Salter Osteotomy Combined With Femoral Osteotomy For The Treatment Of Tonnis Type ? Developmental Dysplasia Of The Hip

Objective : To evaluate the efficacy of Salter osteotomy combined with femoral osteotomy for the treatment of Tonnis type ? developmental dysplasia of the hip.Methods:Between January 2010 and December 2015,52 patients(57hips)with Tonnis type ? DDH were treated in our hospital,including 28patients(33 hips)treated with Salter osteotomy combined with femoral osteotomy,and 24 patients(24 hips)treated with Salter osteotomy alone as a control group.Results:The cases were followed up for about 12~64 months(mean,26.8 months).At the last follow-up,the acetabular index(AI),center edge(CE)angle and Sharp angle was 18.1±5.2°,36.3±36.1° and 41.4±4.7° in the Salter osteotomy combined with femoral osteotomy group.That was15.7±4.8°(AI),37.8±11.6°(CE angle)and 40.1±5.0°(Sharp angle)in the Salter osteotomy group.There were 2 hips(2/33)with avascular necrosis of femoral head in the Salter osteotomy combined femoral osteotomy groupand 6 hips(6/24)with avascular necrosis of femoral head in the Salter osteotomy group,the difference was statistically significant(c 2=4.131,P=0.042).According to Severin radiographic classification,15 hips were excellent,11 hips were good,6 hips were better,1 hip was poor in the Salter osteotomy combined with femoral osteotomy group,while 5hips were excellent,14 hips were good,5 hips were better,0 hip was poor in the Salter osteotomy group,the difference was not statistically significant(Z=-1.277,P=0.202).According to Mc Kay's hip function evaluation criteria,17 hips were excellent,11 hips were good,5 hips were better,0 hip was poor in the Salter osteotomy combined with femoral osteotomy group,but13 hips were excellent,7 hips were good,4 hips were better,0 hip was poor in the Salter osteotomy group,the difference was not statistically significant(Z=-0.107,P=0.915).Conclusion:Salter osteotomy combined with femoral osteotomy is effective for the treatment of Tonnis type ? developmental dysplasia of the hip.The femoral osteotomy can effectively reduce the incidence of avascular necrosis of femoral head.