Changes in sagittal vertebral–pelvic ratios in children with a high position of the large trochanter after surgical treatment
- Authors: Pozdnikin I.Y.1, Bortulev P.I.1, Vissarionov S.V.1, Barsukov D.B.1, Baskaeva T.V.1
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Affiliations:
- H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
- Issue: Vol 11, No 3 (2023)
- Pages: 315-326
- Section: Clinical studies
- Submitted: 04.06.2023
- Accepted: 21.07.2023
- Published: 29.09.2023
- URL: https://journals.eco-vector.com/turner/article/view/472122
- DOI: https://doi.org/10.17816/PTORS472122
- ID: 472122
Cite item
Abstract
BACKGROUND: Alteration in the anatomical shape and structure of the proximal femur is a common orthopedic problem in children. In most cases, this is accompanied by a high position of the large trochanter, which leads not only to the development of extraarticular impingement syndrome and the progression of coxarthrosis, but also to impaired vertebral–pelvic relations.
AIM: To evaluate the effect of the transposition of the large trochanter in children on changes in the radiological parameters of sagittal vertebral–pelvic ratios.
MATERIALS AND METHODS: The study included 20 patients (20 hip joints) aged 9–15 years with deformity of the proximal femur, which was accompanied by a high position of the large trochanter. The patients underwent clinical and X-ray examination before and after surgical treatment, i.e., transposition of the large trochanter according to original methods. The pelvic angle, lumbar lordosis, thoracic kyphosis, pelvic deviation angle, sacral tilt, and sagittal vertical axis (SVA) were evaluated. The obtained data were analyzed statistically.
RESULTS: Excessive pelvic anteversion and vertical posture of the hyperlordotic type are characteristics of the patients analyzed. These signs were manifested as a significant increase in global lumbar lordosis and the angle of inclination of the sacrum and a decrease in the angle of inclination of the pelvis, in combination with a negative imbalance in SVA. The surgery made it possible to normalize the articulotrochanteric distance index and increase the angle of inclination of the pelvis while reducing the sacral slope, which improved global lumbar lordosis.
CONCLUSIONS: After the surgical intervention, in addition to restoring normal ratios in the hip joint and eliminating the extraarticular femoroacetabular impingement syndrome, the hyperlordotic type of vertical posture transformed toward the normal one in accordance with the classification of R. Rousully, which resulted in the prevention of the development of degenerative and dystrophic changes in the lumbar spine.
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About the authors
Ivan Yu. Pozdnikin
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Author for correspondence.
Email: pozdnikin@gmail.com
ORCID iD: 0000-0002-7026-1586
SPIN-code: 3744-8613
MD, PhD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgPavel I. Bortulev
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: pavel.bortulev@yandex.ru
ORCID iD: 0000-0003-4931-2817
SPIN-code: 9903-6861
Scopus Author ID: 57193258940
MD, PhD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgSergei V. Vissarionov
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN-code: 7125-4930
Scopus Author ID: 6504128319
ResearcherId: P-8596-2015
MD, PhD, Dr. Sci. (Med.), Professor, Corresponding Member of RAS
Russian Federation, Saint PetersburgDmitriy B. Barsukov
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: dbbarsukov@gmail.com
ORCID iD: 0000-0002-9084-5634
SPIN-code: 2454-6548
MD, PhD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgTamila V. Baskaeva
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: tamila-baskaeva@mail.ru
ORCID iD: 0000-0001-9865-2434
SPIN-code: 5487-4230
MD, orthopedic and trauma surgeon
Russian Federation, Saint PetersburgReferences
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