Clinical and radiological outcomes of combined acetabuloplasty with acetabular redirectional osteotomy and femoral shortening for children older than 9 years of age with developmental dysplasia of the hip: a retrospective case series
Autor: | Jie Yang, XueMin Lyu, Chao Feng, Yukun Wang, Zhenhua Zhu, Gang Fu |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Acetabuloplasty Avascular necrosis Osteotomy Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Severity of illness Deformity Medicine Humans Orthopedics and Sports Medicine Femur Range of Motion Articular Child Retrospective Studies 030222 orthopedics business.industry Retrospective cohort study Acetabulum medicine.disease Surgery Treatment Outcome Concomitant Pediatrics Perinatology and Child Health Developmental Dysplasia of the Hip Female medicine.symptom business Range of motion Tomography X-Ray Computed 030217 neurology & neurosurgery |
Zdroj: | Journal of pediatric orthopedics. Part B. 29(5) |
ISSN: | 1473-5865 |
Popis: | Developmental dysplasia of the hip (DDH) is a challenging pediatric condition. This study aimed to investigate the feasibility and the efficacy of Dega osteotomy in combination with pelvic triple osteotomy or periacetabular osteotomy and femoral shortening with derotational osteotomy for the treatment of severe acetabular deformity secondary to DDH in children older than 9 years of age. The clinical data of 22 children treated at our institution were retrospectively collected. Pre- and postoperative hip radiographs were evaluated. Center-edge (CE) angle was measured, and Severin classification and McKay criteria were used to evaluate the final outcome. Twenty-two patients (including 21 female patients) were treated during the study period. The mean age was 10.9 years (range 9.1-14.8). All patients had preoperative Tonnis grades III and IV dislocated hips. Mean follow-up time was 25.7 months (range 14-48). All but three hips underwent open reduction. All had concomitant proximal femoral shortening and derotation osteotomy. At last follow-up visit, all hips remained located and no cases of avascular necrosis were recorded. All patients had Severin grade I-II hips at last follow-up. According to McKay criteria, clinical outcome was excellent in three patients, good in seven, and fair in 12 patients. Acetabuloplasty in combination with periacetabular osteotomy and femoral shortening with derotational osteotomy is a valid and effective treatment for children older than 9 years of age with severe acetabular deformity secondary to DDH. Although the early clinical outcome of the reported procedure is favorable, further studies are necessary to evaluate the long-term effects of the reported technique. |
Databáze: | OpenAIRE |
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