Effect of acetabular morphological parameters applied in proximal femoral varus osteotomy on the treatment of developmental dysplasia of the hip in children

Abstract

Background:The study was carried out based on the background that though proximal femoral varus osteotomy is one of the most effective methods in treating developmental dysplasia of the hip (DDH), its surgical efficiency and effect need to be improved. Methods:The neck shaft angle and acetabular morphological parameters were measured before and after operation and during clinical follow-up. The Severin criteria and McKay criteria were both adopted to score the measurements. The distance from the center of the femoral head to the medial cutting bone (expressed as C value) and the shortened lengths of the proximal femur (expressed as Δ S) calculated by formula and obtained by actual measurement were compared.Results: The neck shaft angle and acetabular morphological parameters after operation and during clinical follow-up were significantly lower than those before operation (P<0.05). The proportion of children with McKay scores of I, II, III, and IV after operation was 50.00%, 41.67%, 8.33%, and 0.00%, respectively; while the proportion of children with Severin scores of I, II, III, and IV was 55.00%, 38.33%, 6.67%, and 0.00%, respectively. There were no significant differences in the C value and Δ S obtained after formula calculation and actual measurement (P>0.05). Conclusions:The acetabular morphological parameters applied in proximal femoral varus osteotomy are of great value for the treatment of DDH in children.

Case report: Morphological changes evident after manual therapy in two cases of late-diagnosed developmental dysplasia of the hip

“…At 3 years of age, the femoral neck-shaft angle is expected to reduce from 150° in neonate age to 145° ( 34 ). Greater than 150° is consistent with DDH ( 35 ).…”

Visualized simulative surgery in preoperative planning for proximal femoral varus osteotomy of DDH

“…Proximal femoral varus osteotomy with locking compression pediatric hip plate (LCP-PHP; Synthes, Switzerland) is an effective surgical procedure for DDH, which could provide a stable and concentrical hip joint in children via decreasing excessive neck-shaft angle [ 1 – 3 ]. Nevertheless, an ideal surgery is still a technical challenge for most orthopaedic surgeons because inappropriate surgical management may result in severe complications such as re-dislocation or avascular necrosis (AVN) [ 4 , 5 ]. The success of the surgery mainly depends on the surgeon’s experience, which includes both excellent preoperative planning and precise intra-operative design.…”