scholarly journals Trochanteric epiphysiodesis in complex treatment of children with hip pathology: analysis of preliminary results

2020 ◽  
Vol 8 (3) ◽  
pp. 249-258
Author(s):  
Ivan Y. Pozdnikin ◽  
Vladimir E. Baskov ◽  
Dmitry B. Barsukov ◽  
Pavel I. Bortulev ◽  
Ekaterina A. Kostomarova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Joint ◽  
Complex Treatment ◽  
Greater Trochanter ◽  
Surgical Interventions ◽  
High Position ◽  
Neck Shaft Angle ◽  
Slowing Down ◽  
Shaft Angle ◽  
Radiological Examinations

Background. The relative overgrowth of the greater trochanter is one of the most common deformities of the proximal femur in association with several disorders of the hip joint. Aim. To analyze the dynamics of proximal femoral growth after trochanteric epiphysiodesis as well as to determine the options for using this method in the complex treatment of children with hip pathology. Materials and methods. We analyzed the data of clinical and radiological examinations and surgical treatment (permanent trochanteric epiphysiodesis with metal fixation) outcomes for 43 (52 joints) patients aged 412 years with a developing high position of the greater trochanter. Results. The surgery enabled slowing down of the growth of the greater trochanter on the side of intervention by (average) 50% (p 0.05), although the values of the neck-shaft angle both on the affected side and the side opposite to it did not change (p 0.05). Conclusion. In moderate disorders of the growth plate of the femoral head epiphysis, trochanteric epiphysiodesis can prevent the progression and, in some cases, correct disturbed ratios of the hip joint, thereby avoiding the need for larger surgical interventions.

scholarly journals Transposition of the great trochanter: A look at the problem

2021 ◽  
Vol 9 (2) ◽  
pp. 195-202
Author(s):  
Ivan Y. Pozdnikin ◽  
Pavel I. Bortulev ◽  
Dmitry B. Barsukov ◽  
Vladimir E. Baskov
Keyword(s):  
Surgical Treatment ◽  
Femoral Neck ◽  
Range Of Motion ◽  
Hip Joint ◽  
Proximal Femur ◽  
Great Trochanter ◽  
Clinical Parameters ◽  
Greater Trochanter ◽  
Hip Joints ◽  
High Position

BACKGROUND: Multiplanar deformity of the proximal femur with a high position of the greater trochanter is one of the most common residual deformities of the hip joint. The VeauLamy transposition of the greater trochanter does not fully treat the mutual trauma of the components of the hip joint, as it only brings down the greater trochanter to provide tension for the gluteal muscles. AIM: This study aimed to share the experience of performing transposition of the greater trochanter according to our proposed technique. MATERIALS AND METHODS: The study included 15 patients (15 hip joints) aged 916 years with a high position of the greater trochanter of the femur, who underwent surgical treatment in the period from 2018 to 2019. In addition to the actual transposition of the greater trochanter, the intervention provided a modeling resection of the base (bed) of the greater trochanter and the formation of an offset of the femoral neck. RESULTS: Patients were followed up for period of up to 30 months. All patients showed positive changes after surgical treatment with improvement of radiological and clinical parameters. CONCLUSIONS: The proposed intervention allows restoration of the function of the gluteal muscles, improves the range of motion in the hip joint, and prevents and treats extra-articular impingement syndrome.

scholarly journals Reconstruction of the Hip in Multiple Hereditary Exostoses

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 490
Author(s):  
Dong Hoon Lee ◽  
Dror Paley
Keyword(s):  
Hip Joint ◽  
Joint Involvement ◽  
Neck Shaft Angle ◽  
Multiple Hereditary Exostoses ◽  
Femur Neck ◽  
Radiographic Outcomes ◽  
Surgical Dislocation ◽  
Center Edge ◽  
Shaft Angle ◽  
Coxa Valga

The hip joint involvement in multiple hereditary exostoses (MHE) occurs in 30–90%, causing pain and limitation of motion by femoroacetabular impingement, coxa valga, acetabular dysplasia, hip joint subluxation, and osteoarthritis. The purpose of this study was to investigate the clinical and radiographic outcomes of ten hips in seven patients treated by surgical dislocation and corrective osteotomies between 2004 and 2009. Surgical dislocation and excision of the osteochondromas and varus intertrochanteric osteotomies were performed in all cases when the neck–shaft angle was > 150°. Common sites of osteochondromas were medial, posterior, and anterior neck of the femur. Neck–shaft angle of the femur was improved from a mean of 157° to 139°, postoperatively. On an average, the center-edge angle improved from 20° to 30° postoperatively. We believe that Ganz’s safe surgical dislocation technique is the preferred treatment of MHE. This safeguards the circulation of the femoral head and the osteochondromas can be resected under direct vision. It can be combined with additional corrective osteotomies because the hip affected by MHE is frequently associated with dysplastic changes which can result in premature osteoarthritis.

