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Comparison of salter osteotomy results in two different age groups in the treatment of developmental hip dislocation

Yıl 2020, Cilt: 4 Sayı: 3, 199 - 202, 01.03.2020
https://doi.org/10.28982/josam.700839

Öz

Aim: Surgical treatment of developmental hip dislocation is highly challenging in children of walking age. The most common complications following surgery include avascular necrosis and redislocation. In this study, we aimed to compare the preoperative and postoperative acetabular index, avascular necrosis (AVN) and redislocation rates between two age groups of open reduction and Salter osteotomy in DDH (Developmental Dysplasia of the Hip).
Methods: This prospective cohort study included patients who underwent open reduction and salter osteotomy for DDH between 2014 and 2017. Patients were grouped based on age as follows: Group 1: 18 -30 months old (n=44), Group 2: 31-48 months old (n=41). Preoperative, postoperative, and final acetabular indexes, AVN and redislocation rates were compared.
Results: Among 85 patients included in the study, 20 were male and 65 were female. The mean ages of Groups 1 and 2 were 21.6 months and 38.5 months, respectively. Following surgery, Group 1 mean acetabular index reduced to 25.9 degrees from 35.1 degrees, while that of Group 2 decreased to 22.1 degrees from 33 degrees. AVN was present in 10 patients (22.72%) in Group 1 and 4 patients (9.75%) in Group 2.
Conclusion: The acetabular index was adequately corrected in both groups. AVN was more frequent in children who had early interventions. We believe that the higher rate of avascular necrosis in children who underwent early intervention is due to surgical technique and using tighter sutures in the hip joint capsule. 

