Application Of Salter’s Osteotomy On Surgical Treating Developmental Dysplasia Of The Hip (Reports Of19Cases)

Objective: To discuss the effects of Salter’s osteotomy on treating developmentaldysplasia of the hip (DDH).Methods: From2005.7to2012.12. To improve cover range of femoral head from theacetabulum,19cases aged2-6years old (3.4years old on average) suffered fromunilateral development dysplasia of the hip (acetabular index≥30°,CE angle≤10°)were treated by Salter’s osteotomy, on the basic of adductor tenotomy, hip openreduction, partly underwent femoral shortening and derotational osteotomy.Collecting the pre-operative and post-operatvie X-rays index of all the cases, andmeasure the pre-operative and post-operative index about acetabular and CE angle ofthe affected side and the normal side. The indexs were compared with matching t test,P<0.05means a statistical significance. All cases were assessed clinically with X-raysand MacKay Criteria.Results: All cases were followed up for2years to8years (3.4years on average),seventeen hips had got excellent clinical results and two good result. The acetabularindex of the affected side were37.79°±5.04°pre-operatively,22.89°±2.00°post-operatively, and the normal side were22.53°±1.81°; the CE angel of theaffected side were3.32°±6.17°pre-operatively,42.00°±3.18°post-operatively,while the normal side were41.95°±2.90°. The pre-operative and post-operativeacetabular index were compared with matching t test, P<0.05; the post-operative andthe normal acetabular index had a P>0.05result. The pre-operative andpost-operative CE angle were compared with matching t test, P<0.05; thepost-operative and the normal CE angle got a P>0.05result. It shows that the coverrange of femoral head from the acetabulum had been improved dramatically, there isno significant differences between the affected side and the normal side. Resultwithout complications such as hip redislocation, avascular necrosis of femoral head,sciatic nerve lesion, infection, and bone nonunion.Conclusion: For patients aged2~6years old, applying Salter’s osteotomy afteradductor tenotomy and hip open reduction is conductive to restore the hip’s normalstructure, and to accelerate the normal development of the hip. For patients had ahigher pressure of femoral head from the acetabulum, using femoral shortening andderotational osteotomy can efficiently prevent the complications such as hipredislocation, avascular necrosis of femoral head, sciatic nerve lesion.