ESTIMATING THE FUNCTIONAL STATE OF THE HIP JOINT AND LIFE QUALITY AFTER SURGICAL TREATMENT OF LEGG-CALVE-PERTHES DISEASE
S. I. Golovkin , N. A. Shabaldin , F. V. Titov , G. N. Krasavin , V. B. Bakovsky , D. G. Gibadullin
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ›› 2017, Vol. 7 ›› Issue (2) : 19 -27.
ESTIMATING THE FUNCTIONAL STATE OF THE HIP JOINT AND LIFE QUALITY AFTER SURGICAL TREATMENT OF LEGG-CALVE-PERTHES DISEASE
Purpose: comparative analysis of the functional state of the hip joint and life quality in children following various types of surgical treatment of Legg-Calve-Perthes disease.
Materials and methods: the surgery was performed in two groups of patients with Perthes disease. In the first group consisting of 12 children, the proximal portion of the femur was stabilized using a L- shaped plate. In the second group, 29 patients were operated using the internal method and intramedullary titanium elastic nail (TEN) fixation. According to TEN, medialization, varization and elimination of the epiphyseal subluxation of the femoral fragment are performed immediately using two flexible elastic rods. Functional capabilities of the operated joint were estimated radiologically and using the Iowa Hip Score. Patients (n=41) operated using various methods
were included in the perspective health-related study of life quality. They used the MOS 36‑item short-form health survey.
Results: dynamics of restoration of the operated joint using the proposed method occurred from 1.5 to 1.7 years in one group, and within 2.4 years in the other group. Analyzing the results obtained in the study of functional outcomes and life quality, we found the advantages of TEN osteosynthesis in treatment of Legg- Calve-Perthes disease in children leading to the soonest positive physophysical treatment result.
Conclusion: pathogenetically substantiated method of surgical treatment of the 2nd and 3rd stage of Legg-Calve-Perthes disease in children is intramedullary titanium elastic nail (TEN) fixation. The minimally invasive and effective method of surgery promotes early vertical orientation of the patient without specific prevention of depressive and asthenic states and improves the patient’s life quality in the early and remote period.
Perthes disease / hip joint / life quality / children
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Golovkin S.I., Shabaldin N.A., Titov F.V., Krasavin G.N., Bakovsky V.B., Gibadullin D.G.
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