Hernández S, Haces F, Orellana C

Language: Spanish
References: 9
Page: 24-30
PDF size: 1141.45 Kb.

ABSTRACT

The goal of this article, is to value the clinical and radiological results in the surgical treatment in septic arthritis of the hip. We made the study of 62 patients with 69 hips from 1985 to 1997 in Shriners Hospital Mexico City. The range that followed up was from 3 to 10 years, with average 12.2% in 2 to 19 years old children with average of 4.6 years old. Using Hunka classification we made; five groups; 10 hips type I, 2 with Hunka IIA, 4 hips type IIB, 7 hips type IVA, 14 type IVB and 32 type V: surgical treatment was: Weissman technique in 18 hips, Weissman and Salter osteotomy in 12 hips, open reduction with Salter osteotomy in 9, only open reduction in 9 hips, Shelf and Chiari osteotomy in 4 and proximal femur valguizant osteotomy in 3 hips. The results from surgical treatment and Hunka classification was 14.49% with Hunka type I (10 hips), type IIA 2.89% (2 hips), type IIB 5.79% (4 hips); All of them with excellent or good results; the patients with Hunka IVA was 7 hips (10.14%), at all with 5 hips (7.24%) excellent or good results, 1 (1.44%) with regular, 1 (1.44%) with bad results. Fourteen hips with Hunka IVB (20.28%), 7 (10.24%) excellent or good results; 3 (4.34%) regular and 4 (5.79%) bad results; the 32 hips (46.37%) with Hunka V, 16 (23%) was excellent or good, 6 (8.64%), regular and 10 (14.46%) with bad results. All of 69 hips; 55 (79.79%) get surgical treatment, 44 (63.76%) with non surgical treatment with excellent and good results, 10 hips with regular and 15 (21.73%) with bad results. Six patients with hip pain get well in 3, 16 patients with different length in lower limbs, 9 was treated with lengthening and 7 without surgery. The prognosis of the hip with Hunka type I and II is good, the management is non surgical in type IIA and IIB, the point is the containment of the hip and good coverage with adductors release and open reduction and proximal femoral osteotomy. In type III is a difficult management, for type IV and V, the Weissman technique, proximal femoral osteotomy, Salter osteotomy, open reduction or both are a good alternative of treatment to get wall the function of the hip.

REFERENCES

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