scholarly journals Corrective Intertrochanteric Osteotomy of the Femur for Aseptic Necrosis of the Femoral Head after Bloodless Reduction of Congenital Dislocation in School-Age Children

2021 ◽  
Vol 07 (10) ◽  
Author(s):  
Khojaakhmed Shaykhislamovich Alpysbaev ◽  
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Hip Dislocation ◽  
School Age Children ◽  
Congenital Dislocation ◽  
School Age ◽  
Greater Trochanter ◽  
Congenital Hip Dislocation ◽  
Aseptic Necrosis ◽  
Results Of Treatment

The immediate results of treatment of 72 children aged 7 to 12 years with aseptic necrosis of the femoral head after bloodless reduction of congenital hip dislocation were analyzed. When treating patients, the following types of surgical treatment were used:extra-articular or open centering of the femoral head with intertrochanteric-torsion-varizing or devarizing and rotational osteotomy of the femur with bringing down the greater trochanter in the caudal direction. In all patients, pain and lameness disappeared, internal rotation of the lower extremities when walking, and the range of motion in the hip joint improved. Improved radiometric parameters characterizing the ratio of the acetabulum and the head of the femur and the angular values of the hip joint and proximal femur.

scholarly journals THE TACTIC OF CEMENTLESS TOTAL ENDOPROSTHESIS REPLACEMENT OF HIP JOINT IN PATIENTS WITH INHERENT HIP DISLOCATION

2017 ◽  
Vol 23 (3) ◽  
pp. 127-131 ◽  
Author(s):  
K. S Yusupov ◽  
N. N Pavlenko ◽  
A. S Letov ◽  
A. V Sertakova ◽  
O. Yu Voskresenskiy ◽  
...  
Keyword(s):  
Hip Joint ◽  
Hip Dislocation ◽  
Congenital Dislocation ◽  
Systemic Complications ◽  
Double Support ◽  
Results Of Treatment ◽  
Type Iv ◽  
Total Endoprosthesis ◽  
Dislocation Type ◽  
Surgical Tactics

Introduction. The total endoprosthesis replacement is a main method of treatment of congenital dislocation of hip. However, significant disorders of joint, resistant muscular contractures create technical complications under operation and force to apply various surgical tactics. Methods. The analysis was implemented concerning results of Crowe total endoprosthesis replacement in 69 patients with one-sided high hip dislocation type IV operated on the basis of traumatological orthopedic department of Saratovskii research institute of traumatology and orthopedics during 2010-2015. The treatment of patients was implemented using original genuine technique including total endoprosthesis replacement of hip joint combined with double V-subtrochanteric osteotomy. Results. The pathological types of implantation in operated hip joint are absent. On the whole, one can notice amelioration of bio-mechanical indices: cycle of step, period of double support, coefficient of rhythm. Among systemic complications of total endoprosthesis replacement one is to mark out phlebothrombosis established in 3 patients (7.1%) that was conditioned by sedentary state of patients. Among specific complications one stated dislocation related to inobservance of restrictive orthopedic regimen in 1 (2.4%) patient. None case of instability of prosthesis and difference in length of extremities in average periods of observation more than on 0.5 cm was established. This is a proof of effectiveness of developed technique of correcting V-subtrochanteric osteotomy. Therefore, the proposed technique of femoral bone osteotomy permitted to ameliorate the results of treatment and to diminish number of complications. The applied technique permits to obtain satisfactory clinical and technical results of surgical treatment of patients with high hip joint dislocation. The osteotomy permitted to eliminate difference in length of bones of patients and at that to ameliorate conditions for union of distal and proximal fragments of femur bone at the expense of larger surface of their contact.

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.

