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A Bula - One of the best experts on this subject based on the ideXlab platform.
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the treatment of salter Pelvis Osteotomy on the developmental dislocation of hip in children
Journal of Clinical Orthopaedics, 2010Co-Authors: A BulaAbstract:Objective To explore the curative effect of hip-joint open reduction,subtrochanteric Osteotomy and Salter Pelvis Osteotomy on the developmental dislocation of hip(DDH) in children.Methods 54 cases(62 hips) of DDH were observed and analyzed,who were treated with hip-joint open reduction,subtrochanteric Osteotomy and Salter Pelvis Osteotomy.Results With 2～5 years' follow-up,the average acetabular index was rectified from 30～45° before operation to 20～25°after rectification.On the curative effect according to Zhou Yong-de criteria,49 cases were excellent,12 good,1 poor and the excellent and good rate was 98%.According to Severin grades of X-ray morphology,51 cases were excellent,10 good,1 fair and the excellent and good rate was 98%.Conclusions It can provide satisfied effect with hip-joint open reduction,subtrochanteric Osteotomy and Salter Pelvis Osteotomy on the developmental DDH in children.
J I Shiju - One of the best experts on this subject based on the ideXlab platform.
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morphological change of developmental dislocation of the hip after salter Pelvis Osteotomy
Chinese Journal of Pediatric Surgery, 2004Co-Authors: J I ShijuAbstract:Objective To characterize the morphological progress of developmental dislocation of the hip after Salter Pelvis Osteotomy. Methods Forty patients(45hips) were followed-up for an average of 5.7 years. The following indices were studied: the postoperative acetabular index (AI), acetabular-head index (AHI), center-edge angle (CE angle), acetabular index of depth to width [AI(D/W)], acetabular width growth rate, the enlargement rate of femoral head and the ratio of area of obturator foramen. Clinical assessment was correlated with X-ray findings in 40 hips.Results AI and AHI decreased gradually with time. AI was within 15°and AHI was more than 84% 3～4 years postoperativly. AI(D/W) and CE angle increased gradually. They were close to normal at 5 years of age or 3～4 years postoperativly. The acetabular width growth rate and the enlargement of femoral head were most obvious 3～4 years postoperativly. The ratio of the area of obturator foramen decreased significantly at the immediate postoperative stage, and completely recovered 6 months postoperatively. Excellent and good results were obtained in 97.5% of patients. Conclusions The child was in the first developmental peak when Salter innominate Osteotomy was performed and the remodeling potential was great. The hip was close to that of normal 3～4 years postoperativly, and the hip joints hold the femoral heads properly and the fit was close to perfect. However, Salter Pelvis Osteotomy may result in increased femoral head at this age and result in inadequate cover. Excessive physical activity should be avoided to minimise osteoarthrosis.
Anisimov D.l. - One of the best experts on this subject based on the ideXlab platform.
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The assessment system of the grade of dysplastic changes in hip joint of children of early age
Saratov State Medical University, 2018Co-Authors: Anisimova Е.А., Zotkin V.v., Anisimov D.l.Abstract:Aim: to analyze the method of choice of treatment for children aged 1-3 yrs. with hip joint dysplasia with respect to the complex of pathological changes by the elaboration of CAD programs. Material and Methods. We defined the grade of dysplastic changes in joint components of 82 children with hip joint dysplasia (113 joints) aged 1-3 yrs by CAD program. Results. The grade of dysplastic changes in hip joint (mild — I, moderate — II, severe — III) was identified with the elaborated program and the treatment was administered. We identified 28 children (33 joints) to have mild (I) dysplasia grade, moderate (II) 31 children (42 joints) and severe (III) 23 (38 joints). Mild dysplasia grade (I) corresponded to the score from 5 to 13, and to the option of conservative treatment with dynamic follow-up and coxarthritis prevention, moderate (II) — to the score from 14 to 26 and the option of intertrochanteric detorsion varus corrective Osteotomy, severe (III) — to the score from 27 to 39 and the option of Pelvis Osteotomy and intertrochanteric detorsion varus corrective Osteotomy. Conclusion. The treatment of patients with hip dysplasia depends on the grade of dysplastic changes. The elaborated program allows effectively define dysplasia grade and choose treatment method for the patients.
