الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 186 |  |  |
| | | from | 186 | | |
Abstract
We aimed to evaluate the effectiveness of different techniques of acetabular augmentation andl or proximal femoral valgus osteotomy in the treatment of osteonecrosis of the femoral head in children and adolescents.
Forty nine patients were included in this study whom had unilateral osteonecrosis of the femoral head for Perthes’ disease, iatrogenic during treatment of DDH or following SUFE. Patients were classified to 3 groups according to the method of surgical treatment they will receive. Thirty three patients had shelf acetabuloplasty, 3 patients underwent Chiaril Kawamaura’s pelvic osteotomy while the remaining 14 patients received their treatment in the form of proximal femoral valgus osteotomy.
All patients’ X-ray were recorded pre-operatively and in the immediate post-operative period then patients were invited for regular clinical and radiological checks at 6 weeks, 3 months, 6 months then yearly follow up following surgery when radiological and functional evaluation of their hips have been done whenever applicable. The short form SFIl2 of Oxford hip score has been used to functionally evaluate all patients who had C/K osteotomy and the adolescents who had proximal femoral valgus osteotomy.
Shelf acetabuloplasty has shown to prevent further deformity of the femoral head especially in those patients over the age of 8 years however, it cannot reverse the original deformity. The use of calcium sulphate pellets in some of our patients enhanced shelf incorporation and improved bone stock. Valgus femoral osteotomy did help to improve pain leg lenth discrepancy in most of our patients.
The shelf procedure seems to fulfil the principles of restorin. maintaining free hip movement, correcting subluxation and reducing through the hip in patients with ON of the femoral head, particularl
those who are older than 8 years at presentation and with
ng the outcome for Perthes’ disease in the over 8’s if empIe, early and also in prolonging survival of non-congruent painful hips . improving acetabular bone-stock and probably improving the survival 01 THR when it inevitably is required.
fail or resorb. In these successful.
VGO has been shown bduction pain, with th hortening and hip abduct It is more likely to produ surgery is done before thl sh If acetabuloplasty can 1 to improve an unstable ac the head. VGO does not c hinge abduction) but can a
The Chiari/ Kawamaura pelvic osteotomy, which improves art! cover and abductor muscle function, is another effective salvage proced for the non-congruent painful hip. This procedure does not compromise I THR and indeed may improve long-term THR survival by increas