Triple pelvic osteotomy was performed for sequel of DDH including AVN between 1981 and 2002 for 329 patients (351 hips, 280 females, 49 males, average age at surgery 16.5 years, range 9-41 years, follow-up 4-25 years). A small modification of Steel's technique consisting of strictly subperiostal resection of segment from both pubic and ischial bone was used. Average gain of lengthening extremity was 1.8 cm. The average CE angle was improved from 7.8 to 35.5 degrees. Clinical results were evaluated according to Merle d'Aubigne and reflected to the preoperative clinical and radiological findings. There were 146 hip joints in 128 patients (76%) with excellent results in the group of congruent hips without arthrosis. In 182 hips in 178 patients with hip joints with some deformity, limited ROM and decentration, 40% were excellent, 32% good, 23% fair and 5% unsatisfactory results were achieved. The group of decentrated hip joints in young adults in incongruency, limited ROM and sometimes severe arthrosis consisted of 23 monolateral surgeries with 39% unsatisfactory, 39% fair and 22% good results, respectively. No major neurovascular complications were seen. Non-unions were recorded in 19 patients (5.4%), including 2 triple and 2 double non-unions. Based on our long-term experience, we can conclude that triple pelvic osteotomy according to Steel in our modification is a safe method and gives regularly excellent or good results for correction of clinical and radiographic appearance of acetabular dysplasia when there is a proper indication.

• Publikační typ
• časopisecké články MeSH

Kuwait has a very high incidence of all types of developmental dysplasia of the hip. One of the most complicated forms is the deformed dysplastic acetabulum, which has not only abnormal orientation but it also has lost its shape by the pressure of the subluxed femoral head. The outer part of the socket involves the upper part of the original acetabulum, thus giving it a bipartite appearance. Clear border like edge separates this outer part from the inner part, which represents the lower part of the original acetabulum and it has no direct contact with the femoral head. Combined pelvic osteotomy (CPO) restores both the original shape and treats the malalignment of the acetabulum. Twelve children, aged between 18 and 54 months underwent CPO, two of them bilaterally. The follow up is between 36 - 60 months. In all cases, concentric stable reduction with good acetabular cover was obtained.

• MeSH
• acetabulum chirurgie   MeSH
• kojenec MeSH
• lidé MeSH
• následné studie MeSH
• osteotomie * MeSH
• pánevní kosti chirurgie   MeSH
• předškolní dítě MeSH
• vývojová kyčelní dysplazie chirurgie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: The rhomboid flap method (RFM) is a new technique for primary skin closure utilizing a modified posteromedial approach to cover skin and soft tissue defect, which is the result of full correction of the severe club foot deformity. SETTING: Al-Razi Orthopedic Hospital, Kuwait. METHOD: The vertical incision of the posteromedial approach declines laterally at approximately 30 degrees from midline, which widens the rhomboid flap thus, preserving blood supply to the flap and preventing scar adhesions to the Achilles tendon. After full correction, the stretched rhomboid flap covers the wound. RESULTS: The RFM was used in 51 patients aged between six months and 8.5 years. The follow-up was between 11 and 48 months. The RFM was used in 62 cases: 59 primary surgeries and three revisions of previous surgeries. Sufficient skin cover was achieved in all cases. In 59, healing was by primary intention and in three necroses smaller than one square centimeter developed. CONCLUSION: The RFM proved to be a beneficial method in the treatment of severe clubfoot in the concerned age group.

