Evaluation of the operative treatment of the developmental hip dislocation performed second year of life.
Background. Both conservative and surgical treatment are applied in the treatment of developmental hip dislocation in the second year of life. Our study to evaluated the results of surgical treatment at this age using open reduction combined with transiliac osteotomy and translation of the distal insertion of the iliopsoas muscle. Material and methods. The analyzed group consisted of 21 hip joints. The mean follow-up was 6 years (2-11 years). The age of the patients at surgery was 13 -24 months, average 18 months. Results. According to Severin's classification scheme 71% of the patients had excellent results and 29% good. However, when the analyzed joints were evaluated according to our classification scheme, the results were significantly worse: 29% excellent, 48% good, 23% satisfactory. The difference between the results was caused by parameters not included in Severin's classification: neck-shaft angle and neck centering angl. The true antetorsion angle was decreased in the final examination in comparison to preoperative results. The mean head-metaphyseal index of Kruczyński averaged 120.61% of normal in the whole group, and values higher than 120% were found in 13 cases (62%). Conclusions. The described method of treatment provided stable reduction with good coverage of the femoral head by the acetabular roof in more than 90% of cases. The problem of increased neck-shaft angle and neck centering angle occurring in 25% of cases remains unsolved. The antetorsion angle is still high in some cases at follow-up.
Małgorzata
M
Wierusz-Kozłowska
Jacek
J
Markuszewski
Waldemar
W
Woźniak
Tomasz
T
Timmler
Andrzej
A
Lempicki