DYNAMICS OF WIDTH OF PROXIMAL FEMORAL GROWING ZONE IN PATIENTS WITH PERTHES DISEASE AFTER SURGICAL TREATMENT
- Authors: Teplenky M.P.1, Parfenov E.M.1, Bunov V.S.1
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Affiliations:
- Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopedics”
- Issue: Vol 20, No 3 (2014)
- Pages: 60-68
- Section: Clinical studies
- Submitted: 12.09.2016
- Published: 01.07.2014
- URL: https://journal.rniito.org/jour/article/view/79
- DOI: https://doi.org/10.21823/2311-2905-2014-0-3-60-68
- ID: 79
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Full Text
Abstract
Objective - to study the effect of tunnelization and apparatus hip decompression on the state of proximal femur growing plate. Material and methods. A pattern of changes in proximal femur growing plate of the affected and intact extremities was investigated in 46 children with III degree Perthes disease. The follow-up was 3 years. To unload the affected joint, an external fixator (most often, the Ilizarov apparatus) was placed on pelvic and femoral bones, which was used in a mode of non-articulating arthrodiastasis. The measurements of width of proximal femur growing zone were performed on pelvic bones rentgenograms in anteroposterior projection with internal hip rotation achieved with 1 meter focal length and their subsequent transfer to a digital format. Results. In the study group wire tunneling and apparatus fixation were shown not to result in growing plate locking, providing conditions for recovery of the shape and structure of the femoral head, which was accompanied by a slowdown in its width decrease in the affected extremity and led to the compliance of this parameter between the intact and affected extremities. No correlation was revealed between the degree of structural metaphyseal damage and the state of proximal growing zone.
About the authors
M. P. Teplenky
Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopedics”
Author for correspondence.
Email: teplenkiymp@mail.ru
Россия
E. M. Parfenov
Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopedics”
Email: ed.ortoped@mail.ru
Россия
V. S. Bunov
Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopedics”
Email: office@ilizarov.ru
Россия
References
- 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):109-111.
- Шевцов В.И. и др. Лечение детей с болезнью Пертеса. Гений ортопедии. 1995;(2):5-8.
- Bames J.M. Premature epiphyseal closure in Perthes disease. J. Bone Joint Surg. 1980;62-B:432-437.
- Bowen J.R. et al. Premature femoral neck physeal closure in Perthes disease. Clin. Orthop.1982;171:24-29.
- Craveiro L.N., Bettencourt P. Legg-Calve-Perthes disease. Results of surgical treatment by transphyseal neck-head drilling on hips with more than 50% of head involvement and without head at risk signs. Rev. Ortop Traum IB [P]. 1988;14(1):39-46.
- Craveiro L.N. Doenca de Legg-Calve-Perthes. Current Concept Review. Rev. Port. Ortop. Traum. 1994;2 (1):75-79.
- Craveiro L.N. Study of the effects of transphyseal neck-head drilling as a method to prevent Legg-Calve-Perthes. Experimental model on the White New Zealand Rabbit. Rev. Port. Ortop. Traum. 1994;2(4):395-404.
- Eaton G.O. Long-term results of treatment in coxa plana: A follow-up study of eighty-cight patients. J. Bone Joint Surg. 1967;43-A:1031.
- Edgren W. Coxa plana. Acta Orthop. Scand. 1965;84:93-129.
- Haas S.L. Restriction of bone growth by pins through the epiphyseal cartilaginous plate. J. Bone Joint Surg. 1950;32-A:338-343.
- Herring J.A. Tachdjian s pediatric orthopaedics. Elsevier; 2008.1:918. achdjian's pediatric orthopaedics Herring, John A; Tachdjian, Mihran O. Pediatric orthopedics; Texas Scottish Rite Hospital for Children. 4th ed. Philadelphia : Saunders/ Elsevier, c2008.
- Katz J.F. Legg-Calve- Perthes disease. The role of distortion of normal growth mechanisms in the preduction of deformity. Clin. Orthop.1970;71:193-198.
- Katz J.F., Siffert R.S. Capital necrosis, metphyseal cyst and subluxation in coxa plana Clin. Orthop. 1975;106:75-85.
- Langenskiöld A. Changes in the capital growth plate and the proximal femoral metaphysis in Legg-Calvé-Perthes disease. Clin. Orthop. 1980;(150):110-114.
- MacEwan J. Value of prognostic evaluation in LCP syndrome. Orthop. Rev. 1979;8:173.
- Ponseti I.V. Legg-Perthes disease: Observations on pathological changes in two cases. J. Bone Joint Surg. 1956;38-A:739-750.
- Sanctis N. et al. Prognostic evaluation of LCP disease by MRI part I: the role of physeal involvement. J. Pediatr. Orthop. 2000;205:455-462.
- Siffert R.S. The effect of staples and longitudinal wires on epiphyseal growth. J. Bone Joint Surg. 1956;38-A:1077-1088.
- Sponseller T.D., De Sai S.S., Millis M.B. Abnormalities of proximal femoral growth after severe Perthes disease. J. Bone Joint Surg. 1989;71-B:610 - 614.
- Tachdjian M.O., Kelikian A.S. Distal and lateral advancement of the greater trochanter. In: Congenital dislocation of the hip. New York; 1982:721-739.