电邮这篇文章 Surgical treatment of children with hip dysplasia complicated with avascular necrosis of the femoral head
- 作者: Teplenky M.P.1, Oleinikov E.V.1, Bunov V.S.1
-
隶属关系:
- Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
- 期: 卷 7, 编号 1 (2019)
- 页面: 25-34
- 栏目: Original papers
- URL: https://ogarev-online.ru/turner/article/view/8395
- DOI: https://doi.org/10.17816/PTORS7125-34
- ID: 8395
如何引用文章
详细
Introduction. Avascular necrosis of the femoral head complicates the surgical treatment of hip dysplasia and aggravates the prognosis.
Aim. We studied the immediate and medium-term results of reconstructive treatment in 18 children with hip dysplasia complicated by avascular femoral head necrosis, which developed after closed repositioning of a congenitally dislocated femur.
Material and methods. Average age at the time of operation was 4.2 ± 0.2 years. The patients were divided into two groups. Group 1 included 12 children with hip subluxation who underwent extra-articular reconstructions on articular components, spinal tunneling of the neck and head, and hardware unloading of the joint and group 2 included six patients with hip dislocation in whom an additional open reduction was performed. Functional results were estimated using D’Aubigne-Postel classification, whereas X-ray results were evaluated using Kruczynski classification.
Results. Duration of observation was 3–7 years (average, 4.2 ± 0.3 years). Functional results were good (15–18 points) in nine joints in group 1, satisfactory (12–14 points) in three joints in group 1 and five in group 2, and unsatisfactory (11 points) in one joint in group 2. X-ray results were good in six joints in group 1, satisfactory in six joints in group 1 and five in group 2, and unsatisfactory in one joint in group 2.
Conclusions. Extra-articular reconstructive and stimulatory interventions combined with hardware decompression helps improve the shape and structure of the femoral head, and formation of congruent articular surfaces in children with subluxation of the thigh complicated by avascular necrosis.
作者简介
Mikhail Teplenky
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
Email: teplenkiymp@mail.ru
ORCID iD: 0000-0002-1973-5192
MD, PhD, Head of Joint Pathology Laboratory, Head of Department 11 (Pediatric Joint Pathology), Highest Category Orthopaedic Surgeon
俄罗斯联邦, 6, M.Ulianova St., Kurgan, 640005Evgeny Oleinikov
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
编辑信件的主要联系方式.
Email: ortho-kgn@mail.ru
ORCID iD: 0000-0002-2454-7161
SPIN 代码: 3973-8308
MD, PhD, Orthopaedic Surgeon, Department 9 (Pediatric Joint Pathology), Junior Researcher, Joint Pathology Laboratory
俄罗斯联邦, 6, M.Ulianova St., Kurgan, 640005Vyacheslav Bunov
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
Email: bvsbunov@yandex.ru
ORCID iD: 0000-0002-5926-7872
MD, PhD, Leading Researcher, Joint Pathology Laboratory
俄罗斯联邦, 6, M.Ulianova St., Kurgan, 640005参考
- Connolly P, Weinstein SL. The course and treatment of avascular necrosis of the femoral head in developmental dysplasia of the hip. Acta Orthop Traumatol Turc. 2007;41 Suppl 1:54-59.
- Roposch A, Ridout D, Protopapa E, et al. Osteonecrosis complicating developmental dysplasia of the hip compromises subsequent acetabular remodeling. Clin Orthop Relat Res. 2013;471(7):2318-2326. https://doi.org/10.1007/s11999-013-2804-2.
- Cooperman DR, Wallensten R, Stulberg SD. Post-reduction avascular necrosis in congenital dislocation of the hip. J Bone Joint Surg Am. 1980;62(2):247-258.
- Malvitz TA, Weinstein SL. Closed reduction for congenital dysplasia of the hip. Functional and radiographic results after an average of thirty years. J Bone Joint Surg Am. 1994;76(12):1777-1792.
- Read HS, Evans GA. Avascular necrosis as a complication in the management of developmental dysplasia of the hip. Curr Orthop. 2002;16(3):205-212. https://doi.org/10.1054/cuor.2002.0247
- Brougham DI, Broughton NS, Cole WG, Menelaus MB. Avascular necrosis following closed reduction of congenital dislocation of the hip. Review of influencing factors and long-term follow-up. J Bone Joint Surg Br. 1990;72(4):557-562. https://doi.org/10.1302/0301-620X.72B4.2380203.
- Kruczynski J. Avascular necrosis of the proximal femur in developmental dislocation of the hip. Incidence, risk factors, sequelae and MR imaging for diagnosis and prognosis. Acta Orthop Scand Suppl. 1996;268:1-48. https://doi.org/10.3109/17453679609155228.
