24 immature dogs as models developedfor transplanting autogenons iliac crest apophyseal graft into defect in epiphysis of the femoral head. In group I the graft was pedicled with deep circumflex iliac vessels. In gro...24 immature dogs as models developedfor transplanting autogenons iliac crest apophyseal graft into defect in epiphysis of the femoral head. In group I the graft was pedicled with deep circumflex iliac vessels. In group Ⅱthe same technique was used without pedicle. All the animals were followed for one to six months. The specimens were studied by macroscopic, histological and electronmicroscopical examinations. The results revealed that the pedicle grafts suvived with good remodeling in the joint with defect. The ossification of the iliac crest apophysis seemed to be normal. The most superficial of the graft was similar to the cartilage of the femoral head. Acetabuloplasty utilizing pedicle crest epiphysis transplatation was carried out in 20 patients whose ages ranged from 6 to 12 years old with Perthes' disease with poor relation between femoral head and acetabulum. All patients had been followed for 8 to 48 months. Almost all cases had satisfactory results showing radiographic evidence of best joint congruency. No hip joint space narrowing was found. The result enables the authors to propose a new surgical technique in the treatment of certain difficult dysplastic condition in the hip joint of the children.展开更多
Background Most orthopedic surgeons prefer spica cast immobilization in children for 4 to 12 weeks after surgical hip reconstruction in children with developmental hip dysplasia.This challenging treatment may be assoc...Background Most orthopedic surgeons prefer spica cast immobilization in children for 4 to 12 weeks after surgical hip reconstruction in children with developmental hip dysplasia.This challenging treatment may be associated with complica-tions.Studies are lacking that focus on early mobilization without casting for postoperative care after hip reconstruction.Methods Twenty-seven children(3.4±2.0 years),including 33 hips with developmental hip dysplasia(DDH)and dislocation of the hip(Tonnis grade 1 to 4),who underwent hip reconstruction(Dega acetabuloplasty,varisation-derotation osteotomy and facultative open reduction)were retrospectively included in this study.Postoperatively the patients were placed in an individual foam shell with 30 degrees of hip abduction,hip extension,and neutral rotation.Early mobilization physiotherapy was performed within the first few days after the surgery under epidural anaesthesia.Full weight bearing was allowed after 3-4 weeks.All children received a clinical examination and radiographic evaluation before and after surgical intervention.The follow-up period was 12.3±2.9 months.Results On average,the postoperative acetabular index decreased significantly from 36.9 to 21.7 degrees and the center-edge angle increased from 9.9 to 28.6 degrees.All hips had reached Tonnis grade 1 at the time of the last follow-up.No complications such as dislocation of the bone wedge,avascular necrosis of the acetabulum or femur,lack of non-union,or nerve injury,were reported.Conclusions In this cohort study,hip reconstruction was successful according to clinical and radiographic outcome param-eters after early mobilization without cast therapy.Early mobilization may be used as an alternative treatment option after hip reconstruction in DDH.展开更多
文摘24 immature dogs as models developedfor transplanting autogenons iliac crest apophyseal graft into defect in epiphysis of the femoral head. In group I the graft was pedicled with deep circumflex iliac vessels. In group Ⅱthe same technique was used without pedicle. All the animals were followed for one to six months. The specimens were studied by macroscopic, histological and electronmicroscopical examinations. The results revealed that the pedicle grafts suvived with good remodeling in the joint with defect. The ossification of the iliac crest apophysis seemed to be normal. The most superficial of the graft was similar to the cartilage of the femoral head. Acetabuloplasty utilizing pedicle crest epiphysis transplatation was carried out in 20 patients whose ages ranged from 6 to 12 years old with Perthes' disease with poor relation between femoral head and acetabulum. All patients had been followed for 8 to 48 months. Almost all cases had satisfactory results showing radiographic evidence of best joint congruency. No hip joint space narrowing was found. The result enables the authors to propose a new surgical technique in the treatment of certain difficult dysplastic condition in the hip joint of the children.
文摘Background Most orthopedic surgeons prefer spica cast immobilization in children for 4 to 12 weeks after surgical hip reconstruction in children with developmental hip dysplasia.This challenging treatment may be associated with complica-tions.Studies are lacking that focus on early mobilization without casting for postoperative care after hip reconstruction.Methods Twenty-seven children(3.4±2.0 years),including 33 hips with developmental hip dysplasia(DDH)and dislocation of the hip(Tonnis grade 1 to 4),who underwent hip reconstruction(Dega acetabuloplasty,varisation-derotation osteotomy and facultative open reduction)were retrospectively included in this study.Postoperatively the patients were placed in an individual foam shell with 30 degrees of hip abduction,hip extension,and neutral rotation.Early mobilization physiotherapy was performed within the first few days after the surgery under epidural anaesthesia.Full weight bearing was allowed after 3-4 weeks.All children received a clinical examination and radiographic evaluation before and after surgical intervention.The follow-up period was 12.3±2.9 months.Results On average,the postoperative acetabular index decreased significantly from 36.9 to 21.7 degrees and the center-edge angle increased from 9.9 to 28.6 degrees.All hips had reached Tonnis grade 1 at the time of the last follow-up.No complications such as dislocation of the bone wedge,avascular necrosis of the acetabulum or femur,lack of non-union,or nerve injury,were reported.Conclusions In this cohort study,hip reconstruction was successful according to clinical and radiographic outcome param-eters after early mobilization without cast therapy.Early mobilization may be used as an alternative treatment option after hip reconstruction in DDH.