Anisimova Е.А. - One of the best experts on this subject based on the ideXlab platform.
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The assessment system of the grade of dysplastic changes in hip joint of children of early age
Saratov State Medical University, 2018Co-Authors: Anisimova Е.А., Zotkin V.v., Anisimov D.l.Abstract:Aim: to analyze the method of choice of treatment for children aged 1-3 yrs. with hip joint dysplasia with respect to the complex of pathological changes by the elaboration of CAD programs. Material and Methods. We defined the grade of dysplastic changes in joint components of 82 children with hip joint dysplasia (113 joints) aged 1-3 yrs by CAD program. Results. The grade of dysplastic changes in hip joint (mild — I, moderate — II, severe — III) was identified with the elaborated program and the treatment was administered. We identified 28 children (33 joints) to have mild (I) dysplasia grade, moderate (II) 31 children (42 joints) and severe (III) 23 (38 joints). Mild dysplasia grade (I) corresponded to the score from 5 to 13, and to the option of conservative treatment with dynamic follow-up and coxarthritis prevention, moderate (II) — to the score from 14 to 26 and the option of intertrochanteric detorsion varus corrective Osteotomy, severe (III) — to the score from 27 to 39 and the option of Pelvis Osteotomy and intertrochanteric detorsion varus corrective Osteotomy. Conclusion. The treatment of patients with hip dysplasia depends on the grade of dysplastic changes. The elaborated program allows effectively define dysplasia grade and choose treatment method for the patients.
René M. Castelein - One of the best experts on this subject based on the ideXlab platform.
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Results of Pavlik harness treatment in children with dislocated hips between the age of six and twenty-four months.
Journal of pediatric orthopedics, 2010Co-Authors: Virginie Pollet, Hans E. H. Pruijs, Ralph J. B. Sakkers, René M. CasteleinAbstract:Background We retrospectively studied the outcome of Pavlik harness treatment in late-diagnosed hip dislocation in infants between 6 and 24 months of age (Graf type 3 and 4 or dislocated hips on radiographs) treated in our hospital between 1984 and 2004. The Pavlik harness was progressively applied to improve both flexion and abduction of the dislocated hip. In case of persistent adduction contracture, an abduction splint was added temporarily to improve the abduction. Methods We included 24 patients (26 hips) between 6 and 24 months of age who presented with a dislocated hip and primarily treated by Pavlik harness in our hospital between 1984 and 2004. The mean age at diagnosis was 9 months (range 6 to 23 mo). The average follow-up was 6 years 6 months (2 to 12 y). Ultrasound images and radiographs were assessed at the time of diagnosis, one year after reposition and at last follow-up. Results Twelve of the twenty-six hips (46%) were successfully reduced with Pavlik harness after an average treatment of 14 weeks (4 to 28 wk). One patient (9%) needed a secondary procedure 1 year 9 months after reposition because of residual dysplasia (Pelvis Osteotomy). Seventeen of the 26 hips were primary diagnosed by Ultrasound according to the Graf classification. Ten had a Graf type 3 hip and 7 hips were classified as Graf type 4. The success rate was 60% for the type 3 hips and 0% for the type 4 hips. (P=0.035). None of the hips that were reduced with the Pavlik harness developed an avascular necrosis (AVN). Of the hips that failed the Pavlik harness treatment, three hips showed signs of AVN, 1 after closed reposition and 2 after open reposition. Conclusion The use of a Pavlik harness in the late-diagnosed hip dislocation type Graf 3 can be a successful treatment option in the older infant. We have noticed few complications in these patients maybe due to progressive and gentle increase of abduction and flexion, with or without temporary use of an abduction splint. The treatment should be abandoned if the hips are not reduced after 6 weeks. None of the Graf 4 hips could be reduced successfully by Pavlik harness. This was significantly different from the success rate for the Graf type 3 hips. Level of evidence Therapeutic study, clinical case series: Level IV.