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.

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 PECULIARITIES OF THE SURGICAL TREATMENT OF PATIENTS WITH DEEP FACE BURNS

2017 ◽  
Vol 19 (4) ◽  
pp. 14-20
Author(s):  
Ya L Butrin ◽  
S A Petrachkov
Keyword(s):  
United States ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
The United States ◽  
Surgical Patients ◽  
Facial Burns ◽  
Different Types ◽  
Pros And Cons ◽  
Surgical Tactics

The article is devoted to the study of different types of surgical approach in the treatment of patients with deep face burns. The data of the facial burns frequency in time of peace and in time of war in Russia, the United States are given, the most common reasons of burns are indicated. The data on the different specialists’ approaches in the surgical patients’ treatment with deep burns face have been presented. Pros and cons of each approach have been described. Specific features of facial burns treatment are indicated. The necessity of searching the optimal surgical tactics in the treatment of deep face burns has been justified

scholarly journals Developmental dislocation of the hip is still important problem: Therapeutic guidelines

2006 ◽  
Vol 53 (4) ◽  
pp. 17-19 ◽  
Author(s):  
Z. Vukasinovic ◽  
C. Vucetic ◽  
G. Cobeljic ◽  
Z. Bascarevic ◽  
N. Slavkovic
Keyword(s):  
Surgical Treatment ◽  
Open Reduction ◽  
Nonoperative Treatment ◽  
Leg Length ◽  
Leg Length Inequality ◽  
Important Complication ◽  
Therapeutic Guidelines ◽  
Second Year ◽  
Dislocation Of The Hip ◽  
Hip Necrosis

The authors are describing currently important problem - developmental dislocation of the hip. Guidelines for the treatment have been given according to literature date and upon their own experience. Therapeutic suggestions for the first twelve months of life are based on the ultrasound typing - it is advised to perform nonoperative treatment (abduction devices, "over head" traction, Pavlik harnesses). During the second year of life a pause in the treatment should be advised in order to avoid postreduction avascular hip necrosis as a very important complication. After that period surgical treatment has to be done (open reduction, pelvic and femoral osteotomies). Special suggestions have been given for the treatment of consecutive leg length inequality and the deformities caused by postreduction avascular hip necrosis.

scholarly journals Bilateral One-half Spica Cast After Open Reduction and Pelvic Osteotomy in the Developmental Dislocation of the Hip

2013 ◽  
Vol 15 (12) ◽  
Author(s):  
Hadi Makhmalbaf ◽  
Amir Reza Kachooei ◽  
Seyed Mahdi Mazloumi ◽  
Mohamad Ebrahimzadeh ◽  
Farzad Omidi-Kashani ◽  
...  
Keyword(s):  
Open Reduction ◽  
Pelvic Osteotomy ◽  
Spica Cast ◽  
Dislocation Of The Hip

scholarly journals Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy

2003 ◽  
Vol 11 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Guaracy Carvalho Filho ◽  
Alceu Gomes Chueire ◽  
Helencar Ignácio ◽  
Márcio de Oliveira Carneiro ◽  
João Francese Neto ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Reduction ◽  
Weight Bearing ◽  
Clinical Results ◽  
Congenital Dislocation ◽  
Radiological Criteria ◽  
Clinical Criteria ◽  
Innominate Osteotomy ◽  
Walking Age ◽  
Dislocation Of The Hip

The congenital dislocation of the hip, after the function of weight bearing begins or walking phase requires surgical treatment, and one of the options is the open reduction combined to innominate osteotomy (Salter). In this study, the results of 18 patients, 22 surgically treated hips with congenital dislocation, were evaluated from 1989 and 1995, using innominate osteotomy, by Salter's technique after open reduction. The age of the patients at the time of surgery ranged from 12 to 30 months (age after march), mean age of 19 months. Fifteen were female and 3 were male, 4 patients had bilateral dislocation and in the remaining, 8 had their left hip dislocated and 6 had their right hip dislocated. The results were evaluated according to Dutoit et al.(3) clinical criteria and to Severin(12) radiological criteria, after a mean follow-up of 48 months. Eighteen percent of excellent clinical results (4); 54% of good results (12); 14% of regular results (3) and 14% of bad results(3) were obtained. As to the radiologic criteria, 36% of the hips were classified as excellent (8); 45% as good (10); 5% regular (1) and 14% bad (3). There were 3 cases of re-dislocation which were treated by a different surgical technique. No cases of infection, graft fracture and vascular or nervous injury were reported.

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 Number of screws in the articular segment of distal humerus AO/OTA C-type fractures treated with open reduction internal fixation is associated with complication rate

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 25
Author(s):  
Brian F. Grogan ◽  
Nicholas C. Danford ◽  
Cesar D. Lopez ◽  
Stephen P. Maier ◽  
Pinkawas Kongmalai ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Surgical Approach ◽  
Revision Surgery ◽  
Complication Rate ◽  
Open Reduction ◽  
Distal Humerus ◽  
Open Reduction Internal Fixation ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Introduction: Surgical treatment of distal humerus fractures can lead to numerous complications. Data suggest that the number of screws in the distal (articular) segment may be associated with complication rate. The purpose of this study is to evaluate the association between a number of screws in the distal segment and complication rate for surgical treatment of distal humerus fractures. We hypothesize that the number of screws in the articular segment of distal humerus AO/OTA C-type fractures treated with open reduction internal fixation (ORIF) will be inversely proportional to the complication rate. Methods: We performed a single-center retrospective cohort study of 27 patients who underwent ORIF of distal humerus fractures C-type with at least six months of radiographic and clinical follow-up. Clinical outcomes including a range of motion, pain, revision surgery for stiffness and/or heterotopic ossification (HO), nonunion, and persistent ulnar nerve symptoms requiring revision neurolysis were recorded. Results: In C-type fractures, the use of three or fewer articular screws was significantly associated with nonunion or loss of fixation (RR 17, p = 0.006). Nineteen of 36 (53%) patients experienced at least one complication. The surgical approach, plate configuration, age, and ulnar nerve treatment (none, in situ release, transposition) were not associated with the need for revision surgery. Men had a higher risk of requiring surgical contracture release due to improving post-operative stiffness (RR 12, p = 0.02). Conclusion: In this retrospective study, the use of three or fewer screws to fix articular fragments in AO type C fractures was a significant risk for nonunion or loss of fixation. Plate configuration and surgical approach did not correlate with outcomes. Men had higher rates of complications and required more frequent revision surgery compared to women.

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