%0 Journal Article
%T Surgical Results and Complications of Developmental Dysplasia of the Hip - One Stage Open Reduction and Salter¡¯s Osteotomy for Patients between 1 and 3 Years Old
%A Chia-Hsieh Chang
%A Hsuan-Kai Kao
%A Wen-E Yang
%A Chun-Hsiung Shih
%J Chang Gung Medical Journal
%D 2011
%I 
%X Background: Reports of the efficacy of Salter¡¯s osteotomy have often been based ongroups of patients with complex disease conditions and treatment. The purposesof this study were to document the results of patients with well-definedconditions, focusing on the onset and sequelae of osteonecrosis.Methods: The study participants consisted of 63 patients with unilateral hip dislocationwho had undergone one-stage open reduction and Salter¡¯s innominateosteotomy between the ages of 1 and 3 years. The results were evaluatedclinically by McKay¡¯s classification and radiologically by the modifiedSeverin¡¯s classification. Early signs of osteonecrosis were identified by neckwidening, epiphysis fragmentation, and presence of a metaphyseal growthdisturbance line in the first year after the operation.Results: After a follow-up of 10 years on average, good clinical and radiographicresults were noted in 89% and 92% of the patients, respectively.Osteonecrosis occurred in 30 hips, of which 14 subsequently developedfemoral head deformity. Residual dysplasia was noted in 5 hips, mostlyresulting from late-onset coxa valga. Eighty-five percent of the hips withoutosteonecrosis and 53% of the hips with osteonecrosis (p < 0.05) were classifiedas Severin class 1. No pre-operative factors were found to be associatedwith the occurrence of osteonecrosis.Conclusion: One-stage open reduction and Salter¡¯s osteotomy was an effective treatmentfor developmental dysplasia of the hip after walking age. However, parentsmust be informed of the two major complications, osteonecrosis and residualdysplasia, that can lead to long-term morbidity.
%K developmental dysplasia of the hip
%K Salter¡¯s osteotomy
%K osteonecrosis
%U http://memo.cgu.edu.tw/cgmj/3401/340109.pdf