Double osteotomy in the surgical treatment of Perthes’ disease: Dega's transiliac osteotomy and subtrochanteric osteotomy
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2004, Vol 6, Issue 6
Abstract
Background. The combination of Dega transililiac and femoral subtrochanteric is used in our department in the treatment of Legg-Calvé-Perthes' disease. Subtrochanteric osteotomy, initially performed as varus-derotation osteotomy, is now mainly extension osteotomy with shortening. Femoral shortening is crucial for joint decompression and makes room for pelvic redirection after pelvic osteotomy.Material and methods. 34 children (36 hips) were analyzed retrospectively. All children were operated using subtrochanteric osteotomy with shortening and Dega's transiliac osteotomy of the pelvis. There were several variants of subtrochanteric osteotomy: extension osteotomy only, varus-extension, extension-varus-derotation, extension-derotation, and varus-derotation. In one case only varus osteotomy was performed. Before surgery 18 hips were Catterall group IV, 14 group III and 4 group II; in the Herring classification, 24 hips were group B, 11 group C, and 1 group A. All patients were evaluated clinically and radiologically at follow-up using the Stulberg classification. The mean follow-up was 8 years.Results. In the Stulberg classification 4 hips were scored after surgery as group I, 23 as group II, 4 as group III, 4 as group IV and only 1 hip as group V. In 6 patients limping was observed, 2 patients had a positive Trendelenburg sign, and 11 a positive Duchenne sign. The mean shortening of the lower limb was 0.25 cm. Six patients complained of pain after physical activity.Conclusion. Subtrochanteric shortening osteotomy of the femur combined with Dega transiliac osteotomy is a safe and valuable procedure for surgical treatment of Perthes' disease.
Authors and Affiliations
Marek Napiontek, Szymon Pietrzak
Keywords
Related Articles
- EP ID EP56315
- DOI -
- Views 121
- Downloads 0
Anemia – the Neglected Problem in Patients with Orthopedic Conditions
Anemia and the necessity of blood product transfusion in perioperative procedures is an important and frequently discussed clinical issue. Presently, a constantly growing interest in this problem is observed among clinic...
Wznowa procesu gruźliczego po alloplastyce stawu biodrowego po 58 latach od pierwotnej infekcji
Streszczenie W pracy przedstawiono przypadek chorego, lat 73, po przebytej gruźlicy stawu biodrowego w dzieciństwie, u którego założono endoprotezę Exeter. Po 58 latach od pierwotnej infekcji a 9 latach po założeniu endo...
Leczenie operacyjne kręgosłupa u chorych z guzami nowotworowymi - odmienności w postępowaniu chirurgicznym i problemy wynikające z choroby nowotworowej. Analiza 474 chorych
Wstęp. Leczenie operacyjne guzów kręgosłupa, a zwłaszcza nowotworów przerzutowych, staje się coraz częstsze, a jego wyniki zachęcające. Nieodzowna jest jednak dobra znajomość kliniki nowotworów oraz technik operacyjnych....
Chronically Unreduced Posterior Dislocation of the Elbow
Background. Chronically unreduced posterior dislocation of the elbow is a complex and difficult problem for the surgeon and its treatment significantly influences future functional performance of the patient. There are f...
Wzorzec chodu u kobiet po menopauzie. Badanie pilotażowe
Wstęp. Wraz ze starzeniem się w organizmie następuje szereg zmian degeneracyjnych. Po menopauzie proces starzenia się zachodzi nieco gwałtowniej. Kobiety już po 40 roku życia zaczynają zauważać ograniczenia funkcjonalne...