Background. The relative overgrowth of the greater trochanter is one of the most common deformities of the proximal femur in association with several disorders of the hip joint. Aim. To analyze the dynamics of proximal femoral growth after trochanteric epiphysiodesis as well as to determine the options for using this method in the complex treatment of children with hip pathology. Materials and methods. We analyzed the data of clinical and radiological examinations and surgical treatment (permanent trochanteric epiphysiodesis with metal fixation) outcomes for 43 (52 joints) patients aged 412 years with a developing high position of the greater trochanter. Results. The surgery enabled slowing down of the growth of the greater trochanter on the side of intervention by (average) 50% (p 0.05), although the values of the neck-shaft angle both on the affected side and the side opposite to it did not change (p 0.05). Conclusion. In moderate disorders of the growth plate of the femoral head epiphysis, trochanteric epiphysiodesis can prevent the progression and, in some cases, correct disturbed ratios of the hip joint, thereby avoiding the need for larger surgical interventions.

BACKGROUND: Currently, the number of adolescents with terminal stages of coxarthrosis of various origins who underwent total hip joint arthroplasty has increased, as the use of modern implant models with a long service life has narrowed the age limit and expanded the indications for this intervention. AIM: This study aimed to assess the effectiveness of total hip arthroplasty in adolescents with stage 3 coxarthrosis caused by acute hematogenous osteomyelitis. MATERIALS AND METHODS: The study analyzed preoperative data and postoperative clinical, radiological, and functional examination data of 40 patients aged 1318 (15 1.2) years with stage 3 coxarthrosis caused by acute hematogenous osteomyelitis. The study group was composed of 21 (52.5%) boys and 19 (47.5%) girls. The control group consisted of 32 patients with stage 3 post-traumatic coxarthrosis, aged 1218 (15.4 1.7) years, of which 14 (43.75%) were girls and 18 (56.25%) were boys. RESULTS: The long-term functional results were evaluated using the Harris hip score (14). The average Harris hip scores before and after arthroplasty were 44.87 5.65 and 80 7.61 (p 0.05), respectively. In the comparison group, the mean Harris hip scores before and after surgery were 33.73 4.28 and 89.47 5.60 points, respectively (p 0.05). The postoperative follow-up duration was 5 3 M SD (95% confidence interval) years. No complications were observed in the early and late postoperative periods. CONCLUSIONS: In adolescents, total hip arthroplasty is an effective surgical treatment for complications of acute hematogenous osteomyelitis. It quickly provides attainable, stable, and favorable outcomes, which improve the quality of life and social adaptation of adolescents.

Background. Deforming arthrosis of the hip joint in children leads to serious disorders of the walking biomechanics due to a decrease in the support and motor functions of the lower limbs. In patients with stage III coxarthrosis, when the potential of reconstructive surgeries has been exhausted, a total hip arthroplasty is performed. Objective. To study the biomechanical parameters of support ability of the lower limbs in children with bilateral coxarthrosis before and after bilateral total hip arthroplasty. Material and methods. Stabilometric and plantographic studies were conducted in 12 patients with bilateral coxarthrosis, aged from 13 to 17 years old, before and after hip arthroplasty. The time interval between operations on the contralateral joints ranged from 6 to 12 months. The control group consisted of 15 children of the same age, with no signs of orthopedic disorders. Results. Before carrying out hip arthroplasty in patients, the tension of the statokinetic system was revealed during the implementation of support for the vertical balance of the body. The plantography method made it possible to diagnose disorders of the support function of the feet in the form of supination rigidity of the anterior section, a tendency toward rigidity of the internal longitudinal arch. After bilateral total hip arthroplasty in patients, the stability of the vertical posture improved, the support ability of the heads of the 1st metatarsal bones was significantly restored, and the weight-bearing distribution across the foot sections was normalized. Conclusion. After bilateral hip arthroplasty in patients with coxarthrosis, stabilization of the support function of the postoperative lower limbs was achieved.