Destekleyen Kurum

yok

Proje Numarası

-

Teşekkür

-

Kaynakça

  • 1. Dezateux C, Rosendahl K. Developmental dysplasia of the hip. Lancet. 2007;369(9572):1541-52.
  • 2. Doğan E, Gül S, Çullu N, Doğan MM. Case of incomplete fibular hemimelia with tarsal coalition, pes planus, ball and socket ankle. J Surg Med. 2019;3(3):271-3.
  • 3. Novacheck TF. Developmental dysplasia of the hip. Pediatr Clin North Am. 1996;43(4):829–48
  • 4. Wedge JH, Kelley SP. Strategies to improve outcomes from operative childhood management of DDH. Orthop Clin North Am. 2012;43(3):291–9.
  • 5. Akman B, Ozkan K, Cift H, Akan K, Eceviz E, Eren A. Treatment of Tonnis type II hip dysplasia with or without open reduction in children older than 18 months: a preliminary report. J Child Orthop. 2009;3(4):307–11.
  • 6. Danielsson L. Late-diagnosed DDH: a prospective 11-year follow-up of 71 consecutive patients (75 hips). Acta Orthop Scand. 2000;71(3):232–42.
  • 7. Williamson DM, Glover SD, Benson MK. Congenital dislocation of the hip presenting after the age of three years. A long-term review. J Bone Joint Surg (Br). 1989;71(5):745–51.
  • 8. Dogan M, Bozkurt M, Sesen H, Yildirim H. One-stage treatment of congenital severely dislocated hips in older children through various acetabuloplasty techniques: 22 children followed for 1-5 years. Acta Orthop. 2005;76(2):212–19.
  • 9. Karakas ES, Baktir A, Argun M, Turk CY. One-stage treatment of congenital dislocation of the hip in older children. J Pediatr Orthop. 1995;15(3):330–6.
  • 10. Tönnis D. General radiography of the hip joint Congenital Dysplasia and Dislocation of the Hip in Children and Adults. Springer. 1987;100-42.
  • 11. Salter RB. Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. J Bone Joint Surg. 1961;43:518-39.
  • 12. Tönnis D. Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res. 1976;119:39-47.
  • 13. Weinstein SL, Mubarak SJ, Wenger DR. Developmental hip dysplasia and dislocation. Part II. Instr Course Lect. 2004;53:531–42.
  • 14. Schmidutz F, Roesner J, Niethammer TR, Paulus AC, Heimkes B, Weber P. Can Salter osteotomy correct late diagnosed hip dysplasia: A retrospective evaluation of 49 hips after 6.7 years? Orthop Traumatol Surg Res. 2018;104(5):637-43.
  • 15. López-Carreño E, Carillo H, Gutiérrez M. Dega versus Salter osteotomy for the treatment of developmental dysplasia of the hip. J Pediatr Orthop B. 2008;17(5):213-21.
  • 16. Barrett WP, Staheli LT, Chew DE. The effectiveness of the Salter innominate osteotomy in the treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1986;68:79–87.
  • 17. El-Sayed M, Ahmed T, Fathy S, Zyton H. The effect of Dega acetabuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age: short- to middle-term follow-up. J Child Orthop. 2012;6(6):471-77.
  • 18. Kandill AE, Saeed A, El-Barbary H, Hegazi M, El-Sobky M. Salter versus Dega osteotomy after open reduction of developmental dysplasia of the hip in young children. Egypt Orthop J. 2013;48:80–7.
  • 19. Saqib M, Salman M, Hayat S, Khan MA, Ullah S. Developmental Dysplasia Of The Hip In Older Children; Prospects Of Functional And Radiological Outcome Following A Single Stage Triple Procedure. J Ayub Med Coll Abbottabad. 2019;31(3):427-31.
  • 20. Salter RB, Kostuik J, Dallas S. Avascular necrosis of the femoral head as a complication of treatment for congenital dislocation of the hip in young children: a clinical and experimental investigation. Can J Surg. 1969;12:44–61.
  • 21. Tonnis D. Surgical treatment of congenital dislocation of hip. Clin Orthop Relat Res. 1990;258:33–40.
  • 22. Mellerowicz HH, Matussek J, Baum C. Long-term result of Salter and Chiari hip osteotomies in developmental hip dysplasia. A survey of over 10 years follow-up with a new hip evaluation score. Arch Orthop Trauma Surg. 1998;117:222–7.
  • 23. Danielsson L. Late-diagnosed DDH: a prospective 11-year follow-up of 71 consecutive patients (75 hips). Acta Orthop Scand. 2000;71:232–42.
  • 24. Metin D, Murat B, Hakan S, Hasan Y. One-stage treatment of congenital severely dislocated hips in older children through various acetabuloplasty techniques. Acta Orthop. 2005;76:212–19.
  • 25. Otaify AE. One-stage surgery for developmental dysplasia of the hip in older children. Pan Arab J Orthop Trauma. 2002;6:49–61.
  • 26. Smith BG, Kesser JR, Hey LA, Betchtold RE. Postreduction computed tomography in developmental dislocation of the hip: Part 1. Analysis of measurement reliability. J Pediatr Orthop. 1997;17:626–30.
  • 27. Kershaw CJ, Ware HE, Pattinson R, Fixsen JA. Revision of failed open reduction of congenital dislocation of the hip. J Bone Joint Surg (Br). 1993;75(5):744-9.
  • 28. Kamath SU, Bennet GC: Re-dislocation following open reduction for developmental dysplasia of the hip. Int Orthop. 2005;29(3):191-4.

Gelişimsel kalça çıkığı tedavisinde salter osteotomisinin iki farklı yaş grubundaki sonuçlarının karşılaştırılması

Yıl 2020, Cilt: 4 Sayı: 3, 199 - 202, 01.03.2020
https://doi.org/10.28982/josam.700839

Öz

Amaç: Yürüme dönemi çocuklarda gelişimsel kalça çıkığının cerrahi tedavisi oldukça zordur. Avasküler nekroz ve kalça çıkığı tekrarlaması, cerrahi sonrası en sık karşılaşılan problemlerdir. Bu çalışmadaki amacımız GKD (Gelişimsel Kalça Çıkığı) tedavisinde uyguladığımız açık redüksiyon ve Salter osteotomisi yönteminin 2 grup arasındaki ameliyat öncesi ve sonrası asetabuler indeks, avasküler nekroz (AVN) ve redislokasyon oranlarını karşılaştırmaktır.
Yöntemler: Bu prospektif kohort çalışmaya 2014-2017 yılları arasında GKD nedeniyle açık redüksiyon ve salter osteotomisi yapılan hastalardan elde edilen verilerle yapıldı. Grup 1: 18 ay -30 ay (44), Grup 2: 31 ay-48 ay arası (41) hasta mevcuttu. Grupların ameliyat öncesi, ameliyat sonrası ve final asetabuler indeksleri, AVN ve redislokasyon oranları karşılaştırıldı.
Bulgular: Çalışmaya alınan 85 kalçanın 20’si erkek, 65’i kadın idi. Grup 1 hastaların yaş ortalaması 21,6 ay, Grup 2 hastalarının yaş ortalaması ise 38.5 ay idi. Ameliyat sonrası Grup 1 asetabuler indeks ortalama 35.1 dereceden 25,9 dereceye düşürülürken, Grup 2 de ise 33 dereceden 22,1 dereceye kadar düşürüldü. Grup 1 de 10 hastada (%22,72), Grup 2 de ise 4 (%9,75) hastada AVN vardı.
Sonuç: Asetabular indeks her iki grupta da yeterince düzeltildiği gözlendi. AVN’in erken müdahale yapılan çocuklarda daha yüksek oranda olduğu görüldü. Erken müdahale yapılan çocuklarda AVN’in daha yüksek olmasının kalça eklemi kapsülünün daha sıkı sütüre edildiği ve yapılan cerrahi teknikten kaynaklandığına inanıyoruz.

