Correction of femoral deformities of inflammatory genesis (osteomyelitis sequalae) in children: an analysis of the treatment results of 76 patients

Abstract

Backgrоund. In most cases, haematogenic osteomyelitis affects the long bones of the skeleton. Predominantly, the centers of destruction are located in the lower extremities. The orthopedic complications of haematogenic osteomyelitis were observed (according to different data) in 22%71.2% of childhood cases. In 16.2%53.7% of cases, the complications can lead to childhood (nascent) disability.
 Aim. The purpose of the research is to conduct a retrospective analysis of femoral deformity correction results in children with haematogenic osteomyelitis consequences by applying both an Ortho-SUV Frame (based on passive computer navigation) and following the Ilizarov method.
 Materials and methods. The study examined 76 patients of both genders aged between 8 and 17 years old who were experiencing the consequences of haematogenic osteomyelitis in the long bones of the lower extremities. A comparative assessment of the parameters reflecting the effectiveness of circular external fixation in combination with an Ortho-SUV Frame and the Ilizarov method was conducted. Reference lines and angles before and after surgery, elongation size, distraction time, deformity correction period, external fixation index, number of complications, and the functional result were all considered.
 Results. All the children underwent deformity correction surgery, and the length of the afflicted lower extremity segment was reconstructed (restored). The use of the repositioning unit enabled a higher correction accuracy (94.45%) of the femur in comparison with the Ilizarov frame (30%). The frequency of excellent functional results in the first group of patients was more than 1.5 times higher than in the second group, whereas the satisfactory results turned out to be almost twice as low. Fewer complications were observed while using the Ortho-SUV hexapod.
 Conclusions. The application of the Ortho-SUV Frame at the long-bone-deformity-correction stage facilitates an increase in the efficiency of the circular external fixation method.