Application Of Digital Simulation Surgery In The Treatment Of Older DDH

Background:The incidence of DDH(Developmental dysplasia of the hip)in children is between 0.15%-2%.If the treatment is not timely and incorrect,it will lead to many complications,such as joint development disorder and reshaping.Pelvic triplet osteotomy plus femoral osteotomy is currently one of the most effective surgical procedures for the treatment of older children with DDH.However,intraoperative pelvic osteotomy and shortening length and rotation angle mainly depend on radiology parameters and operative experience.There may be some deviations,and some patients need artificial hip replacement eventually.Now we mainly rely on three-dimensional reconstruction of CT and pelvis positive x ray to provide reference for pelvic osteotomy and shortening length and rotation angle.However,there are various kinds of pelvic deformity in older children with DDH.The angle of correction of femoral anteversion is also different.The degree of correction of deformity may have an impact on the prognosis of children.But so far,there has not been a study of preoperative simulation for older children with DDH.Objective:The digital technique was used to guide the triple osteotomy of the pelvis for the treatment of DDH in the elderly.The feasibility of the preoperative simulated operation and the accuracy of the osteotomy parameters were discussed,which provided a basis for the clinical application of DDH.Methods:1.Totally random methods were used to take 10 DDH children who had undergone preoperative simulation surgery as a simulated operation group,and 10 children with DDH underwent surgical treatment as the traditional operation group.2.The improved Trevor score and AI、LCEA、ACEA、EI was used to evaluate the postoperative imaging results and clinical functions of the children.3.Mimics software was used to simulate the operation before operation.The postoperative Trevor scores were compared between the simulated operation group and the traditional operation group,and AI、LCEA、ACEA、EI.Results:1.The difference of AI,LCEA,ACEA and EI between the two groups after operation was compared with the target value.One side DDH takes the healthy side parameters as the target value,and the bilateral DDH as the normal range as the target value.It was found that the difference between the traditional operation group and the simulated operation group was 5.7 times that of the simulated operation group,and the osteotomy parameters in the simulated operation group were more accurate.2.In the traditional operation group,3 cases had femoral head necrosis(3/13).There was no case of femoral head necrosis in the simulated operation group.The probability of femoral head necrosis in the traditional operation group was higher than that in the simulated operation group.3.The average improved Trevor score of the children in the simulated operation group(18.2 + 2.2)was higher than that in the traditional operation group(15.9 + 2.5),and the difference was statistically significant(P < 0.05).Conclusions:The digital technique is used to guide the triple osteotomy of pelvis for the treatment of DDH.The preoperative design is more accurate,the postoperative imaging parameters are better,and the clinical effect is better.It provides a clinical basis for the digital treatment of DDH.