Dynam Is Research On The Developm Ent Of The Acetabulum After The Improved Arthroplasty Treatm Ent Of Developm Ental Dislocation Of Hip

Objective: DDH (Developmental Dislocation of the Hip, DDH) is acommon pediatric orthopedic acetabular lesions are relatively heavy, earlydetection of the more conservative treatment, part deformity severe or failedearly discoverer to require surgery.The main purpose of treatment is early tomaximize the recovery of the normal physiology of the hip structure and stressrelations, in order to avoid or delay the further development of pathologicalchanges and thus due to the occurrence of late osteoarthritis. Third Hospital ofHebei Medical University, pediatric orthopedic developmental dislocation ofthe hip were treated with a hip incision reset+rotor rotation shorteningosteotomy+Pemberton acetabular arthroplasty cases the clinical study andfollow-up observation, analysis of postoperative hip acetabular developmentalchanges, summarize the surgical experience, and provide a scientific basis toimprove the surgical treatment of developmental dislocation of the hip.Methods: Collection, inpatient surgery, pediatric orthopedics Nov2009to June2011, the Third Hospital of Hebei University Hospital of DDHpatients. Meet the diagnostic criteria of developmental dislocation of the hip,before admission were not treated patients from selected patient cases,46cases (54hips), including18males and28females,aged12years old,minimum of2years.18cases, the left side, right side in20cases,8cases ofbilateral Were followed up for9months to1year and5months, an average of13months. Surgical methods for the different degrees of choice traction orfemoral condyle or tibial tuberosity bone traction for about two weeks timeshift on the performance of the femoral head before surgery in children withage and X-ray, traction to the femoral head in acetabular level in the basis+caudal or epidural anesthesia Pemberton acetabular angioplasty treatment. The check method is the application of the German Siemens company multi-slicespiral CT machine preoperative and postoperative children with CT scan andsend to the three-dimensional reconstruction of the CT workstation, and thenthree-dimensional observation and data measurement. Grouping: Select38contralateral hip as the control group,54ipsilateral hip as the preoperativegroup, and then to54after the treatment of postoperative hip as thepostoperative group.Results:1Control group the various parts of acetabular index (AI): the front of themean AI of20.216°±3.359°, the central part of the21.658°±3.891°, therear is20.134°±3.472°; preoperative group the various parts of AI: the frontof the (AI) was37.264°±5.749°, Central39.762°±5.296°, the rear is35.656°±6.488°; various parts of AI in the postoperative group mean: thefront of the (AI) was19.324°±2.923°, Central21.130°±3.161°, the rear is21.620°±2.112°. Mean multiple comparisons: control group, in the rear ofAI and the postoperative group, in the rear of AI difference was notstatistically significant (P>0.05), before the control group, the rear AI andafter surgery were no significant differences; preoperative group, the rear ofAI and the control group and the postoperative group, in the rear of AIdifferences have significant (P <0.01), intraoperative group and control groupin the rear of AI was significantly lower than the preoperative group.2Control group the mean femoral neck anteversion (FNA) is22.382°±5.212°; group of children with FNA in the preoperative degree of variation, thelargest of which76.14°,33.24°minimum, average48.038°±9.662°;postoperative group an average of18.206°±5.612°. Mean multiplecomparison showed that: FNA of the control group, the preoperative groupdifference was significant (P<0.01), preoperative group FNA was significantlygreater than the control group; control group of FNA and postoperative group,the difference was not significant (P>0.05), the control group and thepostoperative group FNA was no significant difference; group FNA afterpreoperative group difference was significant (P<0.01),significantly reduced postoperative children with the FNA.Conclusion: Children with developmental dislocation of the hip is aninfant common hip deformity, early detection cured by conservative treatment,if found late conservative treatment failure, it will take surgery. More surgicalmethods, the treatment effect is not the same. In this paper the cases hiparthrotomy reset+rotor rotation to shorten the osteotomy+Pembertonacetabular angioplasty were followed up for10months to1year2months toobserve the developmental changes in the acetabulum and hip joint functionchanges, the results show that the Pemberton surgery, more able to change theshape of the acetabulum to correct the acetabular index, can also increase theacetabular coverage is more suitable for the treatment of developmentaldislocation of the hip. Pemberton after surgery, the majority of hip remodelingprocess, the imaging on the form of significant improvement. Most hip clinicalfunction of good, but there is the probability of postoperative hip stiffness,suggesting that we should pay attention to in the future treatment ofpostoperative rehabilitation exercises, if necessary, the hip joint grant to movethe surgery, to reduce the incidence of hip stiffness. And analysis results,children with the younger treatment to recover the greater the chance, themore it can achieve a satisfactory therapeutic effect.