A new technique of angulated innominate osteotomy for treating developmental dysplasia of the hip
10.3760/cma.j.issn.0253-2352.2019.17.004
- VernacularTitle: 折线形骨盆截骨治疗发育性髋关节发育不良
- Author:
Bo LIU
1
;
Shu CHEN
2
;
Ming YANG
2
;
Weiping WU
2
;
Dadi JIN
3
;
Xu LI
3
Author Information
1. Department of Pediatric Orthopaedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China (is working on the Department of Orthopaedics, Shenzhen Children's Hospital, Shenzhen 518000, China)
2. Department of Pediatric Orthopaedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
3. Huaxin Orthopaedic Hospital, Guangzhou 510000, China
- Publication Type:Clinical Trail
- Keywords:
Child;
Pelvis;
Osteotomy;
Hip dislocation, congenital
- From:
Chinese Journal of Orthopaedics
2019;39(17):1061-1067
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce a new technique of angulated innominate osteotomy modified from Salter innominate osteotomy and to compare its early clinical effects with the traditional Salter technique.
Methods:Data of 45 cases treated with innominate osteotomy from January 2015 to December 2016 were retrospectively analyzed. There were 14 cases (1 male and 13 females; average age 34.21 months, range from 20 to 43 months) treated by traditional Salter innominate osteotomy (the traditional group) and 31 cases (5 males and 26 females; average age 25.42 months, range from 17-42 months) treated by angulated innominate osteotomy (the modified group). The acetabular index was evaluated radiographically for assessing surgical effects. The operation time and total blood loss during the operation were also collected. McKay method was used for clinical evaluation at the last follow-up. The images of the follow-ups, including the latest one, were used to confirm the exist of complications of avascular necrosis of femoral epiphysis, re-dislocation or subluxation of the hip.
Results:The mean follow-up time of traditional group was 23.64 months (range, 8-50 months) and modified group's was 18.94 months (range, 8-35 months). The mean time consumption of modified group (262.42±67.56 min) was significantly lower than traditional group's (306.43±48.37 min) (t=2.482, P=0.018) and the mean total amount of blood loss in the modified group was 81.28±29.00 ml, significantly lower than that of the traditional group's of 117.85±45.55 ml (t=2.762, P=0.013). All the involved hips in the two groups achieved varying degrees of deformities correction after surgery. In the traditional group, the mean correction angle was 13.19°±2.89°, compared to 15.46°±4.29° of the modified group's, and there was statistical differences (t=-2.078, P=0.045). As for McKay results, the excellent combined with good rates in the traditional group and the modified group were 86% and 90%, respectively. The occurrence rate of avascular necrosis of modified group was about 25.81% while traditional group's was 50%. Two patients had subluxation signs in the traditional group.
Conclusion:In this research, the angulated innominate osteotomy had good early outcomes with less blood loss and lower incidence of complications than the traditional one.
