Email this article Personalized preoperative planning in children with recurrent patellar dislocation severe
- Authors: Kotelnikov G.P.1, Lartsev Y.V.2, Povelihin A.K.2, Ryzhov P.V.2, Kudashev D.S.2, Zuev-Ratnikov S.D.2, Shmel’kov A.V.2, Bagdulina O.D.2
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Affiliations:
- Federal state budgetary educational institution of higher education "Samara state medical University" of the Ministry of health of the Russian Federation
- Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
- Issue: Vol 26, No 3 (2019)
- Pages: 31-36
- Section: Original study articles
- URL: https://journals.rcsi.science/0869-8678/article/view/47182
- DOI: https://doi.org/10.17116/vto201903131
- ID: 47182
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Abstract
The aim of the study: was to improve the results of treatment in children with recurrent severe patellar dislocation, through the development of a differentiated approach to preoperative planning.
Material and Methods. In SLLP Clinics Samara state medical University from 2014 to 2018 was observed 54 patients with this disease. In 37 patients recurrent severe dislocation. The average age of patients is 14.2 years. The patients underwent postural radiography of the lower extremities, radiography of the knee joint in the lateral projection, computed tomography of the knee joints, computed tomography of the hip joints. Research patients measured parameters, confirming mnohopocetny dysplastic changes of the joint angle Q, the index Insall—Salvati, the congruence angle on Merchant and anticarsia of the femoral head. Because of the severe degree of the disease, bone plastic surgery is indicated. Patients underwent corrective supracondylar derotationdialysisa osteotomy of the femur in combination with medialization and distalization of the tibial tuberosity. During this operation, it is possible to perform a correction in all three planes.
Results. In the postoperative period,32 patients have no complications,1 patient has relapse,4 patients have contracture. In the long-term postoperative period 86.5% of positive results and 13.5% of unsatisfactory results, which is much lower than 36.1% — the percentage of complications according to the medical literature.
Conclusion. The proposed personalized approach in preoperative planning for recurrent dislocation of the patella of severe degree, allows you to choose the best option for surgery
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##article.viewOnOriginalSite##About the authors
G. P. Kotelnikov
Federal state budgetary educational institution of higher education "Samara state medical University" of the Ministry of health of the Russian Federation
Email: phenicks-fire@mail.ru
doctor of medical Sciences Professor, Academician, head of chair of traumatology, orthopedics and extreme surgery
Russian Federation, SamaraYu. V. Lartsev
Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
Email: phenicks-fire@mail.ru
doctor of medical Sciences, Professor department of traumatology, orthopedics and extreme surgery, head of Department of traumatology and orthopedics №2
Russian Federation, SamaraA. K. Povelihin
Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
Email: phenicks-fire@mail.ru
doctor of medical Sciences, Professor department of traumatology, orthopedics and extreme surgery
Russian Federation, SamaraP. V. Ryzhov
Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
Email: ortosl@yandex.ru
PhD, associate professor department of traumatology, orthopedics and extreme surgery, head of children’s traumatological-orthopaedic department
Russian Federation, SamaraD. S. Kudashev
Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
Email: dmitrykudashew@mail.ru
PhD, assistant depart ment of traumatology, orthopedics and extreme surgery, doctor the traumatologist-orthopedist of traumatology and orthopedics №2
Russian Federation, SamaraS. D. Zuev-Ratnikov
Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
Email: stenocardia@mail.ru
PhD, assistant department of traumatology, orthopedics and extreme surgery, doctor the traumatologist-orthopedist of traumatology and orthopedics №2
Russian Federation, SamaraA. V. Shmel’kov
Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
Author for correspondence.
