Hip myodysplasia: treatment
Miodisplasia de cadera: tratamiento
Resumen:
Success of treatment depends on early diagnosis. Treatment is based on the etiogenic concept of this disease which Prof. Bado blames on the muscle. Genetic and hereditary muscular dysplasia affects certain muscular groups -above all psoas and adductors- and through growth, determines cervical and epyphiseal alterations and secondary alterations of cotyloid cavity (acetabulum) which, in turn, lead to spontaneous thigh displacement. Disease is evolutive andmay appear at different periods of the child's life, in ny stage of evolution. Consequently, we find a diversity of anatomoclinical situations that cannot be solvedby one single therapeutic formula. Ideally, the patient should be treated during the very early stages. The thigh should be adjusted and positioned correctly, maintaining it so during all the time necessary. Before the age_ of three months, surgery is not generally required; a splint, or plaster cast, followed by a splint, is all that is required. Between the. ages of 3 to 6 onths, we find two types of situations: Easy adjustment and positioning: non-surgical treatment; plaster cast or splint adjustment: surgical treatment, abscission of adductors and psoas and, if so required, capsule, followed by plasetr cast and/or splint. After the age_ of 6 months, treatment is generally surgical followed by plaster cast and/or splint.After the age of one year, adjustment is surgical and is followed, one month later, by derotating varus osteotomy. Walking is allowed 2 months after osteotomy.
El éxito del tratamiento depende del diagnóstico precoz. El tratamiento se basa en el concepto eteopatogénicode la enfermedad. Según el concepto del Prof. Bado el responsable de la enfermedad es el músculo. Una displasia muscular, genética y hereditaria queafecta a ciertos grupos musculares sobre todo psoas y adductores determina a través del crecimiento las alteraciones cervicales y epifisarias y secundariamentecotiloideas que conducen a la luxación espontánea de la cadera. Es una enfermedad evolutiva y puede ser sorprendida en diversas épocas de la vida del niño yen cualquier etapa de la evolución. Por esta razón se presentan innumerables situaciones anatomoclínicas y que no se pueden resolver con una sola fórmula terapéutica.El ideal del tratamiento es la precocidad de su comienzo. El objetivo es la reducción, el correcto centrado y el mantenimiento durante el tiempo necesario. Antes de los 3 meses, en general es incruento. Basta con la colocación de una férula o yeso seguido de férula. Entre 3 y 6 meses se dan dos situaciones: Reducción y centrado fácil: tua.tamiento incruentoon yeso y/o férula. Si la reducción es fácil: tratamiento cruento, con ·sección de músculos adductores y psoas y cápsula si es necesario y luego yeso y /o férula.Después de los 6 meses de edad el tratamiento es en general quirúrgico seguido de yeso y/o férula. Después del año de edad: tratamiento quirúrgicopara reducir y al mes, en muchos casos, osteotomía desrotadora y varizante para autorizar la marcha a los 2 meses de la osteotomía.
1973 | |
cadera cirugía hip surgery |
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Español | |
Sociedad de Cirugía del Uruguay | |
Revista Cirugía del Uruguay | |
https://revista.scu.org.uy/index.php/cir_urug/article/view/2493 | |
Acceso abierto |
Sumario: | Success of treatment depends on early diagnosis. Treatment is based on the etiogenic concept of this disease which Prof. Bado blames on the muscle. Genetic and hereditary muscular dysplasia affects certain muscular groups -above all psoas and adductors- and through growth, determines cervical and epyphiseal alterations and secondary alterations of cotyloid cavity (acetabulum) which, in turn, lead to spontaneous thigh displacement. Disease is evolutive andmay appear at different periods of the child's life, in ny stage of evolution. Consequently, we find a diversity of anatomoclinical situations that cannot be solvedby one single therapeutic formula. Ideally, the patient should be treated during the very early stages. The thigh should be adjusted and positioned correctly, maintaining it so during all the time necessary. Before the age_ of three months, surgery is not generally required; a splint, or plaster cast, followed by a splint, is all that is required. Between the. ages of 3 to 6 onths, we find two types of situations: Easy adjustment and positioning: non-surgical treatment; plaster cast or splint adjustment: surgical treatment, abscission of adductors and psoas and, if so required, capsule, followed by plasetr cast and/or splint. After the age_ of 6 months, treatment is generally surgical followed by plaster cast and/or splint.After the age of one year, adjustment is surgical and is followed, one month later, by derotating varus osteotomy. Walking is allowed 2 months after osteotomy. |
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