scholarly journals Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

2020 ◽  
Vol 73 (2) ◽  
pp. 293-297
Author(s):  
Oleh E. Kanikovskyi ◽  
Andrii V. Osadchyі ◽  
Sergey I. Androsov ◽  
Anatolii V. Tomashevsky ◽  
Oleh A. Yarmak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Antibacterial Therapy ◽  
Treatment Duration ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Surgical Clinic ◽  
Modern Technologies ◽  
Clinical Emergency ◽  
Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

scholarly journals Results of surgery using a locking plate for proximal humerus fractures in patients older than 80 years: A retrospective case series

2019 ◽  
Author(s):  
Won Chul Shin ◽  
Suk-Woong Kang ◽  
Seung Min Son ◽  
Hyuk Bae
Keyword(s):  
Surgical Treatment ◽  
Locking Plate ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Bone Union ◽  
Neck Shaft Angle ◽  
Radiological Results ◽  
Comminuted Fracture ◽  
Shaft Angle ◽  
The Mean

Abstract Background: To evaluate the results of surgical treatment using a locking plate for proximal humeral fractures in patients aged >80 years. Methods: Between September of 2013 and March of 2016, there were 22 patients who received locking plate fixation from proximal humeral fractures over 80 years-old. Among the 22 cases, Clinical, radiological results were analyzed for 19 patients who were able to follow up more than one year. We analyzed bone union, neck-shaft angle, UCLA score, range of motion compared to opposite side and complication. Clinical, radiological results were investigated for medial comminuted fracture or not. Results: All the patients achieved bone union. The mean bone union time was 13.7 weeks, and the mean neck-shaft angle was 126.4. The mean University of California, Los Angeles, shoulder score was 22.4, and score was <28 point in 12 patients. The mean forward flexion, abduction, external rotation, and internal rotation angles were 129.2°, 112.3°, 44.2°, and L2. All motions were significantly different from the normal shoulder motion. A significant difference was found in the loss of neck-shaft angle according to the medial comminuted fracture. Conclusion: In the surgical treatment of proximal humeral fractures in patients aged >80 years, use of a locking plate attained bone union with relatively satisfactory results. However, we considered that prevention of and training for postoperative stiffness are necessary. Other surgical methods should be considered for patients with complex displaced fractures, especially those with medial comminuted fractures.

Study of neck shaft angle of femur in population of Bihar

2017 ◽  
Vol 5 (11) ◽  
pp. 4819
Author(s):  
Rajiv Ranjan Sinha ◽  
Binod Kumar ◽  
Sanjay Kumar ◽  
Ruchi Ratnesh ◽  
Md. Jawed Akhtar ◽  
...  
Keyword(s):  
Hip Joint ◽  
Diagnosis And Treatment ◽  
Coxa Vara ◽  
Normal Range ◽  
Male And Female ◽  
Neck Shaft Angle ◽  
Normal Neck ◽  
Shaft Angle ◽  
Medical Colleges

Background: Neck shaft angle is the angle formed between the long axis of shaft and long axis of neck. Neck shaft angle of femur is an important parameter considering the biomechanics of hip joint. Neck shaft angle gives important information regarding race to which they belong. Normal neck shaft angle is in the range of 1200 -1400. Objective of the study was to find out the neck shaft angle of femur and correlate with the previous study.Methods: present study was conducted on 60 dry femur collected from different medical colleges of Bihar. The neck shaft angle was measured by Goniometer.Results: In this study the neck shaft angle of femur was 130.820, in male neck shaft angle of femur was 130.280 and in females it was 131.420.Conclusions: There is no significance difference between the male and female neck shaft angle. Orthopaedists use the normal range and mean of the neck shaft angle in diagnosis and treatment of the disease of hip. The angle is increased in poliomyelitis, congenital subluxation and dislocation of hip and decreased in congenital coxa vara.

scholarly journals Relative overgrowth of the greater trochanter and trochanteric-pelvic impingement syndrome in children: causes and X-ray anatomical characteristics

2019 ◽  
Vol 7 (3) ◽  
pp. 15-24
Author(s):  
Ivan Y. Pozdnikin ◽  
Vladimir E. Baskov ◽  
Dmitry B. Barsukov ◽  
Pavel I. Bortulev ◽  
Andrey I. Krasnov
Keyword(s):  
Hip Joint ◽  
Hip Dislocation ◽  
Preschool Age ◽  
Greater Trochanter ◽  
X Ray ◽  
High Position ◽  
Anatomical Changes ◽  
Joint Pathology ◽  
Developmental Hip Dislocation ◽  
Survey Results