• MeSH
• chirurgické laloky * MeSH
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• noha (od hlezna dolů) chirurgie   MeSH
• pes equinovarus chirurgie   MeSH
• předškolní dítě MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

This paper evaluates the results of conservative treatment for developmental dysplasia of the hip after an average follow-up of 3 years in 69 patients and 99 hips: 31 bilateral, 23 left side, and 14 right. They were treated at the Al-Razi Hospital, Kuwait, between January 1995 and December 1996. There were 59 girls and 10 boys aged between 5 months and 24 months (average age 12 months). The treatment consisted of traction for 1 or 2 weeks, followed by manipulation in 36 hips and manipulation with adductor longus tenotomy in 45 hips and with adductor longus and psoas tenotomy in 18 hips. Avascular necrosis of the femoral head developed in 16 hips (16%): 14 hips on the affected side and 2 hips on the unaffected side. Persistent acetabular dysplasia was present in 13 hips, subluxation in 9 hips and dislocation in 13 hips. Open reduction was later required in 5 hips, open reduction and innominate osteotomy in 8 hips, and hip extracapsular innominate osteotomy in 1 hip. The results were evaluated according to the age groups with highest rate of complications after the age of 15 months. The treatment protocol was changed to limit conservative treatment until the age of 14 months.

• MeSH
• kojenec MeSH
• lidé MeSH
• manipulace ortopedická MeSH
• retrospektivní studie MeSH
• trakce MeSH
• vývojová kyčelní dysplazie komplikace   chirurgie   terapie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kuvajt MeSH

The supracondylar fracture of the humerus is one of the most common in children, approximately one hundred per year, in Kuwait. The treatment consists in manipulation and fixation by plaster of Paris in the most stable position, usually maximal possible flexion in the elbow joint. For irreducible or unstable cases a percutaneous fixation by Kirschner wires was introduced in September 1993. Two or three Kirschner wires were used either parallel from radial condyle or cross fixation from ulnar and radial condyle. Cross fixation was used in older children without swelling of the elbow. This method has helped to reduce and stabilize the fracture allowing fixation of the elbow at 90 degrees flexion reducing the risk of the blood supply disturbance. The aim of this study was to find rules for proper selection of these two types of fixation.

• MeSH
• dítě MeSH
• fraktury humeru chirurgie   MeSH
• kojenec MeSH
• kostní hřeby * MeSH
• lidé MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• vnitřní fixace fraktury metody   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Long-term results of traction treatment for congenital hip dislocation (CDH) performed between 1984 and 1990 are presented. The new traction scheme consists of 4 distinctive phases. It is based on gradually changed direction of traction--first, from the longitudinal direction to flexion and abduction against the hypomochilion. The traction is applied by means of non irritable adhesive tape using 1/4-1/5 of the child's body weight. The period of active traction is followed by retention period in Hanausek's biomechanical device. The success rate of the scheme, in terms of reduction, was 90 per cent. In 31 per cent the Salter innominate osteotomy was performed because of residual deformity. In 10 per cent of the cases open reduction was necessary.

• MeSH
• časové faktory MeSH
• kojenec MeSH
• kombinovaná terapie MeSH
• kyčelní kloub diagnostické zobrazování   MeSH
• lidé MeSH
• následné studie MeSH
• radiografie MeSH
• trakce přístrojové vybavení   metody   statistika a číselné údaje   MeSH
• vývojová kyčelní dysplazie diagnostické zobrazování   epidemiologie   terapie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Long-term results of Ludloff's open reduction of the hip were studied in 62 joints of 56 children with an average follow-up of 11 years (range 5-18 years). Results were considered good in 76% and poor in 24%. A decisive factor in assessing long-term results was a proper centric reduction of the femoral head. The most frequent obstacles to proper reduction were a shortened inferomedial part of a joint capsule with the transverse ligament pulled into the joint cavity (14%), joint capsule contracture (100%), and an inverted limbus (92%), which was accompanied in 17% of patients by an impression of reflected head of the rectus femoris. Earlier nonoperative treatment affected the success of the reduction as well as long-term results.

• MeSH
• kojenec MeSH
• lidé MeSH
• následné studie MeSH
• ortopedie metody   MeSH
• vývojová kyčelní dysplazie chirurgie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• Perthesova nemoc chirurgie   MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• acetabulum chirurgie   MeSH
• artritida chirurgie   MeSH
• dospělí MeSH
• kyčelní kloub chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• osteotomie * MeSH
• vývojové onemocnění kostí chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• vývojová kyčelní dysplazie chirurgie   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH