| Objective:Through analysis the imaging and immunological changes before and after operation of 1.5 years old~4 years old children with DDH undergoing Salter innominate osteotomy and allogeneic bone implantation, to discuss the early postoperative immune rejection and short-medium tearm clinical effects.Methods:Forty DDH children of Shanxi children hospital undergoing Salter innominate osteotomy and allogeneic bone implantation were collected from March 2012 to March2015,whose ages were 1.5 years old~4 years old,including 8 boys and 32 girls. The postoperative follow-up time of forty children was 9 months~2.5 years,and 38 cases with complete preoperative and postoperative imaging data and follow-up time above one year.The 37 cases of hip-joint were selected as the experimental group,and 37 normal hips in 37 childen with hip dislocation were selected as control group.By comparing the preoperative and postoperative changes of acetabular index and femoral neck anteversion,using the Mckay hip score and X-ray Severin clinical criteria,to evaluate the clinical effect of Salter innominate osteotomy in the treatment of hip dislocation.And by comparing the changes of immunological indexes in all the patients during preoperation and 7 days after operation, to evaluate the early immune rejection after allogeneic bone transplantation.At last,applying SPSS17.0 software and then process statistical analysis.Results:1.The postoperative body temperature of majority children was elevated, fluctuating in the 37.4 °C~38.5 °C, it began to recover on fourth day after the operation,dropped to normal on seventh day,and the bodys were in good condition.White blood cell count began to increase in first days after operation, and it falled to normal in one week.All incisions were healed well without incisional infection one year later.2.The study shows that there is no statistically significant difference between preoperation and postoperation about CD3,CD4 and CD8(P>0.05). The CD4/CD8-group,C3-group and C4-group had no statistically significant difference between preoperation and postoperation(P>0.05).3.The AI and FNA of experimental group followed-up improved obviously between preoperation and one year after operation(P<0.05).Compared with the control group, the AI and FNA were not significantly different after treatment(P>0.05).There is no statistically significant difference about AI and FNA of control group between preoperation and one year after surgery. There is statistically significant difference about AI and FNA of peroperation between experimental group and control group.4.The excellent and good rate of 38 children’s hip-joint adopting Mckay scale rule is89.4%,and which adopting Severin scale rule is 84.2% in one year postoperation.Conciusion:1.Although WBC count and body temperature were increased slightly in the early postoperative period, they were not caused by infective factors.2.Immunological rejection of mix up autogenous bone with allogeneic bone in Salter innominate osteotomy and allogeneic bone implantation is not obvious,and there was no adverse effect on the healing of bone graft and hip joint function in the late stage.3.The short-term imaging changes and hip function of Salter osteotomy and allograft bone implantation treating DDH were improved significantly,and the clinical effects were better.4.It may play a certain role in enhancing the stability of bone graft and reducing the immune rejection to combine the broken bone pieces of children with the allograft bone. |
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