Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients

Ramazanov, Rafik; yılmaz, guney; KAMACI, SAYGIN; aksoy, cemalettin; Kaymakoglu, Mehmet

doi:10.52312/jdrs.2021.1

Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients

Saygın KAMACI, (Hacettepe Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Mehmet KAYMAKOĞLU, (Bornova Türkan Özilhan Devlet Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalı, İzmir, Türkiye)

Rafik RAMAZANOV, (Hacettepe Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Mehmet Cemalettin AKSOY, (Hacettepe Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Güney YILMAZ (Hacettepe Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara, Türkiye)

Joint diseases and related surgery

0 0

Yıl: 2021 Cilt: 32 Sayı: 2 Sayfa Aralığı: 454 - 460 Metin Dili: İngilizce DOI: 10.52312/jdrs.2021.1 İndeks Tarihi: 13-10-2021

Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients

Öz:

Objectives: The aim of this study is to investigate whether rigidfixation after triple pelvic osteotomy (TPO) utilizing a 3.5-mmlocking plate and screws without hip spica cast can provide enoughstability and prevent correction loss in pediatric patients withdevelopmental dysplasia of the hip (DDH) and Legg-Calvé-Perthesdisease (LCPD).Patients and methods: A total of 21 hips of 21 pediatric patients(9 males, 12 females; mean age: 9.3±2.0 years; range, 6 to 14 years)who underwent rigid fixation with locking plate/screws after TPOfor DDH and LCPD between June 2015 and October 2018 wereretrospectively analyzed. Preoperative, immediate postoperative,and six-month follow-up anteroposterior radiographs werecompared for the Wiberg’s center-edge angle (CE), Sharp angle,acetabular coverage of the femoral head (ACFH), and center-headdistance discrepancy (CHDD). The patient demographics, surgerytime, perioperative complications were evaluated.Results: Underlying diagnosis were DDH in 14 patients andLCPD in seven patients. In patients with DDH, postoperativeevaluation showed significant increase in the mean CE angle(5.6±16.1° vs. 30.5±9.3°, respectively) and ACFH (46.4±16.8%vs. 84.5±12.1%, respectively), and a significant decrease inthe mean Sharp angle (55.3±6.2° vs. 35.6±7.8°, respectively)and CHDD (14.6±10.7% vs. 6.2±5.6%, respectively). Thefinal follow-up revealed that there was no correction loss inthese parameters. In the patients with LCPD, postoperativeevaluation showed a significant increase in the mean CE(20.1±11.1° vs. 38.3±9.6°, respectively) and ACFH (62.9±18%vs. 91.4±10.1%, respectively), and a significant decrease in themean Sharp angle (46±3.6° vs. 25.2±5.5°, respectively). Thefinal follow-up revealed that there was no correction loss inradiological parameters. No perioperative complications werenoted.Conclusion: Our study results suggest that rigid fixation constructwith a 3.5-mm locking plate and screws without hip spica cast canprovide adequate stability to allow early mobilization followingTPO in children without any loss of correction, until bony healingat the osteotomy sites.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Le Coeur P. Orientation of the hip joint by osteotomy of the ischium and ilium. Rev Chir Orthop 1965;51:211–212.
2. Chen IH, Kuo KN, Lubicky JP. Prognosticating factors in acetabular development following reduction of developmental dysplasia of the hip. J Pediatr Orthop 1994;14:3-8.
3. Herring JA, Kim HT, Browne R. Legg-Calve-Perthes disease. Part II: Prospective multicenter study of the effect of treatment on outcome. J Bone Joint Surg [Am] 2004;86:2121-34.
4. Peters CL, Fukushima BW, Park TK, Coleman SS, Dunn HK. Triple innominate osteotomy in young adults for the treatment of acetabular dysplasia: A 9-year follow-up study. Orthopedics 2001;24:565-9.
