TITLE:
Comparative Study Age at Time Operation between Younger and Older than 18 Months for Development Dysplasia of the Hip in Children
AUTHORS:
Nguyen Ngoc Hung, Hoang Hai Duc, Nguyen Do Ngoc Hien
KEYWORDS:
Hip Dysplasia, Congenital Dislocation of the Hip, Innominate Osteotomy, De-velopment Dysplasia of the Hip, Allograft
JOURNAL NAME:
Open Access Library Journal,
Vol.5 No.2,
February
28,
2018
ABSTRACT: Background: The Innominate osteotomy as an integral component of combined open reduction for the treatment of dysplasia developed of the hip in children. Materials and Methods: Between 2011 and 2015, 198 hips of 176 patients with developmental dislocation of the hip underwent 0 operation. The patients were divided into two Variant based on the age at the time of open reduction: 12 months- less than 18 months (Variant 1) and upper 18-36 months (Variant 2). There were 120 hips in V 1 and 69 hips in V 2. Preoperative Patients didn’t use skin or skeletal traction, or femoral osteotomies. All patients were Open reduction and iliac osteotomy according to Zigzag morphology combined Fibular Allograft. Dislocations were graded according to Tonnis system. The acetabular index was measured common procedure: Clinical evaluation of modified McKay criteria, and Roentgenographic evaluation of Severin. Results: There were 134 (76.1%) of the patients were girls and 42 (23.9%) were boys. Twenty two (12.5%) patients were affected bilaterally. The right hip was involved in 31 (17.6%), and the left hip in 123 cases (69.9%). Tonnis grade: Tonnis 3 in 46 (23.3%), Tonnis. 4 in 152 (76.7%). The patient was performed at a mean age of 21.5 months (12 to 36) and the mean age at latest follow-up was 72.1 months (58 to 115), and the mean time follow-up was 41 months (32 to 53 months).Overall favorable result 188 hips (94.9%) and unfavorable result 10 hips (5.1%). Roentgenogrphic results were Excellent 79.8%, Good 15.2%, Fair 3.5%, Poor 1.5%. There were Redislocation 14 (7.1%) and Avascular necrosis 47 (23.7%). Conclusion: This operation was of good safety and efficacy. Fibular allograft was strength and graft was not resorption, more stable and structurally sound interposition material which could be contoured to the shape of the osteotomy site. The Zizag octeotomy acetabuloplasty the same shape of the acetabulum by hinging the horizontal branch of the triradiate cartilage following an incomplete osteotomy. At latest results, both Variant were none different.