Femoral head coverage rate of CT in evaluation of Salter osteotomy for developmental dislocation of hip in children / 上海第二医科大学学报

Objective To analyse the femoral head coverage rate of CT in evaluation of Salter osteotomy for developmental dislocation of hip(DDH) in children. Methods Thirty-eight patients with unilateral DDH for Salter osteotomy were enrolled,and X ray photography of pelvis and spiral CT scanning of femoral articulation were performed one week before and 6 months after Salter osteotomy.The femoral head coverage rate of X ray and that of CT were calculated and compared.Another 38 children with normal femoral articulation were served as controls. Results The femoral head coverage rate of X ray was significantly higher than that of CT in patients with DDH(P

Bikini Cut Treatment for Childhood Developmental Dislocation of Hip / 实用儿科临床杂志

0.05).But in Bikini cut group,there was no intraoperative lateral femoral cutaneous nerve injury,and operation cut was so hidden and so parents were willing to accept the operation.If it was hecessary to carry out femur rotation osteotomy and internal fixation of femur,the steel plate accords with the principle of tension band,so the fixation could be stable and the fracture can easily heal up.Conclusions In the treatment of DDH,Salter pelvic osteotomy through Bikini cut has exact clinical efficacy comparing with S-P cut,and its operation cut is safe,hidden,and there is rare injury to joint function after operation.

The Results of Treatment in Developmental Dislocation of the Hip between 6 and 24 Months Old / 대한정형외과학회잡지

PURPOSE: To evaluate the outcome of treatment for developmental dislocation of the hip (DDH) in children in whom the treatment was delayed until they were 6 to 24 months old. MATERIALS AND METHODS: Fifty two hips of 48 children between 6 and 24 months old, who have not been treated for DDH were selected for this study. The treatments for these children were closed reduction in 16 hips and open reduction in 36 hips. Patients were followed-up for 11 years on average and for 5 years at minimum. RESULTS: According to Severin's classification, 39 hips (75%) were included in the `satisfactory group', while 13 hips (25%) were `unsatisfactory'. The `unsatisfactory group' consisted of 7 hips showing an impaired secondary ossification center in the acetabular rim, 5 hips with persistent resubluxation after weaning the orthosis, and one hip showing severe coxa magna. Additional bony procedures for the underdeveloped acetabuum and/or proximal femur were required in 12 hips, except for one showing severe coxa magna. CONCLUSION: The radiological outcome of DDH in children in whom the treatment was delayed until 6 to 24 months old was satisfactory in 39 hips (75%). Unsatisfactory hips required additional bony procedures, which we expect will improve the final outcome.

Coxa Magna after Open Reduction of Developmental Dislication of Hip: Contributing factors and Acetabular development / 대한정형외과학회잡지

The authors reviewed 50 patients of congenital dislocation of the hip who had surgical treatment at the Department of Orthopedic Surgery, Seoul National University Children's Hospital from October, 1985 to August, 1993. We investigated the contributing factors to coxa magna after surgical treatment and it's relationship to the avascular necrosis of femoral head, and observed the influnce of coxa magna on the development of the hip joint. Coxa magna was defined as a femoral head with the greatest diameter 15% greater than the opposite side. To assess the development of the acetabulum in the hips with coxa magna, radiographical horizontal and vertical parameters were measured preoperatively, and at postoperative 1 year, 2 year, and 3 year or more. Twenty-one of fifty hips had coxa manga. The incidence of coxa magna increased in patients who had open reduction at younger age(average 30 months), compared to older age(average 44 months). Neither femoral osteotomy nor pelvic osteotomy increased statistically the incidence of coxa magna. Avascular necrosis of femoral head did not necessarily resulted in coxa magna. There were not statistically significant differences in the coverage ratios of femoral head by the acetabulum between coxa magna positive and negative groups, because lateral acetabular growth accompanied in accordance with enlargement of femoral head in the majority of cases with coxa magna. Open reduction alone caused concomitant vertical overgrowth of ipsilateral hemi-pelvis with resultant pelvic tilt and leg length inequality(IHD>5mm, upto 2cm) in 6 of 10 cases. The patients, who had coxa magna with good radiological results by Severin's classification, underwent open reduction at younger age and had lesser enlargement of the femoral head, compared to those with fair or poor results.