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 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 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.

scholarly journals Comparative analysis of the dynamics of the duration of the surgery and hematological indicators of blood loss after osteotomy of the ilium and acetabuloplasty in treatment of children with spina bifida

2021 ◽  
Vol 10 (2) ◽  
pp. 137-143
Author(s):  
Stanislav V. Ivanov ◽  
Vladimir M. Kenis
Keyword(s):  
Comparative Analysis ◽  
Spina Bifida ◽  
Blood Loss ◽  
Hip Joint ◽  
Surgical Intervention ◽  
Herniated Disc ◽  
Pronounced Decrease ◽  
Pediatric Orthopedic ◽  
Hematological Indicators ◽  
Dislocation Of The Hip

Introduction. Spina bifida is a severe malformation of the spine and spinal cord. Pathology of the hip joint in children with spina bifida has always been one of the most challenging pediatric orthopedic problems. Purpose of the study. The aim of this study is to perform a comparative analysis of the duration of operations and hematological indicators of blood loss after performing osteotomy of the ilium and acetabuloplasty to treat children with herniated disc consequences in the presence of hip subluxation and dislocation. It also seeks to determine the safest surgical intervention. Materials and methods. We observed and treated 60 patients aged 38 years with spina bifida with subluxation and dislocation of the hip. Patients were subdivided into two groups of 30 patients each, differing in the technique of performing the intervention on the pelvic component of the joint. The first group is represented by patients who underwent osteotomy of the ilium (52 joints) aimed to stabilize the hip joint. The second group comprised children who underwent acetabuloplasty (55 joints), another variant of intervention on the pelvic component of the joint. Results. As our study shows, performing osteotomy of the ilium required significantly more time than acetabuloplasty (p = 0.0088 (p 0.05)). In addition, performing osteotomy of the ilium was accompanied by a more pronounced decrease in the level of both hemoglobin and the number of blood erythrocytes than when performing acetabuloplasty. Conclusion. Our study demonstrates that osteotomy of the ilium requires more time for its implementation. It is accompanied by a more pronounced decrease in hemoglobin and blood erythrocytes than acetabuloplasty. Therefore, we can conclude that acetabuloplasty is preferable in cases where the expected clinical result and the required degree of correction are comparable.

Successful surgical treatment of Nicolau’s syndrome combined with intravenous iloprost

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 378-381
Author(s):  
Gormus ◽  
Tanyeli ◽  
Senaran ◽  
Duman ◽  
Solak Görmüs ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Doppler Ultrasonography ◽  
Surgical Intervention ◽  
Distal Phalanx ◽  
Venous Thrombectomy ◽  
Acute Thrombosis ◽  
The Third ◽  
Standard Management ◽  
Iloprost Infusion ◽  
Early Surgical Intervention

A 4 year-old boy was admitted to our clinic with symptoms of pain and ecchymosis in his right leg and foot after injection of benzathine penicilline. There was a localized gangrenous area at the femoral injection site. Doppler ultrasonography showed no arterial flow in the femoral artery and clear evidence of acute thrombosis of the superficial femoral and popliteal veins. Femoral arterial and venous thrombectomy and fasciotomy were performed immediately. After surgery the boy was treated by Iloprost infusion and enoxaparine. One week later necrotic changes had regressed, fasciotomies were closed and only the distal phalanx of the third toe needed amputation. Early surgical intervention and standard management combined with Iloprost infusion may help in healing the lesions by increasing extremity perfusion and may prevent extremity loss.

Posterior dislocation of the hip joint with fracture of both the femoral head and neck

2008 ◽  
Vol 18 (5) ◽  
pp. 387-390
Author(s):  
Takashi Ikegami ◽  
Keiji Matsuda ◽  
Sung-Gon Kim ◽  
Koichi Maeda ◽  
Reiko Kubota ◽  
...  
Keyword(s):  
Femoral Head ◽  
Head And Neck ◽  
Hip Joint ◽  
Posterior Dislocation ◽  
Dislocation Of The Hip

scholarly journals Surgical Management in Primary Congenital Glaucoma: Four Debates

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Ta C. Chang ◽  
Kara M. Cavuoto
Keyword(s):  
Surgical Treatment ◽  
Surgical Management ◽  
Medical Management ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Congenital Glaucoma ◽  
Definitive Treatment ◽  
Primary Congenital Glaucoma ◽  
Compare And Contrast ◽  
Early Surgical Intervention

Primary congenital glaucoma is a worldwide diagnostic and therapeutic challenge. Although medical management is often a temporizing measure, early surgical intervention is the definitive treatment. As the abundance of surgical treatment options continues to expand, the authors will compare and contrast the available options and attempt to provide a consensus on surgical management.

