Open reduction and Pemberton periacetabular osteotomy (PPO) is one of the most preferred techniques for the treatment of developmental hip dyslaplasia (DDH) after the walking age. Performing the surgery as a one-stage operation or two separate consecutive operations is a controversial issue. In this study, we aimed to compare the outcomes, length of hospitalization and total cost between the patients whom had single-stage open reduction and PPO or two consecutive operations due to bilateral DDH in the walking age children. One hundred thirty patients with bilateral DDH had undergone open reduction and PPO for both hips. Seventy-five patients had one-stage open reduction and PPO for both of the hips, whereas 55 patients have two separate consecutive operations. Total time of exposure to anesthetics, blood loss and duration of operation were noted. Hospitalization period and total treatment costs were also noted for each patient. There was no statistically significant difference between the groups regarding the preoperative and postoperative AIs (P > 0.05). Comparing the total cost, length of hospitalization, exposure to anesthetics, perioperative blood loss, there was statistically significant difference between the groups (P < 0.005). Single-stage surgery had favorable outcomes. Major benefits of single-stage surgery for treatment of bilateral DDH are the reduced costs, anesthesia duration, intraoperative blood loss and hospitalization period. Also it can be presumed that prolonged immobilization can lead to loss of bone strength and resulting in fragility fractures. So single-stage open reduction and PPO for bilateral DDH can be preferred in experienced clinics.
Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and tripleblinded peer-review principles. The journal is the official publication of
Asetabulum kırıkları sık rastlanmayan, kompleks yaralanmalardır. Bu çalışmada posterior yaklaşımlarla opere ettiğimiz asetabulum kırıklı hastaların radyolojik ve fonksiyonel sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem 2011 ile 2014 yılları arasında asetabulum kırığı nedeniyle opere edilen, en az 1 yıllık takipleri yapılabilmiş olan 36 olgu bu çalışmaya dahil edilmiştir. Retrospektif olarak planlanan çalışmamızda kırık sınıflandırması Letournel Judet sistemine göre, radyolojik değerlendirme Matta kriterlerine göre, fonksiyonel skorlar modifiye Merle d'Aubigne Postel sistemine göre yapıldı. Bulgular Toplam 36 olgunun 25'i sadece posterior yaklaşımla opere edilmişken 11'inde kombine anterior ve posterior yaklaşım uygulanmıştır. Komplikasyon oranları güncel literatürle uyumlu bulunmuştur. Fonksiyonel skorlar değerlendirildiğinde 29 (%80,6) olguda mü-kemmel ve iyi sonuç, 3 (%8,3) olguda orta, 4 (%11,1) olguda kötü sonuç elde edilmiş, radyolojik sonuçlar değerlendirildiğinde 29 (%80,6) olguda mükemmel ve iyi sonuç, 3 (%8,3) olguda orta, 4 (%11,1) olguda kötü sonuç elde edilmiştir. Sonuç Asetabulum kırıkları cerrahisi, teknik olarak zor, komplikasyon oranları yüksek olmasına rağmen deplase asetabulum kırıklarında açık redüksiyon ve internal fiksasyon endike olduğu durumlarda altın standart tedavi yöntemidir. Olgu sayısı kısıtlı olan 36 olguluk serimizde radyolojik ve fonksiyonel sonuçlarımızın başarılı ve güncel literatürle uyumlu olduğunu gördük.
Objectives This study aims to compare the radiological outcomes and rate of complication between single-stage and staged operation for the treatment of bilateral developmental dysplasia of the hip (DDH). Patients and methods A total of 100 patients (13 males, 87 females; mean age: 18.1±2.1 months; range, 12 to 36 months) with bilateral DDH who were older than 15 months of age and treated with open reduction (OR) or Pemberton pericapsular osteotomy (PPO) were retrospectively analyzed. Of the patients, 48 were operated with OR and 52 were operated with PPO. Improvements in acetabular indices, presence of avascular necrosis, radiological results, and other complications were noted. Results There was no statistically significant difference in the preoperative acetabular indices, range of International Hip Dysplasia Institute (IHDI) classification, follow-up period, and age at the time of operation between the groups (p>0.05). There was no statistically significant difference in the acetabular indices, rate of avascular necrosis, and radiological results at the end of 24 months of follow-up between the groups (p>0.05). Conclusion Our study results show no significant difference in the radiological outcomes and complications between simultaneous and staged surgeries for the treatment of bilateral DDH in children in the walking age.
Background/Aim: The coccyx has several variants which could sometimes be confused with fractures. Our study aimed to alert physicians about the types of coccyges that can be easily confused with coccyx fractures in daily practice. Methods: Mid-sagittal and mid-coronal computerized images of 75 patients were analyzed to determine the types of coccygeal fracture, the coccyx types, number of segments, joint fusion, coccygeal bony spicules, subluxation, sacrococcygeal angle (SCA), intercoccygeal angle (ICA), and lateral deviation of the coccyx. Results:The mean age of the patients was 43.5 (13.6) years. There were 33 (44%) males, and 42 (56%) females. While 57 (76%) patients were thought to have a coccygeal fracture, only 18 patients (24%) actually had them. There was a significant difference between the coccyx types mistaken for fractures and actual coccygeal fractures (P<0.001). Conclusion:It is essential to know the coccyx types and distinguish normal variants from fractures. If the difference between coccyx fractures and coccyx types is known and the patients are informed accordingly, both the loss of workforce decreases, and the necessary treatment can be started early.
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