TO EVALUATE THE CHANGES IN HIP JOINT RELATED TO LOWER LIMB DOMINANCE AND ITS ASSOCIATION WITH HIP DISLOCATION

1969 ◽  
Vol 5 (1) ◽  
pp. 635-638
Author(s):  
NIAZ MOHAMMAD ◽  
MAQBOOL ILAHI ◽  
QAISAR ZAMAN
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Lower Limb ◽  
Weight Bearing ◽  
Hip Dislocation ◽  
Congenital Dislocation ◽  
Left Femur ◽  
Horizontal Diameter ◽  
The Mean ◽  
The Right

BACKGROUND: The stability of a joint depends on the arrangement of the articular surfaces. Thefailure of acetabulum to deepen along with associated relaxed capsule can be a causative factor leadingto congenital dislocation of hip in babies. The right traumatic hip dislocation is less uncommon ascompared to left side in adults.OBJECTIVE: To correlate the majority of right-footed population with the bony parameters of hipjoint bilaterally and to find out its association with left congenital and right acquired traumaticdislocation of hip.MATERIAL AND METHODS: As the right footed people are considerably more (90%) than the leftfooted and this study work was correlated with the bones collected from cadavers in Anatomydepartment of KGMC Peshawar from January 2014 to December 2014. We included 14 pairs of femurs,14 pairs of hip bones in this study to see the structural differences when dominant hip joint is comparedwith non-dominant hip joints. The measurements were performed with the help of vernier caliper.RESULTS: The mean horizontal diameter of right (dominant) and left acetabulum was 50.14±0.69 mmand 52.35±0.65mm. The mean horizontal depth of right and left acetabulum was 22.21±0.82mm and25.25±0.52mm. The horizontal diameter of right and left femur was 46.42±0.62mm and 43.85±01mm.The thickness of femoral head was 26.71±01mm on right (dominant) side but this thickness was29.17±01mm on left side.CONCLUSION: The left acetabulum was having a significant larger diameter in adult, allowing thesmaller left femoral head to fit snugly which can be correlated with the more common left congenitaldislocation hip. On the other hand, in adults, the left acetabulum is deeper, allowing the thicker left headof femur as an adjustment for weight bearing functionwhile the larger rightfemoral head fit into acomparatively shallow socket. This may be a factor to improve mobility at the cost of stability; as righttraumatic dislocationhip is less uncommon as compared to left side.KEY WORDS: Hip joint, Ball and socket joint. Dominant lower limb, Right footedness,Left footedness, Congenital dislocation hip, Traumatic dislocation hip.

scholarly journals Pathohistologic Changes in Hip Tissues and Clinical-Morphologic Correlations in Diseases Complicated by Femoroacetabular Impingement Syndrome

2014 ◽  
Vol 21 (2) ◽  
pp. 67-73
Author(s):  
V. V Grigorovskiy ◽  
V. V Filipchuk ◽  
M. S Kabatsiy
Keyword(s):  
Femoral Head ◽  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Comparison Study ◽  
Acetabular Labrum ◽  
Aseptic Necrosis ◽  
Association Coefficient ◽  
Absolute Value ◽  
Femoroacetabular Impingement Syndrome ◽  
Fai Syndrome

The purpose of the work was to detect clinical-morphologic correlative dependences in patients with clinically marked femoroacetabular impingement (FAI) syndrome basing on the study of pathomorphologic changes in hip joint tissues, semiquantitative quantification of pathologic changes intensity, frequency analysis of their occurrence in nosologic groups of comparison. Study was performed on specimens of hip joint tissues - femoral head, acetabulum, acetabular labrum and joint capsule, resected during indicated corrective surgeries for femoral head aseptic necrosis and juvenile epiphysiolysis. Clinical-morphologic study revealed various pathologic changes: dystrophic-destructive, ischemic-necrotic and productive-inflammatory. In patients with FAI syndrome clinical and morphologic correlative dependences varied by absolute value, sign and degree of reliability of association coefficient parameters, i.e. groups of patients with certain nosologic units retained the peculiarities of rate and characteristics proportions in correlative dependences

scholarly journals Congenital Hip Dislocation with a Genu Recurvatum in Togo: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 72-76
Author(s):  
Agbeko FY ◽  
Fiawoo M ◽  
Djomaleu RA ◽  
NZonou M ◽  
Talboussouma S ◽  
...  
Keyword(s):  
Hip Dislocation ◽  
Black Population ◽  
Lower Limbs ◽  
Sub Saharan Africa ◽  
Congenital Dislocation ◽  
Congenital Hip Dislocation ◽  
Genu Recurvatum ◽  
Ultrasound Of The Hip ◽  
The Right ◽  
Dislocation Of The Hip

