scholarly journals Bilateral pathological hip dislocation in children

2017 ◽  
Vol 5 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Yuriy E. Garkavenko
Keyword(s):  
Functional State ◽  
Hip Joint ◽  
Hip Dislocation ◽  
Well Being ◽  
Hip Joints ◽  
Hematogenous Osteomyelitis ◽  
Number Of Patients ◽  
Hip Reduction ◽  
Dislocation Of The Hip ◽  
Open Hip Reduction

Introduction. Pathological dislocation of the hip is one of the most severe complications of acute hematogenous osteomyelitis. The program of treatment for children with pathological hip dislocation is complex, but it has been sufficiently developed and implemented very successfully. At the same time, the available literature provides no cases of treating children with bilateral pathological hip dislocations after hematogenous osteomyelitis. There is no information on the incidence of such cases or in regards to remote functional results. Materials and methods. The results of the treatment of 18 children with bilateral pathological dislocation of the hip after hematogenous osteomyelitis are presented, which constituted 23.1% of the total number of patients (78) who underwent surgery in 2000–2016 for the diagnosis of pathological hip dislocation. Both hip joints were surgically operated on in 12 patients, while one hip joint was operated on in 6 patients. To assess the anatomical and functional state of hip joints, the clinical and roentgenological diagnostic techniques were used. Results and discussion. To stabilize and restore the function of the hip joints, 18 children underwent 30 surgical interventions: simple open hip reduction (19) and open hip reduction with hip arthroplasty with one (6) or two (5) demineralized osteochondral allogeneic grafts. The decision regarding the possibility of performing surgical intervention on the second hip joint was made only after a child's check-up examination was complete and after positive information about the anatomical and functional state of the operated hip joint was obtained. According to these criteria, 14 (77.8%) children underwent surgical treatment of the second hip joint 1–1.5 years after the course of conservative measures to restore the range of motion in the previously operated hip joint. Over a period of 1–12 years, 17 patients were examined, 10 of which underwent an operation on both sides (27 joints). The preservation of up to 80º or more of motion amplitude was noted in 17 (62.9%) of 27 operated hip joints. When assisting patients with pathological hip dislocation, it is necessary to understand that it is practically impossible to restore the affected joint to the anatomical state of the opposite unaffected joint. As for the bilateral lesion, this is most certainly impossible, and the development of arthrosis is inevitable. Therefore, the most important factor reflecting the degree of well-being and stability of the affected joint is the amplitude of active movements. Preserving this amplitude in the affected joints with a careful and attentive attitude is a fundamental and feasible task.

scholarly journals Surgical management of the congenital dislocation of the knee and hip in children presented after six months of age

2020 ◽  
Vol 44 (12) ◽  
pp. 2635-2644
Author(s):  
Amrath Raj B.K. ◽  
Kumar Amerendra Singh ◽  
Hitesh Shah
Keyword(s):  
Knee Flexion ◽  
Hip Dislocation ◽  
Congenital Dislocation ◽  
Hip Joints ◽  
Surgical Interventions ◽  
Joint Dislocation ◽  
Spontaneous Reduction ◽  
Ligamentous Laxity ◽  
Rare Congenital Disorder ◽  
Dislocation Of The Hip

Abstract Purpose Congenital dislocation of the knee and hip is a rare congenital disorder. The specific aim of the study was to evaluate the clinical and radiological outcomes of the children with congenital dislocation of the knee and hip who presented after six months of age. Methods All the consecutive children with congenital dislocation of the knee and hip joints were retrospectively reviewed. We included cases that were treated after six months of age and followed up for a minimum of two years. Twenty-four children with congenital dislocation of the knee and hip (thirteen with ligamentous laxity, eleven children with stiff joints) were included. The knee was dislocated in 45 limbs; the hip was dislocated in 40 instances. The knee joint dislocation was treated with quadricepsplasty in all twenty-four children (45 knees). The hip dislocation (n = 32) was addressed with either closed reduction (n = 8) or open reduction of the hip (n = 24). Eight hip dislocations were not addressed. The outcome of the hip and knee was evaluated. Results The clinical and radiological outcomes were better in children with ligamentous laxity than without laxity. Twenty-two children were community walkers. An orthosis was needed in eight children. The frequency of spontaneous reduction of unreduced dislocation of the hip was noted in three children (5/8 hips). Conclusion Outcome in combined dislocation of knee and hip is good in most cases with surgical interventions. The outcome is better in children with ligamentous laxity. Spontaneous reduction of the dislocated hips might be achieved after gaining knee flexion following knee surgery for congenital the knee in a few cases.

