A Study on the Complications of Surgical Treatment for Bilateral Developmental Dysplasia of the Hip and A Comparison of Two Osteotomy Techniques

Ezirmik, Naci; Yıldız, Kadri

doi:10.5152/eajm.2011.38

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…Developmental dysplasia of the hip (DDH), which is characterized by a shallow acetabulum, shortened femoral neck, excessive femoral anteversion and narrow femoral medullary cavity ( Nakahara et al, 2014 ), may result in a range of complications to the hip joint such as dislocation, focal necrosis, and discrepancies in leg length ( Naci and Kadri, 2011 ). Modular hip system and straight cone femoral stem are usually recommended for the treatment of DDH, due to the free setting of anteversion ( Zhen et al, 2017 ; Wang, 2019 ; Gholson et al, 2020 ), and have shown good postoperative results ( Gholson et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip

Zhang

Liu

et al. 2021

Front. Bioeng. Biotechnol.

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ObjectiveThis study aimed to assess the morphology of the femoral medullary canal in subjects with developmental dysplasia of the hip (DDH) with the intent of improving the design of femoral stems in total hip arthroplasty.MethodsComputed tomography images of 56 DDH hips, which were classified into Crowe I to Crowe IV, and 30 normal hips were collected and used to reconstruct three-dimensional morphology of the femoral medullary cavity. Images of twenty-one cross sections were taken from 20 mm above the apex of the lesser trochanter to the isthmus. The morphology of femoral cavity was evaluated on each cross section for the longest canal diameter, the femoral medullary torsion angle (FMTA), and the femoral medullary roundness index (FMRI).ResultsThe Crowe IV group displayed the narrowest medullary canal in the region superior to the end of the lesser trochanter, but then gradually aligned with the medullary diameter of the other groups down to the isthmus. The FMTA along the femoral cavity increased with the severity of DDH, but the rate of variation of FMTA along the femoral canal was consistent in the DDH groups. The DDH hips generally showed a larger FMRI than the normal hips, indicating more elliptical shapes.ConclusionA femoral stem with a cone shape in the proximal femur and a cylindrical shape for the remainder down to the isthmus may benefit the subjects with severe DDH. This design could protect bone, recover excessive femoral anteversion and facilitate the implantation in the narrow medullary canal.

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Section: Introductionmentioning

confidence: 99%

The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip

Zhang

Liu

et al. 2021

Front. Bioeng. Biotechnol.

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“…Regarding postoperative complications, we witnessed AVN in 4 hips (4.4%) which was a low rate compared to several studies [22–25]. Graft or pin displacement, relocation of osteotomy segments, redislocation of the hip, hematoma, superficial and deep infections, persistent stiffness of the hip joint, femoral fracture, and AVN of the femoral head are examples of postoperative complications of the classic Salter osteotomy [26, 27]. We believe that skeletal traction after adductor tenotomy and iliopsoas release for 1-2 weeks (based on the above-mentioned conditions) and before open reduction and pelvic osteotomy, and also not reefing the capsule after the open reduction, avoid excessive pressure on the femoral head after the surgery, and thereby has significant effects on decrease in rate of AVN.…”

Section: Discussionmentioning

confidence: 98%

A Newly Modified Salter Osteotomy Technique for Treatment of Developmental Dysplasia of Hip That Is Associated with Decrease in Pressure on Femoral Head and Triradiate Cartilage

Esmaeilnejad-Ganji

Zamani

et al. 2019

BioMed Research International

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Background and Purpose. The Salter innominate osteotomy has been an effective method to treat the developmental dysplasia of hip (DDH) over the past decades; however, several postoperative complications and deficiencies were reported. In this study, we evaluated outcome of a newly modified Salter osteotomy in patients presenting with DDH. Methods. We reviewed retrospectively 76 patients (90 hips) with DDH aged ≥ 18 months, who underwent open reduction and a modified osteotomy by a single surgeon. The distal osteotomy segment of pelvis was shifted anterolaterally in the amount of osteotomy cross-section, but not downwards. The mean age at surgery was 2 years and 11 months (1.5 to 16 years). Femoral shortening was conducted when necessary. The duration of operation varied between 60 and 90 minutes. The mean follow-up was 4 years and one month (range 15 months to 7 years and 9 months). All patients were followed up both clinically (based on the modified MacKay criteria) and radiologically (based on the modified Severin criteria). Results. Clinically, 94.5% of hips had excellent and good results at final follow-up, and only 5.5% had a fair condition. Radiographically, at the final follow-up 77.8% of hips were grade IA (excellent), 12.2% were grade IB, 6.7% were grade II, and 3.3% were grade III (fair). The preoperative mean acetabular index was 47.85° (41° to 59), which decreased to 17.16° (13° to 22°) immediately after the surgery (p<0.0001) and progressed to 11.24° (7° to 19°) at the final follow-up (p<0.0001). The mean initial postoperative center-edge angle was 30.3° (25° to 42°) significantly improved to 39.1 (31° to 56°) at the final follow-up (p<0.0001). Avascular necrosis of femoral head occurred in 4.4% of hips (4 patients). Conclusion. The results show that our modified Salter osteotomy is safe and associated with significant benefit for the management of patients suffering from DDH.

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“…Gleichzeitig steigt der Druck des Pfannendachs auf die Hüftkopfepiphyse an. In der Folge kann eine Hüftkopfne-krose entstehen [1]. Um diese gefürch-tete Komplikation zu vermeiden, sollte neben einem ausgiebigen weichteiligen Release, bei der häufig gleichzeitig durchgeführten intertrochantären femoralen Umstellungsosteotomie, eine knö-cherne Verkürzung des Femur erfolgen [6].…”

Section: Introductionunclassified

Innominatumosteotomie nach Salter

Schulze

Tingart

2016

Orthopäde

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The prevalence of congenital hip dysplasia in Germany is 2-4 % and that of hip dislocation is 0.5-1 %. If early therapy is not successful or the hip dysplasia or dislocation is diagnosed too late (children of over 1 year of age) surgical treatment is indicated to increase the femoral coverage. The innominate osteotomy, published by Robert B. Salter 1961, is a worldwide established technique to improve the lateral and ventral coverage of the femoral head in primary or secondary hip dysplasia or dislocation. In this paper we discuss Salter's technique and present indications, the perioperative procedure, operative modifications and operative extensions and demonstrate the anatomical requirements, postoperative biomechanical changes and long-term results.

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A Study on the Complications of Surgical Treatment for Bilateral Developmental Dysplasia of the Hip and A Comparison of Two Osteotomy Techniques

Abstract: Objective: This study aims to present a review about complications of surgical treatment of Developmental Dysplasia of the Hip and comparing the kinds and ratios of two osteotomy technique (Salter Innominate Osteotomy and Pemberton Pericapsular Osteotomy).

Cited by 5 publications

References 28 publications

The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip

The Three-Dimensional Morphology of Femoral Medullary Cavity in the Developmental Dysplasia of the Hip

A Newly Modified Salter Osteotomy Technique for Treatment of Developmental Dysplasia of Hip That Is Associated with Decrease in Pressure on Femoral Head and Triradiate Cartilage

Innominatumosteotomie nach Salter

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