Medial percutaneous hemi-epiphysiodesis improves the valgus tilt of the femoral head in developmental dysplasia of the hip (DDH) type-II avascular necrosis.
Background and purpose - Avascular necrosis (AVN) is a major cause of disability after treatment of developmental dysplasia of the hip (DDH), leading to femoral head deformity, acetabular dysplasia, and osteoarthritis in adult life. Type-II AVN is characterized by retarded growth in the lateral aspe...
| Publicado en: | Acta Orthopaedica Vol. 86; no. 4; pp. 506 - 511 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images pictorial research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Medical Journals Sweden AB
Aug2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=108450563&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 108450563 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Aug2015 vid: 86 iid: 4 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 108450563 108450563 108450563 10.3109/17453674.2015.1037222 108450563 ppf: 506 ppct: 5 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Medial percutaneous hemi-epiphysiodesis improves the valgus tilt of the femoral head in developmental dysplasia of the hip (DDH) type-II avascular necrosis. aug: au: Agus, Haluk Önvural, Burak Kazimoglu, Cemal Reisoglu, Ali Kalenderer, Onder affil: Orthopedics and Traumatology, Izmir Tepecik Education and Research Hospital sug: subj: Osteonecrosis Surgery Treatment Outcomes Bone Diseases, Developmental Human Male Female Child Adolescence Parametric Statistics T-Tests Mann-Whitney U Test Wilcoxon Signed Rank Test Data Analysis Software Randomized Controlled Trials Postoperative Complications Bone Transplantation Child: 6-12 years Adolescent: 13-18 years Male Female ab: Background and purpose - Avascular necrosis (AVN) is a major cause of disability after treatment of developmental dysplasia of the hip (DDH), leading to femoral head deformity, acetabular dysplasia, and osteoarthritis in adult life. Type-II AVN is characterized by retarded growth in the lateral aspect of the physis or by premature lateral fusion, which produces a valgus deformity of the head on the neck of the femur. We investigated the effect of medial percutaneous hemi-epiphysiodesis as a novel technique in the treatment of late-diagnosed type-II AVN. Patients and methods - 9 patients (11 hips) with a diagnosis of type-II AVN who underwent medial percutaneous hemi-epiphysiodesis after the surgical treatment for DDH were included in the study. 10 patients (12 hips) with the same diagnosis but who did not undergo hemi-epiphysodesis were chosen as a control group. Preoperative and postoperative articulotrochanteric distances, head-shaft angles, CE (center-edge) angles, and physeal inclination angles were measured. The treatment group underwent medial hemi-epiphysodesis at a mean age of 8 years. The mean ages of the treatment group and the control group at final follow-up were 14 and 12 years respectively. The mean duration of follow-up was 5.7 years in the treatment group and 8.3 years in the control group. Results - Preoperative articulotrochanteric distance, head-shaft angle, and functional outcome at the final follow-up assessment were similar in the 2 groups. However, preoperative and postoperative CE angles and physeal inclination angles differed significantly in the treatment group (p < 0.05). The final epiphyseal valgus angles were better in the treatment group than in the control group (p = 0.05). The treatment group improved after the operation. Interpretation - Medial percutaneous epiphysiodesis performed through a mini-incision under fluoroscopic control is a worthwhile modality in terms of changing the valgus tilt of the femoral head. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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