RESUMO
Perthes' disease involving the whole of the femoral head in 36 children was treated by innominate osteotomy. Radiographs of all cases were reviewed to see the effect of the osteotomy on the shape, the degree of acetabular cover and any subluxation of the diseased femoral head. All femoral heads which were circular before operation remained so, and over half of the previously deformed heads became circular after the osteotomy. The improved acetabular cover provided by the osteotomy resulted in a CE angle of 25 degrees or more in 92% of hips. Possible subluxation of the femoral head was studied by inspecting Shenton's line. If this was intact before operation it remained so; of the 14 which were broken before operation, 11 were restored to normal after osteotomy. We conclude that innominate osteotomy is a worthwhile procedure for Perthes' disease involving the whole of the femoral head.
Assuntos
Necrose da Cabeça do Fêmur/cirurgia , Doença de Legg-Calve-Perthes/cirurgia , Osteotomia/métodos , Ossos Pélvicos/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Humanos , Masculino , RadiografiaRESUMO
Hemiarthroplasty is commonly used in the treatment of displaced subcapital fractures of the femur. Review of 92 patients at least 4 years after this operation showed that 19 per cent had required further operations. Review of a separate series of 70 patients each of whom had undergone a revision operation after a hemiarthroplasty showed that over half needed operation within 3 years of the original treatment. The average age at revision was 70 years and some patients required operation at up to 79 years of age. The results from both series indicate that the medical condition of the patient at the time of fracture provided a better prognosis for survival than age alone. They also suggest that hemiarthroplasty should be reserved for patients over 79 and for medically unfit patients over 65.
Assuntos
Fraturas do Colo Femoral/cirurgia , Prótese de Quadril , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , ReoperaçãoAssuntos
Traumatismos da Medula Espinal/diagnóstico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico por imagem , Osteofitose Vertebral/complicações , Osteofitose Vertebral/diagnóstico por imagemRESUMO
Two cases of non-union of fractures of the carpal scaphoid in children are described, which were successfully treated by cancellous bone grafting with Kirschner wife fixation.
