Dislocation Of Hip In Children Research Articles

Traumatic Posterior Hip Dislocation in a Child: When is an Anterior Open Reduction Indicated? A Case Report

Traumatic hip dislocations in children are uncommon, occurring in about 5% of all dislocations in children. Neglected hip dislocations are rarer and pose a serious threat to the normal development of the hip with complications of avascular necrosis and unstable gait. Open reduction is usually required, but the most appropriate surgical approach has not been clearly defined. We reported a child with a traumatic posterior hip dislocation who was successfully treated through an anterior approach after a previously failed posterior open reduction. An anterior open reduction of the hip following a previous failed posterior open reduction is a safe procedure and avoids the likelihood of an iatrogenic injury to the sciatic nerve. Pre-operative imaging with a CT scan or MRI is required in neglected cases to visualise intra-articular bone fragments, which can prevent a concentric reduction.

Treatment perspective after failed open reduction of congenital hip dislocation. A systematic review.

Failure of open reduction of developmental hip dislocation is a serious complication and revision surgery appear to be technically demanding with high complication rates. Little attention has been given in literature to patients in whom open reduction of developmental hip dislocation has failed. We present a systematic review about current perspectives and timing when to perform surgical revision after failed open reduction of developmental hip dislocation in children. Following the recommendations of the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) statements we performed a comprehensive search of the PubMed and Google Scholar bibliographic database in order to select all studies published between 1980 and 2022. Studies were screened for the reasons for failure of open reduction, timing when revision surgery was performed, and for the surgical techniques used for revision. A total of 10 articles including 252 patients and 268 hips has been recorded. The most common causes of re-dislocation after open reduction are inadequate exposure and failure to release the obstructing soft tissues inside and around the hip. In 90% of the cases the anterolateral approach was performed for revision surgery. Avascular necrosis occurred in 5%-67% of cases and was the most encountered complication. Redislocation of developmental hip dislocation after an open reduction has poor long-term outcomes mainly due to a high rate of avascular necrosis of the femoral head. It is mandatory to obtain a stable reduction at the second surgery combining soft tissue release, capsulorrhaphy, pelvic and femoral osteotomies.

Study Confirms Safety and Effectiveness of Intra-Articular Glucocorticoids for Painful Hip Dislocation in Children and Young Adults with Neurologic Impairment.

Hip dislocation is a common source of pain in children with neurologic impairment. When medical interventions fail, orthopedic surgery does not guarantee a definitive result as the displacement may continue postoperatively and a second operation is often required. Retrospective analysis of data regarding the safety and effectiveness of an intra-articular corticosteroid injection (IACI) in 11 patients, aged 15 ± 5 years old, collected through a telephonic questionnaire administered to parents. 21 IACIs were performed, a mean number of 1.9 ± 1.5 times for each patient, at a mean age (of the first IACI) of 13.5 ± 5 years. According to the parents, the IACI significantly lowered the number of participants experiencing pain (82% reduction) and using analgesics (60% reduction). There was also a significant improvement in the children's hip mobility (63% reduction in patients experiencing stiffness), decubitus (90% reduction in obligated positioning), behavior (80% reduction in lamenting or crying patients), sleep quality (87.5% reduction in patients awakening every night), and caregivers' quality of life (91% reduction in worried parents). The mean reported duration of the IACIs' benefit was 5.4 ± 2.4 months (range 1-9), with a positive correlation with the number of IACIs (r = 0.48; p-value = 0.04) and a negative correlation with the age at the first injection (r = -0.71; p-value = 0.02). The only reported adverse event was mild local swelling in one child. the IACI could represent a safe and effective intervention for painful hip dislocation, both before and after surgery, with a long-lasting benefit which seems to increase as multiple IACIs are performed.

Definition of hip displacement and dislocation by acetabular dysplasia in children with cerebral palsy.

