choice of surgical tactics for the treatment of children with destructive pathological dislocation of the hip after hematogenous osteomyelitis

A surgical approach to the treatment of destructive pathological dislocation of the hip in children has been substantiated, depending on age, the severity of destruction of the proximal femur and acetabulum. Reconstructive - restorative operations in most patients ensure the stability of the hip joint and thereby improve the patient's gait and statics, reduce the pelvic misalignment and eliminate the Trendelenburg symptom. The experience of surgical treatment of patients with pathological hip dislocations has shown that the most favorable outcomes are achieved with the use of open reduction of the stump of the head or neck of the femur with intertrochanteric detorsion shortening and varizing osteotomy with rotational pelvic osteotomy according to Salter and acetabular plasty according to Pemberton.

Restoration of neglected fracture dislocation hip in elderly: a case report

<p class="abstract">Neglected traumatic fracture dislocation of the hip is a challenging problem due to soft tissue contractures, adhesions, fibro fatty tissue filling acetabulum, avascular necrosis, arthritis and myositis ossificans. These types of injury often get missed at initial evaluation in the presence of distracting injuries and in poly trauma patients. Femoral head fractures account for only 7-16% of all hip fracture dislocations, with combined femoral head and acetabular fractures in elderly being even lower. Literature favours primary hip replacement as compared to hip salvage in age above 60 years and in patients with neglected hip fracture dislocations of more than 3 months duration due to high chances of afore mentioned complications. Here, we report a case of 69 years old male with neglected hip fracture dislocation associated with posterior acetabular wall and femoral head fracture for the challenges in management with a total hip replacement.</p>

Reconstructive and restorative interventions at the proximal end of the thigh and pelvic bones in destructive pathological dislocation of the hip in children after hematogenous osteomyelitis

It is generally known that children tend to get injured more easily than adults. Moreover, these injuries they get in growing period may leave for long in the forms of disability. This paper is about reconstructive and restorative interventions at the proximal end of the thigh and pelvic bones in destructive pathological dislocation of the hip in children after hematogenous osteomyelitis. After hematogenous osteomyelitis of the proximal end of the femur, destruction of the head and neck of the femur is often observed, up to their destruction. The optimal age for surgical treatment of pathological dislocation of the hip, according to our data, is 4-5 years of age of the child, because by this time the process of ossification of the structures of the hip joint ends in most patients, and early surgical intervention often causes severe secondary deformities, up to their destruction.

Treatment of congenital dislocation of the hip in young children Jaeger (Surg. Gyn. A. Obst. V. 50, No. 4)

Jaeger (Surg. Gyn. A. Obst. V. 50, No. 4) gives 2 cases of successful treatment of congenital hip dislocation in young children. In contrast to the generally accepted late reduction, when the deformation of the glenoid cavity has already gone far, the author proposes to set it early.

Complex fracture pattern involving ipsilateral intertrochanteric fracture associated with ipsilateral posterior hip dislocation and posterior acetabular wall fracture: A rare combination of injuries

Introduction:High-energy trauma has increased the incidence of traumatic hip dislocation. In most cases, dislocation of the hip is associated with fractures of the acetabulum. However, its association with ipsilateral intertrochanteric fracture is very rare. Case Report:We present a case of a 54-year-old male who had uncommon fracture pattern involving ipsilateral intertrochanteric femur fracture associated with ipsilateral posterior fracture dislocation of hip following a road traffic accident. He underwent closed reduction of the dislocation followed by an open reduction and internal fixation of the fractures. Through Kocher-Langenbeck approach, the intertrochanteric fracture was reduced and fixed with dynamic hip screw and derotation anti-rotation screw. Acetabulum fractures then fixed after reduction with two reconstruction plates. Conclusion:Early recognition and orthopedic intervention constitute the cornerstones of satisfactory outcomes in cases with such complex injuries. Keywords:Posterior hip dislocation, acetabular fractures, intertrochanteric fracture.