Clinical characteristics of limb overgrowth after proximal femoral osteotomy for unilateral developmental dysplasia of the hip in children
10.3760/cma.j.cn121113-20250215-00141
- VernacularTitle:儿童单侧发育性髋关节发育不良股骨近端截骨术后肢体过度生长的临床特点
- Author:
Qingda LU
1
;
Chenxin LIU
;
Huan WANG
;
Yating YANG
;
Jiaju WANG
;
Xue HAO
;
Pengzhen CHENG
;
Qiang JIE
Author Information
1. 西安交通大学附属红会医院儿童病医院，西安 710054
- Publication Type:Journal Article
- Keywords:
Developmental dysplasia of the hip;
Osteotomy;
Limb overgrowth;
Leg length discrepancy
- From:
Chinese Journal of Orthopaedics
2025;45(10):613-620
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of limb overgrowth following proximal femoral osteotomy (PFO) for unilateral developmental dysplasia of the hip (DDH) in children.Methods:A retrospective analysis was conducted on 36 children with unilateral DDH who underwent PFO at Xi'an Honghui Hospital from June 2017 to June 2021. The cohort included 4 males and 32 females, with a mean age of 4.23±3.15 years (range: 2-12 years), comprising 28 left-sided and 8 right-sided cases. According to the International Hip Dysplasia Institute (IHDI) classification, there were 2 type I, 9 type II, 16 type III, and 9 type IV cases. Radiographic parameters [femoral length, femoral neck anteversion angle, neck-shaft angle, acetabular index (AI), center-edge angle (CEA), center-head distance discrepancy (CHDD)] and PFO parameters (varus angle, shortening length, derotation angle) were measured on X-ray and 3D CT reconstructions. Comparisons were made between the overgrowth ≥1 cm group ( n=14) and <1 cm group ( n=22) to analyze risk factors and patterns. Results:The overgrowth ≥1 cm group had significantly younger patients (2.49±1.03 years vs. 5.13±3.47 years, t=-2.757, P<0.001). Overgrowth magnitude varied significantly across age subgroups: 11.08±6.17 mm in the 2-4 years group, 5.08±0.19 mm in the >4-<6 years group, and 2.44±4.50 mm in the ≥6 years group ( F=5.436, P=0.031). The highest incidence of overgrowth occurred in the 2-4 years subgroup (56%, 20/36). Limb overgrowth initiated at 3 months postoperatively, exhibited a linear correlation with follow-up duration during 6-18 months [ r=0.78, 95% CI(0.62, 0.88), P<0.001)], and plateaued after 18 months [ r=-0.15, 95% CI(-0.75, 0.57), P=0.710]. Postoperative CEA and CHDD showed significant improvements ( P<0.05), while AI remained unchanged ( P>0.05). Conclusions:Children aged 2-4 years exhibit higher incidence and severity of post-PFO limb overgrowth. The rapid progression phase occurs within 6-18 months postoperatively, stabilizing thereafter. CEA and CHDD serve as critical indicators for evaluating intervention efficacy in DDH-related overgrowth.