The acetabulum interacts with the femoral head in daily activities and may exhibit structural changes in the presence of hip disorders. This study aims to redefine hip disorders in children with cerebral palsy by structural characteristics of the acetabulum in relation to the degree of the migration percentage. The clinical and radiographic data of 70 patients (36 males, 34 females; mean age 8.2 years) with spastic cerebral palsy were retrospectively analyzed. The acetabular structure was measured by the acetabular index on reconstructed three-dimensional computerized tomography for precision of measurement. Any significant change in acetabular index measured on the reconstructive computerized tomography related to every 10% increment of migration percentage was regarded as clinically significant in hip disorders. The acetabular index measured on the reconstructive computerized tomography showed an increasing trend with the increment of migration percentage. The most significant acetabular index measured on the reconstructive computerized tomography change occurred between the 20%-29% and 30%-39% migration percentage groups (p < 0.001), suggesting that a migration percentage of 30% is the starting point of hip disorder. A significant increase in the posterolateral acetabular index measured on the reconstructive computerized tomography occurred in migration percentages >50%, indicating posterolateral acetabular dysplasia. Hips with migration percentages from 80% to 100% had consistent acetabular indexes measured on the reconstructive computerized tomography values, suggesting complete dislocation and no more contact and interaction between the femoral head and acetabular fossa. Structural characteristics in the acetabulum reflect hip dysfunction and potentially classify hip disorders. Results suggest the migration percentage 30% as a starting point of hip disorder and 80% as a turning point of hip dislocation in children with cerebral palsy. level IV, diagnostic study.

Epidemiology and injury morphology of traumatic hip dislocations in children and adolescents in Germany: a multi-centre study.

Traumatic hip dislocations are very rare in childhood and adolescence. The aim of this multi-centre study is to analyse the current epidemiology and injury morphology of a large number of traumatic hip dislocations in children. This can provide a better understanding of childhood hip dislocations and contribute to the development of a therapeutic approach in order to prevent long-term impacts. This retrospective, anonymised multi-centre study included patients, aged up to 17years, with acute traumatic hip dislocations and open growth plates. The patients came from 16 German hospitals. Exclusion criteria included insufficient data, a positive history of hip dysplasia, or an association with syndromal, neurological or connective tissue diseases predisposing to hip dislocation. An analysis was carried out on the patients' anthropometric data and scans (X-ray, MRI, CT), which were collected between 1979 and 2021. Gender, age at the time of dislocation, associated fractures, mechanism of injury, initial treatment including time between dislocation and reduction, method of reduction, treatment algorithm following reduction and all documented complications and concomitant injuries were evaluated. Seventy-six patients met the inclusion criteria. There were two age peaks at 4-8years and 11-15years. There was an increased incidence of girls in the under-eight age group, who had mild trauma, and in the group of over-eights there were more boys, who had moderate and severe trauma. Dorsal dislocation occurred in 89.9% of cases. Mono-injuries dominated across all age groups. Concomitant injuries rarely occurred before the age of eight; however, they increased with increasing ossification of the acetabulum and appeared as avulsion injuries in 32% of 11-15-year-olds. Of the 76 patients, 4 underwent a spontaneous, 67 a closed and 5 a primary open reduction. A reduction was performed within 6h on 84% of the children; however, in around 10% of cases a reduction was not performed until after 24h. Concomitant injuries needing intervention were identified in 34 children following reduction. Complications included nerve irritation in the form of sensitivity disorders (n = 6) as well as avascular necrosis (AVN) of the femoral head in 15.8% of the patients (n = 12). Traumatic hip dislocations are rare in childhood and adolescence and have high complication rates. The most severe complication, femoral head necrosis, occurred in 16% of cases. Minor injuries, especially in younger children, are enough to cause a dislocation. Posterior dislocation was more frequent and primarily occurred as a mono-injury; however, concomitant injuries must be considered with increasing age. Children continue to experience delayed reductions. The length of time until reduction, age and the severity of the concomitant injury play a role in the development of femoral head necrosis; however, this topic requires additional investigation.

Acetabular development after open reduction to treat developmental dysplasia of the hip after walking age

Objectives: Treatment of developmental dysplasia of the hip (DDH) with high hip dislocation in children using a one-stage operation appears tedious and associated with complications. This study aimed to assess a less traumatic approach for the surgical treatment of irreducible hips among children with DDH after walking age. The treatment strategy involved open reduction (OR) alone and non-invasive monitoring of acetabular development. Methods: This was a retrospective analysis of 22 hips of 20 female patients with complete dislocation of the hip and a mean age of 25.09 ± 4.6 months, performed between February 2013 and February 2018. All DDH patients underwent OR alone and had an irreversible hip dislocation. After surgery, a spica cast was applied for 6 weeks and then reduced to a broomstick cast for a considerable period. Finally, night abduction brace was placed until a normal acetabular index (AI) was obtained. The mean follow-up was 44.60 ± 12.36 months. Results: Out of 20 patients with DDH, 18 (90%) were successfully treated by OR alone. The main pre-operative AI of 41.82° ± 5.54° decreased to 16.19° ± 7.09° at the final follow-up (P &lt; 0.001). An initial negative center-edge angle at the pre-operative stage gradually increased to a mean of 26.86° ± 6.56° during the follow-up period. Conclusion: Relatively less invasive approach adopted in this study not only obviated the need for an additional procedure but also had a favorable effect on the acetabular and hip joint development.

