The Effect Of Modified Salter Innominate Osteotomy For Treating Late-diagnosed Developmental Dysplasia Of The Hip

Objective:1.To introduce a new technique of modified Salter innominate osteotomy;2.To evaluate the clinical effects and surgical procedure of the modified Salter innominate osteotomy,and to compare the outcomes of traditional Salter innominate osteotomy.Methods:A retrospective analysis was conducted,involving the patient who require medical advice and had an operation of Salter innominate osteotomy(traditional or modified)for unilateral involved DDH in our hospital from January 2015 to December 2016.The preoperative,postoperative and final follow-up imaging data of all cases were collected,and the preoperative and postoperative Acetabular Index(AI)were measured to evaluate the surgical effect.The condition of the broken end of the osteotomy,the development of the femoral head and acetabulum were evaluated according to the imaging data of the last follow-up,judging whether there is complications such as malformation aggravating,dislocation recurrence or occurrence of avascular necrosis of the femoral head.All cases were classified with McKay assessment criteria.The operation time and total blood loss during the operation were calculated.The above parameters were used to evaluate the effects and surgical procedure of modified Salter innominate osteotomy and compared with traditional Salter innominate osteotomy.Results:All the involved hips received varying degrees of deformities correction after surgery.In the traditional group,the mean correction of acetabular index was 13.19±2.89 degrees,and the modified group had a mean correction of 15.46±4.29 degrees.In this study,there were differences in the corrective effects between the two groups(p<0.05)and it was considered that the modified group had greater corrective ability.However,there was no difference between the two groups in terms of surgical accuracy(p>0.05).All cased obtained follow-up for period(?6 months).Clinical evaluation was performed referring to the last follow-up.The excellent and good rates in the traditional group and the modified group were 86%and 94%,respectively,and the imaging evaluation matched.In terms of surgical procedure,the mean total amount of blood loss in the modified group was 83.89ml lower than that of the traditional group of 124.38ml with significant difference(p<0.05)while the means of the operation time of the two groups are the same(p>0.05).Conclusions:Modified Salter innominate osteotomy is effective for the early treatment of pediatric pediatric patients with acetabular dysplasia with an age of 1.5 to 4 years old.It is more concise than the traditional Salter pelvic in osteotomy procedure,and its total intraoperative blood loss is smaller,so it is worth popularizing.