Lei Ting,Zhu Guanghui,Liu Kun,et al.Comparative study of periacetabular sciatic notch osteotomy versus Pemberton osteotomy in the treatment of developmental hip dislocation in children[J].Journal of Clinical Pediatric Surgery,,21():731-737.[doi:10.3760/cma.j.cn101785-202204045-006]
Comparative study of periacetabular sciatic notch osteotomy versus Pemberton osteotomy in the treatment of developmental hip dislocation in children
- Keywords:
- Hip Dislocation; Congenital/SU; Osteotomy; Treatment Outcome; Follow-Up Studies; Child
- Abstract:
- Objective To compare the effects of periacetabular sciatic notch osteotomy (PASO) of pelvis and Pemberton osteotomy (PO) of pelvis in the treatment of developmental dislocation of the hip (DDH) in children.Methods From May 2004 to November 2021,DDH children undergoing PASO (n=47,61 hips) and PO (n=29,35 hips) were followed up.Correction degree of acetabulum index (CAI),terminal acetabulum index (TAI),central edge angle (CEA) and excellent/good rate of Severin radiological evaluation and McKay clinical hip function evaluation were compared.Results The average follow-up time was (7.14±1.59) years in PASO group and (5.77±0.60) years in PO group.The mean preoperative acetabular index was (39.66±5.46)° in PASO group and (41.47±3.48)° in PO group,postoperative CAI:PASO group (26.63±7.35)°,PO group (23.92±5.61)°(P>0.05);TAI:PASO group (12.25±8.17)°,PO group (16.67±4.98)°(P<0.01);CEA:PASO group (35.28±8.50)° versus PO group (29.05±7.60)°(P<0.01).The McKay hip function evaluation in PASO group:excellent 43 hips,good 13 hips,fair 4 hips,poor 1 hip.The excellent/good rate was 91.8%.PO group:excellent 30 hips,good 3 hips,fair 2 hips and poor 0 hips.The excellent/good rate was 94.2%.Severin rated PASO group:excellent 45 hips,good 14 hips,medium 1 hip,poor 1 hip.And the excellent/good rate was 96.7%;PO group:excellent 24 hips,good 8 hips,medium 3 hips,poor 0 hips.The excellent/good rate was 91.4%.In PASO group,there were 0 hips in AVN1 group,2 hips in AVN2 group,2 hips in AVN3 group and 4 hips in AVN4 group.The incidence of AVN was 13.1%.In PO group,there were 0 hips in AVN1 group,2 hips in AVN2 group,1 hip in AVN3 group and 3 hips in AVN4 group.The incidence of avascular necrosis of femoral head (AVN) was 17.1%.Conclusion As compared with pemberton osteotomy,PASO is an effective treatment of DDH.
References:
[1] Schaeffer E,Lubicky J,Mulpuri K.AAOS appropriate use criteria:the management of developmental dysplasia of the hip in infants up to six months of age:intended for use by orthopaedic specialists[J].J Am Acad Orthop Surg,2019,27(8):e369-e372.DOI:10.5435/JAAOS-D-18-00499.
[2] Perlik PC,Westin GW,Marafioti RL.A combination pelvic osteotomy for acetabular dysplasia in children[J].J Bone Joint Surg Am,1985,67(6):842-850.
[3] 梅海波,赫荣国,刘昆,等.髋臼坐骨切迹周围骨盆截骨对儿童DDH的疗效探讨[J].临床小儿外科杂志,2007,6(4):6-9.DOI:10.3969/j.issn.1671-6353.2007.04.003. Mei HB,He RG,Liu K,et al.Pelvic osteotomy with periacetabular-sciatic notch for developmental dysplasia of the hip in children[J].J Clin Ped Sur,2007,6(4):6-9.DOI:10.3969/j.issn.1671-6353.2007.04.003.
[4] T?nnis D.Normal values of the hip joint for the evaluation of X-rays in children and adults[J].Clin Orthop Relat Res,1976,(119):39-47.
