Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 1-2, Pages: 58-63
https://doi.org/10.2298/SARH1102058M
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Results of surgical treatment of developmental dysplasia of hip considering child’s age
Milašinović Sonja (Institut za bolesti djece, Klinički centar Crne Gore, Podgorica, Crna Gora)
Introduction. Developmental dysplasia of the hip (DDH) represents one of
common diseases of the locomotor system. Late discovery and inadequate
healing of this defect leads to serious disability in the best years of human
life. Objective. The aim of this study was to analyze the quality of
functional and anatomic restitution of the diseased hip, depending on the age
of the patient at the time of surgery. Methods. Our retrospective study was
developed on 78 children surgically treated for DDH. The examiners were
distributed in three groups according to age in which they had been operated.
The data were produced on the basis of full-scale medical documents for each
patient. Results. We analyzed and compared anatomic and functional results of
surgeries treating DDH in the group of examiners. On examination, we got data
that the most prevalent were distorted gait, inequality of the legs and
positive Trendelendburg’s sign in the group of children who had been operated
in the oldest age. The patients who were surgically treated in older age had
worse postoperative results in aspect value angle of flexion and abduction in
treated hip, higher frequency in manifesting pain and asymmetric gait. Better
corrective results on aspect of dimension of the colodiaphyseal and
Hilgenrainer’s angle will be obtained if DDH treatment is conducted in
younger age of patients. In 94.95%, the patients were treated with Salter
innominate osteotomy of pelvis with osteotomy of the femur involving its
shortening and reverse rotation. Preoperative treatment with Pavliks harness
was provided in 44.02% children, with abduction of Hilgenrainer’s apparatus
in 2.6%, with abductions “Niva” slips in 2.6% and preoperative extension in
28.2%. Conclusion. The surgical treatment of DDH in the observed patients
done at the earlier age of growth resulted in the evidently better anatomical
and functional results at postoperative observation.
Keywords: articulation of the hip, developmental dysplasia of the hip, dysplasia, osteotomy, children
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