Development of Hip Joint in Early Aged Children after Open Hip Reduction

2011 ◽  
Vol 18 (1) ◽  
pp. 28-32
Author(s):  
Ivan Yur'evich Pozdnikin ◽  
I Yu Pozdnikin
Keyword(s):  
Early Detection ◽  
Hip Joint ◽  
Closed Reduction ◽  
Open Reduction ◽  
Treatment Initiation ◽  
Joint Development ◽  
Hip Reduction ◽  
Open Hip Reduction

Peculiarities of hip joint development after its open reduction were studied in 45 early aged children. Depending on the pathology severity, terms of treatment initiation and its quality the types of postoperative hip joint development were determined. It was shown that open hip reduction was most effective in children under 12-15 months old on condition of early detection of hip irreducibility and refusal of repeated attempts of closed reduction.

scholarly journals A detailed review of hip reduction maneuvers: a focus on physician safety and introduction of the Waddell technique

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Bradford S. Waddell ◽  
Shafiq Mohamed ◽  
John Trey Glomset ◽  
Mark S. Meyer
Keyword(s):  
Occupational Safety ◽  
Hip Dislocation ◽  
Health Administration ◽  
Modified Technique ◽  
Reduction Techniques ◽  
Safety And Health ◽  
Closed Treatment ◽  
Hip Reduction ◽  
Posterior Hip Dislocation ◽  
Dislocation Of The Hip

Dislocation of the hip is a well-described event that occurs in conjunction with highenergy trauma or postoperatively after total hip arthroplasty. Bigelow first described closed treatment of a dislocated hip in 1870, and in the last decade many reduction techniques have been proposed. In this article, we review all described techniques for the reduction of hip dislocation while focusing on physician safety. Furthermore, we introduce a modified technique for the reduction of posterior hip dislocation that allows the physician to adhere to the back safety principles set for by the Occupational Safety and Health Administration.

scholarly journals Parents and Caregivers Satisfaction After Palliative Treatment of Spastic Hip Dislocation in Cerebral Palsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Aleksander Koch ◽  
Joanna Krasny ◽  
Magdalena Dziurda ◽  
Magdalena Ratajczyk ◽  
Marek Jozwiak
Keyword(s):  
Hip Joint ◽  
Steroid Injection ◽  
Hip Dislocation ◽  
Interposition Arthroplasty ◽  
Hip Joints ◽  
Fourth Group ◽  
The Third ◽  
Perineal Care ◽  
Femoral Resection

Objectives: Pain appearance is one the most common complication of spastic hip disease in children with cerebral palsy (CP). It determines child and caregiver quality of life and life priorities. Reconstruction hip surgery should be considered as a treatment of choice. Some clinical conditions give the inability to perform such a procedure. In our paper, we would like to present four palliative methods of spastic hip dislocation treatment in children with CP.Material: We analyzed four groups of patients treated because of hip pain. Inclusion criteria were pain appearance (visual analog scale-11 or numeric rating scale-11) and hip joint dislocation (migration percentage >80%). All patients were admitted to our department between 2008 and 2018. In the first group, patients were treated only by steroid injections to hip joints; in the second group, patients were recruits after hip interposition arthroplasty with shoulder spacer; in the third group, they were patients after valgus subtrochanteric osteotomy (Schanz); and in the fourth group, these were patients after proximal femoral resection (Castle procedure). The minimal follow-up time was 2 years. The first group consisted of 15 patients (15 hips) with a mean age of 15.5 (8–17) years; the second group, 20 patients (24 hips) with a mean age of 14.2 (9–22.6) years; the third group, 22 patients (24 hips) with a mean age of 13.5 (7–20.5) years; and the fourth group, 10 patients (15 hips) with a mean age of 12.9 (7–17.6) years.Methods: Radiological evaluation was based on a standardized anteroposterior X-ray of the hip joints. Pain severity before surgery and at the last follow-up time was measured by visual analog scale-11. Parents or caregivers were asked about their child's pain during sitting, perineal care, and rest. During the visit, all caregivers were asked about treatment satisfaction (no 0 to max 10) and if they would decide again for the same surgery.Results: In all groups of patients, we observed a decrease in pain complaints. The observed reduction of pain in the first group was from 7.88 (4–10) to 3.08 (0–8) (p = 0.05), but results of injection were observed only for 4 months (2–8), and it has to be repeated (average: two times). In the second group, level of pain was reduced from 4.93 (1–10) to 0.93 (0–5) (p < 0.001); in the third group, from 6.22 (3–10) to 0.59 (0–6) (p < 0.001); and in the fourth group, pain reduces from 5.43 (2–10) to 2.13 (0–5) (p < 0.001). Observed changes concerned mostly sitting position and perineal care. The complication rate was in the second group, 6 of 24 cases of extraarticular ossification; in the third group, 2 of 24 cases with extraarticular ossification, two cases of revision surgery. In the fourth group, two cases needed another femoral resection. In the first group, five patients died during follow-up time, so they were excluded from the study. In the steroid injection group, parents' treatment evaluation was 6.83 (0–10), and only in three cases that they would resign from the treatment. In the hip interposition arthroplasty group, caregivers' evaluation was 7.41 (0–10), and in five cases, parents did not accept the surgery. In the Schanz osteotomy group, parents' evaluation was 5.9 (0–10), and in eight cases, caregivers would not repeat surgery. In the proximal femoral resection group, satisfaction was the highest, 8.3 (3–10), and only two parents would not decide for surgery again.Conclusion: All procedures can be considered as palliative treatment options for pain complain in a spastic hip joint dislocation in children with CP. Steroid injections to the hip joint need to be repeated, and with the follow-up time, it becomes less effective. Steroid injection seems to be the treatment of choice for patients with general anesthesia contraindications. Interposition arthroplasty of the hip joint seems to give better final results, but the highest parents' satisfaction surprisingly was observed in the proximal femoral resection group, but differences were not statistically significant.