5. Terjesen T, Horn J. Management of late-detected DDH in children under three years of age: 49 children with followup to skeletal maturity. Bone Jt Open 2020;1:55-63.
6. Steel HH. Triple osteotomy of the innominate bone. 1973. J Bone Joint Surg [Am] 2004;86:644.
7. de Kleuver M, Kooijman MA, Pavlov PW, Veth RP. Triple osteotomy of the pelvis for acetabular dysplasia: Results at 8 to 15 years. J Bone Joint Surg Br 1997;79:225-9.
8. Carlioz H, Khouri N, Hulin P. Ostéotomie pelvienne triple juxta-cotyloïdienne. Rev Chir Orthop 1982;68:497–501.
9. Tönnis D, Behrens K, Tscharani F. A modified technique of the triple pelvic osteotomy: Early results. J Pediatr Orthop 1981;1:241-9.
10. Eren A, Omeroglu H, Güven M, Ugutmen E, Altintas F. Incomplete triple pelvic osteotomy for the surgical treatment of dysplasia of the hip in adolescents and adults. J Bone Joint Surg [Br] 2005;87:790-5.
11. Camurcu IY, Yildirim T, Buyuk AF, Gursu SS, Bursali A, Sahin V. Tönnis triple pelvic osteotomy for Legg-CalvePerthes disease. Int Orthop 2015;39:485-90.
12. Vukasinovic Z, Spasovski D, Vucetic C, Cobeljic G, Zivkovic Z, Matanovic D. Triple pelvic osteotomy in the treatment of Legg-Calve-Perthes disease. Int Orthop 2009;33:1377-83.
13. Conroy E, Sheehan E, O' Connor P, Connolly P, McCormack D. Triple pelvic osteotomy in Legg-Calve-Perthes disease using a single anterolateral incision: A 4-year review. J Pediatr Orthop B 2010;19:323-6.
14. Janssen D, Kalchschmidt K, Katthagen BD. Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip. Int Orthop 2009;33:1555-9.
15. Vukasinovic Z, Pelillo F, Spasovski D, Seslija I, Zivkovic Z, Matanovic D. Triple pelvic osteotomy for the treatment of residual hip dysplasia. Analysis of complications. Hip Int 2009;19:315-22.
16. Lipton GE, Bowen JR. A new modified technique of triple osteotomy of the innominate bone for acetabular dysplasia. Clin Orthop Relat Res 2005;(434):78-85.
17. van Hellemondt GG, Sonneveld H, Schreuder MH, Kooijman MA, de Kleuver M. Triple osteotomy of the pelvis for acetabular dysplasia: Results at a mean follow-up of 15 years. J Bone Joint Surg [Br] 2005;87:911-5.
18. Özcan Ö, Yeşil M, Altın R. Triple nonunion after steellike triple pelvic osteotomy. Eklem Hastalik Cerrahisi 2018;29:193-7.
19. Wiberg G. Shelf operation in congenital dysplasia of the acetabulum and in subluxation and dislocation of the hip. J Bone Joint Surg [Am] 1953;35-A:65-80.
20. Sharp IK. Acetabular Dysplasia-the Acetabular Angle. J Bone Joint Surg [Br] 1961;43:268-72.
21. Wenger DR, Pring ME, Hosalkar HS, Caltoum CB, Lalonde FD, Bastrom TP. Advanced containment methods for LeggCalvé-Perthes disease: results of triple pelvic osteotomy. J Pediatr Orthop 2010;30:749-57.
22. EzirmikN,YıldızK.SalterinnominateosteotomyorPemberton pericapsular osteotomy in treatment of developmental dysplasia of hip. Turk J Med Sci 2012;42:1058-62.
23. Rahimi H, Kachooei AR, Hallaj-Moghaddam M, Gharedaghi M, Mirkazemi M, Shahpari O, et al. A modified triple pelvic osteotomy for the treatment of hip hypoplasia. Arch Bone Jt Surg 2013;1:31-4.
24. Farsetti P, Caterini R, De Maio F, Potenza V, Efremov K, Ippolito E. Tönnis triple pelvic osteotomy for the management of late residual acetabular dysplasia: Midterm to long-term follow-up study of 54 patients. J Pediatr Orthop B 2019;28:202-6.
25. Tschauner C, Sylkin A, Hofmann S, Graf R. Painful nonunion after triple pelvic osteotomy. Report of five cases. J Bone Joint Surg [Br] 2003;85:953-5.
26. Yilmaz E, Damla H, Norvell DC, Kalchschmidt K, Luering C, Zahedi AR. Risk factors associated with non-union after triple pelvic osteotomy (Toennis and Kalchschmidt technique): A case-control study and review of the literature. Arch Orthop Trauma Surg 2019;139:173-80.