Surgical Method for the Treatment of Multiplanar Deformities of the Proximal Femur in Children with Aseptic Necrosis of the Femoral Head

The aim of the study was to evaluate the effectiveness of corrective intertrochanteric osteotomies of the femur in multiplanar deformities of the proximal femur after bloodless reduction of congenital hip dislocation in children.

Children's Hip Predictive (CHiP) Score: A Triage Tool for Hip Dislocation in Children Referred With Suspected Hip Dysplasia.

A fundamental tenent of treating developmental dysplasia of the hip is to identify patients with dislocated hips early so as to avoid the long-term sequelae of late diagnosis. The aim of this study was to develop a readily useable triage tool for patients with suspected hip dislocation, based on the clinical history and examination findings of the referring practitioner. All primary care referrals (n=934) over a 3-year period for suspected developmental dysplasia of the hip to a tertiary pediatric center were evaluated. Defined parameters with respect to history and clinical examination were evaluated. Multivariable logistic regression was used to establish predictors of hip dislocation, and from this a predictive model was derived which incorporated significant predictors of dislocation. An illustrative nomogram translated this predictive model into a usable numerical scoring system called the Children's Hip Prediction score, which estimates probability of hip dislocation. There were 97 dislocated hips in 85 patients. The final predictive model included age, sex, family history, breech, gait concerns, decreased abduction, leg length discrepancy, and medical/neurological syndrome. The area under receiver operating curve for the model is 0.761. A Children's Hip Prediction score of≥5 corresponds to a sensitivity of 76.3% and a score of≥15 has a specificity of 97.8%, corresponding to an odds ratio of 27.3 for increased risk of dislocation. We found that a novel clinical prediction score, based on readily available history and examination parameters strongly predicted risk of dislocations in hip dysplasia referral. It is hoped that this tool could be utilized to optimize resource allocation and may be of particular benefit in less well-resourced health care systems. Level II.

Acetabular plasty assisted by 3D printing for the treatment of dislocation of hip joint in children with cerebral palsy

To identify types of acetabular dysplasia, select the most suitable acetabular plasty, and analyze indications and efficacy of three types of acetabular plasty in treating dislocation of hip joint in children with cerebral palsy by 3D printing technology. From July 2019 to December 2019, 7 children with cerebral palsy with hip dislocation were treated with acetabular plasty assisted by 3D printing technology, including 3 males and 4 females, aged from 3 from 8 years old;3 patients on the left side, 2 patients on the right side, and 2 patients on both sides. Subluxation of hip joint occurred in 2 patients and dislocation of hip joint occurred in 5 patients. Preoperative full-length CT scan of pelvis and femur was performed in all children. The types of acetabular dysplasia were determined by 3D printing reconstruction technology, and the results were presented as follows:2 anterior hips, 2 anterior outer hips, 1 outer upper hip, 2 posterior hips, 1 posterior outer hip, and 1 hip without dysplasia(with no acetabular plasty). Pemberton, Dega and San Diego surgery simulations were performed on the 8 hips respectively to find the most suitable and the suitable operations were then conducted. Migration percentage (MP), acetabular index (AI) and cenal-edge angle (CEA), Shenton line, and gross motor function classification system(GMFCS) between preoperative and last follow-up were compared and complications were recorded. The wound healed well after operation and no complication occurred. Seven patients were followed up for 18 to 24 months. The 8 hips were underwent soft tissue release for the first stage+proximal femoral varus and rotation reduction osteotomy+hip reduction+acetabular plasty;1 hip was underwent soft tissue release for the first stage+proximal femoral varus removal and rotation reduction osteotomy +hip reduction. MP decreased from 58% to 100% preoperatively to 0 to 17.9% at the latest follow-up. AI decreased from 25.0° to 47.6° preoperatively to 11.1° to 25.3° at the latest follow-up. CEA increased from 0° preoperatively to 21.1° to 48.5° at the latest follow-up. Shenton's lines changed from interrupted ones to continuous ones. The GMFCS grade of 5 cases decreased by 1 grade, and 2 cases showed no change. There is diversity for the hip dislocation of hip in children with cerebral palsy of acetabular dysplasia present type. Accurate judgments could be made with the help of 3D printing reconstruction techniques. There are differences between scopes of applications for three kinds of acetabulum keratoplasty. 3D printing technology could be helpful to choose the most suitable operation method and estimate the treatment effect. Thus the individualized and accurate treatment for hip dislocation in children with cerebral palsy can be gained with 3D printing technology.