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 THE RESULTS OF MODULAR ENDOPROSTHESIS OF PERIACETABULAR REGION IN TUMOR LESIONS OF THE ACETABULUM AND HIP JOINT

2019 ◽  
Vol 6 (2) ◽  
pp. 20-31
Author(s):  
G. D. Iluridze ◽  
V. Yu. Karpenko ◽  
V. A. Derzhavin ◽  
A. V. Bukharov
Keyword(s):  
Surgical Treatment ◽  
Disease Progression ◽  
Hip Joint ◽  
Locally Advanced ◽  
Functional Results ◽  
Giant Cell Tumors ◽  
Modular Systems ◽  
Pelvic Bones ◽  
Oncology Research ◽  
Modular Endoprosthesis

Surgical treatment of patients with tumoral defeat of pelvic bones, of preacetabular region, in particular, is one of the most challenging topics of modern oncorthopedics. Currently, one of the most modern methods of reconstruction of the pelvic bones is the use of modular endoprostheses based on the conical leg, the advantage of which is the ability to intraoperatively simulate an endoprosthesis that best meets the specific clinical situation. Purpose of research. To assess the benefits of modular endoprosthesis of the acetabulum in patients with tumoral defeat periacetabular region.Patients and methods. Within the period of 2011–2018 30 patients underwent surgical treatment in form of periacetabular resection with a modular endoprosthesis reconstruction in P.Hertsen Moscow Oncology Research Institute – Branch of National Medical Research Radiological Centre of Ministry of Health of Russian Federation. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary bone cancers were in 19 (63%) patients, giant cell tumors in 5 (17%), locally advanced soft tissue sarcoma in 1 (3%), solitary metastases of kidney cancer in 2 (7%), and recurrent sarcomas after previous surgical treatment in 3 (10%) patients.Results. The average duration of the operation was 310 min (145–520 min), the volume of intraoperative blood loss was 5520 ml (600–20 000 ml). The positive edge of resection according to the results of the planned morphological study was revealed in 3 (10%) patients. The average follow-up period was 36 months (4-73 months). Disease progression in terms of 6 to 40 months was revealed in 10 (33%) patients. 8 (27%) patients from disease progression. Complications of different types were diagnosed in 11 (37%) patients, among whom infectious complications prevailed 9 (30%). The average value of the functional results on a scale MSTS accounted for 59% (15 to 82%). Conclusion. The use of modular systems of endoprosthesis replacement of the acetabulum and hip joint in tumor lesions is a promising surgical technique that allows to achieve adequate functional results with a comparable number of postoperative complications.

scholarly journals SURGICAL TREATMENT OF CHRONIC RECURRENT HEMATOGENOUS OSTEOMYELITIS

2019 ◽  
pp. 48-51
Author(s):  
А. М. Shamsiev ◽  
S. S. Zayniev
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Satisfactory Result ◽  
Inpatient Treatment ◽  
Surgical Intervention ◽  
Control Group ◽  
Basic Group ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Duration Of Disease

SUMMARY. According to the WHO data, the acute hematogenous osteomyelitis becomes chronic in 20–60 % of patients. The aim – to improve the results of surgical treatment of chronic recurrent hematogenous osteo­myelitis (CRHO) by optimizing the surgical intervention. Material and Methods. 180 patients with CRHO were involved (from 1995 to 2016), average age was (15.5±5.9) years, the ratio of boys and girls was 2.3/1. The duration of disease in 63.3 % of patients exceeded 4 years, including 12.8 % – 10 years. All patients were divided into two clinical groups: the control group consisted of 74 (41.1 %) – patients who received traditional surgical treatment from 1995 to 2003 (local sequesternecrectomy in the zone of greatest lesion). The basic group of patients consisted of 106 (58.9 %) patients who underwent surgical treatment in the period from 2004 to 2016 according to the developed methodology (a technique of extended sequesternecrectomy with recanalization of the affected bone). Results. The proposed tactics of surgical treatment of CRHO allowed to statistically significantly reduce the frequency of wound purulent complications from 20.3 to 3.8 %, reduce the overall duration of inpatient treatment (from (31.2±2.1) to (21.9±0.6) days) and the duration of stay in the clinic in the postoperative period (from (18.3±0.9) to (14.9±0.35). Special questionnaire for assessment of the distant results of surgical treatment of CRHO, demonstrated good results in the main group in 97.7 %, in the control group – only in 34.7 % of cases. A satisfactory result in the basic group was in 1 (1.2 %) patient, while in the control group there were 32.7 %. The number of unsatisfactory results in the basic group was significantly lower (1.2 %) than in the control group (32.7 %). Conclusions. Comparative analysis of the outcomes of CRHO treatment showed that the developed tactics of surgical treatment allowed reducing the recurrence rate of the disease from 32.7 % to 1.2 % and in 98.9 % of patients getting good and satisfactory results.

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