Surgical results of developmental dysplasia of the hip in older children based on using three-dimensional computed tomography.
BACKGROUND
The surgical management of developmental dysplasia of the hip (DDH) in older children has been the subject of controversy. The purpose of this study was to evaluate the outcome in patients with neglected DDH who underwent individual procedures based on using three-dimensional computed tomography.


METHODS
Forty-seven patients (59 hips) were treated using Pemberton osteotomy or Dega plus Pemberton osteotomy. Subtrochanteric transverse femoral shortening and derotation osteotomy were performed for all patients. The average age at the time of surgery was 10.5 y for group 1 (bilateral dislocation, 24 hips) and 11.2 y for group 2 (unilateral dislocation, 35 hips). Mean follow-up was 5.3 y for group 1 and 5.8 y for group 2.


RESULTS
At the end of follow-up, 13 hips (54.2%) were rated excellent, eight hips (33.3%) were good, and three hips (12.5%) were fair in group 1. In group 2, 20 hips (57.1%) were rated excellent, 10 hips (28.6%) were good, and five hips (14.3%) were fair. There were five patients who had a limb length discrepancy of approximately 1.5 cm in group 2. Six hips in group 1 and seven hips in group 2 had osteonecrosis of varying severity.


CONCLUSIONS
We believe that preoperation three-dimensional computed tomography evaluation, personalized operation plans, and experience with the surgical procedure are the main reasons for the satisfactory therapeutic effects achieved in this study in older children with DDH.
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Xiong
X
Zhao
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Ya-Bo
YB
Yan
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Peng-Chong
PC
Cao
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Yi-Shan
YS
Ma
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Zi-Xiang
ZX
Wu
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Yang
Y
Zhang
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China.
Yuan
Y
Zang
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China. Electronic address: jiqiang@fmmu.edu.cn.
Qiang
Q
Jie
Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi'an, P.R. China. Electronic address: wlspine@163.com.
Wei
W
Lei
D000077:Acetabulum / Q000000981:diagnostic imaging; D000293:Adolescent; D002648:Child; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
Developmental dysplasia of the hip; Older children; Three-dimensional CT