SURGICAL TREATMENT OF CHILDREN WITH CONSEQUENCES OF INFANTILE SEPTIC ARTHRITIS

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Abstract

Introduction. The consequences of infantile septic arthritis are quite diverse and can manifest themselves as a damage to the growth zone, deformation and destruction of the articular components, and violation of the articular relationships. To treat this pathology, technically complex and traumatic surgical interventions are used. The purpose of this work is to analyze the medium-term results of the use of these methods in the treatment of children with septic coxitis consequences.

Material and methods. The outcomes of treatment for 37 children with consequences of septic coxitis using Ilizarov apparatus were analyzed. Average age of patients at the time of the surgery was 8.2±0.5 years (from 6 to 10 years). Follow up period was from 3 to 10 years (average 4.7 years). Functional outcomes were assessed by C.L. Colton, radiologic indices — by E. Severin score and J. Kruczynski.

Results. Patients were distributed into three groups according to anatomical features. Functional outcomes of patients in the 1st group: good (12–15 points) — 3 joints, satisfactory (9–11 points) — 5 joints, unsatisfactory (8 points) — 1 joint. X-ray findings of patients in the 1st group according to J. Kruczynski criteria: good — 5 joints, satisfactory — 4 joints; by E. Severin criteria: Ia — 1, Ib –1, IIa — 2, IIb — 3, III — 2. Functional outcomes of patients in the 2nd group: good (12–14 points) — 10 joints, satisfactory (9–11 points) — 8 joints. Distribution in the second group by J. Kruczynski criteria: good — 9, satisfactory — 9; by E. Severin criteria: IIa — 14, IIb — 4. Distribution of functional outcomes in the 3rd group in accordance with C.L. Colton criteria: good (12–15 points) — 3 joints, satisfactory (9–11 points) — 7 joints. Distribution in the third group according to J. Kruczynski criteria: good — 4, satisfactory — 6; by E. Severin criteria: IIa — 5, IIb — 4, III — 1.

Conclusion. The use of the presented transosseous external fixation technique in children with the consequences of septic coxitis provides sufficient stability of the joint without causing its decompensation and stiffness. The use of the Ilizarov fixator extends the age limits for reconstructive treatment of abnormal distal hip dislocation. 

About the authors

M. P. Teplenky

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Author for correspondence.
Email: teplenkiymp@mail.ru

Mikhail P. Teplenky — Dr. Sci. (Med.), Head of Joint Pathology Laboratory, Head of Department 11 (pediatric joint pathology), Highest Category Orthopaedic Surgeon 

6, ul. M. Ulyanovoi, Kurgan, 640014

Россия

E. V. Oleinikov

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Email: fake@neicon.ru

Evgeny V. Oleinikov — Cand. Sci. (Med.), Orthopaedic Surgeon, Department 9 (pediatric joint pathology), junior researcher, Joint Pathology Laboratory 

6, ul. M. Ulyanovoi, Kurgan, 640014

Россия

V. S. Bunov

Ilizarov Russian Scientific Center “Restorative Traumatology and Orthopedics”

Email: fake@neicon.ru

Vyacheslav S. Bunov — Cand. Sci. (Med.), Leading Researcher, Joint Pathology Laboratory 

