Surgical Hip Dislocation Technique in Treatment of Patients with Slipped Capital Femoral Epiphysis

封面


如何引用文章

全文:

详细

Purpose: to evaluate the efficiency of modified Dunn procedure for treatment of severe slipped capital femoral epiphysis.

Material and Methods. The authors used the modified Duim procedure for treatment of 6 patients with SCFE aged from 10 to 13 years and displacement degree over 55°. Chronic disease form was reported in one patient, acute displacement along the chronic process was reported in 5 patients. All patients had a stable form of SCFE by Loder classification. Surgical procedure was performed within 6 to 12 months from the onset of disease.

Results. Normal anatomical relations in the hip joint were restored in all patients. During follow up from 18 until 48 months the patients did not demonstrate aseptic femoral head necrosis or chondrolysis. Adolescents did not complain on pain or hip motion limitations. Treatment outcomes assessment by Harris hip score was 97 points.

Conclusion. Based on outcomes of the modified Durm procedure the authors conclude that the method provides for complete restoration of the anatomical relations between femoral neck and epiphysis and, thus, the hip joint biomechanics. Femur dislocation allows to form an extended flap to ensure epiphysis perfusion which improves overall blood supply in the femoral head and consequently decreases the risk of aseptic necrosis and chondrolysis

 

作者简介

P. Vvedenskiy

Privolzhsky Research Medical University

编辑信件的主要联系方式.
Email: petr_v@mail.ru

Petr S. Vvedenskiy — Cand. Sci. (Med.), orthopaedic surgeon. Pediatric Orthopaedics Department, University Clinic

Nizhny Novgorod

俄罗斯联邦

N. Tenilin

Privolzhsky Research Medical University

Email: fake@neicon.ru

Nikolay A. Tenilin — Dr. Sci. (Med.), leading researcher. Pediatric Orthopaedics Department, University Clinic

Nizhny Novgorod

俄罗斯联邦

M. Vlasov

Privolzhsky Research Medical University

Email: fake@neicon.ru

Maxim V. Vlasov — Cand. Sci. (Med.), head of Pediatric Orthopaedics Depatment, University Clinic

Nizhny Novgorod

俄罗斯联邦

A. Bogosyan

Privolzhsky Research Medical University

Email: fake@neicon.ru

AlexandrB. Bogosyan — Dr. Sci. (Med.), leading researcher. Pediatric Orthopaedics Department, University Clinic

Nizhny Novgorod

俄罗斯联邦

A. Novikov

Privolzhsky Research Medical University

Email: fake@neicon.ru

Alexandr V. Novikov — Dr. Sci. (Med.), chief researcher of Consultation and RehabiUtation Department, University Clinic

