title: Pathological dislocation of the hip due to coxotuberculosis in children: a 29-case report.
abstract: BACKGROUND
  The aim of this study is to evaluate the clinical outcome of various surgery methods in children suffering pathological dislocation of the hip joint due to coxotuberculosis.
  
  
  METHODS
  From January 2006 to January 2011, 29 children with coxotuberculosis hip dislocation were treated with open reduction (4 children) and acetabular reconstruction (25 children). According to degree of dislocation and age, acetabular reconstructions included Salter osteotomy (nine children), Pemberton operation (six children), Dega operation (seven children), the hip shelf arthroplasty (two children), and Chiari operation (one child). During acetabular reconstruction, 16 children underwent upper femoral rotational shortening osteotomies simultaneously, 6 children underwent the femoral head and neck reconstruction simultaneously, and 3 children were underwent corrective osteotomy. After operation, children were immobilized with plaster external fixation for 1-3 months and treated with routine anti-infective therapy for 3 days. During follow-up study (12-18 months), the hip stability was examined via X-ray. The recovery was evaluated via acetabular index (AI) and Harris hip score.
  
  
  RESULTS
  Postoperative X-ray films of 29 children showed concentric reduction of all hips. Total 25 children healed I incision surgery, while 4 children with skin antrum of incision were further treated leading to 1-3 months delay of healing. Total 24 children were followed up for 2-5 years. X-ray examination revealed no redislocation after 2 years postoperative. The postoperative AI was normal (15°-20°) in 22 children and increased to 25°- 30° in 2 children. After 2 years postoperative, 8 children had normal function of hip joint, 13 children had mild limitation of flexion and rotation, and 3 children had fibrous ankylosis. The average of Harris hip score was 83 (ranged, 62-90).
  
  
  CONCLUSIONS
  In our study, pathological hip dislocations of children attributed to coxotuberculosis were treated via open reduction and acetabular reconstruction and the outcomes were both excellent. Individual characteristic should be taken into consideration during treatment, and proper surgery approach should be adopted according to pathological changes of the hip.
authors.forename: Xin
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Pediatric Surgery, West China Hospital, Sichuan University, No, 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China. yuanlilili@hotmail.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Lijun
authors.initials: L
authors.lastname: Liu
authors.forename: MingXin
authors.initials: M
authors.lastname: Peng
authors.forename: XueYang
authors.initials: X
authors.lastname: Tang
authors.forename: DaoXi
authors.initials: D
authors.lastname: Wang
authors.forename: XiaoDong
authors.initials: X
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006617:Hip Dislocation / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications