ABSTRACT
This is a series of 7 children (14 hips) with a mean age of 7.3 years (range, 3.3-10.5 years) and an underlying diagnosis of developmental dysplasia of the hips and no previous open-hip surgery who underwent plain radiographic and magnetic resonance imaging (MRI) measures of bony acetabular index. There was a significant correlation between the measurement of acetabular index using plain radiography and MRI, with a Spearman correlation coefficient of 0.88 (95% confidence interval, 0.61-0.96; P<0.001) and a mean difference between the 2 measures of 0.36+/-6.5 degrees. Furthermore, the bony and cartilaginous acetabular indexes as measured by MRI had a significant correlation with a Spearman correlation coefficient of 0.88 (95% confidence interval, 0.80-0.98; P<0.001). We suggest that plain radiography is still an appropriate tool for follow-up for the nonoperated hip with developmental dysplasia and may be a good indicator of hip cartilaginous development.
Subject(s)
Acetabulum/diagnostic imaging , Hip Dislocation, Congenital/classification , Hip Dislocation, Congenital/diagnosis , Image Interpretation, Computer-Assisted/methods , Magnetic Resonance Imaging , Radiography , Severity of Illness Index , Acetabulum/pathology , Child , Child, Preschool , Female , Humans , Male , Outcome Assessment, Health Care/methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Tibial osteotomies in children have been associated with a number of complications. A retrospective review of 116 children who had 129 tibial osteotomies was performed to assess these complications at our institution. Results showed that there were 35 cases of wound problems, 6 cases of recurrence/reoperation, 5 cases of delayed union, 2 cases with transient peroneal nerve palsy, 1 case of nonunion, and 1 case of mal-union. Patients having certain comorbidities had a higher frequency of complications. There were no significant differences between the location of the tibial osteotomy (proximal or distal) and the incidence of complication. External fixation was associated with a lower incidence of complications than the use of pins and casting. Although our results demonstrate an overall low complication rate, there is a significant association between complications and comorbid conditions. This highlights the need to recognize comorbidities preoperatively and the potential of increased postoperative complications.
