ABSTRACT
BACKGROUND: There is no consensus on best treatment of advanced tuberculous coxarthritis in young patients. PATIENTS AND METHODS: We report our results concerning hip arthrodesis for advanced tuberculous arthritis of the hip in 32 adolescents. The operation was preceded by standard antituberculous chemotherapy for 4 weeks, which was continued for 12 months after surgery. At the last follow-up, clinical and radiographic examinations of the ipsilateral knee, contralateral hip and lower back were done. We evaluated function, limitations, and presence of pain with our usual questions. RESULTS: Their average age at the time of operation was 16 (12-18) years and the average duration of followup 12 (10-18) years. Solid bony fusion occurred in all patients after mean 5 months and no complications developed in the postoperative period. 28 patients were satisfied with the fused hip. No patients had reactivation of tuberculosis in any part of their body. The results were comparable to those of arthrodesis performed for other causes. INTERPRETATION: Hip arthrodesis is an alternative method of treatment for advanced stages of tuberculous coxarthritis in the adolescent.
Subject(s)
Arthritis, Infectious/surgery , Arthrodesis , Hip Joint , Tuberculosis, Osteoarticular/surgery , Adolescent , Child , Female , Humans , Male , Time Factors , Treatment OutcomeABSTRACT
Fifty-three consecutive children ages 6 to 14 with femur fractures treated with early percutaneous intramedullary fixation were evaluated retrospectively. The operation was performed within 24 hours in 50 patients and in the remainder after 48 hours. All patients were mobilized and allowed full weight-bearing in a functional brace in the early postoperative period. The average hospital stay was 4 days. The average follow-up was 24 months. There were no significant intra- or postoperative complications. An average overgrowth of 1.8 mm was measured using scanogram 24 months after surgery. In the authors' experience, this technique is highly effective for the treatment of children 6 to 14 years old with femur fractures. The main advantages of this method are early weight-bearing, immediate mobilization, short hospitalization, and fewer complications.
Subject(s)
Braces , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/methods , Adolescent , Bone Nails , Bone Wires , Child , Female , Femoral Fractures/diagnostic imaging , Fracture Healing/physiology , Humans , Male , Radiography , Retrospective Studies , Treatment OutcomeABSTRACT
This study compared the effects of axial dynamization and staged destabilization on fracture healing. Bilateral midshafts of canine tibiae were osteotomized and fixed with an external fixator. The hind limbs were divided into two groups: the destabilized group in which the fixator's stiffness was progressively reduced over time and the axially dynamized group in which the fixator was axially dynamized. The healed tibiae were tested for 3-point bending in the anteroposterior plane. The biomechanical tests performed 2 months postoperatively revealed that the side with the destabilized fixator was more rigid than the side with the axially dynamized fixator, but the differences were insignificant (P=.20). This study showed staged destabilization of the fixator's stiffness was as effective on the enhancement of fracture healing as axial dynamization.
