Application Of Lock Compress Plate To Treat The Disease Of Developmental Dysplasia Of The Hip Of Big Children And Analysis The Influence Factor Of Curative Effect With It

Background:Developmental dysplasia of the hip is common disease and frequently encountered disease of department of orthopaedics in children, is one of three congenital deformity of department of orthopaedics in children. Now disease rate don′t have unitive statistics, disparity comparatively large in different region, girl′s disease rate is 4 times than boy, right disease rate is more than left. Although the cause of a disease is not very clear, many scholars′research consider developmental dysplasia of the hip is the result of heredity factor and environment factor in China and foreign country. The main pathological change of developmental dysplasia of the hip the following change after dislocation, acetabular bone lack excitation of femoral head, acetabular bone gradually grow down, femoral head develop slow, neck of femur become widen short, anteversion angle become large, articular capsule become thick, ambient muscle contracture, adductor tension, so add positioning difficult, in the end appearance crispation malformation. The therapeutic principle of developmental dysplasia of the hip is early diagnosis, early treatment. The treatment the more early, the effect the more better, and can cut down complication probability in the near future and long-term. The goals of treatment is restitution dislocation as soon as possible, prevent femoral head osteoepiphysis occurrence ischemic necrosis, correct rudimental harmful development. Because of the treatment of developmantal dysplasia of the hip concerned with age and pathology typing, so should basis different pathology variance choose different treatment methods. The treatment method very much, but curative effect vary, especially advanced stage patient and age larger than 6 years children curative effect disaffect, early diagnosis and rational therapy have important significance to improve prognosis. The type of operation in treatment of developmental dysplasia of the hip was more. Osteotomy of the pelvic and the proximate of femoral bone has been received which was available. If the actab developed more better, Only the osteotomy of the proximate of femoral bone should be applicated. Nowadays, there are many systems of internal fixation to applicated in this disease. The method of LCP applicated in our division on lately to fix the proximate of femoral bone after osteotomy in Development Dysplasia of the Hip of big children was original and available, especially in this children whose collodiaphyseal angle of femoral bone must be rected, which contrasted with the others was more better on effect in clinic. Objective: To study of the application of LCP (Lock Compress Plate) to treat the disease of the Developmental Dysplasia of the Hip of big children and to study the influence factor of curative effect possiblity, and to analysis the effectiveness of the fixation of femoral bone with LCP after recting the collodiaphyseal angle and anterior tilt angle of it in the disease of DDH.Methods: From 2007 to 2009, with the method of retrospective analysis, 28 cases were therapied with LCP, In the 28 cases(32 hips), man 5 cases, woman 27 cases. The years of age was 6~14, average 9. Four female cases were invasion of double hips. Before operation, we must consummate all preparation. All cases'collodiaphyseal angle and anterior tilt angle were measured with X-ray and CT-3D. Of course, the collodiaphyseal angle and anterior tilt angle of femoral bone which we were measuring preoperative in the class increased obviously, it must be corrected.Results: All cases were followed-up after operation, followed-up for 12 months to 2 year and 4 months. The angle after operation has been improved obviously to compare it before operation through statistical analysis with"t"(P<0.050). Followed-up after operation, almost not lost the angle which was rected with LCP all cases have afer operation followed-up to compare it on post-op one day. The broken ends of fractured in this group have been knitting after operation followed-up more than 6 months; no has been late healed or disunion; no has been coxa adducta because of collapsing of collum femoris; no has been anti-nail or nail brokendown, no hip with the method of LCP have been avascular necrosis of the femoral head, and so on. Clinical assessment was performed according to Mckay'S classification. On the basis of if the hip joint pain or claudication, to check up the hip joint activity and if had Trendelenburg signe, The results showed that excellent 22 hips (68.75%), good 7 hips (21.87%), acceptable 3 hips (9.38%),poor 0 hip (0%), the overall excellent or good rate was 90.62%.Conclusions: The method of LCP to fix the proximate of femoral bone after osteotomy in Development Dysplasia of the Hip of big children is original and available, especially in this children whose collodiaphyseal angle of femoral bone must be rected, which should be applied widely in clinic.