Email: phenicks-fire@mail.ru
ORCID iD: 0000-0001-6900-0824
fullime graduate student of the Department of traumatology, orthopedics and extreme surgery, doctor the traumatologist-orthopedist the children’s trauma and orthopedic department
Russian Federation, SamaraO. D. Bagdulina
Federal state budgetary educational institution of higher education 'Samara state medical University'of the Ministry of health of the Russian Federation
Email: Olga.bag.724@mail.ru
correspondence graduate student of the Department of traumatology, orthopedics and extreme surgery, doctor the traumatologist-orthopedist the children’s trauma and orthopaedic department
Russian Federation, SamaraReferences
- Маепраа Н., Lehto M.U. Patellar dislocation. The long-term results of nonoperative management in 100 patients. Am J Sports Med. 2003;25(2):213-7.
- Мовшович И.А. Оперативная ортопедия. Монография; 2006.
- [ Movshovich LA. Operative orthopedics. Monograph; 2006. (In Russ.)].
- Буравцов П.П., Сизова Т.В. Взаимосвязь врожденного вывиха надколенника с общими диспластическими изменениями в опорно-двигательной системе. Гений ортопедии. 2007;2:26-9. [Buravcov Р.Р., Sizova T.V. Interrelation of congenital dislocation of the patella with general dysplastic changes in the musculoskeletal system. Genius Orthopedics Journal. 2007;2:26-9. (In Russ.)].
- Garth W.P., Di Christina D.G., Holt G. Delayed proximal repair and distal realignment after patellar dislocation. Clin. Orthop. 2004;377:132-144.
- Грунтовский В.И. Метод оперативного лечения врожденного вывиха надколенника. Ортопед., травматол. 1981;10:56- 7. [Gruntovskiy V.I. Method of surgical treatment of congenital dislocation of the patella. Orthopedist., traumatol. 1981; 10:56-7. (In Russ.)].
- Johnson D., Amendola N.A., Barber F.A., Field L.D., Richmond J.C., Sgaglione N. Operative Arthroscopy. New York: Lippincott Williams & Wilkins,2013.
- Буравцов П.П., Гореванов Э.А., Мурадисинов С.О. Методы лечения вывиха надколенника в отечественных и зарубежных публикациях (обзор литературы). Гений ортопедии. 2006;3:69. [Buravcov P.P., Gorevanov Е.А., Muradisinov S.O. Methods of treatment of patellar dislocation in domestic and foreign publications (literature review). Genij ortopedii. 2006;3:69. (In Russ.)].
- Solomon L., Warwick D., Nayagam S. Apley’s System of Orthopaedics and Fractures, Ninth Edition. London: Hodder Arnold an Hachette UK Company,2010.
- Клименко И.Г. Диспластический рецидивирующий вывих надколенника (синдром нарушения равновесия). Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской Академии медицинских наук. 2013;5:93. [Klimenko I.G. Dysplastic recurrent dislocation of the patella (syndrome of imbalance). Bjulleten’ Vostochno- Sibirskogo nauchnogo centra Sibirskogo otdelenija Rossijskoj Akademii medicinskih nauk. 2013;5:93. (In Russ.)].
- Дохов M.M., Куркин C.A., Рубашкин С.А., Тимаев М.Х., Сертакова А.В., Герасимов В.А., Зверева К.П. Коррекция осевых деформаций нижних конечностей в детском возрасте. Проблемы ортопедии детского возраста. 2018;2:22- 5. [Dohov М.М., Kurkin S.A., Rubashkin S.A., Timaev M.H., Sertakova A.V., Gerasimov V.A., Zvereva K.P. Correction of axial deformities of the lower extremities in childhood. Problemy ortopedii detskogo vozrasta. 2018;2:22-5. (In Russ.)].
- Ворончихин E.B., Кожевников В.В., Тимофеев В.В. Диагностика и лечение последствий травм коленного сустава у детей. Основные направления отечественной травматологии и ортопедии. М.,2016. [Voronchihin E.V., Kozhevnikov VV, Timofeev VV Diagnosis and treatment of the consequences of knee injuries in children] Osnovnye napravleniya otechestvermoj travmatologii i ortopedii. M.,2016. (In Russ.)].
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