| Background:Developmental dislocation of the hip(DDH)is one of the common joint deformity disease in pediatric orthopedics.DDH,a kind of developmental disorder,can cause various kinds of bone defects in structure of the hip,which lead to abnormal development of acetabulum and flabby ligaments around hip joint,and would result in subluxation of the hip joint or complete dislocation,even disability in adult.Object:By analyzing the results from children aged 1.5 to 6 years with DDH diagnosed who underwent one-stage combined proximal femoral osteotomy and Salter pelvic osteotomy surgical treatment,we evaluate the efficacy of this procedure and sum up its advantages.Method:A retrospective review of 75 children aged 1.5 to 6 years with DDH diagnosed who underwent one-stage combined proximal femoral osteotomy and Salter pelvic osteotomy surgical treatment.Result:During follow-up,60 hips(67.4%)were excellent,19 hips(21.3%)were good,6 hips(6.7%)were fair,and 4 hips(4.5%)were poor,according to McKay clinical criteria,with an overall clinical excellent rate was 88.8%.The clinical excellent and good rate in group 1(aged 18-month to 2years old)was 100%,rate in group 2(aged 2 years old to 4 years old)was 90.7%,and rate in group 3(aged 4 years old to 6 years old)was 73.7%.The clinical excellent and good rate in group 1 and group 2 were greater than 90%,and the differences among three groups was statistically significant(P<0.01).According to Severin radiological assessment criteria,62 hips(69.7%)were Excellent,18 hips(20.2%)were Good,5 hips(5.6%)were Fair and 4 hips(4.5%)was Poor,with an overall radiological excellent rate was 89.9%.The radiological excellent and good rate in group 1 was 100%,rate in group 2 was 88.9%,and rate in group 3 was 84.2%.The radiological excellent and good rate among three groups were greater than 80%,and the differences among three groups was statistically significant(P<0.01).Meanwhile,four children(4.5%)were diagnosed with AVN,with two cases in group 2(1 Grade Ⅰ,1 Grade Ⅱ),two cases in group 3(1 Grade Ⅰ,1 Grade Ⅱ).Redislocation occurred in two Patients(2.2%).Conclusions:For children aged 1.5 to 6 years,one-stage combined proximal femoral osteotomy and Salter pelvic osteotomy surgical treatment could correct femoral and acetabular deformities DDH caused,which is a demanding technique but also a satisfactory surgical procedure.This treatment could improve the anterolateral coverage of the femoral head and provide stability on the load-bearing surface.This operation could also reduce the duration of treatment and eliminate the need for preoperative traction,without an increase in the risk of avascular necrosis.In this study,we conclude that the optimal age for this approach is before the age of 4 years. |
