Proximal femoral resection-interposition arthroplasty.

Castle, Maurice E.; Schneider, C

doi:10.2106/00004623-197860080-00005

Cited by 134 publications

(79 citation statements)

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“…However, neglected hip displacement is still common in severely disabled patients with cerebral palsy. Surgical treatment for neglected hip dislocations includes constructive or salvage procedures, from total hip arthroplasty [16], to hip reconstruction [6,7], subtrochanteric valgus osteotomy without resection of the femoral head [13], resection of the femoral head [9,28,29], resection of the femoral head with articulated hip distraction [30], and subtrochanteric valgus osteotomy with femoral head resection [11,12]. Arthrodesis [14] is another option for nonreconstructible hips.…”

Section: Discussionmentioning

confidence: 99%

“…These patients usually experience hip pain, and their condition does not allow appropriate sitting or adequate nursing and hygiene ( Figure 1). Described salvage procedures for nonreconstructible hips include proximal femoral head resection [4,9,10], valgus osteotomy [11][12][13], hip arthrodesis [14,15], and total hip arthroplasty [16]. In 1990, McHale et al described their technique of subtrochanteric valgus osteotomy in 5 patients with spastic quadriplegia [11].…”

Section: Introductionmentioning

confidence: 99%

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McHale Operation in Patients with Neglected Hip Dislocations: The Importance of Locking Plates

Eidelman

Katzman

Zaidman

et al. 2014

Advances in Orthopedic Surgery

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Neglected hip dislocation in patients with cerebral palsy is a challenge for the pediatric orthopedic surgeon. Many patients experience pain, limitation of hip motion, and sitting and hygiene problems. Arthrodesis, proximal femoral head resection, and subtrochanteric valgus osteotomy are effective salvage procedures for patients with painful hip dislocation and restricted hip motion when reconstruction of the hip is not possible. Osteopenia is one of the problems that can complicate the postoperative course in these patients. Postoperative cast immobilization may further worsen the osteopenia and can predispose to fractures of the femur after cast removal. Standard plating of the proximal osteotomy may not always provide adequate stability of the fixation. In order to prevent postoperative osteoporotic fractures we use locking plates, without casting. Since 2003 until 2011, we operated on 9 patients (14 hips) with painful neglected hip dislocations. The first three patients (five hips) were operated on using standard nonlocking plates. All other patients (nine hips) were operated on using locking plates. During the followup, the hardware failed in one of these cases. All patients treated with locking plates had not been casted postoperatively, and none had loss of fixation or fractures during the followup.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

McHale Operation in Patients with Neglected Hip Dislocations: The Importance of Locking Plates

Eidelman

Katzman

Zaidman

et al. 2014

Advances in Orthopedic Surgery

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“…-устранение или снижение болевого синдрома [27,34,35,36,37,38,39]; -устранение порочного положения бедра, возмож-ность его беспрепятственной мобилизации [27,28,34,40,41,42,43]; -улучшение условий ухода за пациентом, в том числе гигиены промежности [27,28,34,40].…”

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“…Очень распространенным методом хирургическо-го вмешательства остается проксимальная артропла-стическая резекция бедра, предложенная в 1978 Castle et al [34]. Данное вмешательство заключается в экс-трапериостальной резекции проксимального конца бедра ниже уровня малого вертела.…”

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“…Улучше-ние условий и способности сохранять позицию сидя, увеличение пассивной амплитуды движений бедра в той или иной степени отмечается у всех пациентов в отдаленном периоде [28,41,43,50]. Важным элементом послеоперационного периода при выполнении проксимальной артропластической резекции бедра является мягкотканное или скелетное вытяжение или внешняя фиксация на период 2-6 не-дель с целью уменьшения проксимальной миграции бедра и исключения, таким образом, возникновения механического контакта между бедром и костями таза [28,34,41]. Однако это увеличивает период госпитали-зации, что является негативным элементом лечения с точки зрения Knaus и Leet [41,52].…”

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Hip dislocation in adolescents and adults with cerebral palsy: palliative methods of surgical treatment (literature review)

Bidjamshin¹,

Попков²

2017

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Hip

Cerebral Palsy

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The hip joint is the largest joint in the body and is the joint that causes the most problems both from a functional perspective and at the level of walking, sitting, and lying in children with cerebral palsy (CP). Hips in children with CP are normal at birth, and the problems develop slowly as the children grow and deform under the influence of abnormal forces caused by the CP. A second group of children with CP do not actually develop deformity; however, the infantile shape of their proximal femur does not resolve because there is not enough normal force present. In summary, these children develop contractures and increased abnormal forces that lead to dislocation and dysplasia, or alternatively, they fail to resolve the infantile torsional malalignment. After addressing the concerns of equinus contractures in children with CP, hip problems are the next main area of interest to orthopaedists treating these children. The treatment of hip problems has the largest literature base in the area of orthopaedic management of CP. A review of the abstract listings in the National Library of Medicine revealed 496 references published from 1963 to 2000 that address hip problems in children with CP. Although the literature is extensive, much of it does not include any standardized control or standardized radiographic measurements and has a poor description of specific patterns. A substantial body of this literature addresses the natural history of the problem of hip dysplasia, and its etiology has been fairly well understood. The evaluation of treatment outcomes suffers especially from poor categorization, poor standard evaluation procedures, and, most of all, very poor long-term follow-ups. Spastic HipsHip problems in children with CP first need to be divided by children's level of tone into either spastic children or those children who are hypotonic. The spastic (hypertonic) group should also include children with movement disorders such as athetosis and dystonia. The hypertonic hips can be subdivided further by the direction of the dysplasia or the abnormal force into posterosuperior, anterior, inferior and, additionally, by several contracture patterns that may be independent of or concurrent with dysplastic hips. These contracture patterns include windblown hips and hyperabducted hips. The hypotonic hips in children with CP are a little more diffuse and are harder to further categorize.

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Proximal femoral resection-interposition arthroplasty.

Cited by 134 publications

References 0 publications

McHale Operation in Patients with Neglected Hip Dislocations: The Importance of Locking Plates

McHale Operation in Patients with Neglected Hip Dislocations: The Importance of Locking Plates

Hip dislocation in adolescents and adults with cerebral palsy: palliative methods of surgical treatment (literature review)

Hip

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