Tian Kaixuan,Li Tianyou,Zhu Lichao,et al.Correlation between ischium overlap sign and postoperative redislocation of developmental dysplasia of the hip[J].Journal of Clinical Pediatric Surgery,,19():161-165.[doi:10.3969/j.issn.1671-6353.2020.02.014]
Correlation between ischium overlap sign and postoperative redislocation of developmental dysplasia of the hip
- Keywords:
- Bone Diseases; Developmental; Developmental Dysplasia of The Hip; Postoperative Complications; Ischium Overlap Sign
- CLC:
- R726.1;R726.8;R681.6
- Abstract:
- Objective To propose the concept of ischium overlap sign (IOS) and explore its relationship with postoperative redislocation of developmental dysplasia of the hip (DDH).Methods From September 2013 to March 2017,retrospective analysis was performed for clinical data of 88 DDH children (105 hips).There were 16 boys and 72 girls with an average age of 12(5-24) months.The mean follow-up period was 34(15-59) months.The affected side was bilateral (n=17),left (n=63) and right (n=42).The causes were acetabular dysplasia (n=1),subluxation (n=11) and dislocation (n=93).Intraoperative hip arthrography was performed and closed or open reduction selected according to the Bowen’s standard.IOS refers to the relationship of inner edge of femoral head cartilage and outer edge of sciatic bone on hip arthrography in human position.Overlap is grade Ⅰ,converging Ⅱ and separating Ⅲ.Ninety-three dislocated hips were divided into three groups based upon IOS.And the redislocation rates were compared among different groups.Results Acetabular dysplasia (n=1) and subluxation (n=11) belonged to IOS grade Ⅰ.Among 93 dislocated hips,there were 14 hips of IOS grade I and 39 hips of IOS Ⅱ.Both groups underwent closed reduction plus casting and there was no redislocation.Among 40 hips of IOS Ⅲ,17 hips underwent closed reduction plus casting and 6/17 hips became redislocated.Among 23 hips undergoing open reduction plus casting,one hip was redislocated.The results showed that group of IOS Ⅲ had a higher rate of redislocation (7/40,17.5%) than other groups (P=0.006).In group of IOS Ⅲ,the redislocation rate in children undergoing closed reduction (6/17,35.3%) was statistically higher than those with open reduction (1/23,4.4%)(χ2=4.518,P=0.034).Conclusion A close relationship exists between IOS and postoperative redislocation in DDH.If closed reduction plus casting is performed for DDH of IOS grade Ⅲ,there may be a high redislocation rate.
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Memo
收稿日期:2018-09-07。
基金项目:国家自然科学基金（编号：81501844）；山东省自然科学基金（编号：BS2015YY009）
通讯作者:李天友,Email:tianyouli1983@126.com