Reconstruction of the hip joint in children after septic coxitis

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Abstract

Background.

Surgical treatment of destructive dislocations is problematic, and controversial. Treatment options range from active monitoring to complex multistage reconstruction protocols.

Materials and methods.

The results of treatment of 17 children with disruptive dislocation of the hip (class IV according to the Choi classification) are presented. The mean age at which treatment was started was 6.3 ± 0.5 years (range: 3-9 years). Treatment strategies included formation of the weight-bearing contact of the proximal femur and acetabulum and ilium osteotomy using an Ilizarov frame. The follow-up period lasted from 2 to 11 years. Clinical results were assessed using Colton’s criteria. Assessment of the radiology findings included the anatomy relations and congruence of the articular surfaces. The patients were divided into two groups, according to age, for data analysis.

Results.

The majority (88%) of the children had positive anatomical and functional outcomes. The functional results were good (12-15 points), satisfactory (9-11 points), and unsatisfactory (8 points) for 3, 5, and 1, respectively, among 3-6 year olds and 2, 6, and 0, respectively, among 7-9 year olds. The distribution of joint congruence types I, III, and IV was 2, 4, and 3, respectively, in the younger group and 1, 6, and 1, respectively, in the older group.

Conclusion.

The use of reconstructive surgery using the Ilizarov apparatus in children with a defect of the proximal femur creates conditions for the adaptation of incongruent articular components without causing decompensation of the joint.

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About the authors

Mikhail P Teplenkiy

Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics

Author for correspondence.
Email: ortho-kgn@mail.ru
MD, PhD, professor. Highest category orthopaedic surgeon. Head of Joint Pathology Laboratory, Head of Department 11 (pediatric joint pathology). Russian Iizaov Scientific Centre. Russian Federation

Evgeny V Oleinikov

Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics

Email: ortho-kgn@mail.ru
MD, PhD, junior researcher of the Joint Pathology Laboratory, orthopaedic surgeon of the department 11 (pediatric joint pathology). Russian Iizaov Scientific Centre Russian Federation

Vyacheslav S Bunov

Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics

Email: ortho-kgn@mail.ru
MD, PhD, leading researcher of the Joint Pathology Laboratory. Russian Iizaov Scientific Centre. Russian Federation

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Copyright (c) 2016 Teplenkiy M.P., Oleinikov E.V., Bunov V.S.

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