Gromov A. Correction of deformities of trochanter major at surgical treatment of hip joint pathology in children

Object: hip joint pathology in children, which is accompanied by deformation of the greater trochanter. Aim: to amend the diagnosis and methods of surgical correction of deformities of the greater trochanter of the femur, and on their basis to improve the function of hip joint in children. Methods: clinical, X-ray diagnostics (radiography, computed tomography and magnetic resonance imaging), statistical. For the first time on the basis of the developed biomechanical models and conducted graphoanalytical research the features of load and function of the hip joint in children with deformities of the greater trochanter of the femur, depending on the type and grade of these deformities have been identified. For the first time new knowledge about the features of three-plane location and dynamics of the development of the greater trochanter when it has got deformities in children in a hip joint disease of various origins, as well as pre- and postoperative periods (using radiodiagnostics methods - radiography,) were obtainedin cases of strains in children under hip pathology of various origins, as well as pre- and postoperative periods (radiodiagnostics using methods - radiography, computer tomography) were obtained. First the dynamics of biomechanical and electromyographic parameters of hip functioning depending on the degree of deformation of the greater trochanter and its changes in the pre- and postoperative periods, which may be predictive of efficacy of treatment and further development of the joints, was studied. For the first time working classification of the greater trochanter deformities in children was proposed. It is possible to introduce into clinical practice a differentiated approach to the treatment strategy according to the type of the greater trochanter deformity and features of the hip joint pathology. The use of grounded, developed and implemented in the practice of diagnostic and treatment algorithm for early diagnosis, prediction and surgical correction of deformities of the greater trochanter in children allows to obtain the best anatomical and functional results of treatment of patients with this disease. The use the proposed method of surgical treatment of deformations of the greater trochanter of the femur and device for its realization with the use of temporary blocking its growth plate and a method of treatment of the pathological hip dislocation improves hip joint stability, which can increase the results of treatment of such patients and their quality of life. Results of the study were introduced into clinical practice in SI "Sytenko Institute of Spine and Joints Pathology of the National Academy of Medical Sciences of Ukraine", city children's hospital № 5 (Sevastopol) "Health Centre for children and mothers," children's city clinical hospital (Poltava) and in the educational process of profile departments in Kharkiv Medical Academy of Postgraduate Education, Bogomolets National Medical University of Ministry of Health of Ukraine, Uzhhorod National University of The Ministry of Education and Science of Ukraine. Traumatology and Orthopaedics