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 87
- Downloads 0
Wpływ aplikacji kinesiotapingu na aktywność bioelektryczną mięśnia obszernego przyśrodkowego. Doniesienie wstępne
Physical activity of elderly patients after total hip arthroplasty
Background. Total hip arthroplasty (THA) is the most common method of treatment of severe hip osteoarthritis. There is little data concerning the physical activity of total hip arthroplasty patients in Poland and investi...
Ocena wpływu rodzaju nowotworu oraz metod leczenia na przeżycie chorych z guzami złośliwymi kręgosłupa
Wstęp Układ kostny zajmuje trzecie miejsce (po płucach i wątrobie) pod względem częstości lokalizowania się w nim przerzutów i to one są najczęstszymi złośliwymi nowotworami kości.Celem pracy była ocena wpływu rodzaju no...
Leg Length Discrepancy Treatment with Subtrochanteric Shortening Osteotomy and Blade Plate Fixation
Background. Subtrochanteric femoral shortening osteotomy is a method of surgical treatment of lower limb discrepancy (LLD). It is less commonly used due to numerous limitations and the resulting decrease in height, which...
New technique of surgical treatment of malignant calcaneal tumours. Preliminary report.
Background. Malignant tumours of the calcaneus are very rare among children, constituting up to 3% of all bone tumours. This paper presents the outcome of a new technique of surgical treatment of malignant calcaneal tumo...