Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease

Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease

Omar Q Samarah,1 Abdullah Nimer,2 Fahed Al Karmi,2 Osama Mustafa,2 Suzan Naser,2 Lujain Al Omari,2 Yazan Hammad,1 Ziad Ermeley3 1Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan; 2School of Medicine, University of Jordan, Amman, Jordan; 3Department of Health and...

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Autores principales: Samarah OQ, Nimer A, Al Karmi F, Mustafa O, Naser S, Al Omari L, Hammad Y, Ermeley Z
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2020
Materias:
perthes disease
hip arthrodiastasis
external fixator
distraction
safety.
Therapeutics. Pharmacology
RM1-950
Acceso en línea:https://doaj.org/article/2dbd6911fd294284ab32f340b6f1f714
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spelling oai:doaj.org-article:2dbd6911fd294284ab32f340b6f1f7142021-12-02T11:12:54ZRole of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease1178-203Xhttps://doaj.org/article/2dbd6911fd294284ab32f340b6f1f7142020-11-01T00:00:00Zhttps://www.dovepress.com/role-of-arthrodiastasis-using-hinged-monolateral-external-fixator-with-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XOmar Q Samarah,1 Abdullah Nimer,2 Fahed Al Karmi,2 Osama Mustafa,2 Suzan Naser,2 Lujain Al Omari,2 Yazan Hammad,1 Ziad Ermeley3 1Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan; 2School of Medicine, University of Jordan, Amman, Jordan; 3Department of Health and Recreation, School of Physical Studies, University of Jordan, Amman, JordanCorrespondence: Omar Q SamarahSchool of Medicine, University of Jordan, Amman 11942, JordanTel +962 6 5353 444/2451Fax +962 6 5353 338Email o.samarah@ju.edu.joPurpose: Presentation with the advanced stage of Legg–Calve–Perthes disease (LCPD) carries a poor prognosis, regardless of the treatment that the patient receives. The aims of this study are to assess the clinical and radiological outcomes of arthrodiastasis in advanced cases of LCPD using a hinged monolateral external fixator without soft tissue release and to raise safety issues regarding its low rate of complications.Patients and Methods: Six patients with LCPD who were classified as lateral pillar types B and C and were operated on in our department were included in this retrospective study. Data collected from medical files and X-ray measurements were retrospectively reviewed.Results: A total of six male patients were included in this analysis. The mean age at onset of symptoms was 8.5 years (range 7– 10 years). The mean follow-up period was 46 months (range 40– 50 months). Five cases were Herring C and one case was Herring B at presentation. The average distraction time was 8 days (range 7– 9) and the average duration of external fixator application was 3.1 months (range 2.5– 3.5 months). The range of motion of the hip in flexion, abduction and internal rotation were improved postoperatively. Pain score and limping were also improved. At the final follow-up, the mean sphericity deviation score was 10.6. The mean epiphyseal index was improved from 19.3% to 23.8%. In addition, the mean cervical index improved from 99.7% to 89.7% at the last follow-up. Femoral fractures, pin loosening, mechanical failure of the fixator, chondrodiastasis, and hip subluxation were not seen in this group of patients.Conclusion: Arthrodiastasis with a hinged monolateral external fixator without soft tissue release improved both the clinical and radiological outcomes in this group of patients.Keywords: Perthes disease, hip arthrodiastasis, external fixator, distraction, safetySamarah OQNimer AAl Karmi FMustafa ONaser SAl Omari LHammad YErmeley ZDove Medical Pressarticleperthes diseasehip arthrodiastasisexternal fixatordistractionsafety.Therapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 16, Pp 1117-1124 (2020)
institution DOAJ
collection DOAJ
language EN
topic perthes disease
hip arthrodiastasis
external fixator
distraction
safety.
Therapeutics. Pharmacology
RM1-950
spellingShingle perthes disease
hip arthrodiastasis
external fixator
distraction
safety.
Therapeutics. Pharmacology
RM1-950
Samarah OQ
Nimer A
Al Karmi F
Mustafa O
Naser S
Al Omari L
Hammad Y
Ermeley Z
Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease
description Omar Q Samarah,1 Abdullah Nimer,2 Fahed Al Karmi,2 Osama Mustafa,2 Suzan Naser,2 Lujain Al Omari,2 Yazan Hammad,1 Ziad Ermeley3 1Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan; 2School of Medicine, University of Jordan, Amman, Jordan; 3Department of Health and Recreation, School of Physical Studies, University of Jordan, Amman, JordanCorrespondence: Omar Q SamarahSchool of Medicine, University of Jordan, Amman 11942, JordanTel +962 6 5353 444/2451Fax +962 6 5353 338Email o.samarah@ju.edu.joPurpose: Presentation with the advanced stage of Legg–Calve–Perthes disease (LCPD) carries a poor prognosis, regardless of the treatment that the patient receives. The aims of this study are to assess the clinical and radiological outcomes of arthrodiastasis in advanced cases of LCPD using a hinged monolateral external fixator without soft tissue release and to raise safety issues regarding its low rate of complications.Patients and Methods: Six patients with LCPD who were classified as lateral pillar types B and C and were operated on in our department were included in this retrospective study. Data collected from medical files and X-ray measurements were retrospectively reviewed.Results: A total of six male patients were included in this analysis. The mean age at onset of symptoms was 8.5 years (range 7– 10 years). The mean follow-up period was 46 months (range 40– 50 months). Five cases were Herring C and one case was Herring B at presentation. The average distraction time was 8 days (range 7– 9) and the average duration of external fixator application was 3.1 months (range 2.5– 3.5 months). The range of motion of the hip in flexion, abduction and internal rotation were improved postoperatively. Pain score and limping were also improved. At the final follow-up, the mean sphericity deviation score was 10.6. The mean epiphyseal index was improved from 19.3% to 23.8%. In addition, the mean cervical index improved from 99.7% to 89.7% at the last follow-up. Femoral fractures, pin loosening, mechanical failure of the fixator, chondrodiastasis, and hip subluxation were not seen in this group of patients.Conclusion: Arthrodiastasis with a hinged monolateral external fixator without soft tissue release improved both the clinical and radiological outcomes in this group of patients.Keywords: Perthes disease, hip arthrodiastasis, external fixator, distraction, safety
format article
author Samarah OQ
Nimer A
Al Karmi F
Mustafa O
Naser S
Al Omari L
Hammad Y
Ermeley Z
author_facet Samarah OQ
Nimer A
Al Karmi F
Mustafa O
Naser S
Al Omari L
Hammad Y
Ermeley Z
author_sort Samarah OQ
title Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease
title_short Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease
title_full Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease
title_fullStr Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease
title_full_unstemmed Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease
title_sort role of arthrodiastasis using hinged monolateral external fixator without soft tissue release in advanced stage of legg–calve–perthes disease
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/2dbd6911fd294284ab32f340b6f1f714
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