The authors have replanted 162 parts in 120 children over the past 15 years. The youngest patient, undergoing successful replantation, was aged 7 months, 3 weeks. Unlike an adult, any child suffering a traumatic amputation should be considered for a possible replantation. Replantation should consist of minimal bone shortening to preserve epiphyseal plates, with repair of all severed structures. Longitudinal K-wires usually provide adequate fixation. Our survival rate for complete replantation in children under the age of 16 years is 77%. Long-term study showed that continued skeletal growth occurred and the digit attained 81% of normal longitudinal length at maturity. Recovery of sensibility in the replanted digit is nearly as good as for isolated digital nerve repair. Patient and parent satisfaction is high when replantation is successful, with uniform approval of the extensive effort required.
We treated 15 hips (15 patients) with developmental dysplasia by a single-stage combination of open reduction through a medial approach and innominate osteotomy. The mean age of the patients at the time of operation was 20 months (13 to 30). The mean follow-up period was 9.6 years (4 to 14). At the final follow-up, 14 hips were assessed clinically as excellent and one hip as good. Radiologically, ten hips were rated as class I, four as class II and one as class III according to the criteria of Severin. No avascular necrosis was seen. No patient required subsequent surgery. Our results indicate that satisfactory results can be obtained with the single-stage combination of open reduction by the medial approach and innominate osteotomy for developmental dysplasia of the hip in a selected group of children older than 12 months. To our knowledge, no similar combined technique has been previously reported.
The rates of survival of the amputated part and the functional outcomes were studied retrospectively after 13 replantations and 12 revascularizations in 25 children. The ages of the patients ranged from 2 to 15 years (mean, 6.4 years). The average duration of follow-up was 4.2 years (range, 2 to 7 years). The survival rate was higher after revascularization (94.6%) than after replantation (84.6%). Sensory recovery of all digits was satisfactory. The mean growth rate of replanted digits relative to contralateral digits was 80%. Functional results were rated as excellent in 11 cases, good in 8 cases, moderate in 2 cases, and poor in 1 case. In order to prevent functional and growth disturbances and due to cosmetic reasons, replantation or revascularization should definitely be tried for children.
Metal-on-metal dysplasia cup total hip arthroplasty for hip osteoarthritis secondary to developmental dysplasia of the hipGelişimsel kalça displazisine bağlı kalça osteoartriti için metal-metal displazi cup total kalça artroplastisi Developmental dysplasia of the hip (DDH) is the most common cause of secondary hip osteoarthritis. Dysplasia includes deformities such as hypoplastic acetabulum, narrow femoral intramedullary canal, leg-length discrepancy, shortened muscles around the hip, and abnormal neurovascular structures. All of these anatomical abnormalities require a challenging surgical operation in the treatment of dysplastic hips.In this study, we aimed to evaluate the clinical and radiological results of metal-on-metal dysplasia cup total hip arthroplasty (THA) for hip osteoarthritis secondary to DDH. İki hastada ameliyat sonrası siyatik sinir arazı gelişti. Bir hastada ameliyattan bir yıl sonra tekrarlayan çıkık meydana geldi. Ortalama cup inklinasyonu 46.5° idi (dağılım 42°-51°). Sekiz hastada heterotopik osifikasyon meydana geldi. Hiçbir hastanın asetabüler ve femoral komponenti anlamlı şekilde yer değiştirmedi veya çökmedi. Hiçbir implant revize edilmedi. Sonuç: Gelişimsel kalça displazisinde displazi cup TKA'nın erken dönem klinik ve radyolojik sonuçları tatmin edicidir.Anahtar sözcükler: Gelişimsel kalça displazisi; metal-metal kalça protezi; total kalça artroplastisi.Objectives: This study aims to evaluate the clinical and radiological results of metal-on-metal dysplasia cup total hip arthroplasty (THA) for hip osteoarthritis secondary to developmental dysplasia of the hip (DDH). Patients and methods: Between May 2009 and October 2011, THA was performed on 27 hips (7 Crowe type II, 9 Crowe type III, 11 Crowe type IV) of 22 patients (2 males, 20 females; mean age 43 years; range 25 to 63 years) with hip osteoarthritis secondary to DDH. All patients were evaluated clinically and radiographically. Results: Average follow-up period was 34.2 months (range 24-53 months). While mean Harris hip score (HHS) was 43 (range 30 to 72 points) preoperatively, it was 92 (range 87 to 98 points) at final follow-up. Two patients developed sciatic nerve palsy postoperatively. Recurrent dislocation occurred in one patient one year after the operation. Mean cup inclination was 45.6° (range 42°-51°). Heterotopic ossification developed in eight patients. No patient's acetabular and femoral component migrated or subsided significantly. None of the implants was revised. Conclusion: Early clinical and radiological results of metalon-metal dysplasia cup THA in DDH are satisfactory.Keywords: Developmental dysplasia of the hip; metal-on-metal hip prosthesis; total hip arthroplasty.
In this study, we aimed to evaluate the long-term clinical and radiological results of single-stage open reduction through a medial approach and Pemberton acetabuloplasty in developmental dysplasia of the hip. We treated 32 hips (22 patients) with developmental dysplasia by a single-stage open reduction through Ferguson’s medial approach and Pemberton acetabuloplasty. The procedure was performed bilaterally in 10 patients. The mean age of the patients at the time of the operation was 19.8 months (16–24 months). The mean follow-up period was 10.9 years (7–19 years). Group I avascular necrosis according to the Kalamchi and MacEwen classification was observed in two hips and group II in one hip. Radiologically, 90.6% of the hips were classified as Severin class I and 9.4% of the hips were classified as Severin class II. At the latest follow-up, 30 hips were assessed clinically as excellent and two hips as good. No patient required subsequent surgery. We conclude that single-stage medial open reduction and Pemberton acetabuloplasty represent an effective method for developmental dysplasia of the hip in children older than 15 months of age.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.