| OBJECTIVE:To evaluate the clinical effect of Bernese periacetabular osteotomy on the treatment of the developmental dysplasia of the hips. This research aim for optimizing the therapeutic effects of the surgery and explore its cautions and indication, provide more data for the operation of the developmental dysplasia of the hips.METHODS.Totally 15 cases(16 hips) were adopted in this study who diagnosed as developmental dysplasia of the hip in our orthopaedics department from March 2013 to May 2014. Diagnostic criteria based on Huang jiasi surgery. All the patients treated upon Bernese periacetabular ostoeotomy. The main clinical symptoms were measured, compared and analyze on admission and at 6 months after surgery, including the CE angle, AC angle, Sharp’s angle, Harris hip score, the numbers of each Tonnis grade, femoral head coverage rate and total effective rate.RESULTS:1.The average CE angle increased from(11.5±8.8)°to (23.6±5.1)°(t=4.58,P<0.05).The average AC angle was decreased from (49.2±4.8) °to (11.4±2.8) °(t=4.36, P<0.05). The average Sharp’s angle was decreased from (49.2±4.8) °to (38.1±5.5) (t=4.21, P<0.05). The data above were all significant statistically differences after surgery.2. According to the Harris hip joint score, patients were classified as level "A", "B", "C", "D". Preoperative assessment of Harris hip joint score were A:0, B:4, C:8, D:4, meanwhile Postoperative assessment were A:3, B:9, C:3, D:1. The mean Harris hip score was improved from (75.4±3.5) to (88.4±4.2) after Bernese Periacetabular ostoeotomy(t=4.55,P<0.05). After surgery, the number of hips on levelA and B both elevated significantly (X2=5.49, P<0.05;X2 =4.76, P<0.05) accompanied with the number of hips on level C and D obviously decreased (X2=5.21 P<0.05;X2=4.87, P<0.05)3.The average anterior femoral head coverage rate increased from (22.1±2.4)%to (36.3±3.5)%(t=3.91, P<0.05). The average posterior femoral head coverage rate improve from (31.6±3.4)%to(37.2±4.2)%(t=4.18,P<0.05). The average femoral head coverage rate raised from (53.7±3.6)%to (73.5±3.9)%(t=4.61, P<0.05) These were significant statistically differences after surgery.4.Tonnis grade including 4 stages:stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲ. Preoperative evaluation of Tonnis grade were stage 0:4, stage Ⅰ:3, stage Ⅱ:8, stage Ⅲ:1, meanwhile postoperative evaluation of Tonnis grade were stage 0:8, stage Ⅰ:6, stage Ⅱ:1, stage Ⅲ:1. After operation, the number of hips on stage 0 and stage Ⅰ increased obviously (X2=5.49, P<0.05; X2=4.76, P<0.05), while the number of hips on stage Ⅱ, stage Ⅲ were no significant change (X2=5.21, P<0.05; X2=4.87, P<0.05)5.After surgery,13 cases were recovered and 4 cases were improved and 1 case unhealed, the percentage in total patients is 81.25%,12.50%,6.25% respectively. The clinical efficacy rate is 93.75%.Conclusions:1.After Bernese periacetabular ostoeotomy, CE angle, AC angleand, Sharp’s angle were ameliorated and the mean Harris hip score increased obviously. The results suggested this surgery is effective in alleviating movement, relax and ease the pain, improve patients’quality of life.2. The average femoral head coverage was increased significantly after Bernese surgery. After operation, the number of the hips on stage 0, stage Ⅰ and stage Ⅱ incresed obviously while no difference on stage Ⅲ, implies the surgery is more helpful for the patients in early-stage, but is useless in the later stages.3.Bernese periacetabular ostoeotomy have an excellent therapeutic effects on the treatment of the developmental dysplasia of the hips, which is worthy of further investigation and promotion. |
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