Doğuştan Kalça Çıkığı Tedavisinde Açık Redüksiyon, Salter ve Femoral Osteotomi Kombinasyonu

Abstract

Bu çalışmada AÜTEF, Ortopedi ve Travmatoloji Kliniğinde 1979 - 1987 yılları arasında D.K.Ç. tanısıyla açık redüksiyon, Salşer ve femoral osteotomi yapılan 61 hastanın 84 kalçası klinik ve rTadyo- lojik olarak değerlendirildi. Ortalama yaş 29.5 ay, orlalama takip süresi 170 5 yıldı. 67 kalça (© 80) radyolojik olarak normal (Severin i veya 2; kabul edildi. Klinik olarak da 81 kelça (96 96) çok iyi veya iyi olarak değerlendirildi. 30 kalçada ise (5 36) değişik derecelerde avas- küler nekroz gözlendi. Bu yöntem konsantrik redüksiyonu tek scans- ta sağlaması ve hastanede kalış süresini azaliması bakımından tat- minkar olarak kabul edildi.

Keywords

• ortapedi
• kalça çıkıklığı
• doğuştan çıkıklık

COMBINATION OF OPEN REDUCTION, SALTER AND FEMORAL OSTEOTOMY IN THE TREATMENT OF CONGENITAL HIP DISLOCATION

Abstract

In this article, we analyzed the radiographic and clinical results of 84 congenitaliy dislocated hips of 61 patients. Open reduction, Sal- ter and femoral osteotomy was the operative technigue. The 2verage âge6 at operation was 29.5 months and the average İollow-up period was 5 years. Radiosraphically, 67 hips (X 80) were considered <1Or- mal» (Severin class 1 or 2), Clinically 81 hips (© 96) were conside- red «excellent» or «good». Avascular necrosis was observed in 30 hips (X& 36). In our opinion, this method of treatment is satisfactory, as it achieves concentric reduction at one session and shortens the time of stay at hospital.

Keywords

• orthopaedics
• dislocated hips
• congenital dislocation

References

1. 1. Ashley RK Lansen 1J James PM : Reduction of dişlocation of the hip in ölder shildren. A preliminary report. I Bone Joint Surg. 54-A : 545-550, 1979.
2. 2. Barret WP Staheli LT Chew DE : The ellectiveness of innominate oşteotomy in the treatment of congenital dislocation of ihe hip. J Bone Joint Surg. 68-A ; 79-87, 1986,
3. Berkeley ME Cain TE Donovan MM : Surgical therapy for congenital dislocation of the hip in patients who are twelwe to thirty-six months old. J Bone Joint Surg. 66-A : 412-420, 1984.
4. Çhakirgil GS : Radical reduction operation in treatment of congenital dislocation of the hip. An analysis of 2789 cases. Orthopedics. 10 : 711-720, 1987.
5. Chuinard EG Logan ND : Varus-producing and derotational subirochanteric osteotomy in the treatment of congenital dislocation ol the hip. J Bone Joint Surg. 45-A : 1397-1408, 1963.
6. Colonna PC : Capsular arthroplesty for congenital dislocation of the hip : Indiçations and techniğue. J Bone Joint Surg. 47-4 : 447-449, 1965.
7. Cooperman DR, Stulberge SD ; Post-reduction avascular necrosis in congenilal dislocation of the hip. J Bone Joint Surg. 62-A : 247-258, 1980.
8. Dege, W Lenod J Polakowskic : Surgical treatment of congenital dislocation of the hip in children. J Bone Joint Surg. 41-A ; 920-934, 1959,

