RESUMO
During the period 1960 to 1983, 2,789 operations were performed in patients with congenital dislocation of the hip. Of these, 784 patients were between 1 1/2 and 4 years of age, 1,646 patients were between 4 and 8 years of age, and 359 patients were between 8 and 14 years, with an average age of 10 years. The procedure is performed in a single operation by sectioning all contracted muscles, opening and debriding the joint, and reducing the femoral head into the acetabulum after removal of 2 cm to 3 cm bone segment from the subtrochanteric region of the femur. Fixation of the femoral shaft in a derotation, varus position is done with a bone plate. Finally, a transiliac acetabuloplasty is performed. The bone segment removed from the subtrochanteric region is used to support the acetabular roof. The results, graded according to Severin's classification, were 83.3% successful and 16.7% unsuccessful.
Assuntos
Luxação Congênita de Quadril/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Luxação Congênita de Quadril/diagnóstico por imagem , Humanos , Lactente , Masculino , Métodos , Complicações Pós-Operatórias , RadiografiaRESUMO
During the years 1975 to 1982, what was named the double osteotomy--which is a combination of pelvic osteotomy together with subtrochanteric varus, extension and derotation osteotomy--was applied to 26 cases suffering from coxa plana (Perthes-Calvé-Legg disease). The postoperative follow up averages a period of three years and five months and was undertaken at the Department of Orthopedics and Traumatology of the Faculty of Medicine, University of Ankara, Turkey.
Assuntos
Necrose da Cabeça do Fêmur/cirurgia , Doença de Legg-Calve-Perthes/cirurgia , Osteotomia/métodos , Acetábulo/cirurgia , Criança , Pré-Escolar , Feminino , Fêmur/cirurgia , Seguimentos , Humanos , Doença de Legg-Calve-Perthes/diagnóstico por imagem , Masculino , Cuidados Pós-Operatórios , Radiografia , Fatores de TempoRESUMO
The most important complication following the treatment of congenital dislocation of the hip is avascular necrosis. The potential sequelae that may arise after the onset of avascular necrosis are worse than if the hip remained dislocated. We evaluated 38 hips in which avascular necrosis developed after reduction. The average patient age at the time of reduction was 4.3 years, with a follow up of 6 to 15 years. Twelve hips had closed reduction and 26 had open reduction. Following reduction, 8 hips had Type I, 6 had Type II, 9 had Type III, and 15 had Type IV avascular necrosis. In this article, we evaluate our cases and review current literature on the subject. Close follow up and timely interventions can reduce potential sequelae to a minimum.
Assuntos
Necrose da Cabeça do Fêmur/etiologia , Luxação Congênita de Quadril/complicações , Adolescente , Braquetes , Criança , Pré-Escolar , Feminino , Necrose da Cabeça do Fêmur/classificação , Luxação Congênita de Quadril/terapia , Humanos , Lactente , Masculino , Osteotomia/métodos , Estudos Retrospectivos , TraçãoRESUMO
During the period 1962-76, 1,500 operations were performed in patients with congenital dislocation of the hip. Of these, 420 patients were aged between 6 and 13 years (average age, 10 years). The procedure is to perform in a single operation the sectioning of all contracted muscles, the opening and cleaning of the joint, and the reduction of the femoral head into the acetabulum after removal of a bone segment 2 to 3 cm long from the subtrochanteric region of the femur. Reunion of the femoral shaft in a derotation varus position is then done with a bone plate and, finally, a transiliac acetabuloplasty is performed. The bone segment removed from the subtrochanteric region is used to support the acetabular roof. The results, graded according to Severin's classification, were 83.3% successful and 16.7% unsuccessful.