Pemberton's Acetabuloplasty In The Treatment Of Dysplasia Dislocation Of Hip In The Children

BackgroundDysplasia dislocation of 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 7 times than left. Although the cause of a disease is not very clear, many scholars′research consider dysplasia dislocation of hip is the result of heredity factor and environment factor in China and foreign country.The main pathological change of dysplasia dislocation of 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 dysplasia dislocation of 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 dysplasia dislocation of hip concerned with age and pathology typing,so should basis different pathology variance choose different treatment method.The treatment method very much,but curative effect vary, especially advanced stage patient and age larger than 7 years children curative effect disaffect, early diagnosis and rational therapy have important significance to improve prognosis. Pemberton's acetabuloplasty can procure good clinical therapeutic efficacy to treat developmental dislocation of the hip in children.The injury of this operation is little than basin osteotomy,after reposition the hip joint stable, acetabular index retrieve satisfaction, after operation joint function reablement satisfaction, joint function stiffness is little .ObjectiveTo explore the experiences of treating dysplasia dislocation of hip (DDH) of children. MethodsFrom Jan 2003 to Feb 2007,118 hips in 92 patients(17 male,75 female)with developmental dislocation of the hip underwent Pemberton's acetabuloplasty ,and 30cases underwent operation on left hip,36 cases on right hip,26 cases on both hips,of them there were 42 cases underwent femur rotation osteotomy .ResultsAll patients were followed up for a period from 2 years to 6 years (mean,4 years and 2 months),and were assessed clinically and radiologically.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 87 cases (73.73 % ), good 24 cases (20.34%),acceptable 7 cases (5.93%),poor 0 case (0%), the overall excellent or good rate was 94.07% .Radiological assessment was perform edaccording to Severin'S classification.To observe the shape of femoral head and acetabular bone and the relation of them, measuring the CE angle and acetabular index, and the results showed that excellent 85 cases (73.03%), good 23 cases (19.49%),acceptable 10 cases (8.48%),poor 0 case (0%),the overall excellent or good rate was 91.52% . ConclusionsPemberton's acetabuloplasty can procure good clinical therapeutic efficacy to treat developmental dislocation of the hip in children.The injury of this operation is little than basin osteotomy,after reposition the hip joint stable, acetabular index retrieve satisfaction, after operation joint function reablement satisfaction, joint function stiffness is little .So, Pemberton's acetabuloplasty is an effective method to treat developmental dislocation of the hip in children.