9. Gage JR Winter hB : Avascular necrosis of the capital femoral epiphysis asa complication of closed redüction of congenital dislocation of the hip. A critical review of twenty years experience al Gilette Children's Hospital, J Bone Joint Surg. 54-A : 373-388, 1972.
10. Galphin RD Roaçlh JW Wenger DR Herning JA Birch JG ; Öne stage treatment of dislocation of the hip in older children, including femoral shortening' J Bone Joint Surg, 71-A : 734-741, 1989.
11. Gibson PH Benson MKD : Congenital dislocation of the hip, Review at maturity of 147 hips ireated by excisilon of the limbus and derotation osteotomy. J Bone Joint Surg. 84-B : 169-175, 1982.
12. Hannson G Nachenson A Pauer K : Screening of children with congenital dislocadion. of ihe hip İsint on the maternity wards in Sweden, J Pediatr Orthop. 3.271, 1983.
13. Harris NH Lloyd-Robert GC Galier R ; Acetabular development in congenital dislocation of the hip with special reference to indications for acetabuloplasty and pelvic or femoral realignment osteotomy. J Bone Joint Surg. 57-B ; 46-53, 1975.
14. Herold HZ Daniel D : Reduction of neglected congenital dislocation of the hip in children over the age of six years. J Bone Joint Surg. 61-B : 4-12, 1978.
15. Kahle WK Anderson MB Alpert J Stevens PM Coleman SS ; The value of, preliminary traction in the treatment of congenital dislocation of the hip. J Bone Joint Surg. 72-A : 1043-1048, 1990,
16. Kalamchi A MacEwen GD : Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Joint Surg. 62-A : 876-888, 1980.
17. Karamidas JE Holloway GMN : Growth of the proximal femur after varusderotation osteotomy in the trestment congenital dislocation of the hip. Clin Orthop. 98 : 61-68, 1974,
18. Kasser IR Bowen JR MacEwen GD : Varus derotation osteotomy in the treatmeni of persisteni dysplasia in congenital dislocation of the hip. J Bone Joint Surg. 67-A : 195-202, 1985.
19. Lehman WL Grogan DP : Innominate osteotomy and varus derotational osteotomy in the trestment of congenital dysplasia of the hip. Orthopedics. 8 : 979-988, 1985.
20. 20. Lindstrom JR, Ponseti IV Wegner DR : Acetabular development after reduction in congenital dislocation of the hip. J Bone Joint Surg. 6i-A : 112-117, 1979.
21. 21. MekKay DW ; A comparison of innominale and the pericapsular osteotomy in the treatment ol congenital dislocation ol the hip, Clin Orthop, 98 : 124-132, 1974,
22. 22. Morel G: The treatment ol congenital dislocation and subluxation of the hipin the older child. Acta Orthop. Ccand. 46 : 364-399, 1975.
23. 23, Pemberton PA ; Pericapsular osteotomy of the ilium for treatment ol congenital subluxation and dislocation ol the hip. J Bone Joint Surg. 47-A ; 65-86, 1965.
24. 24. Race C Herning JA : Congenitai dislocation of the hip. An evaluation of closed reductüon, J Pediatv Ovthop. 3 : 166-172. 1983.
25. 25. Salter RB : Innominate osteotomy in the treatmeni of congenital subluxation distocation of the hip. J Bone Joint Surg. 43-B : 518-539, 1981.
26. 28. Selter RB Dubos JP : The first filteen years personal experience with innominate osteotomy in the treatment of congenital subluxation dislocation of the hip. Clin Orthop, 98 : 72-108, 1974.
27. 27. Severin E ; Contrubutlon to the knowledge of congenital dislocatlon of the hip joint. Lote results ol clesed reduction and arthrographic studies of recent cüses. Acta Chir Scand. suppl : 63, 1941.
28. 28. Swartz DR : Acetabuler development after reduction of congenital dislocation of the hip. J Bone Joint Surg. 47-A : 705-714, 1965,
29. 29. Teufiler AP Noguera JG ; Experience with innominate osteotomy and medial displacement osteotomy in the treatment of acctabuler dysplasia. Clin Orthop. 908 : 133-137, 1974,
30. 30. Thomas CL Gage JR Oğden JA : Treatment concepis for femoral ischemic necrosis complicating congenital hip disease, J Bone Joint Surg. 64-A : 819-828, 1982.
31. 31. Tonnis D : Congenital hip dislocation. Avascular necrosis. 1982, Theme Stratton, New York.
32. 32. Tonnis D : Surgical treatment of congenital dis'location of the hip. Clin Orthop. 258 : 33-40, 1990. 338. Utterbach TD MacEwen GD : Comparison of pelvic osteotomies for the surgical correction of congenital dislocation of the hip. Clin Orthop. 98 ; 104-110, 1974.
33. 34. Weintroub S Green I Tendinas R Waisman SL : Growth and development of congenitally dislocated hips in early infancy. J Bone Joint Surg. 61-A ; 125-130, 1979. '
34. 35. Weiner DS Houyt WAJR, O'Dell HW ; Congenitel dislocation of the hip. The relationship of premanuplaton tracton and age to avascular neçross of the femoral head. J Bone Join Surg. 59-A : 306-311, 1967,
35. 36. Wenger DR : Congenital hip dislocation : Technigues for primary open reduction including femoral shortening. AAOS Instructional Course Lectures, 38 : 343-357, 1989,
36. 37. Wilkinson JA ; The epidemiology of congenital dislocation of the hip, Current Orthopedics. 1 : 249, 1987.
37. 38. Zoints LF MacEwen GD : Treatment of congenital dislocation of the hip in children between ages ol one and three years. J Bone Joint Surg. 68-A ; 829- 846, 1986,