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Operation for Developmental Dislocation of the Hip

Author: WangQingHai
Tutor: HanJiuHui
School: Hebei Medical University
Course: Surgery
Keywords: Developmental / congenital dislocation of the hip Surgery Osteotomy Open reduction Complication Evaluate
CLC: R684
Type: Master's thesis
Year: 2010
Downloads: 101
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Abstract

Objective: developmental dislocation of the hip (Developmental Dislocation of Hip) is a clinically common congenital deformity of the lower limbs in children. It is not normal due to hip dysplasia, in infancy, there are a variety of exceptions, its etiology so far is not very clear, but genetic and environmental factors both statistically. Some babies mild developmental adverse can disappear, but other untreated hip deformity will progressively increased, resulting in pain, limited mobility, abnormal gait, and eventually cause adult degenerative arthritis. The age of onset of the symptoms associated with the degree of dislocation of the hip. Untreated severe hip dysplasia or dislocation of the hip in patients with youth appeared abnormal gait and joint degeneration caused by a series of symptoms. Thus, the dislocation of the hip does not deal with the consequences of the delay in processing is a very serious, so many experts [1,2] that the newborn DDH screening is necessary. After birth Once the diagnosis of DDH should be dealt with promptly, early DDH conservative treatment can achieve good clinical results; advanced or delayed timing of the best conservative treatment of developmental dislocation of the hip cases often require surgical orthopedic treatment. This group of subjects were cases of surgical treatment, this study was designed after developmental dislocation of the hip (DDH) in children with long-term follow-up and observation to explore the surgical treatment of children with developmental dislocation of the hip and clinical efficacy. Methods: In the period from 1993 to 2003, our hospital in three different Salter, Pemberton and Chiari pelvic osteotomy or concomitant rotation subtrochanteric osteotomy for developmental hip dislocation in children with 889 patients (1044 hips) for various reasons, only one of 108 patients (129 hips) for long-term follow-up. In the present study, a retrospective analysis of clinical data, before suffering from hip surgery, surgical treatment of children 3 to 13 years old from 1993 to 2003, developmental dislocation of the hip after hip joint function, the X-line data collection, Organize. The common developmental hip dislocation efficacy evaluation criteria (Zhou Yongde) [(] Table3) score, analysis of the long-term efficacy of different surgical procedures DDH. Results: In this study, 108 cases of children 7 to 17 years (mean 11.5 years) follow-up, the amount of suffering hip marks to assess the clinical efficacy of different surgical procedures differ (Table 1), excellent in 69 hips (26 to 30 points), good in 32 hips (21 to 25), 16 hips (16 to 20), poor in 12 hips (less than or equal to 15 points), good rate of 78.29%. Conclusion: developmental dislocation of the hip (DDH) especially miss the best conservative treatment cases of timing or failure of conservative treatment, pathological changes of the acetabulum and femoral head in varying degrees, and different age groups of children with pathological changes are not the same, but the relative Chiari surgical Salter and Pemberton osteotomy is more to achieve better clinical efficacy. Therefore, based on the age of the children with DDH and pathological changes in the specific circumstances of the hip, the correct choice of surgical approach is the fundamental guarantee for optimal clinical efficacy.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Joint disease and injury
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