Conjugal chondropathy of the adolescent: general considerations and treatment guidelines
Condropatía conjugal del adolescente: consideraciones generales y directivas de tratamiento
Resumen:
The paper refers to condropathy of joints, its complications and sequella and coxa vara in adolescents. Physiopathological hypothesis of slipping points toaction of adductor and externa] rotating muscles, specially psoas. We base our treatment on above hypothesis;, adductors and psoas are abscissed and action of gravityis avoide.d in cases of non complicated condropathies with chronic slipping; this is followed by adjlstment and immobilization in plaster cast in acute and subacutecases. In the latter, when adjustment is not induced by manouvres, we perform myotomy followed by open field adjustment and immobilization in pelvipaediumplaster cast. Finally, we have treatment of coxa vara sequella through intratrochanteric tendimentional osteotomies, correcting varus and epiphyses retroversion, or throughanterosuperior wedge cervical osteotomies following capsule graft on epiphyses to provide greater vascularization and prevent necrosis.
Se trata el capítulo de la condropatía conjuga! de! ad.olescentes, sus complicaciones y secuelas, la coxa vara del adolescente reseñando como hipótesis fisiopatológicadel deslizamiento, a la acción de los músculos adductores y rotadores externos fundamentalmente el psoas.Realizamos el tratamiento apoyándonos en dichahipótesis; hacemos la sección de adductores y psoas evitando luego la acción de la gravedad en los casos de condropatía no complicada y con deslizamientoscrónicos y seguidos de reducción e inmovilización· enyesada en los casos agudos y subagudos. En estos últimos, cuando no se reduce por maniobras, luego dea miotomía, hacemos la reducción a cielo abierto, inmovilizando luego en yeso pelvipedio. Por último el tratamiento de la secuela de la coxa vara, mediante osteotomías intertrocantérica tridimensional corrigiendo el varo y la retroposición de la epífisis, o por osteotomía cervical a cuña antero superior, previo injerto de cápsula en la epífisis para darle mayor vascularización y así evitar su necrosis.
1973 | |
trastornos de crecimiento afecciones adolescentes growth disorders affections teenagers |
|
Español | |
Sociedad de Cirugía del Uruguay | |
Revista Cirugía del Uruguay | |
https://revista.scu.org.uy/index.php/cir_urug/article/view/2495 | |
Acceso abierto |
Sumario: | The paper refers to condropathy of joints, its complications and sequella and coxa vara in adolescents. Physiopathological hypothesis of slipping points toaction of adductor and externa] rotating muscles, specially psoas. We base our treatment on above hypothesis;, adductors and psoas are abscissed and action of gravityis avoide.d in cases of non complicated condropathies with chronic slipping; this is followed by adjlstment and immobilization in plaster cast in acute and subacutecases. In the latter, when adjustment is not induced by manouvres, we perform myotomy followed by open field adjustment and immobilization in pelvipaediumplaster cast. Finally, we have treatment of coxa vara sequella through intratrochanteric tendimentional osteotomies, correcting varus and epiphyses retroversion, or throughanterosuperior wedge cervical osteotomies following capsule graft on epiphyses to provide greater vascularization and prevent necrosis. |
---|