Introduction: CHD is a condition, which is frequent in pediatrics in the Caucasian population, remains rare in the Black population, and exceptional in sub-Saharan Africa. The Patient: We report this first Togolese case of bilateral congenital dislocation of the hip associated with genu recurvatum observed in a newborn received on the second day of life. The Primary Diagnoses, Interventions, and Outcomes: The pediatric examination had noted extension of lower limbs. The thighs were in adduction with a stiff bilateral genu recurvatum. The abduction of the thighs on the pelvis was considerably limited. The Barlow and Ortolani maneuvers showed a protrusion. There was also a camptodactyly of the thumbs and a cleft palate. The rest of the examination was normal. Ultrasound of the hip showed a bilateral congenital dislocation of the hip with an estimated acetabular fundus of 7 mm on both the right and left sides. Ultrasound and radiography of the knees were normal. Conclusion: Clinical examination at birth is the key step in diagnosis of congenital hip dislocation. In situations where diagnosis is difficult, ultrasound is of capital importance. Treatment is in the majority of cases orthopedic.

scholarly journals Nonunion of the bone fragments during total hip replacement with T. Paavilainen osteotomy — causes of failure

2020 ◽  
Vol 8 (2) ◽  
pp. 119-128
Author(s):  
Alexandr I. Avdeev ◽  
Igor A. Voronkevich ◽  
Dmitrii G. Parfeev ◽  
Anton N. Kovalenko ◽  
David G. Pliev ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Greater Trochanter ◽  
Total Hip ◽  
Shortening Osteotomy ◽  
History Of ◽  
Bone Fragments

Background. Conservative treatment options for hip dysplasia and hip dislocation in early childhood allow for good results in cases of a timely diagnosis. The preferred treatment option for patients with hip dislocation in adulthood is total hip joint replacement. The shortening osteotomy, proposed by T. Paavilainen, allows the surgeon to restore the difference in the lengths of the lower extremities during arthroplasty of the hip joint. However, according to the results of the Paavilainen technique, as presented by Russian orthopedic surgeons, the problem of nonunion of the greater trochanter fragment with the diaphysis of the femur remains unresolved, as evidenced by a massive group of clinical cases. Aim. The aim of this study was to identify factors affecting the consolidation of bone fragments after osteotomy of the greater trochanter, according to T. Paavilainen, during total hip arthroplasty and evaluate their significance after fixation with cerclage screws in comparison with a special trochanteric fork-plate. Materials and methods. The present study includes 208 cases that were treated at the Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden from 2003 to 2019 using various fixation techniques of the greater trochanter fragment. Patients were divided into two groups depending on their type of fixation. The quality of consolidation of a greater trochanter fragment with the femur was assessed during a follow-up period of six months or longer. The fragment of the greater trochanter was divided into the part that was not in contact with the diaphysis, or A, and the part that was in contact with the diaphysis, or B. We assessed the effect of the absolute value of the contact between fragments, the B/A ratio, the distance between the points of insertion of the screws into the diaphyseal part of the femur, the quality of the bone by the modified Barnet-Nordin index, and the history of previous surgical interventions on this joint on the consolidation. Results. When the part of the greater trochanter was in contact with the diaphysis of the femur (B) was less than 3.5 cm, the risk ratio of nonunion of the greater trochanter fragment with the diaphysis of the femur increased. Also, a significant factor is the index of the contact of the greater trochanter fragment (B/A less than 1) with the diaphysis of the femur using the T. Paavilainen technique. In addition, the presence of surgical intervention in the hip joint history significantly increases the relative risk (RR) of nonunion of the greater trochanter fragment with the diaphysis of the femur with this method of shortening osteotomy of the femur. Conclusion. In the absence of timely diagnosis and conservative treatment of children with hip dislocation, reconstructive-plastic techniques on the hip joint do not allow the achievement of proper results and increase the complexity of total hip arthroplasty. According to the results of this study, the absolute value of the contact between fragments (B), the index of the greater trochanter contact with the diaphysis of the femur, and the history of previous surgical intervention on this joint are objective tools for the prognostic assessment of the probability of fragment unions during total hip arthroplasty with the T. Paavilainen technique.

