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Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases
BACKGROUND: Ganz surgical hip dislocation is useful in the management of severe hip diseases, providing an unobstructed view of the femoral head and acetabulum. We present our early experience with this approach in pediatric hip diseases. METHODS: Twenty-three hips of 21 patients with pediatric hip...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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The Korean Orthopaedic Association
2009
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766743/ https://www.ncbi.nlm.nih.gov/pubmed/19885048 http://dx.doi.org/10.4055/cios.2009.1.3.132 |
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author | Shin, Sung Jin Kwak, Hong-Seok Cho, Tae-Joon Park, Moon Seok Yoo, Won Joon Chung, Chin Youb Choi, In Ho |
author_facet | Shin, Sung Jin Kwak, Hong-Seok Cho, Tae-Joon Park, Moon Seok Yoo, Won Joon Chung, Chin Youb Choi, In Ho |
author_sort | Shin, Sung Jin |
collection | PubMed |
description | BACKGROUND: Ganz surgical hip dislocation is useful in the management of severe hip diseases, providing an unobstructed view of the femoral head and acetabulum. We present our early experience with this approach in pediatric hip diseases. METHODS: Twenty-three hips of 21 patients with pediatric hip diseases treated using the Ganz surgical hip dislocation approach were the subjects of this study. The average age at the time of surgery was 15.7 years. There were 15 male and 6 female patients who were followed for an average of 15.1 months (range, 6 to 29 months). Diagnoses included hereditary multiple exostoses in 9 hips, slipped capital femoral epiphysis in 7, Legg-Calvé-Perthes disease in 4, osteoid osteoma in 1, pigmented villonodular synovitis in 1, and neonatal septic hip sequelae in 1. Medical records were reviewed to record diagnoses, principal surgical procedures, operative time, blood loss, postoperative rehabilitation, changes in the range of hip joint motion, and complications. RESULTS: Femoral head-neck osteochondroplasty was performed in 17 patients, proximal femoral realignment osteotomy in 6, open reduction and subcapital osteotomy for slipped capital femoral epiphysis (SCFE) in 2, core decompression and bone grafting in 2, hip distraction arthroplasty in 2, and synovectomy in 2. Operative time averaged 168.6 minutes when only osteochondroplasty and/or synovectomy were performed. Hip flexion range improved from a preoperative mean of 84.7° to a mean of 115.0° at the latest follow-up visit. Early continuous passive motion and ambulation were stressed in rehabilitation. No avascular necrosis of the femoral head was noted up to the time of the latest follow-up visit, except for in one SCFE patient whose surgical intervention was delayed for medical reasons. CONCLUSIONS: Ganz surgical hip dislocation provides wide exposure of the femoral head and neck, which enables complete and precise evaluation of the femoral head and neck contour. Hence, the extensive impinging bump can be excised meticulously, and the circulation of the femoral head can be monitored during surgery. The Ganz procedure was useful in severe pediatric hip diseases and allowed for quick rehabilitation with fewer complications. |
format | Text |
id | pubmed-2766743 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | The Korean Orthopaedic Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-27667432009-11-02 Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases Shin, Sung Jin Kwak, Hong-Seok Cho, Tae-Joon Park, Moon Seok Yoo, Won Joon Chung, Chin Youb Choi, In Ho Clin Orthop Surg Original Article BACKGROUND: Ganz surgical hip dislocation is useful in the management of severe hip diseases, providing an unobstructed view of the femoral head and acetabulum. We present our early experience with this approach in pediatric hip diseases. METHODS: Twenty-three hips of 21 patients with pediatric hip diseases treated using the Ganz surgical hip dislocation approach were the subjects of this study. The average age at the time of surgery was 15.7 years. There were 15 male and 6 female patients who were followed for an average of 15.1 months (range, 6 to 29 months). Diagnoses included hereditary multiple exostoses in 9 hips, slipped capital femoral epiphysis in 7, Legg-Calvé-Perthes disease in 4, osteoid osteoma in 1, pigmented villonodular synovitis in 1, and neonatal septic hip sequelae in 1. Medical records were reviewed to record diagnoses, principal surgical procedures, operative time, blood loss, postoperative rehabilitation, changes in the range of hip joint motion, and complications. RESULTS: Femoral head-neck osteochondroplasty was performed in 17 patients, proximal femoral realignment osteotomy in 6, open reduction and subcapital osteotomy for slipped capital femoral epiphysis (SCFE) in 2, core decompression and bone grafting in 2, hip distraction arthroplasty in 2, and synovectomy in 2. Operative time averaged 168.6 minutes when only osteochondroplasty and/or synovectomy were performed. Hip flexion range improved from a preoperative mean of 84.7° to a mean of 115.0° at the latest follow-up visit. Early continuous passive motion and ambulation were stressed in rehabilitation. No avascular necrosis of the femoral head was noted up to the time of the latest follow-up visit, except for in one SCFE patient whose surgical intervention was delayed for medical reasons. CONCLUSIONS: Ganz surgical hip dislocation provides wide exposure of the femoral head and neck, which enables complete and precise evaluation of the femoral head and neck contour. Hence, the extensive impinging bump can be excised meticulously, and the circulation of the femoral head can be monitored during surgery. The Ganz procedure was useful in severe pediatric hip diseases and allowed for quick rehabilitation with fewer complications. The Korean Orthopaedic Association 2009-09 2009-08-17 /pmc/articles/PMC2766743/ /pubmed/19885048 http://dx.doi.org/10.4055/cios.2009.1.3.132 Text en Copyright © 2009 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Shin, Sung Jin Kwak, Hong-Seok Cho, Tae-Joon Park, Moon Seok Yoo, Won Joon Chung, Chin Youb Choi, In Ho Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases |
title | Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases |
title_full | Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases |
title_fullStr | Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases |
title_full_unstemmed | Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases |
title_short | Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases |
title_sort | application of ganz surgical hip dislocation approach in pediatric hip diseases |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766743/ https://www.ncbi.nlm.nih.gov/pubmed/19885048 http://dx.doi.org/10.4055/cios.2009.1.3.132 |
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