[5] Coleman SS.The incomplete pericapsular (Pemberton) and innominate (Salter) osteotomies;a complete analysis[J].Clin Orthop Relat Res,1974,(98):116-123.DOI:10.1097/00003086-197401000-00012.
[6] Sharp IK.Acetabular dysplasia:the acetabular angle[J].J Bone Joint Surg,1961,43:268-272.
[7] Severin E.Contribution to the knowledge of congenital dislocation of the hip joint:Late results of closed reduction and arthrographic studies of recent cases[J].Acta Chir Scand,1941,84(7):565-566.DOI:10.1001/jama.1942.02830070071035.
[8] McKay DW.A comparison of the innominate and the pericapsular osteotomy in the treatment of congenital dislocation of the hip[J].Clin Orthop Relat Res,1974,(98):124-132.DOI:10.1097/00003086-197401000-00013.
[9] Kalamchi A,MacEwen GD.Avascular necrosis following treatment of congenital dislocation of the hip[J].J Bone Joint Surg Am,1980,62(6):876-888.
[10] Malvitz TA,Weinstein SL.Closed reduction for congenital dysplasia of the hip.Functional and radiographic results after an average of thirty years[J].J Bone Joint Surg Am,1994,76(12):1777-1792.DOI:10.2106/00004623-199412000-00004.
[11] Schoenecker PL,Strecker WB.Congenital dislocation of the hip in children.Comparison of the effects of femoral shortening and of skeletal traction in treatment[J].J Bone Joint Surg Am,1984,66(1):21-27.
[12] Salter RB.Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip[J].J Bone Joint Surg,1961,(43):518-539.
[13] Ertürk C,Altay MA,I?ikan UE.A radiological comparison of Salter and Pemberton osteotomies to improve acetabular deformations in developmental dysplasia of the hip[J].J Pediatr Orthop B,2013,22(6):527-532.DOI:10.1097/BPB.0b013e32836337cd.
[14] Salter RB,Dubos JP.The first fifteen year’s personal experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip[J].Clin Orthop Relat Res,1974,(98):72-103.DOI:10.1097/00003086-197401000-00009.
[15] Pemberton PA.Pericapsular osteotomy of the ilium for treatment of congenital subluxation and dislocation of the hip[J].J Bone Joint Surg Am,1965,47:65-86.
[16] Dega W.Transiliac osteotomy in the treatment of congenital hip dysplasia[J].Chir Narzadow Ruchu Ortop Pol,1974,39(5):601-613.
[17] Mubarak SJ,Valencia FG,Wenger DR.One-stage correction of the spastic dislocated hip.Use of pericapsular acetabuloplasty to improve coverage[J].J Bone Joint Surg Am,1992,74(9):1347-1357.
[18] Grudziak JS,Ward WT.Dega osteotomy for the treatment of congenital dysplasia of the hip[J].J Bone Joint Surg Am,2001,83(6):845-854.DOI:10.2106/00004623-200106000-00005.
[19] Tavares JO.Modified Pemberton acetabuloplasty for the treatment of congenital hip dysplasia[J].J Pediatr Orthop,2004,24(5):501-507.DOI:10.1097/00004694-200409000-00009.
[20] 朱振华,吕学敏,边臻,等.8岁以上儿童发育性髋关节脱位的术式选择及其近期疗效[J].中华骨科杂志,2014,34(12):1175-1182.DOI:10.3760/cma.j.issn.0253-2352.2014.12.001. Zhu ZH,Lyu XM,Bian Z,et al.Treatments and clinical outcome of developmental dislocation of the hip in children aged above 8 years[J].Chinese Journal of Orthopaedics,2014,34(12):1175-1182.DOI:10.3760/cma.j.issn.0253-2352.2014.12.001.
Memo
收稿日期:2022-4-14。
基金项目:国家临床重点专科建设项目-湖南省儿童医院小儿外科(湘卫医发[2022]2号);婴幼儿发育性髋关节脱位早期筛查及治疗(202218015914)
通讯作者:梅海波,Email:meihaibo@sohu.com