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Objective The objective was to discussing the difference between the Pemberton osteotomy and Salter osteot?omy which performed in patients between the ages of 2 and 3 years who suffered from developmental dislocation of the hip (DDH). Methods A retrospective review of the results of operation treatment for DDH in 59 children (84 hips) from January 1998 to De?cember 2008 was conducted. There are 10 boys (14 hips) and 49 girls (70 hips). The age of the patients was between 2-3 years old at the time of treatment 2.5±0.4 years. Surgery consist of open reduction of the hip, capsulorraphy, shortening and derotational oste?otomy of proximal femur, and innominate osteotomy which include Pemberton osteotomy (33 hips), Salter osteotomy (51 hips). McKay and Severin modified criteria were used to assess the function and radiographic results of the hip. Results The average follow?up time was 5.6±3.5 years ranging from 2 to 16 years. According to Severin criteria at final follow?up, 78 hips (93%) had ex?cellent and good results;4 hips were fair and 2 hips poor result. The radiology results in Salter osteotomy were better than Pember?ton osteotomy (rate of excellent and good results 100%vs. 82%,χ2=7.43, P=0.003). According to the McKay criteria Salter osteoto?my and Pemberton osteotomy have no significant difference in latest follow?up (the satisfactory rate 100%vs. 97%,χ2=1.56, P=0.39). 18 hips (21%) had proximal femoral growth disturbance which 10 hips in Pemberton group, 8 hips in Salter group. There is no significant difference (χ2=2.54, P=0.17). Conclusion Open reduction, innominate osteotomy and proximal femoral osteotomy were effective procedures for the treatment of DDH in children between 2-3 years old. More attention should be taken in Pember?ton osteotomy to prevent the acetabular bony edge absorption.

9.Tumors and tumor-like lesions of the foot and ankle: 170 cases treated in a tertiary referral center

Xiangdong LI ; Yu ZHANG ; Zhen WANG ; Zheng GUO

Chinese Journal of Orthopaedics 2012;32(11):1066-1072

Purpose To investigate epidemiology and clinical features of tumors and tumor-like lesions of the foot and ankle,as well as prognosis of malignant tumors.Methods A total of 170 patients,surgically treated for bone and soft tissue tumors of the feet and ankle between 1984 and 2009 in a tertiary referral center specializing in orthopedic oncology,were enrolled in this retrospective study.The age,gender,clinical feature,tumor types,anatomical sites,the correlation between tumor size and tumor types,and the prognosis of malignant tumor were analyzed.Results There were 91 males and 79 females,aged from 7months to 76 years (average,33.1 years).There were 51 cases of bone tumor and 119 cases of soft tissue tumor.Benign tumors commonly occurred in the second and third decades of life,with an average age of 29.54years,while most malignant tumors occurred in patients aged between 40 and 59 years,with an average age of 43.73 years.Skin lesion was a symptom implying malignance.Soft tissue tumor and benign tumor were the most common types in the foot and ankle.Giant cell tumor of the tendon sheath was the most common type among benign soft tissue tumors; subungual exostosis and enchondroma were the most common types among benign osseous tumors; while melanoma and synovial sarcoma were the most common types among malignant soft tissue lesions.Both primary and metastatic bone tumors were very rare.Forefoot was the most common site where foot and ankle tumors happened.There was no correlation between tumor size and types of soft tissue tumor,while there was a high correlation between tumor size and types of bone tumor.Among 44 patients with malignant tumor,16 patients underwent limb salvage surgery,while 28 patients underwent amputation.The mean duration of follow-up was 32.4 months.Six patients survived with no evidence of disease.The 5-year survival rate was 16.13％.Conclusion Benign and soft tissue tumors are the most common tumors in the foot and ankle.Most malignant tumors occur in patients over 40 years of age.Skin lesion is a useful symptom in diagnosing malignant tumor.Forefoot is the most common site where tumor happened.There is a high correlation between tumor size and tumor types.The prognosis of malignant tumor is very poor.