title: Retrospective analysis of the radiographic indicators for peri-acetabular osteotomy of developmental dysplasia in children.
abstract: OBJECTIVE
  Open surgery, nonsurgical positioning device and casting are mainstay treatments of developmental dysplasia of the hip (DDH). The optimal indicators for surgical interventions remain unclear. In this study, we aim to establish empirical, sensitive radiographic indicators for peri-acetabular osteotomy intervention in developmental dysplasia in Chinese children.
  
  
  METHODS
  One hundred and three DDH patients treated in The Soochow University Children's Hospital between 2006 and 2012 were assessed; patients with known causes of neuron muscular and abnormal hip joint origin were excluded. Fifty-four suitable patients, demonstrating 71 dysplasia hips with complete clinical record and adequate X-ray films, were enrolled in this study. Patients were divided into group A (conservative interventions failed, followed by salvage peri-acetabular osteotomy) and group B (conservative treatment only); a total of 16 quantitative parameters were measured on each pelvic X-ray film.
  
  
  RESULTS
  Among 71 hip joints measured, 29 hips of group A underwent salvage peri-acetabular osteotomy (40.8 %,) showed higher X2, Y, h, and Smith c/b (Vh) (p < 0.05). The age, c, HT, b, A2 in the group A salvage operation were statistically significantly different compared to group B patients (without salvage operations) (p < 0.05).
  
  
  CONCLUSIONS
  Pre-operative pelvic X-ray film assessment of acetabulum lateralization markers (X2, c, HT, c/b ratio) and the superior migration measurements (Y, h, h/b ratio) are potentially valuable radiographic indicators for determining which DDH patients will require peri-acetabular osteotomy.
authors.affiliation: Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou Industrial Park, No.92 Zhongnan Street, Suzhou, Jiangsu Province, People's Republic of China. gepcinf@yahoo.com.
authors.forename: Yunfang
authors.identifier: http://orcid.org/0000-0002-4609-1476
authors.initials: Y
authors.lastname: Zhen
authors.affiliation: Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou Industrial Park, No.92 Zhongnan Street, Suzhou, Jiangsu Province, People's Republic of China.
authors.forename: Chunhua
authors.initials: C
authors.lastname: Yin
authors.affiliation: Orthopaedics Department, Shuyang County People's Hospital, Jiangsu, People's Republic of China.
authors.forename: Shiping
authors.initials: S
authors.lastname: Tan
authors.affiliation: Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou Industrial Park, No.92 Zhongnan Street, Suzhou, Jiangsu Province, People's Republic of China.
authors.forename: Quanwen
authors.initials: Q
authors.lastname: Yuan
authors.affiliation: Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou Industrial Park, No.92 Zhongnan Street, Suzhou, Jiangsu Province, People's Republic of China.
authors.forename: Lunqing
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou Industrial Park, No.92 Zhongnan Street, Suzhou, Jiangsu Province, People's Republic of China. wangxd@suda.edu.cn.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D044466:Asian People; D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D016879:Salvage Therapy
keywords: Developmental hip dysplasia; Pelvic osteotomy; X-ray