Korolkov A. Recurrent congenital hip dislocation and subluxation in children

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0511U000920

Applicant for

Specialization

  • 14.01.21 - Травматологія та ортопедія

04-11-2020

Specialized Academic Board

Д 64.607.01

State institution "Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine"

Essay

Object: hip joint formation process in children with congenital hip dislocation and subluxation (after treatment). Purpose: surgical prophylaxis and improvement of the surgical treatment for recurrent congenital hip dislocation and subluxation in children. Methods: clinical, radiographic (ultrasonography, rentgenography, computer tomography), biomechanical, electromyography, morphological, statistics, mathematic model of the hip joint, (final element analysis) and conceptual modeling. Conceptual model "hip joint" and model of the hip joint development after the surgical treatment of the congenital dislocation in children has been developed. For the first time stress-strain distribution of the hip joint in recurrent congenital hip dislocation and subluxation was defined, calculation of the muscles forces before and after reduction with different surgical interventions. Changes of the spine-pelvic balance in congenital hip dislocation and subluxation were studied. It is defined syndromes resulting in recurrent congenital hip dislocation and subluxation such as: syndrome of intraarticular obstacles for the femoral head centration, syndrome of soft tissue inconsistence of the hip joint, syndrome of value inconsistence between femoral head and acetabulum, syndrome of proximal femur anomaly in the frontal and sagittal planes (valgus deformity, deformation of the greater trochanter, increased femoral cervix antetorsion and retrotorsion, syndrome multiplanar proximal femur deformation as the association of the different proximal femur deformation in the different planes, dysplasia of the acetabulum (slipped "roof", pelvic hypoplasia, increased acetabular anterversion-retroversion ), syndrome of hip joint destruction and reactive changes. It has been developed on the basis of obtained data and provided into medical care system of the diagnostic and treatment tactic for the recurrent congenital hip dislocation and subluxation in dependence of individual peculiarities of children's age and anatomical-functional changes. This allowed to get 85,15% of good and satisfactory results in children in the age before 6 years old and 78,42% in the age rom 6 to 18 years old. Results of this study provided into clinical practice of State institution "Institute of Spine and Joint Pathology named after prof. M.I. Sytenko Ukrainian National Academy of Medical Science", Domezk's Research Institute of Traumatology and Orthopedics of M. Gorky National Medical University, Municipal Institution "Kharkiv City Traumatological Hospital", Municipal Institution "Kherson children's regional hospital", Municipal Institution "Regional traumatological hospital" Donetzk, Municipal Institution "City clinical hospital №11" Odessa, Municipal Institution "Sumy regional hospital", City emergency hospital №6 of Simferopol, Odessa regional children's hospital and into educational process of profile cathedras in National medical university named after O.O. Bogomoletz Ministery of Health of Ukraine, Uzhgorod's National University. Traumatology and orthopedics.

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