Mistakes and Complications in Conservative Treatmen of Congenital Hip Dislocation in Children

2003 ◽  
Vol 10 (4) ◽  
pp. 28-33
Author(s):  
O A Malakhov ◽  
I V Levanova ◽  
S E Kralina ◽  
V D Sharpar' ◽  
O A Malakhov ◽  
...  
Keyword(s):  
Femoral Head ◽  
Retrospective Analysis ◽  
Hip Joint ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
Congenital Hip Dislocation ◽  
Hip Reduction ◽  
Plaster Bandage ◽  
And Behavior

Retrospective analysis of treatment of 183 patients, aged 1 month-18 months, with congenital hip dislocation was performed. 146 patients had failed hip reduction. It was detected that in 134 cases (91.8%) inadequate treatment and/or wrong management and behavior of parents took place. Failed treatment with Frejka pillow, abductive splint, Pavlic device, functional plaster bandage, closed reduction were considered. Main mistakes in application of those methods as well as violation of treatment tactics were described. It was shown that repeated failed femoral head reductions were unfavorable factors for the following development of hip joint.

scholarly journals choice of surgical tactics for the treatment of children with destructive pathological dislocation of the hip after hematogenous osteomyelitis

2021 ◽  
Vol 5 (1) ◽  
pp. 15-20
Author(s):  
Akhror Makhmutovich Djuraev ◽  
Khojaakhmed Shaykhislamovich Alpisbaev ◽  
Elyar Abduvalievich Tapilov
Keyword(s):  
Surgical Treatment ◽  
Hip Joint ◽  
Proximal Femur ◽  
Surgical Approach ◽  
Open Reduction ◽  
Pelvic Osteotomy ◽  
Hematogenous Osteomyelitis ◽  
Surgical Tactics ◽  
The Stability ◽  
Dislocation Of The Hip

A surgical approach to the treatment of destructive pathological dislocation of the hip in children has been substantiated, depending on age, the severity of destruction of the proximal femur and acetabulum. Reconstructive - restorative operations in most patients ensure the stability of the hip joint and thereby improve the patient's gait and statics, reduce the pelvic misalignment and eliminate the Trendelenburg symptom. The experience of surgical treatment of patients with pathological hip dislocations has shown that the most favorable outcomes are achieved with the use of open reduction of the stump of the head or neck of the femur with intertrochanteric detorsion shortening and varizing osteotomy with rotational pelvic osteotomy according to Salter and acetabular plasty according to Pemberton.

scholarly journals Reconstructive and restorative interventions at the proximal end of the thigh and pelvic bones in destructive pathological dislocation of the hip in children after hematogenous osteomyelitis

2021 ◽  
Vol 4 (4) ◽  
pp. 367-372
Author(s):  
Khojaakhmed Shaykhislamovich Alpysbaev ◽  
Akhror Makhmutovich Djuraev ◽  
Elyar Abduvalievich Tapilov
Keyword(s):  
Surgical Treatment ◽  
Head And Neck ◽  
Hip Joint ◽  
Surgical Intervention ◽  
Pelvic Bones ◽  
Growing Period ◽  
Hematogenous Osteomyelitis ◽  
Early Surgical Intervention ◽  
Dislocation Of The Hip

