Therapeutic Effect Analysis Of Close Reduction And Cast External Fixation On DDH In Toddlerhood

Objective:Analyze the results of closed reduction and arrow casting external fixation in children with developmental dislocation of the hip during the toddlerhood(10-18 months).Methods: DDH in toddlerhood which were treated with closed reduction and external fixation of arrow casting(affected hip with “human position”,healthy hip joint extension and abduction),from September 2010 to September 2017.112 cases(118 hips)met the standard.Baseline demographics of closed reduction was recorded: the average age 14.5 ± 2.2months(10-18 months),gender and lateral.Imaging evaluation: the degree of hip dislocation was evaluated according to the international hip dysplasia Institute(IHDI)classification,the acetabular index(AI)was recorded,and the postoperative evaluation was performed by Severin classification,and the avascular necrosis(AVN)of femoral head was evaluated by Kalamchi &Mac Ewen classification.Results: 112 cases(118 hips)average follow-up time was 52.7±22.5months.There were 107 male and 9 female hips.The preoperative AI was36.9 ± 5.0 °and the preoperative IHDI grade was grade Ⅳ 58 hips,grade Ⅲ42 hips and gradeⅡ18 hips.There were 109 hips with successful closed reduction(rate of success 92.4%),66 hips with Severin grade Ⅰ,43 hips with grade Ⅱ.9 hips with redislocation and residual deformity(rate of failure 7.6%),6 hips with Severin grade Ⅲ,and 3 hips with gradeⅣ and above,with a success rate of 92.4%.There was no significant difference in age,gender,side,degree of dislocation and AI index before operation between the two groups.Avascular necrosis of femoral head(AVN)was found in 12 hips,and the necrosis rate of femoral head was 11.0%.There was no significant difference in age,gender,lateral,dislocation degree,preoperative AI index and postoperative AI index between AVN group and non AVN group.Conclusions:Closed reduction of hip joint and external fixation with arrow cast for DDH in toddlerhood has reliable curative effect,and can obtain lower redislocation rate and AVN rate.Arrow cast external fixation makes patients more comfortable and easier to care for.