Effects of different pelvic osteotomies on acetabular morphology in developmental dysplasia of hip in children

Developmental dysplasia of hip seriously affects the health of children,and pelvic osteotomy is an important part of surgical treatment.Improving the shape of the acetabulum,preventing or delaying the progression of osteoarthritis is the ultimate goal of pelvic osteotomies.Re-directional osteotomies,reshaping osteotomies and salvage osteotomies are the three most common types of pelvic osteotomy.The influence of different pelvic osteotomy on acetabular morphology is different,and the acetabular morphology after osteotomy is closely related to the prognosis of the patients.But there lacks comparison of acetabular morphology between different pelvic osteotomies,on the basis of retrospective analysis and measurable imaging indicators,this study predicted the acetabular shape after developmental dysplasia of the hip pelvic osteotomy in order to help clinicians make reasonable and correct decisions and improve the planning and performance of pelvic osteotomy.

Intraoperative Goal-Directed Therapies in Femoral and Pelvic Osteotomies in Children and In-Hospital Postoperative Outcomes

Background: Femoral and pelvic osteotomies are potential hemorrhagic interventions where transfusion requirements can be necessary. Objective: We undertook a secondary analysis of patients who underwent femoral and pelvic osteotomy in the initial cohort. The objective of this secondary analysis was to describe intraoperative and postoperative outcomes and to describe intraoperative management in these patients in terms of blood product management and fluid and hemodynamic therapy with the aim of implementing optimization management protocols for postoperative outcome improvement. Methods: A secondary analysis of patients who underwent femoral and pelvic osteotomy surgery was included in the initial retrospective study. Results: There were eighteen patients with a mean age of 104 ± 47.1 months. Four (22.2%) patients had intraoperative and/or postoperative complications. One patient (5.6%) had an intraoperative hemorrhagic shock, two patients (11.1%) had postoperative neurologic failure, and one patient (5.6%) had postoperative wound sepsis. The transfusion rate was 50% in nine patients. Conclusion: Femoral and pelvic osteotomies are interventions where blood, transfusion and fluid requirements can be increased;thus, this implies the necessity of a global patient blood management protocol with point-of-care tests and fluid- and hemodynamic-guided protocols with validated tools in children for intraoperative and postoperative outcome optimization.

A Brief Note on Pathogenesis and Treatment of Perthes Disease

Measurement of intraosseous pressure in the proximal femur, stress test and venography performed on 49 hips with perthes disease and 38 hips of normal children revealed an increase in intrasoseous pressure in Perthes disease group with abnormal stress test and venography. It means that there is venous obstruction in the diseased proximal femur in accompany with raised intraosseous pressure. Core decompression performed on 31 hips with Perthes disease gaves good response in 84% of the hips, whereas Chiari pelvic osteotomy done in 18 hips with late stage disease, 77% of the hips improved fairly well. The anthore' opinion is that core decompression is effective for Perthes disease in early stage, and the Chiaripelvic osteotomy could be recommended in late stage cases.

Investigation on the Physico－Chemical Properties of Lipiodol Anticancerous Chemo－Embolizing Agents

Measurement of intraosseous pressure in the proximal femur, stress test and venography performed on 49 hips with perthes disease and 38 hips of normal children revealed an increase in intrasoseous pressure in Perthes disease group with abnormal stress test and venography. It means that there is venous obstruction in the diseased proximal femur in accompany with raised intraosseous pressure. Core decompression performed on 31 hips with Perthes disease gaves good response in 84% of the hips, whereas Chiari pelvic osteotomy done in 18 hips with late stage disease, 77% of the hips improved fairly well. The anthore' opinion is that core decompression is effective for Perthes disease in early stage, and the Chiaripelvic osteotomy could be recommended in late stage cases.