Prevalence and treatment of hip displacement in children with cerebral palsy in Finland.

Purpose:The aim was to study the prevalence of hip displacements, dislocations, and the hip surgeries performed in a Finnish cohort of children with cerebral palsy not followed up in a hip surveillance program and to compare these with previous studies performed in Northern European countries before and after the implementation of hip surveillance programs.Methods:A cross-sectional study. A cohort including 480 children with cerebral palsy, born during the period 2000–2018, not enrolled in a hip surveillance program. Migration percentages were recorded from hip radiographs, age at first hip surgery and type of surgery was extracted from medical records. In a separate analysis, the inclusion criteria were adapted to fit two studies analyzing hip dislocation and hip surgery in Sweden, Norway, and Scotland before and after the implementation of a hip surveillance program. Chi-square tests were used to assess differences in proportions between the groups.Results:In total, 286 children (60%) have had at least one hip radiograph. Of these, 10 (3.5%) developed hip dislocation, which is more than in children of countries with hip surveillance programs (Sweden 0.7%, Scotland 1.3%, p < 0.001). Initial surgery to prevent hip dislocation was performed at an older age (p < 0.001).Conclusion:Children with cerebral palsy in Finland not participating in a surveillance hip program were more likely to undergo hip surgery at an older age and to develop hip displacements and dislocations. The results support the effectiveness of surveillance programs to prevent hip dislocation in children with cerebral palsy.Level of evidence:III

Our experience in the treatment of congenital hip dislocation in children of different ages

The experience in treatment of children with neglected congenital hip dislocation is presented. The main principles of management are defined. The successive complex of curative measures including conservative treatment using Ter-Egiazarov-Sheptun functional plaster bandage in children over 6 months is described in detail. In failed conservative treatment the reduction of dislocation is performed using over head technique. In children over 3 years descent of femoral head and reduction of dislocation are carried out on distraction system followed by surgical correction of all dysplastic elements of the hip joint. Technique of detorsion-varus osteotomy with application of distraction system and closed reduction is described. Long-term results were evaluated using CITO score system in 255 patients. Good and satisfactory results were in 91.7% of cases.

Development of a wearable orthotic device pattern to prevent hip dislocation in children with cerebral palsy

PurposeThis study suggest the development of a wearable orthotic device pattern that can reduce pain and deformation, and help in the normal development of children with cerebral palsy. Such a pattern enables daily wear before hip subluxation occurs, to prevent hip dislocation and subluxation.Design/methodology/approachThis study set the design line by carrying out cell work on the actual model, then proceeded with the first pattern design. The final version of the second orthotic device was designed by conducting discussions with experts and the patient's guardian, with the device fitted to the child patient. The evaluation of the second orthotic device used the virtual model to check the pressure area and level through virtual fitting. An evaluation was then conducted with the device fitted to the child patient, to verify the functionality and suitability of the final pattern.FindingsFollowing the initial fitting evaluation, the second pattern was presented after modifying and supplementing issues such as movement suitability with posture change, position change of the great trochanter when wearing a diaper, pressure control of the X-shaped band on the genital area and thigh abduction. The master pattern of the final version of the second orthotic device was proposed after confirming that the femoral head of the hip joint was stably fixed, and the compression was applied through a verification based on the virtual fitting using the virtual model, and with the device fitted to the child patient.Originality/valueWith this study, it is expected that the process and design plan for the development of wearable orthotic device patterns for the persons with disabilities impaired mobility can be used as a basic resource to create devices that merge the clothing and medical fields.

Реконструктивные вмешательства при вывихе бедра у детей с церебральным параличом

Introduction The article is a literature review focusing on reconstruction surgery for dislocated hips in children with cerebral palsy (CP). Material and methods Publications in Scopus, PubMed, RSCI indexed journals over the past 20 years were reviewed for hip dislocation in children with CP. Results and discussion The article discusses the prevalence of the orthopaedic complication of cerebral palsy, pathogenesis, diagnosis, indications to surgery, choice of surgical technique, early rehabilitation and long-term outcomes. A report made for the first educational meeting of the European Pediatric Orthopaedic Society held in Russia at the Ilizarov Center in 2021 was used for the contribution. Conclusion Surgical treatment is indicated for hip dislocation in children with CP using holistic approach and principles of single-event multilevel surgery that suggest hip reconstruction, addressing contractures and deformities of the subjacent segments and creating conditions for postoperative postural management. Standardized indications, patient selection and optimal time for intervention are to be carefully considered for the procedure with the use of customized orthopaedic implants and techniques.

