SURGICAL TREATMENT OF CHILDREN WITH CONSEQUENCES OF INFANTILE SEPTIC ARTHRITIS

Abstract

Introduction. The consequences of infantile septic arthritis are quite diverse and can manifest themselves as a damage to the growth zone, deformation and destruction of the articular components, and violation of the articular relationships. To treat this pathology, technically complex and traumatic surgical interventions are used. The purpose of this work is to analyze the medium-term results of the use of these methods in the treatment of children with septic coxitis consequences.Material and methods. The outcomes of treatment for 37 children with consequences of septic coxitis using Ilizarov apparatus were analyzed. Average age of patients at the time of the surgery was 8.2±0.5 years (from 6 to 10 years). Follow up period was from 3 to 10 years (average 4.7 years). Functional outcomes were assessed by C.L. Colton, radiologic indices — by E. Severin score and J. Kruczynski.Results. Patients were distributed into three groups according to anatomical features. Functional outcomes of patients in the 1st group: good (12–15 points) — 3 joints, satisfactory (9–11 points) — 5 joints, unsatisfactory (8 points) — 1 joint. X-ray findings of patients in the 1st group according to J. Kruczynski criteria: good — 5 joints, satisfactory — 4 joints; by E. Severin criteria: Ia — 1, Ib –1, IIa — 2, IIb — 3, III — 2. Functional outcomes of patients in the 2nd group: good (12–14 points) — 10 joints, satisfactory (9–11 points) — 8 joints. Distribution in the second group by J. Kruczynski criteria: good — 9, satisfactory — 9; by E. Severin criteria: IIa — 14, IIb — 4. Distribution of functional outcomes in the 3rd group in accordance with C.L. Colton criteria: good (12–15 points) — 3 joints, satisfactory (9–11 points) — 7 joints. Distribution in the third group according to J. Kruczynski criteria: good — 4, satisfactory — 6; by E. Severin criteria: IIa — 5, IIb — 4, III — 1.Conclusion. The use of the presented transosseous external fixation technique in children with the consequences of septic coxitis provides sufficient stability of the joint without causing its decompensation and stiffness. The use of the Ilizarov fixator extends the age limits for reconstructive treatment of abnormal distal hip dislocation.

Keywords

• infantile septic arthritis
• hip joint reconstruction
• the ilizarov apparatus