جااندازي باز و استيوتومي نوع سالتر در مبتلايان به دررفتگي مادرزادي لگن (بررسي طولاني مدت )

Open Reduction and Salter Innominate Osteotomy for DDH (A Long-Term Survey)

Background: Surgical treatment of developmental dysplasia of hip (DDH) is a real orthopaedic challenge. The ones who receive no treatment will develop knee, hip and spine osteoarthritis in addition to unsightly limp and awkward gait. There are several methods of surgical treatment. In our country, open reduction combined with Salter innominate osteotomy is the treatment of choice in many centers. Methods: In a retrospective case series study out of 1000 cases of DDH in Shafa Hospital (1971-1999), 390 patients (580 hips) had the above-mentioned surgery and were included in this study. Sufficient follow-up and information was available for 92 patients (143w hips), which comprise the bulk of this study. Clinical results and Harris Hip Score (HHS) were evaluated in these cases. Results: Among these 143 hips, 66 ( 46.2%) had full hip motion and 77 ( 53.8%) had different grades of motion limitation. Limitations in flexion and rotation were most common. Positive Trendelenberg sign was observed in 43 hips and 27 of these hips had evidence of avascular necrosis. Excellent results (according to HHS) was observed in 123 hips (76.4% were under 4 years of age and only 23.6% over age 4). Conclusion: Open reduction and Salter innominate osteotomy is a valuable procedure for DDH, and exellent result is to be expected if performed under age 4.