Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients
| Autor: | Kamacı, Saygın, Kaymakoğlu, Mehmet, Ramazanov, Rafik, Aksoy, Mehmet Cemalettin, Yılmaz, Güney |
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| Rok vydání: | 2021 |
| Předmět: |
Male
plate fixation medicine.medical_specialty Adolescent Turkey medicine.medical_treatment Radiography Bone Screws Osteotomy rigid fixation Locking plate Femoral head Hip Dislocation Humans Medicine Orthopedics and Sports Medicine Early rehabilitation Child Pelvic Bones Retrospective Studies Fixation (histology) business.industry Rehabilitation Perioperative Hip spica cast Surgery Casts Surgical Treatment Outcome medicine.anatomical_structure triple pelvic osteotomy Legg-Calve-Perthes Disease Original Article Female business Bone Plates Pelvic osteotomy |
| Zdroj: | Joint Diseases and Related Surgery |
| ISSN: | 2687-4792 2687-4784 |
| DOI: | 10.52312/jdrs.2021.1 |
| Popis: | Objectives: The aim of this study is to investigate whether rigid fixation after triple pelvic osteotomy (TPO) utilizing a 3.5-mm locking plate and screws without hip spica cast can provide enough stability and prevent correction loss in pediatric patients with developmental dysplasia of the hip (DDH) and Legg-Calvé-Perthes disease (LCPD). Patients and methods: A total of 21 hips of 21 pediatric patients (9 males, 12 females; mean age: 9.3±2.0 years; range, 6 to 14 years) who underwent rigid fixation with locking plate/screws after TPO for DDH and LCPD between June 2015 and October 2018 were retrospectively analyzed. Preoperative, immediate postoperative, and six-month follow-up anteroposterior radiographs were compared for the Wiberg’s center-edge angle (CE), Sharp angle, acetabular coverage of the femoral head (ACFH), and center-head distance discrepancy (CHDD). The patient demographics, surgery time, perioperative complications were evaluated. Results: Underlying diagnosis were DDH in 14 patients and LCPD in seven patients. In patients with DDH, postoperative evaluation showed significant increase in the mean CE angle (5.6±16.1° vs. 30.5±9.3°, respectively) and ACFH (46.4±16.8% vs. 84.5±12.1%, respectively), and a significant decrease in the mean Sharp angle (55.3±6.2° vs. 35.6±7.8°, respectively) and CHDD (14.6±10.7% vs. 6.2±5.6%, respectively). The final follow-up revealed that there was no correction loss in these parameters. In the patients with LCPD, postoperative evaluation showed a significant increase in the mean CE (20.1±11.1° vs. 38.3±9.6°, respectively) and ACFH (62.9±18% vs. 91.4±10.1%, respectively), and a significant decrease in the mean Sharp angle (46±3.6° vs. 25.2±5.5°, respectively). The final follow-up revealed that there was no correction loss in radiological parameters. No perioperative complications were noted. Conclusion: Our study results suggest that rigid fixation construct with a 3.5-mm locking plate and screws without hip spica cast can provide adequate stability to allow early mobilization following TPO in children without any loss of correction, until bony healing at the osteotomy sites. |
| Databáze: | OpenAIRE |
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