Proje Numarası

-

Kaynakça

  • 1. Dezateux C, Rosendahl K. Developmental dysplasia of the hip. Lancet. 2007;369(9572):1541-52.
  • 2. Doğan E, Gül S, Çullu N, Doğan MM. Case of incomplete fibular hemimelia with tarsal coalition, pes planus, ball and socket ankle. J Surg Med. 2019;3(3):271-3.
  • 3. Novacheck TF. Developmental dysplasia of the hip. Pediatr Clin North Am. 1996;43(4):829–48
  • 4. Wedge JH, Kelley SP. Strategies to improve outcomes from operative childhood management of DDH. Orthop Clin North Am. 2012;43(3):291–9.
  • 5. Akman B, Ozkan K, Cift H, Akan K, Eceviz E, Eren A. Treatment of Tonnis type II hip dysplasia with or without open reduction in children older than 18 months: a preliminary report. J Child Orthop. 2009;3(4):307–11.
  • 6. Danielsson L. Late-diagnosed DDH: a prospective 11-year follow-up of 71 consecutive patients (75 hips). Acta Orthop Scand. 2000;71(3):232–42.
  • 7. Williamson DM, Glover SD, Benson MK. Congenital dislocation of the hip presenting after the age of three years. A long-term review. J Bone Joint Surg (Br). 1989;71(5):745–51.
  • 8. Dogan M, Bozkurt M, Sesen H, Yildirim H. One-stage treatment of congenital severely dislocated hips in older children through various acetabuloplasty techniques: 22 children followed for 1-5 years. Acta Orthop. 2005;76(2):212–19.
  • 9. Karakas ES, Baktir A, Argun M, Turk CY. One-stage treatment of congenital dislocation of the hip in older children. J Pediatr Orthop. 1995;15(3):330–6.
  • 10. Tönnis D. General radiography of the hip joint Congenital Dysplasia and Dislocation of the Hip in Children and Adults. Springer. 1987;100-42.
  • 11. Salter RB. Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. J Bone Joint Surg. 1961;43:518-39.
  • 12. Tönnis D. Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res. 1976;119:39-47.
  • 13. Weinstein SL, Mubarak SJ, Wenger DR. Developmental hip dysplasia and dislocation. Part II. Instr Course Lect. 2004;53:531–42.
  • 14. Schmidutz F, Roesner J, Niethammer TR, Paulus AC, Heimkes B, Weber P. Can Salter osteotomy correct late diagnosed hip dysplasia: A retrospective evaluation of 49 hips after 6.7 years? Orthop Traumatol Surg Res. 2018;104(5):637-43.
  • 15. López-Carreño E, Carillo H, Gutiérrez M. Dega versus Salter osteotomy for the treatment of developmental dysplasia of the hip. J Pediatr Orthop B. 2008;17(5):213-21.
  • 16. Barrett WP, Staheli LT, Chew DE. The effectiveness of the Salter innominate osteotomy in the treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1986;68:79–87.
  • 17. El-Sayed M, Ahmed T, Fathy S, Zyton H. The effect of Dega acetabuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age: short- to middle-term follow-up. J Child Orthop. 2012;6(6):471-77.
  • 18. Kandill AE, Saeed A, El-Barbary H, Hegazi M, El-Sobky M. Salter versus Dega osteotomy after open reduction of developmental dysplasia of the hip in young children. Egypt Orthop J. 2013;48:80–7.
  • 19. Saqib M, Salman M, Hayat S, Khan MA, Ullah S. Developmental Dysplasia Of The Hip In Older Children; Prospects Of Functional And Radiological Outcome Following A Single Stage Triple Procedure. J Ayub Med Coll Abbottabad. 2019;31(3):427-31.
  • 20. Salter RB, Kostuik J, Dallas S. Avascular necrosis of the femoral head as a complication of treatment for congenital dislocation of the hip in young children: a clinical and experimental investigation. Can J Surg. 1969;12:44–61.
  • 21. Tonnis D. Surgical treatment of congenital dislocation of hip. Clin Orthop Relat Res. 1990;258:33–40.
  • 22. Mellerowicz HH, Matussek J, Baum C. Long-term result of Salter and Chiari hip osteotomies in developmental hip dysplasia. A survey of over 10 years follow-up with a new hip evaluation score. Arch Orthop Trauma Surg. 1998;117:222–7.
  • 23. Danielsson L. Late-diagnosed DDH: a prospective 11-year follow-up of 71 consecutive patients (75 hips). Acta Orthop Scand. 2000;71:232–42.
  • 24. Metin D, Murat B, Hakan S, Hasan Y. One-stage treatment of congenital severely dislocated hips in older children through various acetabuloplasty techniques. Acta Orthop. 2005;76:212–19.
  • 25. Otaify AE. One-stage surgery for developmental dysplasia of the hip in older children. Pan Arab J Orthop Trauma. 2002;6:49–61.
  • 26. Smith BG, Kesser JR, Hey LA, Betchtold RE. Postreduction computed tomography in developmental dislocation of the hip: Part 1. Analysis of measurement reliability. J Pediatr Orthop. 1997;17:626–30.
  • 27. Kershaw CJ, Ware HE, Pattinson R, Fixsen JA. Revision of failed open reduction of congenital dislocation of the hip. J Bone Joint Surg (Br). 1993;75(5):744-9.
  • 28. Kamath SU, Bennet GC: Re-dislocation following open reduction for developmental dysplasia of the hip. Int Orthop. 2005;29(3):191-4.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi, Çocuk Sağlığı ve Hastalıkları, Ortopedi
Bölüm Araştırma makalesi
Yazarlar