The Importance of Allis Maneuver in the Management of Traumatic Posterior Hip Dislocation in Children: A Report of Two Cases

The Importance of Allis Maneuver in the Management of Traumatic Posterior Hip Dislocation in Children: A Report of Two Cases

Hip Surveillance for Children with Cerebral Palsy: A Survey of Orthopaedic Surgeons in India.

The purpose of this study was to assess Indian orthopaedic surgeons' current practices and beliefs regarding hip surveillance for children with cerebral palsy (CP), to determine potential support for developing hip surveillance guidelines, and to identify knowledge gaps and key obstacles to guideline implementation in India. An anonymous, cross-sectional online survey was sent to approximately 350 Paediatric Orthopaedic Society of India (POSI) members who were queried on their practices and beliefs about hip surveillance for children with CP, as well as perceived challenges and requirements for the successful implementation of hip surveillance guidelines in the Indian context. Out of 107 responses obtained from POSI members, almost all (96.2%) agreed that hip displacement requires standardized monitoring, using surveillance and surgery to prevent hip dislocation. Approximately half (51.5%) of respondents reported using existing hip surveillance guidelines, with most (41.2%) using the Australian guidelines. Almost all (97%) surgeons indicated that hip surveillance guidelines in India are needed, with 100% expressing interest in following guidelines specific to India. Respondents most frequently indicated late referrals to orthopaedics (81.2%), loss of patients to follow-up (78.2%), and lack of resources (43.6%) as challenges to successful hip surveillance in India. Perceived requirements for implementation included developing Indian-specific guidelines (83.2%) as well as educating surgeons (56.4%), physiotherapists/pediatricians (90.1%), and families (82.2%). Orthopaedic surgeons practicing in India understand the importance of preventing hip dislocations in children with CP through hip surveillance and timely surgical intervention. The results demonstrated strong support for the development of hip surveillance guidelines designed specifically for the Indian healthcare system. The online version contains supplementary material available at 10.1007/s43465-021-00432-3.

Технология закрытого вправления вывиха бедра по Г.А. Илизарову при лечении детей с врожденной дисплазией тазобедренного сустава

Introduction The possibility of gradual closed reduction of hip dislocation in children over 1.5 years old is considered doubtful. Purpose Analysis of long-term results of applying the Ilizarov technique of gradual closed reduction in combination with the reconstruction of the hip joint components. Methods The outcomes of treatment of 62 children (81 joints) with congenital hip dislocation in the follow-up period from 5 to 16 years were studied. The treatment method included closed reduction of the dislocation using the technology proposed by G.A. Ilizarov and subsequent reconstruction of the joint components. The patients are divided into two groups based on their age. The first group included 33 patients (43 joints) under the age of 5 years. The second group consisted of 29 patients (38 joints) aged 5–8 years. Results Closed reduction failed in five cases. The recurrence of dislocation after closed reduction was 5.3 %. The rate of aseptic necrosis after closed reduction was 9.7 %. Good functional outcomes were reported in 87.7 %. They were significantly better in the younger group. The proportion of good anatomical results did not depend on age and was 77 % in general. Poor results were obtained in 8.8 %. Conclusion The anatomical and functional outcomes and the number of complications by using the technique described were comparable to other methods of gradual closed reduction of hip dislocation. But the technique we have described expands the age restrictions for its use.

Acetabular shape and orientation of the spastic hip in children with cerebral palsy.