- Pospischill R, Weninger J, Ganger R, et al. Does open reduction of the developmental dislocated hip increase the risk of osteonecrosis? Clin Orthop Relat Res. 2012;470(1):250-260. https://doi.org/10.1007/s11999-011-1929-4.
- Асептический некроз головки бедренной кости у детей / Под ред. А.В. Белецкого. – Казань, 2010. – 255 с. [Asepticheskiy nekroz golovki bedrennoy kosti u detey. Ed. by A.V. Beletskiy. Kazan’; 2010. 255 p. (In Russ.)]
- Carey TP, Guidera KG, Ogden JA. Manifestations of ischemic necrosis complicating developmental hip dysplasia. Clin Orthop Relat Res. 1992(281):11-17.
- Robinson HJ, Jr., Shannon MA. Avascular necrosis in congenital hip dysplasia: the effect of treatment. J Pediatr Orthop. 1989;9(3):293-303.
- Salter R, Kostuik J, Dallas S. Avascular necrosis of the femoral head as a complication of treatment for congenital dislocation of the hip in young children: a clinical and experimental investigation. Canadian J Surg. 1969;12:44-61.
- Tonnis D. Congenital dysplasia and dislocation of hip in children and adults. Stuttgart: Ferdinand Enke Verlag; 1987. 535 p.
- Поздникин Ю.И., Камоско М.М., Поздникин И.Ю. Профилактика и лечение деформирующего пре- и коксартроза у детей и подростков с врожденной патологией тазобедренного сустава. – СПб., 2005. – 31 с. [Pozdnikin YI, Kamosko MM, Pozdnikin IY. Profilaktika i lecheniye deformiruyushchego pre- i koksartroza u detey i podrostkov s vrozhdennoy patologiyey tazobedrennogo sustava. Saint Petersburg, 2005. 31 p. (In Russ.)]
- Mesa РА, Yamhure FH. Procedure DEGA type by double approach. Colombian Journal of Orthopedics and Traumatology. 2004;18(3):77-89.
- Mose K. Methods of measuring in Legg-Calve-Perthes disease with special regard to the prognosis. Clin Orthop Relat Res. 1980(150):103-109.
- Cech O, Vavra J, Zidka M. Management of ischemic deformity after the treatment of developmental dysplasia of the hip. J Pediatr Orthop. 2005;25(5):687-694. https://doi.org/10.1097/01.bpo.0000168637.67583.8e.
- Макушин В.Д., Тепленький М.П., Парфенов Э.М. Новый способ лечения остеохондропатии тазобедренного сустава с эпифизарной имплантацией суспензии костного мозга // Гений ортопедии. – 2013. – № 2. – С. 109–111. [Makushin VD, Teplen’kiy MP, Parfenov EM. A new treatment technique for the hip osteochondropathy using epiphyseal implantation of bone marrow suspension. Genii Ortopedii. 2013;(2):109-111. (In Russ.)]
- Torode IP, Young JL. Caput valgum associated with developmental dysplasia of the hip: management by transphyseal screw fixation. J Child Orthop. 2015;9(5):371-379. https://doi.org/10.1007/s11832-015-0681-9.
- Thomas CL, Gage JR, Ogden JA. Treatment concepts for proximal femoral ischemic necrosis complicating congenital hip disease. J Bone Joint Surg Am. 1982;64(6):817-828.
- Gage JR, Winter RB. Avascular necrosis of the capital femoral epiphysis as a complication of closed reduction of congenital dislocation of the hip: a critical review of twenty years’ experience at gillette children’s hospital. J Bone Joint Surg. 1972;54(2):373-388.
- Bar-On E, Huo MH, DeLuca PA. Early innominate osteotomy as a treatment for avascular necrosis complicating developmental hip dysplasia. J Pediatr Orthop B. 1997;6(2):138-145.
- Luedtke LM, Flynn JM, Pill SG. A Review of avascular necrosis in developmental dysplasia of the hip and contemporary efforts at prevention. The University of Pennsylvania Orthopaedic Journal. 2000;13:22-28.
- Тепленький М.П., Чиркова Н.Г. Асептический некроз головки бедра при врожденной дисплазии тазобедренного сустава // Российский вестник детской хирургии, анестезиологии и реаниматологии. – 2012. – Т. 2. – № 3. – С. 84–87. [Teplen’kiy MP, Chirkova NG. Avascular necrosis of the femoral head in developmental hip dysplasia. Rossiyskiy vestnik detskoy khirurgii, anesteziologii i reanimatologii. 2012;2(3):84-87. (In Russ.)]
补充文件
