Surgical treatment of shape and position of the greater trochanter of the femur in children with hip joint pathology
DOI:
https://doi.org/10.15674/0030-5987201525-12Keywords:
hip joint, children, deformation of the greater trochanter of the femur, surgical treatmentAbstract
Objective: To assess the results of correction of the shape and position of the greater trochanter of the femur (GTF) after surgical treatment of hip joint (HJ) pathology in children. Methods: A retrospective analysis of the results of surgical treatment of the GTF deformities in 70 children (46 boys and 24 girls) between 2 and 18 years old. The children were divided into several groups: 18 patients with deformities the GTF (pathological hip dislocation (PHD) and the consequences of osteomyelitis), 8 with avascular necrosis of the femoral head (ANFH), 33 with congenital hip dislocation and 11 with coxa vara. The results of the treatment were assessed in terms from 3 to 16 years with the help of clinical, biomechanical and radiological methods. Results: In 88.7 % of cases there was achieved an improvement in clinical, radiological, biomechanical marks characterizing the HJ state comparing to preoperative ones. So, the symptom of Trendelenburg disappeared or decreased, strength of the abductor muscles increased in average on 11–20 % in the cases of coxa vara and on 30-45% in cases of ANFH. Indicators statopodographic study had a clear tendency towards normalization. Radiographic characteristics of trochanteric component of the HJ were within normal limits for each patient. Based on the working classification of the deformations of the GTF developed a differentiated approach to surgical procedures on it was offered in view of multiplanar character, extent and rate of progression of deformation, as well as with etiological factor and age of the patients. The most favorable outcomes after 3 years or more after the operation were obtained in cases of ANFH and coxa vara, and the least favorable - in the group of children with consequences of inflammatory diseases. Conclusion: The diagnosis and correction of the shape and position of the GTF in children with pathology of the HJ deserves special attention, and the surgical treatment of these abnormalities allows you to get better anatomical and functional results.References
- Lower extremity. Physiological anatomy / А. I. Kapandji. — 6th edit. — 2010. — P. 352.
- Greater trochanteric epiphysiodesis / J. J. Mc¬Carthy, D. S. Weiner // Int. Orthop. — 2008. — Vol. 32 (4). — P. 531–534.
- Tachdjian’s pediatric orthopedics / J. A. Her¬ring eds. — W. R. Sannders Company, 2014. — Vol. 1 — P. 610–611.
- Treatment of congenial hip dislocation (new technologies of osteosynthesis by modules Ilizarov’s apparatus) / [V. I. Shevtsov, V. D. Makushin, M. P. Teplenkii, . A. Atamanskii]. — Kurgan // Zaural’e. — 2006. — P. 1000.
- Planning proximal thigbone surgery / A. M. Sokolovskii, O. A. Sokolovskii, R. K. Goldman, A. B. Dementsov // Medical news. — 2005. — № 10. — P. 26–29.
- Transposition of the apophysis of the greater tro¬chanter for reconstruction of the femoral head after septic hip arthritis in children / P. Benum // Acta Orthop. — 2011. — Vol. 82 (1). — P. 64–68, doi: 10.3109/17453674.2010.548030.
- Congenital dysplasia and dislocation of the hip in children and adult / D. Tonnis. — New York // Springer. — 1987. — P. 461.
- Ortopaedic diagnostics / V. О. Marx. — Minsk // Science and Technology. — 1978. — P. 511.
- Spiral CT scan in preoperative planning treatment hip dysplasia / A. I. Korolkov, V. L. Mosshenko // Orthopedics, traumatology and prosthetics’ herald. — 2004. — № 4. — P. 50–54.
- Elongation of the femoral neck in Perthes disease / V. Pа-pavasiliou, S. Nenopoulos, A. Pаpavasiliou, J. Christoforides // Acta Orthop. Belg. — 2005. — Vol. 71. — P. 414–423.
- Distal transfer of the greater trochanter in acquired coxa vara. Clinical and radiographic results./ I . Martinez, F. Garrido, D. Molto, L. Luch // J. Pediatr. Orthop. — 2003. — Vol. 12-B. — P. 38–43.
- Trochanteric advancement in patients with legg-calve-perthes disease does not improve pain or limp / S. Y. Joo, K. S. Lee, I. H. Koh [et al.] // Clin. Orthop. Relat. Res. — 2008. — Vol. 466 (4). — P. 927–934, doi: 10.1007/s11999-008-0128-4.
- Statistical methods in biomedical researches with using Exel / S. N. Lapach, A. V. Gubenko, P. N. Babich. — K.// Morion — 2000. — P. 320.
- Method of surgery of greater trochanter of the femur strain / Korolkov A. I., Ershov D. B., Gromov A. B.// Patent № 81754 Ukraine, А61В 17/00, А61В 17/56.; founder and owner of the patent SE “Sytenko Institute of Spine and Joint Pathology, AMS Ukraine” — № u201300834; iss.10.07.2013, Bul. № 13.
- Device for surgery of greater trochanter of the femur strain / Korolkov A. I., Ershov D. V., Gromov A. B. // Patent № 81755 Ukraine, А61В 17/56, А61В 17/00.; founder and owner of the patent SE “Sytenko Institute of Spine and Joint Pathology, AMS Ukraine”.— № u201300835; iss.10.07.2013, Bul. № 13.
- Role and value of greater trochanter of the femur strain for hip’s function: creation of working classification / A. I. Korolkov, A. B. Gromov // Orthopedics, traumatology and prosthetics. — 2015. — № 1 (598). — P. 72–77, doi: http://dx.doi.org/10.15674/0030-59872015172-78.
- Biomechanical optimization of different fixation modes for a proximal femoral L-osteotomy / C.-L. Tai, W.-P. Chen, H.-H. Chen [et al.] // Musculoskeletal Disorders. — 2009. — Vol. 10. — Article 112, doi: 10.1186/1471-2474-10-112.
- Temporary blocking of zone of bone growth for knee-joint epimetaphyseal strain correction in children / N. А. Korzsh, S. А. Khmizov, A. I. Korolkov, D. V. Ershov // Orthopedics, traumatology and prosthetics. — 2014. — № 4 (597). — P. 65–69, DOI: http://dx.doi.org/10.15674/0030-59872014470-74.
- Role of greater trochanter in development of hip’s pathology (mathematic modeling) / A. I. Korolkov, A. B. Gromov, M. U. Karpinskii // Chronicle of traumatology and orthopedics. — 2013. — № 1–2 (25–26). — P. 21–29.
- Stresses in the pelvis / V. K. Goel, S. Valliappan, N. L. Svensson // J. Comput. Biol. Med. — 1978. — Vol. 8. — P. 91–104.
- Biomechanics of the normal and diseased hip. Theoretical foundation, thechnique and results of treatment / F. Pauwels. — Berlin. // Springer. — 1976.
- Gelenknahe osteotonien bei der displasiehufte der adolesznten und jungen erwaschenen / R. Bombelli. // Abstracts book of Simposium Nurzburg, 1982. — Stuttgart-New York: Georg Thieme Verlag, 1983. — S. 177–214.
- Value of decentration in hip’s biomechanics (mathematic modeling) / A. I. Korolkov, Z. M. Miteleva, I. V. Laponin // Orthopedics, traumatology and prosthetics. — 2006. — № 2. — P. 49–54.
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