| Objective: To evaluate the efficacy of transsexual tendon flap transposition to repair acetabular defects in developmental hip dysplasia in older children.Methods: The clinical data of 25 children with DDH who were treated with the sartorius muscle flap in the Children’s Hospital of Chongqing Medical University from 2015 to 2018 were retrospectively collected.According to the preoperative measurement data,all the patients were treated with open reduction,proximal femoral shortening and rotational osteotomy,sartorius iliac flap to repair the acetabular defect under general anesthesia.Postoperative assessment of postoperative children was performed using the Acetabular Head Index(AHI),acetabular index(AI),he Macky Hip Functional Standard and Severin’s X-ray criteria.Results: All 25 patients were followed up for 6 to 46 months(mean 25.6 months).Preoperative median acetabular defect width was 40.3 mm and median acetabular defect depth was 8.9 mm.Postoperative acetabular defect was repaired satisfactorily by transplantation of sartorius iliac flap.The Macky function was excellent in 6 cases,good in 16 cases,fair in 2 cases,and poor in 1 case.The excellent and good rate was 88.0%.Severin’s imaging standard was excellent in 7 cases,good in 14 cases,fair in 3 cases,and poor in 1 case.The excellent and good rate was 84.0%.The pre-operative and post-operative AHI(10.4±17.7)and post-operative AHI(92.3±10.4)were significantly improved,compared with pre-operative AHI(P<0.05)by t-test.The pre-operative AI(51.2±6.9)and post-operative AI(18.4±4.7)were significantly improved,and the post-operative AI was significantly improved by t-test(P<0.05).Conclusion: Repair of acetabular defect by transplantation of sartorius iliac flap can effectively improve the cover of acetabulum to femoral head after operation.The joint function after operation is good and the absorption rate of bone graft is low.It is an effective surgical method. |
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