The Meta Analysis Of Salter Osteotomy And Pemberton Osteotomy In The Treatment Of Developmental Dysplasia Of The Hip In Pre-school Children

Objective:Comparing the clinical results of the Salter osteotomy and Pemberton osteotomy in treatment of developmental dysplasia of the hip(DDH) in pre-school children of Meta analysis.Methods: Through the computer retrieval Pubmed, OVI- MEDLINE, WEB OF SCIENCE, Spingerlink,CBM(Chinese bio-medical), China national knowledge internet(CNKI), China Dissertation Database(CDDB), China’s VIP’s official website and manual search some magazines, such as collection(January 1961- December 2015) published Salter osteotomy and by Pemberton osteotomy in the treatment of 1.5 to 6 years old pre-school children developmental dysplasia of the hip(DDH).According to the inclusion criteria and exclusion criteria selection literature, the research of into line quality evaluation and data extraction, using Stata11.0(Statistics/Data Analysis Special Edition) Meta analysis software for the extracted data, binary classification variables using Relative Risk(RR) statistics, continuous variables using the weighted mean differences(SMD) statistics.Results: Through reading and screening all the literatures, a total of five articles were included in this meta-analysis, are using Salter osteotomy and by Pemberton osteotomy treatment of developmental dysplasia of the hip that preschool(developmental dysplasia of the hip, DDH) of children with clinical control study, a total of 364 cases of hip, which USES Salter osteotomy therapy in 175 patients, using by Pemberton osteotomy with 189 cases of treatment.Respectively using the Index of the acetabulum, Severin hip X-ray rating, hip joint function recovery standards: Mc Kay clinical evaluation classification to compare and assess the two kinds of operative methods in treatment of developmentaldysplasia of the hip treatment, postoperative cotyle by computing the two kinds of operation Index(Acetabular Index, AI) measurements, the analysis of statistics Q = 2.40, Q < χ20.05, 3 = 9.49, still can’t believe the project overall effect value is different, so the choice of fixed effects model analysis, and calculate the effect of combined value of 95% Confidence Interval(the Confidence Interval, CI) =(-0.497,-0.062).And adopt Stata11.0(the Statistics/Data Analysis Special Edition) software to Meta Analysis of the extracted Data, the Salter and by Pemberton group preoperative and postoperative acetabulum index(AI) value changes to calculate the standardized mean differences(Standard mean Difference, SMD) =-0.280.In the research literature by Severin hip X-ray rating compared two kinds of operation: recovery of acetabulum Salter fine rate was 91.77%, and by Pemberton group is 89.66%;According to the hip joint function recovery standards: Mc Kay clinical evaluation grading to compare postoperative function recovery of hip: through clinical observation found that the included in the study of postoperative functional recovery of hip fine rate was 83.92%.Conclusions: 1.Salter osteotomy through the analysis of the clinical research and by Pemberton osteotomy for the treatment of preschool developmental dysplasia of the hip(developmental dysplasia of the hip, DDH), all can obtain satisfactory clinical effect.2.In comparison the clinical therapeutic effects of two kinds of operation, no obvious difference was found between the two, and wider clinical scholars are familiar with.3.Because of this study included in these literatures are based on retrospective study, and research design is rigorous, exist the possibility of all kinds of bias.In a further conclusion, therefore, requires multiple design science, multicenter, large sample, prospective studies to confirm.The Clinical observation of Acetabular Index change of developmental Dysplasia of the hip after Salter osteotomyObjective:To study the Salter osteotomy of DDH with acetabulum index of the influence of the change trend of clinical research.Methods: By choosing January 2005- December 2014 in our hospital treated with complete clinical data of DDH patients, including 13 cases of children with 36 cases and Perthes, adopt Salter pelvic osteotomy therapy, measured preoperative children develop and the acetabulum index of hip, hip surgery, postoperative 1 month,post-operative 3 months, post-operative 6 months, postoperative of 12 months and 24 months of postoperative patients with hip and the acetabulum of hip index data, using SPSS17.0 software for statistical analysis, to study the Salter osteotomy of DDH with acetabulum index change trend of clinical observation.Result:By means of two groups of children with preoperative and post-operative 1 month, 3 months, 6 months, 12 months and 24 months of A, B group of measurement and calculation of the acetabulum index AI, we can find that, for the clinical observation of A group of children with DDH-affected side hip acetabulum index averaged 39.66 °, the DDH-unaffected side hip acetabulum index averaged 22.12 °, and the measurement of 24 months of postoperative acetabulum index averaged 18.98 °, the contralateral an average of 17.14 °;Group B group of children with Perthes-affected side hip acetabulum index averaged 18.64 °, the Perthes-unaffected side hip acetabulum index averaged 18.51 °, and the measurement of 24 months of postoperative acetabulum index averaged 11.80 °, average of 14.92 ° of the healthy side.Description of acetabulum AI is gradually decline, and in the treatment of DDH 24 months after operation, Salter osteotomy can obviously reduce the AI of acetabulum.And through calculation of 24 months after A group of DDH children develop and the acetabulum of hip hip AI value decline in value of the mean and standard deviation, the matching design of mean comparison, there is statistical significance, explain Salter osteotomy can obviously reduce the AI of acetabulum, 24 months after an average of 20.68 °.Calculated after 24 months of group B Perthes children develop and the acetabulum AI value of hip hip drop value matching design of mean comparison, there is statistical significance, can increase the tolerance of femoral head, has good clinical significance.Conclusions:1. Salter osteotomy can effectively reduce the DDH with acetabulum index, and the postoperative follow-up observations, impact on the change trend of acetabulum index is significant. 2.Salter osteotomy in treating Perthes disease, can increase the acetabulum inclusive of femoral head, for "inclusive therapy" treatment Perthes disease provides certain clinical basis.