Personalized operative plans among keys to successful hip dysplasia surgery in children

Zheng P. J Orthop Sci. 2011; doi:10.1007/s00776-011-0029-3.

Multiple factors lead to satisfactory postoperative results in patients older than 10 years treated for developmental hip dysplasia.

“We believe that preoperation overall evaluation and personalized operation plans, experience with the surgical procedure and commencement of functional exercise soon after the operation are the main reasons for the satisfactory therapeutic effects in this study after surgery for developmental dysplasia of the hip presenting in children older than 10 years,” wrote Pengfei Zheng, of Nanjing Children’s Hospital and the Affiliated Hospital of Nanjing Medical University, and colleagues.

The researchers enrolled 63 patients (75 hips) who were treated with a Salter osteotomy, Pemberton acetabuloplasty, Dega osteotomy or Westin osteotomy. Patients had a mean age of 11.5 years at the time of surgery. All patients underwent subtrochanter transverse femoral shortening and derotation osteotomy. Postoperatively, patients wore a long-leg cast, and they began progressive flexion and extension hip joint exercises 2 weeks after surgery.

The researchers followed patients for an average of 7.6 years. The fineness ratio was 82.7% according to the McKay criteria and 82.6% according to the Severin X-ray criteria.

Four patients had semiluxation, four had femoral head ischemia necrosis, and nine had hip joint stiffness.