Sezai Özkan 0000-0003-4444-6939

Cihan Adanaş

Proje Numarası -
Yayımlanma Tarihi 1 Mart 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 4 Sayı: 3

Kaynak Göster

APA Özkan, S., & Adanaş, C. (2020). Comparison of salter osteotomy results in two different age groups in the treatment of developmental hip dislocation. Journal of Surgery and Medicine, 4(3), 199-202. https://doi.org/10.28982/josam.700839
AMA Özkan S, Adanaş C. Comparison of salter osteotomy results in two different age groups in the treatment of developmental hip dislocation. J Surg Med. Mart 2020;4(3):199-202. doi:10.28982/josam.700839
Chicago Özkan, Sezai, ve Cihan Adanaş. “Comparison of Salter Osteotomy Results in Two Different Age Groups in the Treatment of Developmental Hip Dislocation”. Journal of Surgery and Medicine 4, sy. 3 (Mart 2020): 199-202. https://doi.org/10.28982/josam.700839.
EndNote Özkan S, Adanaş C (01 Mart 2020) Comparison of salter osteotomy results in two different age groups in the treatment of developmental hip dislocation. Journal of Surgery and Medicine 4 3 199–202.
IEEE S. Özkan ve C. Adanaş, “Comparison of salter osteotomy results in two different age groups in the treatment of developmental hip dislocation”, J Surg Med, c. 4, sy. 3, ss. 199–202, 2020, doi: 10.28982/josam.700839.
ISNAD Özkan, Sezai - Adanaş, Cihan. “Comparison of Salter Osteotomy Results in Two Different Age Groups in the Treatment of Developmental Hip Dislocation”. Journal of Surgery and Medicine 4/3 (Mart 2020), 199-202. https://doi.org/10.28982/josam.700839.
JAMA Özkan S, Adanaş C. Comparison of salter osteotomy results in two different age groups in the treatment of developmental hip dislocation. J Surg Med. 2020;4:199–202.
MLA Özkan, Sezai ve Cihan Adanaş. “Comparison of Salter Osteotomy Results in Two Different Age Groups in the Treatment of Developmental Hip Dislocation”. Journal of Surgery and Medicine, c. 4, sy. 3, 2020, ss. 199-02, doi:10.28982/josam.700839.
Vancouver Özkan S, Adanaş C. Comparison of salter osteotomy results in two different age groups in the treatment of developmental hip dislocation. J Surg Med. 2020;4(3):199-202.