Short-term efficacies of femoral osteotomy for developmental dislocation of the hip in children

Abstract

Objective To explore the short-term efficacies of femoral osteotomy for open reduction of developmental dislocation of the hip (DDH). Methods A retrospective study of 67 DDH patients were conducted between January 2010 and December 2013. Forty-one patients were assigned into group Ⅰ with femoral osteotomy and another 26 into group II without femoral osteotomy. The parameters of acetabular index (AI), avascular necrosis (AVN) and recurrent subluxation rate were analyzed. Results In group Ⅰ, the average age was (2.27±0.46) years, 5 hips developed Bucholz-Ogden type Ⅰ AVN and subluxation recurred in 3 hips. In group Ⅱ, the average age was (1.99±0.38) years, 3 hips developed Bucholz-Ogden type Ⅰ AVN and subluxation recurred in 1 hip. There was 1 case of iatrogenic fracture in 1 hip in group Ⅰ and joint stiffness occurred in 1 hip in group Ⅱ. There were 3 hips with claudication in each group. No significant inter-group differences existed in age, gender, dislocation degree, preoperative AI, 1-year postoperative AI and 2-year postoperative AI (P>0.05). Postoperative AI was obviously smaller in group Ⅰ than that in group Ⅱ (20.57°±6.89°vs 24.21°±7.20°, P<0.05). Conclusions Femoral osteotomy is not required for DDH children undergoing reduction at 18-36 months. Such a decision should be made on the basis of hip stability. Key words: Hip dislocation; Osteotomy; Femur