Outcomes Of Salter Pelvic Osteotomy In Children:Analysis Of Patients With Legg-calve’-perthes Disease And Developmental Dysplasia Of The Hip

Objective: To analyze and summarize the efficacy of Salter pelvic osteotomy in the treatment of Developmental Dysplasia of the Hip(DDH)and Legg-Calve’-Perthes Disease(LCPD).Methods:The clinical data of patients with DDH and LCPD treated by Salter pelvic osteotomy in our hospital from January 2010 to January 2020 were collected.The patients were selected according to the inclusion and exclusion criteria.The patients were divided into groups according to their age by consulting references.Acetabular index(AI),Centreedge angle(CEA),International Hip Dysplasia Institute(IHDI)classification,Herring classification,Severin and Stulberg classification system were used to evaluate the imaging changes before and after operation.Mc Kay criteria for clinical evaluation system was used to evaluate the improvement of clinical function.Results: A total of 66 patients(89 hips)were included in this study,including 41 patients with DDH(64 hips)and 25 patients with LCPD(25 hips).In DDH patients,the AI of patients under 3 years old decreased from 39.10 degrees ±6.572 to 18.20 degrees ±3.242.At the last follow-up,CEA remained at 25.83 degrees ±9.565,92.8% of the patients performed well in Severin classification,and 95.2% performed well in Mc Kay classification.The AI of patients ≥ 3 years old decreased from 37.52 degrees ±4.631 to18.17 degrees ±4.163.At the last follow-up,CEA remained at 29.61 degrees ±12.784,91.4%of the patients performed well in Severin classification,and 91.4% performed well in Mc Kay classification.The postoperative imaging and clinical manifestations of DDH patients in the two groups were improved,but there was no significant difference in Severin classification(U=465.000,P=0.919)and Mc Kay classification(U=464.500,P=0.889)in the last follow-up,except that the preoperative IHDI classification difference was statistically significant(U=391.000,P=0.037).In LCPD patients,the AI of patients under7 years old decreased from 20.00 degrees ±4.604 to 10.50 degrees ±3.782.At the last follow-up,CEA remained at 27.50 degrees ±6.442,66.6% of the patients performed well in Stulberg classification,and 100.0% performed well in Mc Kay classification.The AI of patients ≥ 7 years old decreased from 22.42 degrees ±5.102 to 11.95 degrees ±3.613.At the last follow-up,CEA remained at 27.68 degrees ±7.008,73.7% of the patients performed well in Stulberg classification,and 78.9% performed well in Mc Kay classification.The postoperative imaging and clinical manifestations of LCPD patients in the two groups were improved,there was no significant difference in preoperative Herring classification(U=51.000,P=0.608),the last follow-up Stulberg classification(U=51.500,P=0.683)and the last follow-up Mc Kay classification(U=52.500,P=0.753).Conclusion: After Salter pelvic osteotomy for DDH and LCPD,the acetabular containment of the femoral head increased,the acetabulum and the femoral head matched well,and the function of the hip joint recovered satisfactorily,which had a good short-term effect,and had no significant relationship with age.