Nizhny Novgorod

俄罗斯联邦

参考

  1. Басков В.Е. Результат лечения юношеского эпифизеолиза головки бедренной кости. Ортопедия, травматология и восстановительная хирургия детского возраста. 2014;2(3):14-17. doi: 10.17816/PTORS2314-17.
  2. Барсуков Д.Б., Поздникин И.Ю., Басков B.E., Краснов А.И. Оперативные вмешательства при юношеском эпифизеолизе головки бедренной кости. Амурский медицинский журнал. 2015;4(12):153-154.
  3. Schai P.A., Exner G.U. Conective Imhauser intertrochanteric osteotomy. OperOrthop TraumatoL 2007;19(4):368- 388. (InGerman). DOI: I0.1007/s00064-007-1212-8.
  4. Trisolino G., Pagliazzi G., Di Germaro G.L., StilU S. Longterm results of combined epiphysiodesis and Imhauser intertrochanteric osteotomy in SCFE:a retrospective study on 53 hips. J Pediatr Orthop. 2017;37(6):409-415. doi: 10.1097/BP0.0000000000000695.
  5. Ахтямов И., Абакаров A., Белецкий A., Богосьян A., Соколовский О. Заболевания тазобедренного сустава у детей. Диагностика и хирургическое лечение. Казань; 2008.456 с.
  6. Soni J.F., Valenza W.R., Uliana C.S. Surgical treatment of femoroacetabular impingement after slipped capital femoral epiphysis. Curr Opin Pediatr. 2018;30(l):93-99. doi: 10.1097/MOP.0000000000000565.
  7. Тенилин H.A., Баталов О.A. Способ оперативного лечения юношеского эпифизеолиза головки бедренной кости. Ортопедия, травматология и протезирование. 1989;(4):50-51.
  8. Hall J.E. The results of treatment of shpped femoral epiphysis. J Bone Joint Surg Br. 1957;39-B(4):59-73.
  9. Hiertorm T. Wedge osteotomy in advanced femoral epiphysiolysis. Acta Orthop Scand 1955;25(l):44-62.
  10. Arnold P., Jani L., Soloniewicz A. [Significance and results of subcapital osteotomy in severe shpped capital femoral epiphysis]. Orthopade. 2002;31(9):908-1113. (In German). doi: 10.1007/s00132-002-0380-3.
  11. Ballmer P.M.,Gilg M.,Aebi B.,GanzR.[Resirltsfollowingsub- capital and Imhauser-Weber osteotomy in femur head ep- iphyseolysis]. Z Orthop Ihre Grenzgeb. 1990; 128(1) :63-66. doi: 10.1055/S-2008-1039863.
  12. Broughton N.S., Todd R.C., Durm D.M., Angel J.C. Open reduction of the severely sUpped upper femoral epiphysiolysis./Бопе fointSurgBr. 1988;70(3):435-439.
  13. Clarke H.J., Wilkinson J.A. Surgical treatment for severe slipping of the upper femoral epiphysis. /Bone Joint Surg Br. 1990;72(5):854-858.
  14. Exner G.U., Schai RA., NotzU H.P. [Treatment of acute slips and clinical results in slipped capital femoral epiphysis]. Orthopade. 2002;31(9):857-865. (In German). doi: 10.1007/S00132-002-0374-1/
  15. Lefort G., Cottalorda J., Bouche-PUlonM.A., Lefebvre F., Daoud S. [Open reduction by the Durm technique in upper femoral epiphysiolysis. Report of 14 cases]. Chir Pediatr. 1990;31(4-5):229-234. (In French).
  16. Martin T.j Fayad F. [Severe upper femoral epiphysiolysis. Invasive reduction by Durm’s technic:11 cases]. Rev Chir Orthop ReparatriceAppar Mot. 1986;72(8):587-598. (In French).
  17. Nishiyama K., Sakamaki T., Ishii Y. Follow-up study of the subcapital wedge osteotomy for severe chronic slipped capital femoral epiphysis. / Pediatr Orthop. 1989;9(4):412-416.
  18. Rao J.P., Francis A.M., Siwek C.W. The treatment of chronic slipped capital femoral epiphysis by biplane osteotomy. J Bone Joint Surg Am. 1984;66(8):1169-1175.
  19. Velasco R., Schai RA., Exner G.U. SUpped capital femoral epiphysis :a long-term foUow-up study after open reduction of the femoral head combined with subcapital wedge resection. J Pediatr Orthop B. 1998;7(1): 43-52.
  20. Durm D.M. The treatment of adolescent sUpping of the upper femoral epyphisys. J Bone Joint Surg Br. 1964;46:621-629.
  21. Durm D.M., Angel D.C. Replacement of the femoral head by open operation in severe adolescent sUpping of the upper femoral epyhpysis. J Bone Joint Surg Br. 1978;60-B(3):394-403.
  22. Пулатов A.R, Минеев В.В. Отдалеленные результаты хирургического лечения нестабильных форм юношеского эпифизеолиза головки бедренной кости. Гений ортопедии. 2012;(3):88-90.
  23. Leunig M., Slongo T., Kleinschmidt M., Ganz R. [Subcapital correction osteotomy in sUpped capital femoral epiphysis by means of surgical hip dislocation]. Oper Orthop Traumatol. 2007; 19(4) :389^10. (In German). doi: 10.1007/s00064-007-1213-7.
  24. Tannast M., Jost L.M., Lerch T.D., Schmaranzer F., Ziebarth K., Sieberaock K.A. The modified Durm proce- dureforslippedcapitalfemoral./C/iiZdOrt/iop. 2017;11(2): 138-146. doi: 10.1302/1863-2548-11-170046.
  25. Ziebarth K., Zilkens C., Spencer S., Leunig M., Ganz R., Kim Y.J. Capital realignment for moderate and severe SCFE using a modified Durm procedure. Clin Orthop Relat Res. 2009;467(3):704-716. doi: 10.1007/sll999-008-0687-4.
  26. Slongo T., Kakaty D., Krause F., Ziebarth K. Treatment of sUpped capital femoral epiphysis with a modified Durm procedure. J Bone Joint Surg Am. 2010 Dec 15;92(18): 2898-2908. doi: 10.2106/JBJS.I.01385.
  27. Ziebarth K., Milosevic M., Lerch T.D., Steppacher S.D., Slongo T., Sieberaock K.A. High survivorship and Uttle osteoarthritis at 10-year followup in scfe patients treated with a modiUed Durm procedrae. Clin Orthop Relat Res. 2017;475(4):1212-1228. doi: 10.1007/sl1999-017-5252-6.
  28. Sankar W.N., Vanderhave K.L., Matheney T., Herrera- Soto J.A., Karlen J.W. The modified Drum procedrae for imstable sUpped capital femoral epiphysis :a multicenter perspective. J Bone Joint Surg Am. 2013;95(7):585-591. doi: 10.2106/JBJS.L.00203.
  29. Madan S.S., Cooper A.P., Davies A.G., Fernandes J.A. The treatment of severe slipped capital femoral epiphysis via the Ganz surgical dislocation and anatomical reduction:a prospective study. Bone Joint J. 2013; 95-B(3):424-429. doi: 10.1302/0301-620X.95B3.30113.
  30. Upasani V.V., Matheney T.H., Spencer S.A., Kim Y.J., MUUs M.B., Kasser J.R. CompUcations after modified Durm osteotomy for the treatment of adolescent sUpped capital femoral epiphysis. /Pediatr Orthop. 2014;34(7):661-667. doi: 10.1097/BP0.0000000000000161.
  31. Souder C.D., Bomar J.D., Wenger D.R. The role of capital realignment versus in situ stabilization for the treatment of sUpped capital femoral epiphysis. J Pediatr Orthop. 2014;34(8):791-798. doi: 10.1097/BP0.0000000000000193.
  32. Novais E.N., Hill M.K., Carry P.M., Heare T.C., Sink E.L. Modified Durm procedure is superior to in situ pinning for short-term clinical and radiographic improvement in severe stable SCFE. Clin Orthop Relat Res. 2015;473(6): 2108-2117. doi: 10.1007/sll999-014-4100-l.
  33. Persinger F., Davis R.L. 2nd, Samora W.P., Klingele K.E. Treatment of unstable sUpped capital epiphysis via the modified Durm procedure. J Pediatr Orthop. 2018;38(1): 3-8. doi: 10.1097/BP0.0000000000000737.
  34. Elmarghany M., Abd El-Ghaffar T.M., Seddik M., Akar A., Gad Y, Ragjieb E., Aprato A., Masse A. Surgical hip dislocation in treatment of slipped capital femoral epiphysis. SICOT J. 2017;3:10. doi: 10.1051/sicotj/2016047.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © ,


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


##common.cookie##