Is Kalamchi and MacEwen Group I avascular necrosis of the.
In addition, hips displaying avascular necrosis of the femoral heads in 2008 were classified according to the classification of Kalamchi and MacEwen: group I hips had changes affecting the ossific nucleus, group Il hips had lateral physeal damage, group III hips had central physeal damage, and group IV hips had damage to the entire femoral head and physis.
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Avascular necrosis following treatment of congenital dislocation of the hip. Kalamchi A, MacEwen GD. A review of 119 patients with congenital dislocation of the hip complicated by avascular necrosis, of whom fifty-one patients were skeletally mature, showed that damage to the physis was very common.
At the latest follow up 40 of the 45 hips where Severin grades were recordable (89%) were graded as excellent or good, Severin class I or II. Clinically significant AVN (grade II to III according to the Kalamchi and MacEwen classification) was seen in 6 (13%) of the hips.
Kalamchi and MacEwen. Figure 2. X-Ray of a 8-year old girl with a right-sided avascular necrosis stage II according to the Kalamchi and MacEwen classification. Figure 4. X-Ray of the same girl as in fig. 3 with an improved acetabular and femoral head development.
The aim of this study was to evaluate the correlation between Salter's criteria and Kalamchi's classification of avascular necrosis in patients treated for developmental dysphasia of the hip (DDH).
The final radiographic evaluations were made according to the Kalamchi and MacEwen classification and Severin classification. The mean age at the initial visit was 1 year and 9 months (range, 1 year and 5 months to 3 years).
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The radiographs were also scored for osteonecrosis with use of the Kalamchi and MacEwen classification system and were also assessed for sphericity with use of Mose rings. Results: Forty-seven patients with late-presenting developmental dysplasia of the hip who subsequently underwent successful closed reduction were included.
AVN was evaluated according to the Kalamchi and MacEwen classification (2,5,6). The patients were evaluated in terms of dislocation and their ages at the time of admission were found from the physical examination files of the last follow-up and range of motion (ROM) of the operated hips during the last follow-up were noted. Surgical Technique.
The Kalamchi and MacEwen classification was used to assess osteonecrosis, and the McKay classification was used to assess the clinical outcome at the time of the latest follow-up. For the statistical analyses, we selected the worse side in patients in the bilateral group as the index hip if the outcome was asymmetrical and the left hip if the outcome was symmetrical.
A review of 119 patients with congenital dislocation of the hip complicated by avascular necrosis, of whom fifty-one patients were skeletally mature, showed that damage to the physis was very common. Changes in the secondary ossification center (ossific nucleus) alone were found to be of very little.
The Kalamchi and MacEwen classification was used to assess osteonecrosis, and the McKay clas-sification was used to assess the clinical outcome at the time of the latest follow-up. For the statistical analyses, we selected theworse side in patients in the bilateral group as the index hip if the outcomewasasymmetrical and the left hip if the outcome was symmetrical.
Clinically significant AVN (grade II to III according to the Kalamchi and MacEwen classification) was seen in 6 (13%) of the hips. We found a pelvic osteotomy to be a risk factor for AVN (p 0.02) and age at operation to be a risk factor for poor morphology at final follow up (p 0.03).
Kalamchi and MacEwen also reported that early recognition of lateral growth arrest can be challenging, but one must be alert to the presence of lateral ossification, lateral physeal irregularity and bridging, lateral notching of the epiphysis and a lateral metaphyseal defect in the early radiological detection of this form of AVN. These.
For three patients who had previous surgery in Group II, the effect of the procedures on skeletal growth was considered to be one of the factors which had caused the deformities in the head and neck. The anatomic deformity in patients in the current Group I could not be classified into any group of the classification of Kalamchi and MacEwen.