title: [Acetabular reconstruction surgery in treatment of pathological dislocation of hip joint in children].
abstract: OBJECTIVE
  To investigate the effectiveness of the acetabular reconstruction surgery in children pathological dislocation of the hip joint.
  
  
  METHODS
  Between January 2006 and January 2011, 59 patients (59 hips) with pathological dislocation were treated by open reduction combined with acetabular reconstruction surgery. There were 22 boys and 37 girls, aged from 1 to 15 years (mean, 4.9 years). There were 9 cases of hip subluxation and 50 cases of hip joint dislocation, which were caused by suppurative arthritis of the hip (33 cases) and tuberculosis of the hip (26 cases). The diseases duration ranged from 1 month to 10 years. At preoperation Harris hip score was 43-78 (mean, 61); 14 cases had normal acetabular index (AI), 32 cases had slightly increased AI, and 13 cases had significantly increased AI. The concomitant diseases included acetabular destruction in 28 cases; avascular necrosis of the femoral head in 25 cases, femoral head partial defect in 12 cases, femoral head complete defect in 6 cases, and femoral head and neck defects in 3 cases; 25 cases had increased anteversion angle; and 9 cases had varus deformity.
  
  
  RESULTS
  Immediately postoperative X-ray films showed center reduction in all the hips. Healing of incision by first intention was achieved in 55 cases, and delayed healing in 4 cases. Fifty-three children were followed up 2 to 5 years (mean, 3 years). No re-dislocation of the hip occurred during follow-up. Thirty-eight cases had normal AI, 15 cases had slightly increased AI. The anteversion angle was 15-25 degrees (mean, 20 degrees); the neck shaft angle was 110-140 degrees (mean, 125 degrees); and the anatomical relation between the head and neck returned to normal. After 2 years, 18 cases had normal function of the hip joint; 30 cases had mild limitation of flexion and rotation; and 5 cases had fibrous ankylosis. The Harris hip score was 62-95 (mean, 87).
  
  
  CONCLUSIONS
  Pathological dislocation caused by neonatal acute suppurative arthritis of the hip and the hip joint tuberculosis is often associated with severe bone destruction and deformity of the acetabular and femoral head and neck. Treatment should strictly follow the principle of individual. Proper acetabular reconstruction should be selected according to pathological changes of the hip; if combined with the femoral head and neck reconstruction processing, the satisfactory results can be obtained.
authors.affiliation: Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
authors.forename: Xin
authors.initials: X
authors.lastname: Jiang
authors.forename: Xueyang
authors.initials: X
authors.lastname: Tang
authors.forename: Daoxi
authors.initials: D
authors.lastname: Wang
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Chen
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Xie
authors.forename: Lijun
authors.initials: L
authors.lastname: Liu
authors.forename: Mingxing
authors.initials: M
authors.lastname: Peng
mesh_terms: D000077:Acetabulum / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000601:surgery; D006617:Hip Dislocation / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006621:Hip Joint / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D016268:Internal Fixators; D008297:Male; D015207:Osteoarthritis, Hip / Q000150:complications / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000601:surgery