Pertrochanteric osteotomy and distraction femoral neck lengthening for treatment of proximal hip ischemic deformities in children

Journal of Children's Orthopaedics
Mikhail Teplenky, Waleed Mekki

Abstract

Proximal femoral ischemic deformities in the pediatric population is a challenging pathological situation. Many surgical techniques have been proposed to treat this problem, with variable reported results. We believe that a C-shaped pertrochanteric osteotomy plus neck lengthening utilizing distraction osteogenesis principles would restore the femoral anatomical ratios between neck, shaft, and the head, and redress the biomechanics of the proximal femur with resultant sufficient containment of the femoral head within the acetabulum. We reviewed the results of 19 patients divided into two groups with proximal femoral ischemic deformities. Between 2002 and 2009, preoperative and postoperative clinical examination and radiographs were assessed measuring the neck-shaft angle (NSA), neck-epiphyseal angle (NEA), articulo-trochanteric distance (ATD), lateralization of the greater trochanter (LT), the angle of Wiberg (CEA), index of lateral head displacement by Reimers (IM), and lateral angle of displacement (LDA). All patients were followed prospectively. Clinical outcome was assessed using Colton's criteria, which showed average good improvement in function (58.9 %). Radiological indicators were assessed using Kruczynski's criteria. F...Continue Reading

References

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Citations

Nov 19, 2020·Journal of Children's Orthopaedics·Arash GhaffariOle Rahbek

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