Arthrography Monitoring In The Closed Reduction Of Developmental Dysplasia Of Hip

Objective: To investigate the usage value of the arthrography monitoring in the closedreduction of developmental dysplasia of hip(DDH)．Methods: A total of60patients with DDH which had been firstly operated in ourhospital from Jan.2007to Nov.2011，between12～24months old，the clinical data of themwere collected for statistical analysis.Two groups of patients were treated by the same clinicalteam.Bilateral long adductors and the side sufferring from iliopsoas tenotomies wereperformed, close redution of the hip was used during operation and self-made adjustableexternal fixation were used after operation.The30patients (36hips) in arthrography groupused arthrography monitoring during operation.The30patients (34hips) in control groupdid not used arthrography monitoring during operation.The medial distance between femoralhead and acetabular,fixed abduction of hip and so on were analyed statistically. Redislocationand release of soft tissue in the acetabular were recorded. All of statistic was dealed withSPSS13.0.Results: All of the60patients were followed up for3months at least.①The medialdistance between femoral head and acetabular:0.5～3.5mm (averaged1.78士0.79mm) inarthrography group,0.9～9.3mm (averaged5.54士2.17mm) in control group.②Fixedabduction of hip:30～75degrees (averaged56.00士9.57degrees) in arthrographygroup,60～85degrees (averaged73.59士6.79degrees) in control group.③Redislocation:0patients (0hip) in arthrography group,3patients (3hips) in control group.④Release of softtissue in the acetabular:5patients in arthrography group.Arthrography during operationshowed that the larger distance of the femoral head and acetabular, not to maintain headacetabular concentric reduction.Ferguson surgery were performed from adductorincision,founding the round ligament thick, after the removal of the round ligament, onceagain reduced, up to head acetabular concentric reduction.Safety angle of1patient was10degrees in control group. Ferguson surgery were performed.The thick round ligament wasedremoved, in order to maintain head acetabular concentric reduction and hip stability.Conclusions: Arthrography monitoring can evaluate the anatomy of the hip in theclosed reduction of DDH.It shows clearly that the actual size of the femoral head and grossmorphology of the acetabulum.The soft tissue factors between the femoral head andacetabulum can be identified. It can monitor the stability and accuracy of the reduction andguide hip abduction when hip is fixed by the brace. It is a simple, safe, and effective method.