It is generally known that children tend to get injured more easily than adults. Moreover, these injuries they get in growing period may leave for long in the forms of disability. This paper is about reconstructive and restorative interventions at the proximal end of the thigh and pelvic bones in destructive pathological dislocation of the hip in children after hematogenous osteomyelitis. After hematogenous osteomyelitis of the proximal end of the femur, destruction of the head and neck of the femur is often observed, up to their destruction. The optimal age for surgical treatment of pathological dislocation of the hip, according to our data, is 4-5 years of age of the child, because by this time the process of ossification of the structures of the hip joint ends in most patients, and early surgical intervention often causes severe secondary deformities, up to their destruction.

scholarly journals PATHOLOGICAL DISLOCATION OF THE HIP IN CHILDREN WHO HAVE SUFFERED EPIPHYSEAL OSTEOMYELITIS

2019 ◽  
Vol 22 (6) ◽  
pp. 354-358
Author(s):  
Patimat A. Shihabudinova ◽  
M. I. Izrailov ◽  
Y. M. Yahyaev ◽  
B. M. Mahachev ◽  
F. V. Meilanova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Head And Neck ◽  
Proximal Femur ◽  
Hip Dislocation ◽  
Surgical Correction ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Early Use ◽  
The Right ◽  
Dislocation Of The Hip

Pathological hip dislocation (PHD) is an orthopedic complication of acute hematogenous osteomyelitis in infants. The authors analyzed the results of the diagnosis and treatment of 14 girls and 9 boys aged from 1 month to 1 year, who suffered from acute epiphyseal hematogenous osteomyelitis of the proximal femur, complicated by pathological dislocation of the thigh. PHD was located on the right side in 12 patients, on the left - in 6 cases. Surgery was found to be preferable to be performed at the age of 2.5-3 years while secondary deformations of the osteoarticular system have not yet formed. A favorable outcome of surgical treatment is guaranteed by the exact centering of the head and neck of the thigh or its proximal end; the early use of restorative means after surgery and late loading of the operated limb. Combined surgical correction is indicated mainly for patients with pathological dislocation of the thigh of type III or IV.

Features and methods of assessing health-related quality of life and cognitive functions in patients with glial tumors

2020 ◽  
pp. 47-56
Author(s):  
Vera Arsenyeva ◽  
Boris Martynov ◽  
Gennadiy Bulyshchenko ◽  
Dmitriy Svistov ◽  
Boris Gaydar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Functions ◽  
Well Being ◽  
Health Related Quality ◽  
Number Of Patients ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
Patients With Epilepsy

Gliomas make up about 8 cases per 100,000 population and the number of patients with this disease is only increasing. There can be not only various types of neurological deficits among the symptoms, but also personal and emotional changes, that seriously affects the quality of life. The modern model of health care includes not only recovery of the patient’s physical functions, but also his or her psychosocial well-being. In particular, the assessment and study of the characteristics of health-related quality of life, as well as cognitive functions in patients with gliomas, is increasingly recognized as an important criterion when considering the effectiveness of treatment. To date, the features of health related quality of life and cognitive functions of patients with epilepsy and acute cerebral circulation disorders have been studied sufficiently, and, as a result, techniques have been developed that accurately assess the QOL and CF in patients with these diseases. These are QOLIE-31 and QOLIE-AD-48 questionnaires for patients with epilepsy. This is the National Institutes of Health Stroke Scale (NIHSS), Orgogozo stroke scale (OSS), World Federation of Neurological Surgeons (WFNS) scale for the clinical assessment of subarachnoid hemorrhage (SAH) for patients with acute cerebrovascular accident. At the same time, there are no generally accepted methods for assessing quality of life and neurocognitive functions that are sensitive to changes in the condition of patients with gliomas in the early postoperative period by the time of discharge from the hospital. As a result, there is no systematic information on the dynamics of the quality of life of such patients, their neurocognitive functioning. The purpose of this article was to study the literature on QOL and CF in patients affected by neurological and neurosurgical disorders for the further selection of optimal methods for assessing dynamics of the condition of patients with glial brain tumors before and after surgery. At the moment, such requirements are only partially met by the EORTC QLQ-C30 questionnaire and its application EORTC QLQ-BN20.

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