Analysis Of Clinical Efficacy Of The Severity Of The Dislocation Inlfuencing The Treatment In The Developmental Dislocation Of The Hip By Close Reduction

Objective：To evaluate the impact of severity of dislocation on the therapeutic effect of closereduction that was used to treat developmental dislocation of the hip (DDH).Methods：The results of close reduction for DDH in39children (62hips) were reviewed byX-ray and clinical examination. The degree of dislocation was evaluated by Tonnis’classification before operation. Curative effect was evaluated by Severin-standard andMckay-score; Avascular necrosis of the femoral head (AVN) was diagnosed accordingto the criteria of Kalamchi and MacEwen. Clinical and imageological datas weresummarized to analysis the difference among different severities of the dislocation.Results：46.9%of the patients (30/62) had satisfactory X-ray expression according to Severinclassification. Long-term satisfaction rate for Tonnis typeⅠ, typeⅡ, typeⅢ, typeⅣrespectively were92.9%,50.0%,18.8%and25.0%(P<0.05).77.4%of the patients(48/62) had satisfactory function according to Mckay Standard, The rate of excellentand well for Tonnis typeⅠ, typeⅡ, typeⅢ and typeⅣ respectively were100.0%, 83.3%,62.5%and50.0%(P<0.05). AVN of32.3%of the patients (20/62) wasobserved, and occurrences rates of AVN in different severity of the dislocation wererespectively0%,16.7%,56.3%and87.5%(P<0.05).Conclusions：The severity of the dislocation is one of the important factors affecting therapeuticefficacy. The lower the severity is, the better the therapeutic effect is, also with thelower occurrence rate of AVN.