APA	KAMACI S, Kaymakoglu M, Ramazanov R, aksoy c, yılmaz g (2021). Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. , 454 - 460. 10.52312/jdrs.2021.1
Chicago	KAMACI SAYGIN,Kaymakoglu Mehmet,Ramazanov Rafik,aksoy cemalettin,yılmaz guney Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. (2021): 454 - 460. 10.52312/jdrs.2021.1
MLA	KAMACI SAYGIN,Kaymakoglu Mehmet,Ramazanov Rafik,aksoy cemalettin,yılmaz guney Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. , 2021, ss.454 - 460. 10.52312/jdrs.2021.1
AMA	KAMACI S,Kaymakoglu M,Ramazanov R,aksoy c,yılmaz g Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. . 2021; 454 - 460. 10.52312/jdrs.2021.1
Vancouver	KAMACI S,Kaymakoglu M,Ramazanov R,aksoy c,yılmaz g Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. . 2021; 454 - 460. 10.52312/jdrs.2021.1
IEEE	KAMACI S,Kaymakoglu M,Ramazanov R,aksoy c,yılmaz g "Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients." , ss.454 - 460, 2021. 10.52312/jdrs.2021.1
ISNAD	KAMACI, SAYGIN vd. "Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients". (2021), 454-460. https://doi.org/10.52312/jdrs.2021.1

APA	KAMACI S, Kaymakoglu M, Ramazanov R, aksoy c, yılmaz g (2021). Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. Joint diseases and related surgery, 32(2), 454 - 460. 10.52312/jdrs.2021.1
Chicago	KAMACI SAYGIN,Kaymakoglu Mehmet,Ramazanov Rafik,aksoy cemalettin,yılmaz guney Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. Joint diseases and related surgery 32, no.2 (2021): 454 - 460. 10.52312/jdrs.2021.1
MLA	KAMACI SAYGIN,Kaymakoglu Mehmet,Ramazanov Rafik,aksoy cemalettin,yılmaz guney Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. Joint diseases and related surgery, vol.32, no.2, 2021, ss.454 - 460. 10.52312/jdrs.2021.1
AMA	KAMACI S,Kaymakoglu M,Ramazanov R,aksoy c,yılmaz g Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. Joint diseases and related surgery. 2021; 32(2): 454 - 460. 10.52312/jdrs.2021.1
Vancouver	KAMACI S,Kaymakoglu M,Ramazanov R,aksoy c,yılmaz g Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients. Joint diseases and related surgery. 2021; 32(2): 454 - 460. 10.52312/jdrs.2021.1
IEEE	KAMACI S,Kaymakoglu M,Ramazanov R,aksoy c,yılmaz g "Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients." Joint diseases and related surgery, 32, ss.454 - 460, 2021. 10.52312/jdrs.2021.1
ISNAD	KAMACI, SAYGIN vd. "Preliminary results of rigid fixation (locking plate/screw) after triple pelvic osteotomy without a hip spica cast: A modified fixation method in 21 patients". Joint diseases and related surgery 32/2 (2021), 454-460. https://doi.org/10.52312/jdrs.2021.1