call attention to the usefulness of the Chassard-Lapiné view in ascertaining this position. This view was described by Chassard and Lapiné (2) in 1923 as a method of determining the bi-ischiatic diameter in pregnancy. It was used by Ettinger and Elkin (4) in 1954 in examination of the sigmoid colon, and in 1955 Broderick (1) called attention to its application in various hip disorders. In spite of its simplicity, however, its application has not been popular. In the last 10 cases of congenital hip dislocation seen at The Long Island College Hospital, Brooklyn, N. Y., this view has proved of great assistance because it shows the true anterior-posterior position of the femoral head in relation to the acetabulum with a comparison view of the other hip on the same film. The standard anteroposterior and frog-leg views do not demonstrate the anterior-posterior position of the femoral head in relation to the acetabulum. The procedure is a variation of that originally described by Chassard and Lapiné. The patient is placed in a sitting position with the legs in as much abduction as is comfortable. The trunk is then flexed 50 to 60 degrees. The x-ray cone is positioned perpendicular to the cassette. For infants, we use 200 ma, one-thirtieth of a second, 90–100 kv, with a Bucky diaphragm. Older children require an increase in time, according to size. An attempt should be made to position the normal hip in the same degree of abduction as the dislocated hip for optimal comparison. However, this is not mandatory. Figure 1 identifies the pertinent anatomy in this position. It is possible to employ this view for both pre-reduction and post-reduction films if an abduction splint of the Hilgenreiner type is utilized. With a fixed anatomical point on the right and left sides, such as the ischial tuberosities or the pubic rami, a base line can be drawn from which the presence or absence of dislocation, its direction, and relative amount can be determined (Fig. 2). Discussion The advantages of The Chassard-Lapiné method are as follows: 1. No special equipment other than ordinary x-ray apparatus is needed. 2. No special calculations or tables are required. 3. Both hips are visualized for immediate and accurate comparison in the horizontal plane, giving the physician a third dimensional grasp of the problem. 4. Both hips can be readily compared in any position from complete adduction to complete abduction (Fig. 3B). 5. The femoral epiphysis need not be present, since anterior-posterior displacement can be determined by measuring the most proximal margins of the right and left femur as compared with a fixed point (Fig. 3, lower). 6. The child is easily immobilized." @default.
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• W1890352893 date "1963-04-01" @default.
• W1890352893 modified "2023-10-14" @default.
• W1890352893 title "Congenital Dislocation of the Hip" @default.
• W1890352893 doi "https://doi.org/10.1148/80.4.650" @default.
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