Li Jingchun,Liu Yanhan,Li Yiqiang,et al.A multicenter prospective non-randomized controlled protocol on timing and indications of pelvic osteotomy for residual acetabular dysplasia after closed reduction of developmental dislocation of the hip[J].Journal of Clinical Pediatric Surgery,,():527-534.[doi:10.3760/cma.j.cn101785-202405072-005]
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A multicenter prospective non-randomized controlled protocol on timing and indications of pelvic osteotomy for residual acetabular dysplasia after closed reduction of developmental dislocation of the hip

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2024 06 Page: 527-534 Column: 专题·儿童骨科多中心临床研究 Date of publication: 2024-06-01
Author(s):
Li Jingchun1;  Liu Yanhan1;  Li Yiqiang1;  Zhu Guanghui2;  Guo Yueming3;  Li Ming4;  Kang Xiaopeng5;  Tang Shengping6;  Shen Xiantao7;  Shao Jingfan8;  Chen Shunyou9;  Jiang Fei10;  Li Jin11;  Xu Hongwen1;  Chinese Multicenter Pediatric Orthopedic Study Group (CMPOS)12
1. Department of Pediatric Orthopedics, Municipal Women & Children’s Medical Center, Guangzhou 510623, China;
2. Department of Pediatric Orthopedics, Hunan Children’s Hospital, Changsha 410007, China;
3. Department of Pediatric Orthopedics, Municipal Hospital of Traditional Chinese Medicine, Foshan 528000, China;
4. Orthopedic Center, Affiliated Children’s Hospital, Chongqing Medical University, Chongqing 400014, China;
5. Department of Pediatric Orthopedics, Kunming Municipal Children’s Hospital, Kunming 650228, China;
6. Department of Orthopedics, ShenzhenMunicipal Children’s Hospital, Shenzhen 518038, China;
7. Department of Pediatric Orthopedics, Affiliated Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430015, China;
8. Department of Pediatric Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China
Keywords:
Developmental Dysplasia of the Hip; Hip Dislocation; Congenital; Closed Reduction; Residual Acetabulalr Dysplasia; Osteotomy; Pelvis; Clinical Protocols; Multicenter Studies as Topic
DOI:
10.3760/cma.j.cn101785-202405072-005
Abstract:
Closed reduction under general anesthesia and plaster fixation in human position are commonly applied for treating developmental dislocation of the hip (DDH) under an age of 24 months.However,around one-third of patients still experience residual acetabular dysplasia after closed reduction.Although pelvic osteotomy is widely utilized for residual acetabular dysplasia,its accurate surgical timing and indications have remained elusive.This study was designed to explore timing and indications of surgical intervention for residual acetabular dysplasia after closed reduction of DDH through a multicenter,prospective and non-randomized controlled trial.There were 183 children in observation group and 100 in pelvic surgical intervention group.The surgical group underwent Salter and Pemberton,Triple pelvic or Periacetabular osteotomy based upon age.The follow-up period was at least 10 years.Anteroposterior radiographs of hip joint were taken at 8 timepoints of 1/2/3/4/5-6/7-8/9-10/>10 years post-reduction surgery for measuring the values of acetabular index (AI),center-edge angle of wiberg (CEA) and Reimer’s index (RI).According to the Severin grading of the last follow-up,they were assigned into two groups of satisfactory (grade Ⅰ/Ⅱ) and unsatisfactory (grade Ⅲ/Ⅳ).Logistic and COX regressions were employed for examining the risk factors for residual acetabular dysplasia and comparing the clinical values of AI,CEA,RI and Severin grades between two groups.This study provided evidence-based medical evidence for timing and indications of surgical interventions for residual acetabular dysplasia after closed reduction of DDH.

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Memo

收稿日期:2024-05-28。
基金项目:广州医科大学广州市妇女儿童医疗中心医学系统生物学实验室临床研究基金(GWCMC2020-6-005)
通信作者:徐宏文,Email:xuhongwen@gwcmc.org

Last Update: 1900-01-01