Long term curative effect for DDH treatment by combined close-reduction in children between 18~36 months old / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate long term curative effect on treatment of developmental dislocation of hip(DDH) in children between 18~36 months old by combined close-reduction method of adductor-cut,close-reduction and frog type plaster fixation.[Method]One hundred and fifty-six children(232 hips) treated by combined close-reduction method in 1993 to 2001 were followed-up with mean follow-up time of 9.2(5.5~14.5) years.There were 77 hips of grade Ⅰ dislocation,95 hips of grade Ⅱ,and 60 hips of grade Ⅲ according to Zhou Yongde grading criteria.Periodical imaginological and hip joint function examinations were evaluated and analyzed.[Result]One hundred and ninety-five hips obtained satisfactory concentric reduction with excellent and good rate of 84.05% according to Zhou Yongde criteria.There were 9 hips with femoral head necrosis at follow-up.Mean preoperative acetabular index(AI) of successful reduction hips was(35.34?5.96)%,and that of failure reduction hips was(44.51?5.32)%.The excellent and good rate were 84.41% in cases of grade Ⅰ hips,85.21% in grade Ⅱ hips,and 81.67% in grade Ⅲ hips.[Conclusion]Combined method of adductor-cut,close-reduction and frog type plaster fixation is an effective way for treatment of DDH of children between 18~36 months old.Preoperative AI but not degree of dislocation is the criteria to determine whether close-reduction is necessary or not.