To see if three-dimensional (3D) methods could bring new understanding to acetabular changes in shape and orientation in the spastic hip and in which direction(s) acetabular orientation might change, which is crucial for planning appropriate hip correction surgery. We performed a retrospective study of pelvic computed tomography (CT) examinations in 20 consecutive patients (10 females, 10 males). The mean age of patients was 12 years 9 months (SD 2y; range: 9-16y) at the time of the CT examination. The control group consisted of 18 consecutive pelvic CT examinations (36 acetabula) of deceased individuals (six females, 12 males) aged 4 to 17 years (mean age: 10y 6mo; SD 5y 2mo) whose whole-body CT scans were taken shortly after their death. We compared 3D CT reconstructions of 28 unstable and dislocated hips in children with bilateral cerebral palsy (Gross Motor Function Classification System levels IV and V) with the unaffected side and typically developing controls to assess spatial orientation (inclination, anteversion, and tilt), acetabular volume, and surface area. Additionally, we analysed the multiple factors that may lead to structural and spatial changes of the acetabulum. Patients with dislocated and spastic hips had significantly lower anteversion (-3.2° and -1.4° respectively, p<0.001), increased inclination (85.2° and 85.3° respectively, p<0.001), and decreased tilt (24.6° [p=0.014] and 20.7° [p=0.013] respectively) compared with typically developing individuals. Regarding acetabular volume and surface area, dislocated and unstable hips had significantly lower volume (17.6ml vs 31.5ml respectively, p<0.001) and surface area (28.9cm2 vs 36.2cm2 respectively, p<0.001) than unaffected hips. Among several factors, only Reimer's migration index had an influence on acetabular orientation (i.e. anteversion, p=0.01), volume (p<0.001), and surface (p=0.004). Acetabula in patients with spastic hip disease were severely retroverted with increased steepness; acetabular orientation was distorted superoposteriorly. In rare cases, acetabular orientation was distorted only superiorly or superoanteriorly. Acetabular orientation was distorted superoposteriorly in most patients with severe bilateral cerebral palsy. More pronounced acetabular changes were found in hips with a higher Reimer's migration index.

Outcome of acute septic dislocation of hip in children reduced at arthrotomy

BackgroundPathological dislocation of hip following episode of septic arthritis is a long recognized complication. We determined clinicoradiological outcome in 14 children presenting with acute septic dislocation of hip and reduced at the time of emergency arthrotomy and drainage. MethodsThe retrospective study was conducted at a tertiary care health centre located at suburb of a low income country. The study involved a 10 years chart review of children with confirmed septic arthritis of hip presenting with complication of acute joint dislocation and treated with open reduction at the time of arthrotomy and surgical drainage. All included patients were provided postoperative abduction splintage for minimum 3 months. The clinical evaluation at final follow up was done using modified Moon’s criteria for outcome assessment. The radiological outcome was analyzed in terms of containment (Severin class), sequelae (Choi radiological types) and effect on acetabular development (acetabular index, AI). The AI on normal and reduced sides was compared statistically. ResultsAverage patient age at the time of presentation was 7.2 months and follow up available was 32 months (range, 12–70 months). Functionally, 5 had excellent and 6 had good outcomes at the final follow up. Two patients had fair whereas 1 had poor outcome. Seven hips were Severin class II, 4 class III and 2 class IV and 1 was class VI. One patient had Choi type IA, 3 type IB, 8 type IIA, 1 type IIB and only 1 had type IVA at follow up. The mean AI of reduced hip was 23.4° and was significantly higher than that of unaffected side (mean 15.7°). ConclusionsThe complication of acute septic dislocation of hip in children may not have a sinister prognosis as commonly believed. These hips however were associated with significant acetabular dysplasia in the follow up period.

Measurement of femoral neck anteversion of developmental dislocation of hip in children by 3D printing technique

To explore the method and accuracy of measuring the femoral neck anteversion in children with developmental dislocation of the hip by using 3D printing technology, so as to find out the method of measuring the femoral neck anteversion accurately and guide the formulation of the operation plan. From June 2016 to September 2018, 17 patients with unilateral developmental dislocation of the hip were enrolled in the study, including 2 males and 15 females, aged 2 to 13 (5.47±0.81) years old, 11 on the left and 6 on the right. The methods of CT, 3D printing and intraoperative anteversion of femoral neck were used to measure the anteversion of femoral neck respectively. The intraoperative measurement was used as the standard reference value forstatistical analysis, and the accuracy of the first two methods was compared. The average value of CT was (36.00±1.66)°, the average value of model method was(43.91±1.62)°, and the average value of intraoperative method was(44.21±1.62)°. There were significant differences in CT measurement, model measurement and intraoperative measurement(P<0.05). There was no significant difference between model method and intraoperative method (P>0.05). Compared with the traditional CT method, the 3D printing model method is simpler, more accurate and more repeatable, and can simulate the operation before operation. It is an ideal method to measure the femoral neck anteversion.

Neglected Posterior Dislocation of Hip in Children -A Case Report

Neglected Posterior Dislocation of Hip in Children -A Case Report