Pemberton Osteotomisi (18 ay–5 yaş arası çocuklarda alınan sonuçlar)

Amaç: Erken çocukluk döneminde ve yürüme yaşında, gelişimsel kalça dislokasyonu bulunan çocuklarda ilk tedavi yöntemi olarak, açık redüksiyon ve Pemberton osteotomisinin sonuçlarının incelenmesi. Yöntem ve Gereç: Ocak 2001-Mart 2009 tarihleri arasında, ortalama yaşları 31,3 ay olan 36 çocuğun 38 kalçası ilk tedavi yöntemi olarak belirtilen yöntemle opere edilmiştir. Ortalama 41,7 ay süren takipler sırasında ve sonunda tüm kalçalar asetabuler açı, CE açısı, avasküler nekroz gelişimi, triradiat kıkırdağın erken füzyonu, redislokasyon ve fonksiyonel açıdan değerlendirilmişlerdir. Bulgular: Klinik açıdan % 97,3 mükemmel ve iyi sonuç elde edilmiştir. Asetabuler açı 42 (32-62) dereceden, 20 (10-28) dereceye inmiş, CE açısı -46 dereceden 24 dereceye yükselmiştir. Üç kalçada tip I avasküler nekroz ve 1 kalçada yeniden çıkık saptanmıştır. Sonuç: Pemberton osteotomisi 18. aydan büyük çocuklara ait tipik gelişimsel kalça dislokasyonunun tedavisinde çok başarılı sonuçlar vermektedir. Açık redüksiyon ve Pemberton osteotomisinin ilk tedavi yöntemi olması halinde başarı şansı daha da artmaktadır..

Pemberton Osteotomy (Outcome in children aged between 18 months to 5 years old)

Aim: The aim of this study is to evaluate the outcome of open reduction and Pemberton osteotomy as the first method for the treatment of developmental hip dislocation in children at early childhood period and walking age. Material and Methods: Between January 2001 and March 2009, 38 hips of 36 children were operated with the aforementioned first treatment method. The mean age of the patients was 31.6 months. The mean follow-up period was 41.7 months. During and at the end of the follow-up period the hips were evaluated by means of the acetabular angle, the CE angle, the development of avascular necrosis, the premature closure of the triradiate cartilage, redislocation. Functional evaluation was also conducted. Results: Clinically 97.3 % of the patients revealed excellent and good results. The acetabular angle decreased from 42 degrees (32-62) to 20 degrees (10-28). The CE angle was improved from -46 degrees to 24 degrees. In three hips type I avascular necrosis was developed and in one hip reluxation was occured. Conclusion: The Pemberton osteotomy offers very successful results for the treatment of typical developmental hip dislocation in children older than 18 months. Moreover, the success rate of the open reduction and Pemberton osteotomy is increased if it is preferred as the first treatment method.

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