Relationship of peroxidation indicators and hemograms in children with hip joint pathology

2021 ◽  
Vol 66 (2) ◽  
pp. 104-109
Author(s):  
M. P. Teplen’kiy ◽  
E. L. Matveeva ◽  
E. S. Spirkina ◽  
A. G. Gasanova
Keyword(s):  
Lipid Peroxidation ◽  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Stage Ii ◽  
Perthes Disease ◽  
Antioxidant Protection ◽  
Aseptic Necrosis ◽  
Joint Pathology ◽  
Group I

The increase in the number of patients with hip pathologies among children of different ages makes the diagnosis and treatment of these diseases one of the most actually existing problems in modern orthopedics. The aim of the work was to determine the features of the lipid peroxidation system - antioxidant protection and hemogram indices in children with various forms of hip joint pathology. The results of a preoperative examination of 47 patients aged 6-15 years (average age 10.3 years) who were treated at the clinic “FSBI NICC“ TO ”named after academician G. A. Ilizarova, Ministry of Health of the Russian Federation. There were 25 boys and 20 girls. Given nosology, patients were divided into five groups. The diagnosis was established on the basis of a clinical and radiological examination. Group I consisted of 8 male patients with stage II Perthes disease (mean age 8.75 + 1.63). Group II includes 16 patients (8 boys, 7 girls) with stage III Perthes disease. (average age 11.80 + 0.89). Group III included 12 patients (6 boys, 6 girls) with aseptic necrosis of the femoral head (average age 14.7 + 2.35). Group IV consisted of 4 patients (1 boy, 3 girls) with epiphyseal dysplasia. (average age 10.25 + 1.36). Group V includes 7 patients with hip dysplasia complicated by aseptic necrosis of the femoral head (mean age 8.33 + 2.11). The norm is the data that was obtained after examining 10 healthy male adolescents (age 13-14) and 5 female adolescents (age 8-14 years). Changes in lipid peroxidation rates and antioxidant activity are unidirectional in different forms of pathology of the hip joints in children, and the content of peroxidation products reliably correlates with hemogram values in stage II osteochondropathy and complicated hip dysplasia. In the complex of diagnostic measures for children with dystrophic lesions of the hip joint, to clarify the nature and stage of the pathological process, as additional criteria, hemogram indicators and lipid peroxidation systems - antioxidant protection can be used.

scholarly journals Biochemical Changes in Tissues and Synovial Fluid of Hip Joint in Congenital and Degenerative-Dystrophic Diseases in Children and Adolescents

2016 ◽  
Vol 23 (3) ◽  
pp. 33-40
Author(s):  
O. V Kozhevnikov ◽  
S. E Kralina ◽  
L. N Furtseva ◽  
I. A Bogdanova ◽  
N. M. Savost’yanova
Keyword(s):  
Femoral Head ◽  
Synovial Fluid ◽  
Children And Adolescents ◽  
Biochemical Analysis ◽  
Hip Dislocation ◽  
Aseptic Necrosis ◽  
Tissue Samples ◽  
Femur Bone ◽  
Femoral Head Cartilage ◽  
Glycosaminoglycan Metabolism

Results of biochemical analysis of hip tissues (femoral head cartilage, proximal femur bone tissue, scarry tissue from hip cavity) and synovial fluid in 72 children and adolescents (aged 1 - 18 years) with congenital and pathologic hip dislocation, Legg-Calve-Perthes disease, femoral head aseptic necrosis and early coxarthrosis are presented. In tissue samples the content of hydroxyproline, hexuronic acids and hexoses was determined. In synovial fluid the content of hyaluronic acid, total protein and protein fractions, albumin, glucose and alkaline phosphatase activity was analyzed. It was detected that in congenital and acquired hip pathology the articular cartilage showed increased content of hydroxyproline, disorders of glycosaminoglycan metabolism and shift in glycoprotein metabolism indicative of destructive changes of basic cartilaginous tissue substance. Changes of synovial fluid chemical composition confirmed the disturbance of synovium permeability and were closely related to the clinical picture of metabolic-dystrophic changes in the joint.

Sign in / Sign up

Export Citation Format

Share Document