Hip & pelvis

  • 제30권4호
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  • Pages.260-268
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  • 2018
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
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DOI QR코드

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One-stage Hip Reconstruction for Developmental Hip Dysplasia in Children over 8 Years of Age

  • Qadir, Irfan (Department of Orthopaedic and Spine Surgery, Ghurki Trust Teaching Hospital) ;
  • Ahmad, Saeed (Department of Orthopaedic and Spine Surgery, Ghurki Trust Teaching Hospital) ;
  • Zaman, Atiq uz (Department of Orthopaedic and Spine Surgery, Ghurki Trust Teaching Hospital) ;
  • Khan, Chirag Muhammad (Department of Orthopaedic and Spine Surgery, Ghurki Trust Teaching Hospital) ;
  • Ahmad, Shahzad (Department of Orthopaedic and Spine Surgery, Ghurki Trust Teaching Hospital) ;
  • Aziz, Amer (Department of Orthopaedic and Spine Surgery, Ghurki Trust Teaching Hospital)
  • 투고 : 2018.06.14
  • 심사 : 2018.10.23
  • 발행 : 2018.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). Materials and Methods: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015. The average age at surgery was $11.02{\pm}3.43$ years. According to the Tonnis classification, there were 10, 14, 22, and 31 patients in grades 1, 2, 3, and 4, respectively. The pelvic procedure utilized in this study was triple osteotomy (47 hips) followed by double and Salter osteotomy (18 and 12 hips, respectively). Postoperative evaluations were conducted using the modified MacKay's scoring system (functional outcomes) and Severin's scoring method (radiological assessment). Results: Postoperatively, there were 38 (49.4%), 19 (24.7%), 14 (18.2%), and 6 (7.8%) hips in Severin grade I, II, III and IV, respectively. According to the modified McKay criteria, there were 22 hips (28.6%) in excellent condition, 44 (57.1%) in good condition, 9 (11.7%) in fair condition and 2 (2.6%) in poor condition. Both patients with poor outcomes had an unstable, painful hip with evidence of avascular necrosis of the femoral head. Conclusion: Based on the results presented here, we recommend the single stage procedure of open reduction, femoral shortening and pelvic osteotomy for treatment of DDH in older children with good to excellent functional and radiological outcomes.

키워드

참고문헌

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  1. Acetabular reaming and sartorius muscle pedicle iliac bone grafting in the treatment of developmental dysplasia of the hip in older children: a retrospective study of 15 patients with more than two ye vol.14, pp.3, 2018, https://doi.org/10.1302/1863-2548.14.190116
  2. Biomechanical investigation of pelvic stability in developmental dysplasia of the hip: unilateral salter osteotomy versus one-stage bilateral salter osteotomy vol.15, pp.None, 2018, https://doi.org/10.1186/s13018-020-01683-w
  3. Open reduction, Dega osteotomy and proximal femoral osteotomy in delayed diagnosis of developmental hip dislocation: outcome at 40-year follow-up vol.15, pp.2, 2018, https://doi.org/10.1302/1863-2548.15.210006
  4. The path to minimizing instability in developmental dysplasia of the hip: is Capsulorrhaphy a necessity or a futile habit? vol.22, pp.1, 2021, https://doi.org/10.1186/s12891-021-04065-3
  5. Accuracy of CT for measuring femoral neck anteversion in children with developmental dislocation of the hip verified using 3D printing technology vol.16, pp.1, 2021, https://doi.org/10.1186/s13018-021-02400-x