Bernese triple osteotomy for developmental dysplasia of the hip and its residual deformity in elder children

Abstract

Objective To present short term outcome of Bernese triple osteotomy of the pelvis for developmental dysplasia of the hip (DDH) in elder children and residual hip deformity after previous surgery.Methods From November 2010 to November 2011,33 hips of 29 children underwent Bernese triple osteotomy in this institute.Eleven cases (13 hips) were elder DDH without any previous treatment.The patients included 5 males and 6 females,with a mean age of 11.2 years old (range,7-15 years old).According to the Tonnis grading standard,8 hips were grade Ⅰ DDH,2 were grade Ⅱ,2 were grade Ⅲ,and 1 was grade Ⅳ.Another 20 hips of 18 patients were residual hip deformity.There were 3 males and 15 females with an average age of 7.3 years old (range,3-16 years old).Eleven children (13 hips) were treated conservatively.Seven children (7 hips) underwent open reduction with pelvic and femoral osteotomy.According to the Tonnis grading standard,15 hips were grade Ⅰ DDH,and 5 were grade Ⅱ.Seven hips were diagnosed with avascular necrosis of the femoral head during follow-up.Results Twenty-six patients (30 hips) were followed up for an average time of 14 (7-20) months.Hips' function was judged by the Mckay criteria,17 hips were excellent,9 were good,1 was fair,and 3 were poor.The alignment of joint was evaluated on X radiography according to Severin classification,15 hips were excellent,12 were fair,and 3 were poor.The preoperative ace tabular head index was 44 ± 21％,which was significantly improved to 85 ± 22％ after surgery (P＜0.05).Conclusions The short-term outcome of Bernese triple osteotomy of the pelvis is satisfactory for the treatment of DDH in elder children and residual deformity. Key words: Developmental dysplasia of the hip; Osteotomy; Femur head necrosis