The aim of the present contribution is to explore the possible surgical solution of the problem of dislocation of the hip secondary to infantile septic arthritis, particularly in the form in which the femoral head is totally destroyed. The operation of trochanteroplasty is based on transposing the intact epiphysis of the great trochanter to act as a new femoral head and subsequently restoring the correct anatomical alignment by a trochanteric adduction osteotomy. Sixteen cases so treated over the 11 year period from 1969 to 1980 are reported.

Acetabulum↗

PubMed1984

Congenital aplasia of the tibia.

The authors carried out a study of 15 patients with congenital aplasia of the tibia, 12 total and 6 partial. The clinical and radiographic characteristics of this severe deformity are discussed in relation to the classification and indications for treatment. The authors, whose preference is towards reconstructive surgery, had good results in the partial forms whilst in the total form reconstruction of a new knee joint gave functionally worthwhile results in exceptional cases.

Abnormalities, Multiple↗

PubMed1975

[A case of tibial localization of echinococcal cysts].

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Adult↗

PubMed1975

[Diffuse metastases from pancreatic carcinoma].

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Adenocarcinoma, Mucinous↗

PubMedDate not supplied

Congenital pseudarthrosis of the tibia associated with neurofibromatosis-1: treatment with Ilizarov's device.

We reexamined 21 patients with congenital pseudarthrosis of the leg (congenital pseudoarthrosis of the tibia; CPT) associated with neurofibromatosis-1 (NF-1), > or =2 years after the termination of treatment, for a statistical study of the results obtained by using Ilizarov's external fixator. Of the 21 tibias operated on, 17 consolidated after the first treatment, whereas four did not. Of the 17 consolidated tibias, four refractured and were retreated by using a variety of methods. Only one healed. At follow-up, which occurred > or =2 years after the removal of the fixator, the results were nine consolidations without deformities or with shortening <2 cm, five consolidations with axial deviation, and seven nonconsolidations. The statistically significant results were that (a) patients who were aged 5 years or older at operation had better results, and (b) the assembly II (resection of CPT stumps and their short-term compression possibly associated with corticotomy or epiphyseal distraction to correct limb discrepancy) gave better final results compared with the other device assemblies. We conclude that treatment with Ilizarov's fixator allows (a) a good percentage of healing over time (66.7%), especially in cases of normotrophic and cystic CPT; (b) further operations with or without the fixator to correct secondary or residual axial deviation; and (c) correction of limb discrepancy. This treatment avoids risking injury to the healthy contralateral leg. Additionally, for treatments that do not achieve satisfactory results, other treatment methods are not excluded. The CPT still remains a difficult problem for the orthopedic surgeon to solve.

Adolescent↗

PubMedDate not supplied

Congenital pseudarthrosis of the fibula.

Three cases of congenital pseudarthrosis of the fibula are reported, all with prepseudarthrotic involvement of the omolateral tibia. In patients with this condition, correction of valgus deformity should be deferred until puberty, and the occurrence of tibial fractures should be prevented by means of leg splints.

Child↗

PubMedDate not supplied

Tibial lengthening according to Ilizarov in congenital hypoplasia of the leg.

Thirteen patients with leg length discrepancy due to congenital tibial hypoplasia were treated by the Ilizarov lengthening method. Advantages and disadvantages as compared with the Wagner and Anderson methods are reported, as well as with complications and results.

Adolescent↗

PubMedDate not supplied

Comparison of different methods of leg lengthening.

Corticotomy according to Ilizarov was used for the treatment of congenital leg length discrepancies from June 1984 to June 1986. A comparison of the results of this method and previously performed methods has been made.

Bone Lengthening↗

PubMedDate not supplied

Osteoid osteoma of the vertebral body: a clinical case.

The authors describe a case of lumbar vertebral osteoid osteoma localized in the body of L5 characterized by a very subtle clinical onset (limping as a result of poor positioning of the hip), and by a clinical course where pain was totally absent.

