[Pathogenesis and early conservative combined treatment in the initial stages of osteochondropathy of the femur head in children].
The investigations carried out by the author have revealed that the basis of osteochondropathy of the femoral head in children are neurodystrophic changes caused by disadaptation of vegetotrophic provision of the hip joint area and of the lower extremities on the ground of dysembryogenesis. The predisposing factor for the development of the pathological process may be anatomical and functional immaturity of the vascular net of the joint connected with age. It is advisable to carry on the treatment at the initial stages of Perthes' disease taking into consideration the pathogenetic mechanisms. Improvement in the blood supply of the hip joints is achieved by drug action on the vegetative ganglia of the lumbosacral section of the spine, by an increase in the level of microcirculation in the joint tissues and by local influence on the vascular net of the area by means of physical factors. Early pathogenetic conservative complex treatment of Perthes' disease allows to obtain positive results in most cases (87.4%). In cases of unsuccessful conservative treatment at the initial stages of the disease surgical treatment is advisable for prevention of possible complications, such as deformation of the femoral head and disturbances in the spatial location of the femoral neck. The operation of choice in this case may be plasty of the femoral neck by an osseous autograft on the feeding muscular pedicle.
Veselovskiĭ
Iu A
IuA
D000293:Adolescent; D000367:Age Factors; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D005271:Femur Head Necrosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000209:etiology / Q000601:surgery; D013524:Surgical Flaps
Patogenez i rannee konservativnoe kompleksnoe lechenie nachal'nykh stadiĭ osteokhondropatii golovki bedrennoĭ kosti u deteĭ.