Background. The formation of multiplanar deformities of the proximal femur, in most cases combined with hypertrophy of the greater trochanter (relative overgrowth of the greater trochanter (ROGT)) and its high position relative to the femoral head, up to the development of pelvic and pelvic spine syndrome (trochanteric-pelvic impingement), has been considered one of the most common problems in the treatment of children with hip joint pathology of various etiologies. Aim. The aim of this study was to determine the causes of and characterize the X-ray anatomical changes in children with ROGT. Materials and methods. This study is based on an analysis of the survey results of 350 children 3 to 17 years old with an emerging high position of the greater trochanter due to various diseases of the hip joint. Details of the radiological indicators characterizing the change in the growth of the greater trochanter relative to the head and neck of the thigh were examined in 68 of these children (112 joints). Results. Most often, hypertrophy of the greater trochanter was observed in children with the sequele of ischemic disorders that occurred during the conservative treatment of hip dysplasia and developmental hip dislocation, as well as due to previous hematogenous osteomyelitis. It was revealed that in the affected hip joints, there was a regular decrease in the articulo-trochanteric distance index; simultaneously, TTD values, which characterize the isolated growth of the greater trochanter, were almost the same in normal and pathological conditions (p 0.05). Conclusion. Damage to the growth plates of the pineal gland and neck of the femur of various etiologies was the reason for ROGT formation. The X-ray anatomical changes include progressive shortening of the femoral neck. Moderately pronounced in preschool-age children, they progress with the childs growth and become the cause of chronic trauma injuries of the components of the hip joint.

scholarly journals Development of techniques for greater trochanter fragment fixation during surgical treatment of the dysplastic coxarthrosis

2018 ◽  
Vol 6 (4) ◽  
pp. 59-69
Author(s):  
Igor A. Voronkevich ◽  
Dmitrii G. Parfeev ◽  
Alexandr I. Avdeev
Keyword(s):  
Surgical Treatment ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Pain Syndrome ◽  
Locking Plates ◽  
Greater Trochanter ◽  
Advanced Technique ◽  
Total Hip ◽  
Dysplastic Hip

Isolated fractures of the greater trochanter based on the sources of specialized literature on the subject are extremely rare. However, methods for fixing the greater trochanter are actively developed in connection with the use of various versions of trochanteric osteotomies in the surgical treatment of the dysplastic hip joint. In this article, the anatomical features of the proximal femur, development of the ideas of reattachment of the greater trochanter in the course of total hip arthroplasty, as well as the current state of the problem, were examined. Until recently, patches were used that were fixed to the thigh using the aid of wires for osteosynthesis of a large trochanter. In 2009, studies initially reported on the use of locking plates for osteosynthesis of the trochanter in total hip arthroplasty. Currently, greater trochanter fixation by locking plates shows the best results as previous fixation devices. However, patients sometimes experience greater trochanter pain syndrome after fixation fragment by plates. The analysis of the published works confirmed the relevance of the search for a new more advanced technique and a device for the reattachment of the greater trochanter to the femur in the surgical treatment of the dysplastic hip joint.

scholarly journals The Method of Determining Clinical and Roentgenogrammetric Indicators of Hip Joint in Patients with Cerebral Palsy

2020 ◽  
pp. 35-42
Author(s):  
V.Yu. Hoshko ◽  
N.O. Naumenko ◽  
M.B. Yatsuliak ◽  
A.I. Cheverda ◽  
M.M. Nemesh ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Hip Joint ◽  
Developmental Disorders ◽  
Hip Joints ◽  
Femoral Torsion ◽  
Neck Shaft Angle ◽  
Joint Pathology ◽  
Medical Institutions ◽  
Shaft Angle ◽  
The Subject

Summary. There is no doubt that obtaining the true parameters of the hip joint makes it possible to determine the tactics of treatment of patients with cerebral palsy and it is a relevant object of studying. Objective: to improve the results of diagnostics of pathology of the hip joint in patients with cerebral palsy by developing our own method. Materials and Methods. The study included 20 patients (40 joints): 10 boys and 10 girls. Sixteen joints were operated on. The patients were 3-15 years of age. Femoral torsion according to Ruwe was clinically determined in all the patients; also, our own method for determining the clinical and roentgenogrammetric parameters of the hip joint (utility model patent No. 137567) was used. Results. Our own method is simple, available and cheap; it may be used in all medical institutions with X-ray rooms for the diagnosis of hip joint pathology, as well as for screening. Conclusions. Our own method is simple and reliable for determining the parameters of the hip joint in patients with cerebral palsy (femoral torsion, neck shaft angle, Wiberg's angle, Reimer's index, vertical migration index, acetabular angle, the angle of inclination of the acetabulum) in patients with cerebral palsy. Obtaining radiographic parameters of both hip joints after only one radiograph also significantly reduce the radiation load on the patient, since patients with cerebral palsy are the subject of screening throughout the entire period of their development. This method can be also applied during the examination and screening the patients with developmental disorders and other diseases of the hip joint.

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