Remodelling and congruency of the hip joint in children with Perthes’ disease treated with <br /> varus-derotation subtrochanteric osteotomy
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2004, Vol 6, Issue 6
Abstract
Background. Dislocation of the femoral head to the front and to the side during the course of Perthes’ disease is the main threat to the development of the hip. Containment of the femoral head into the acetabulum is the main goal of conservative and operative treatment. The spherical shape of the acetabulum is used as the modelling factor for the femoral head during the regeneration period, which enables the femoral head to rebuild its spherical shape. The aim of the study is to present the changes occurring within the hip joint during the course of Perthes’ disease, before and after operative treatment with varus-derotation subtrochanteric osteotomy, based on objective radiological measurements.Material and methods. 53 patients, aged from 5 to 10 years, were treated operatively. The necrosis period was assessed on radiographic examination according to Reiberg and Catterall. All patients were treated with varus-derotation subtrochanteric osteotomy, decreasing the neck-shaft angle to an average value of 111°. During the follow-up period of 6 years, a control examination was performed every 12 months. Measurements were compared with norms published in the literature. Various parameters were assessed in this study to assess the proximal end of the femur bone (neck-shaft angle, epiphyseal head index of Heyman and Herndon) and the position of the femoral head inside the acetabulum (centre-edge angle, distance angle, acetabular head index of Heyman-Herndon).Results. During the 6-year follow-up period, the value of the neck-shaft angle remained within the range of norms for the age and group, and for operated limbs the value was lower than the norm. The other assessed parameters showed substantial improvement, which led to the preservation of the correct shape of both the femoral head and acetabulum and improved the congruency of the joint.Conclusion. The value of parameters assessed post-operatively show a substantial improvement compared with preoperative measurements. Good results are obtained as a result of varus-derotation subtrochanteric osteotomy in patients with Perthes’ disease type III and IV according to Catterall, and lead to improvement in the congruency of the joint.
Authors and Affiliations
Maciej Kołban, Jadwiga Darczuk, Michał Chmielnicki
Keywords
Related Articles
- EP ID EP56304
- DOI -
- Views 99
- Downloads 0
The Use of Pedobarographic Examination to Biomechanical Evaluation of Foot and Ankle Joint in Adult - Own Experience
A non-invasive method, that can be used to describe the underfoot pressure distribution during stance and gait, is pedobarography. This examination helps to describe biomechanics of foot and ankle. It has been used to di...
Otwarte złamania trójkostkowe leczone stabilizatorem zewnętrznym metodą Ilizarowa
[b]Wstęp.[/b] Otwarte złamania trójkostkowe są jednymi z najcięższych złamań okolicy stawu skokowego i jednymi z trudniejszych w praktyce chirurgii urazowej. Najczęstszym chirurgicznym sposobem leczenia jest repo-zycja i...
Wieloodłamowe złamania końca bliższego kości ramiennej – zasady diagnostyki, leczenia i usprawniania
Złamania bliższego końca kości ramiennej są urazami, których nieprawidłowe wygojenie oraz niekonsekwentnie i niewłaściwie prowadzone usprawnianie zagraża funkcji stawu ramiennego stając się często przyczyną mniej lub bar...
Bone mineral metabolism in children with juvenile idiopathic arthritis – preliminary report.
Introduction: There are very few reports assessing bone mineral mass and its metabolism in the course of juvenile idiopathic arthritis (JIA). Study objective: To assess the levels of selected serum markers of bone format...
Outcome treatment of pseudoarthrosis of long bones with decortication method depends on morfology of pseudoartrosis
Introduction. Purpose of work was estimation of the results of treatment of pseudoarthrosis of the long bone with the method of decortication, with use of autogenic bone depends of kind of pseudoartrosis..Material and m...