Bone Neoplasms↗

PubMedDate not supplied

Intra-articular deformities of the knee in congenital hypoplasias of the lower limb: an arthroscopic study.

A knowledge of the morphology of the cruciate ligaments in congenital hypoplasias of the lower limb, susceptible to treatment to even the length discrepancy, is of practical importance in the prevention of subdislocation and dislocation of the knee during the distraction phase of femoral and/or tibial lengthening. The authors report their experience with 20 arthroscopies diagnosed in 20 children affected with congenital hypoplasia of the lower limb (shoft congenital femur, longitudinal peroneal hemimelia) performed prior to assembling the Ilizarov external fixator for femoral and/or tibial lengthening. None of the patients had congenital dislocation of the knee or knee with recurvation. In the patients in our study, it is possible to demonstrate that the anatomical cause of instability of the knee in congenital hypoplasias of the lower limb may be constituted by aplasia of one or both cruciate ligaments.

Arthroscopy↗

PubMedDate not supplied

Osteoid osteoma of the lumbar spine. A case report.

The authors report the case of a patient aged 10 years with late diagnosis of osteoid osteoma localized in the right pedicle of L1 due to a paucisymptomatic and aspecific clinical onset, characterized only by the occurrence of left-convex wide-range scoliosis that was completely solved after surgical excision of the neoformation.

Child↗

PubMedDate not supplied

Fracture of the lesser trochanter.

Isolated fracture or detachment of the lesser trochanter is an infrequent occurrence. In most cases the event is part of a complex of fractures involving the femoral neck and the greater trochanter. Isolated fracture caused by direct trauma is rare because of the anatomical location of the lesser trochanter which is protected anteriorly and posteriorly by large muscular masses, superiorly by the head and the neck of the femur, laterally by the femur itself, and medially by the ilio- and ischio-public branches of the pelvis. Trauma is usually indirect, caused by sudden traction by the iliopsoas muscle on the femoral tendinous insertion. The highest frequency is observed in young patients who are still growing where there is an imbalance between muscular strength and resistance of the osteochondral plate of the tendinous insertion. Particularly affected are adolescent athletes of male sex aged from 13 to 17 years. Similar overloading of traction in an adult would probably produce only muscular stretching. Diagnosis is based on radiographic ascertainment, obtained with the thigh in extra-rotation, supported by rather typical clinical findings such as acute pain in the inguinal region and in Scarpa's triangle, limping, passive movement of the hip in all directions with pain in maximum extension and relief when seated. Nonsurgical treatment with the limb resting in flexion, further confirmed by the case presented in this study, still remains the treatment of choice in most cases, obtaining excellent functional results. The authors believe that it was of interest to report this clinical case because of the rareness of the pathology observed and because of the specific features of its etiology.

Adolescent↗

PubMedDate not supplied

Treatment of the sequelae of septic osteoarthritis of the hip during pediatric age.

A total of 69 cases (73 hips) of the sequelae of septic osteoarthritis of the hip are studied. The sequelae are classified based on whether or not the femoral epiphysis is present, and on stability of the joint according to Hunka (1982). Three of the hips were treated non-surgically. All of the others were submitted to from a minimum of 2 to maximum of 5 operations with the purpose of re-establishing joint relationships. The results were: good: 50 hips (72.5%); fair 12 (17.4%); poor: 11 (16%). The most significant sequelae were hip instability, joint function limitation, and shortening of the limb.

Arthritis, Infectious↗

PubMedDate not supplied

The external fixator in the treatment of closed diaphyseal fractures of the lower limb during childhood. Indications and limits.

The authors successfully used an external fixator in 10 children affected by one of the following pathologies: fracture of the femur with poor consolidation and marked shortening of the limb; fracture in a hypoplastic segment; severe multiple trauma; delay in consolidation of pathologic bone; fracture in bone regeneration. On the basis of the results obtained, it is affirmed that the external fixator is the ideal means of osteosynthesis for use in any of the above-described situations.

Adolescent↗