Total hip arthroplasty in children who have undergone arthroplasty with demineralized bone-cartilage allocups

2 ФГБУ «Федеральный центр травматологии, ортопедии и эндопротезирования» Минздрава России, Смоленск Введение. Переломы шейки бедренной кости у детей остаются актуальной проблемой в связи с риском и часто-той возникновения тяжелых осложнений, таких как асептический некроз головки бедренной кости, являющий-ся причиной деформирующего коксартроза и ранней инвалидизации ребенка. Данный вид травмы составляет примерно 1 % от всех переломов костей скелета в детском возрасте. В 80 % случаев причиной перелома шейки бедренной кости служит тяжелая травма, однако у 15 % пациентов перелом происходит при неадекватной травме в случае физиологически нормальной активности ребенка. При переломах шейки бедра без стабильного остеосинтеза консолидация костных отломков наступает крайне редко, а длительный период иммобилизации в ходе консервативного лечения сопровождается риском развития осложнений, обусловленных гиподинамией. Цель работы -провести ретроспективный анализ результатов хирургического лечения различных типов переломов шейки бедренной кости у детей. Материалы и методы. Проанализированы результаты хирургического лечения 5 детей в возрасте от 10 до 17 лет с различными типами переломов шейки бедренной кости по классификации Delbet и Colonna, в том числе 4 мальчиков и 1 девочки. В анамнезе у всех 5 детей причиной перелома стала кататравма. Всем пациен-там в зависимости от типа перелома проведена закрытая репозиция с остеосинтезом фрагментов металлокон-струкциями (канюлированные винты, пластина DHS). Результаты. В сроки наблюдения до 7 лет после хирургического лечения во всех случаях отмечались восста-новление функции тазобедренного сустава, отсутствие болевого синдрома, осложнений, полная социальная и бытовая адаптация. Заключение. Переломы шейки бедренной кости подлежат хирургическому лечению в связи с высоким риском возникновения асептического некроза головки бедренной кости. При корректном техническом исполнении возможно достижение длительного стабильного положительного функционального и рентгенологического результата в отдаленном периоде.Ключевые слова: дети; перелом шейки бедренной кости; хирургическое лечение.

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Results of treatment of children with femoral neck fractures

Bortulev

Игоревич²,

Baskov

et al. 2018

Pediatr Traum Orthop Reconstr Surg

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Fibrous hip ankylosis in adolescents: non-standard approach to treatment (clinical observation)

Kozhevnikov

Всеволодович²,

Kralina

et al. 2018

Pediatr Traum Orthop Reconstr Surg

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The development of secondary deforming coxarthrosis in childhood and adolescence, as a rule, is accompanied by the formation of a pronounced deformity of the hip joint, up to ankylosis, which significantly limits the function of the lower limb and leads to early disability. In most patients, hip ankylosis develops in a vicious position with the resulting flexion-intracavity installation of the lower limb. If such a condition is encountered in childhood and adolescence, treatment currently remains debatable. Various methods are used, ranging from arthroplastic organ-preserving interventions and corrective osteotomies to joint replacement. In this report, we present a clinical case of children treated with post-infectious secondary deforming coxarthrosis with fibrous ankylosis of the hip joint in a vicious position. We applied a coherent combination of modern treatment methods: distraction in the apparatus, arthroscopy, intra-articular injections, physiotherapy, and other rehabilitation. The treatment results were evaluated over a two-year period. In this case, the rational use of a consistent set of remedial measures helped to improve joint function, socialize the patient, and postpone surgery for joint replacement for at least 2 years.

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Our experience of total hip arthroplasty in adolescents with consequences of acute hematogenous osteomyelitis

Imomov

Дустмахмадович²,

Baskov

et al. 2021

Pediatr Traum Orthop Reconstr Surg

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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.

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Total hip arthroplasty in children who have undergone arthroplasty with demineralized bone-cartilage allocups

Cited by 3 publications

References 2 publications

Results of treatment of children with femoral neck fractures

Results of treatment of children with femoral neck fractures

Fibrous hip ankylosis in adolescents: non-standard approach to treatment (clinical observation)

Our experience of total hip arthroplasty in adolescents with consequences of acute hematogenous osteomyelitis

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