6, ul. M. Ulyanovoi, Kurgan, 640014

Россия

References

  1. Severin E. Contribution to the knowledge of congenital dislocation of the hip joint: late results of closed reduction and arthrographic studies of recent cases. Acta Chir Scand. 1941;84(Suppl 63):1-142.
  2. Souza Miyahara Hd., Helito C.P., Oliva G.B., Aita P.C., Croci A.T., Vicente J.R. Clinical and epidemiological characteristics of septic arthritis of the hip, 2006 to 2012, a seven-year review. Clinics (Sao Paulo). 2014;69(7):464-468.
  3. Hunka L., Said S.E., MacKenzie D.A., Rogala E.J., Cruess R.L. Classification and surgical management of the severe sequelae of septic hips in children. Clin Orthop Relat Res. 1982;(171):30-36.
  4. Choi I.H., Pizzutillo P.D., Bowen J.R., Dragann R., Malhis T. Sequelae and reconstruction after septic arthritis of the hip in infants. J Bone Joint Surg Am. 1990;72(8):1150-1165.
  5. Forlin E., Milani C. Sequelae of Septic Arthritis of the Hip in Children. A New Classification and a Review of 41 Hips. J Pediatr Orthop. 2008;28(5):524-528. doi: 10.1097/BPO.0b013e31817bb079.
  6. Goel S.C., Logani V. Management of Sequelae of septicarthritis of Hip in Infancy. JK-Practitioner. 2003;10(3):169-175. doi: 10.4103/0019-5413.37008.
  7. Соколовский А.М., Соколовский О.А. Патологический вывих бедра. Минск : Высшая школа, 1997. 208 с. Sokolovskii A.M., Sokolovskii O.A. Patologicheskii vyvikh bedra [Pathological dislocation of the hip]. Minsk : 1997. 208 p.
  8. Тепленький М.П., Дьячкова Г.В., Олейников Е.В., Дьячков К.А. Рентгенологическая классификация последствий септического коксита у детей. Международный журнал прикладных и фундаментальных исследований. 2015;(11):684-688. Teplenky M.P., Dyachkova G.V., Oleinikov E.V., Dyachkov K.A. [X-ray classification of the consequences of septic coxitis in children]. Mezhdunarodnyi zhurnal prikladnykh i fundamental’nykh issledovanii [International Journal of Applied and Fundamental Research]. 2015;(11): 684-688.
  9. Colton C.L. Chiari osteotomy for acetabular dysplasia in young subjects. J Bone Joint Surg. 1972;54-B(4):578-589.
  10. 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.
  11. Крысь-Пугач А.П., Гук Ю.Н., Куценок Я.Б., Даровский А.С. Наш опыт хирургического лечения ортопедических последствий гнойного коксита у детей. Травма. 2008;(1):66-70. Krys’-Pugach A.P., Guk Ju.N., Kutsenok Ya.B., Darovskii A.S. Our experience in surgical treatment of orthopedic consequences of purulent coxitis in children. Travma [Trauma]. 2008;(1):66-70. (in Russian).
  12. Cheng J.C., Lam T.P. Femoral lengthening after type IVB septic arthritis of the hip in children. J Pediatr Orthop. 1996;16(4):533-539.
  13. Betz R.R., Cooperman D.R., Wopperer J.M., Sutherland R.D., White J.J.Jr., Schaaf H.W., Aschliman M.R., Choi I.H., Bowen J.R., Gillespie R. Late sequelae of septic arthritis of the hip in infancy and childhood. J Pediatr Orthop. 1990;10(3):365-372.
  14. Sucato D.J., Schwend R.M., Gillespie R. Septic arthritis of the hip in children. J Am Acad Orthop Surg. 1997;5(5):249-260.
  15. Goel S.C., Logani V. Management of sequelae of septic arthritis of hip in infancy. JK-Practitioner. 2003;10(3):169-175.
  16. Тепленький М.П., Олейников Е.В. Реконструкция тазобедренного сустава у детей школьного возраста с врожденным вывихом бедра. Гений ортопедии. 2013;(1):24-39. Teplenky M.P., Oleinikov E.V. [Reconstruction of the hip in school-age children with congenital hip dislocation]. Genij ortopedii [Orthopaedic Genius]. 2013;(1):24-39. (in Russian).
  17. Benum P. Transposition of the apophysis of the greater trochanter for reconstruction of the femoral head after septic hip arthritis in children. Acta Orthop. 2011;82(1):64-68. doi: 10.3109/17453674.2010.548030.
  18. Cech O., Vavra J., Zidka M. Management of ischemic deformity after the treatment of developmental dysplasia of the hip. J Pediatric Orthop. 2005;25(5):687-694. doi: 10.1097/01.bpo.0000168637.67583.8e.
  19. Teplenky M., Mekki W. Pertrochanteric osteotomy and distraction femoral neck lengthening for treatment of proximal hip ischemic deformities in children. J Child Orthop. 2016;10(1):31-39. doi: 10.1007/s11832-016-0711-2.
  20. Ахтямов, И.Ф., Абакаров А.А., Белецкий А.В. Заболевания тазобедренного сустава у детей. Диагностика и хирургическое лечение. Казань : ЦОП, 2008. 455 с. Akhtyamov I.F., Abakarov A.A., Beletskii A.V. [Diseases of a hip joint in childhood. Diagnostics and operative treatment]. Kazan: COP, 2008. 455 p.
  21. Wada A., Fujii T., Takamura K., Yanagida H., Urano N., Surijamorn P. Operative reconstruction of the severe sequelae of infantile septic arthritis of the hip. J Pediatr Orthop. 2007;27(8):910-914. doi: 10.1097/bpo.0b013e31815a606f.
  22. Kocaoglu M., Kilicoglu O.I., Goksan S.B., Cakmak M. Ilizarov fixator for treatment of Legg-Calvé-Perthes disease. J Pediatr Orthop B. 1999;8(4):276-281.
  23. Volpon J.B. Comparison between innominate osteotomy and arthrodistraction as a primery treatment for Perthes disease. Int Orthop. 2012;36(9):1899-1905. doi: 10.1007/s00264-012–1598-2.

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