[Surgical treatment of the sequelae of ischemic postdysplasia femur head necrosis in children. II. Surgical technique].
The author presents its concept concerning the possibilities of the surgical treatment of the sequelae of the postdysplastic necrosis of the femoral head originating from the treatment of congenital dislocation or subluxation of the hip joint. The classification is based on the division according to Bucholz and Ogden into 4 types. Indicated for the surgical treatment are hips with the injury of the type II and III. In Grade II type the joint congruence is not affected and the method of operation is the redirection pelvic osteotomy. In children up to the age of 10 the author applies Salter osteotomy and in elder children and adolescents he performs a triple osteotomy of pelvis. Grade III type is the most severe impairment because of the concurrent defect of the joint congruence, limb discrepancy and extensive anatomic changes of the proximal end of femur. Up to the age of 10 he recommends Salter innominate osteotomy with the simultaneous valgus osteotomy, in elder children he recommends successively a triple pelvic osteotomy and a double intertrochanteric valgus osteotomy. This facilitates a considerable improvement of most hip joints affected in this way and at the same time the compensation of the limb length.
Dungl
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Fakultní nemocnice s poliklinikou na Bulovce, ortopedická klinika ILF, Praha.
D000293:Adolescent; D002648:Child; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006618:Hip Dislocation, Congenital / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008722:Methods; D009984:Orthopedic Fixation Devices; D011859:Radiography
Operacní resení následků ischemické postdysplastické nekrózy hlavice kosti stehenní u dĕtí. Cást II. Operacní technika.