Mutlu VURAl, Selçuk BALÜKBAŞI, Necdet ALTUN, Erdal CİLA, Aykın ŞİMŞEK, Ulunay KANATLI

The effect of salter innominate osteotomy on femoral anteversion in developmental dysplasia of the hip: A preliminary report

Salter innommant osteotomisi ile tedavi edilen çocuklarda aşırı femoral anteversiyonun cerrahi olarak düzeltilmesinin gerekip gerekmediğini ortaya koymak için bu çalışmada Şalter ameliyatı sonrası femoral anteversiyon değişikliğini değerlendirdik. Hastalar ve Metod: Gelişimsel kalça displazisi nedeniyle cerrahi tedavi uygulanan bir erkek 14 kız hastanın 23 displastik kalçası bu çalışmaya dahil edildi. Yaşları 1.5 ile 3.5 arasında değişen hastalara ameliyat öncesi ve sonrası bilgisayarlı tomografi ile femoral anteversiyon ölçümü yapıldı. Bulgular: Ameliyat sonrası birinci yılda femoral anteversiyonda 2.51° (-0.8° - 9.4°)' lik bir azalma tespit edildi ve bu istatistiksel olarak anlamlı bulundu (p--0.05). Sonuç: Şalter innommât osteotomisi femoral anteversiyondaki azalmayı hızlandırmasa bile, normal kalçalarda izlenen doğal femoral anteversiyon azalma seyrini etkilememektedir.

Gelişimsel kalça displazisi tedavisinde salter innominat osteotomisinin femoral anteversiyona etkisi: Erken bildiri

To study whether surgical correction of excessive femoral anteversion was necessary or not during Salter innominate osteotomy. Children who had been treated by Ms operation were followed to determine the changes in femoral anteversion. Methods: Twenty-three developmentally dysplastic hips of one male and fourteen female patients, whose ages ranged from 1.5 to 3.5 years, were treated. During follow-up, the children were evaluated for the changes in the femoral anteversion values after the acetabular redirection operation. The femoral anteversion was measured by using computer tomography preoperatively and one year after surgery. Results: At the end of the first postoperative year, there was a mean decrease of 2.51 degrees (range -0.8 to 9.4°) in femoral anteversion and this decrease was found to be statistically significant (p

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1. Kutlu A, Memik R, Mutlu M, Kutlu R, Arslan A.Congenital dislocation of the hip and its relation to swaddling used in Turkey. J. Pediatr Orthop 1992; 12:598-602.
2. Gabuzda GM, Renshaw TS. Reduction of dislocation of the hip. J Bone and Joint Surg (Am) 1992; 74: 624-631.
3. Şalter RB. Editorial: Osteotomy of the pelvis. Clin Orthop 1974; 98:2-4.
4. Şalter RB, Dubos JP. The first fifteen years' experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. Clin Orthop 1974; 98:72-103.
5. Tachdjian MO. Pediatric Orthopedics, 2nd edition, Philadelphia: W. B.Saunders Co; 1990.
6. Hernandez RJ, Tachdjian MO, Poznanski AK, Dias LC. CT determination of femoral torsion. Am J Roentgenol 1981; 137: 97-101.
7. Hernandez RJ, Poznanski AK. CT evaluation of pediatric hip disorders. Orthop Clin North Am 1985; 16: 513-541.
8. Severin E. Contribution to the knowledge of congenital dislocation of the hip joint. Late results of closed reduction and arthrographic studies of recent cases. Acta Chir Scandinavica 1941; 84 (Suppl 63): 1-141.
9. Staheli LT. Torsion-treatment indications. Clin Orthop 1989; 247: 61-66.
10. Barrett WP, Staheli LT, Chew DE. The effectiveness of the Şalter innominate osteotomy in the treatment of congenital dislocation of the hip. J Bone and Joint Surg (Am) 1986; 68: 79-87.
11. Gülman B, Tuncay İC, Dabak N, Karaismailoğlu N. Salter's innominate osteotomy in the treatment of congenital hip dislocation: A long-term review. J. Pediatr Orthop 1994; 14: 382-388.
12. Watanabe R S. Embryology of the human hip. Clin Orthop 1974; 98:8-26.
13. Miller F, Merlo M, Liang Y, Kupcha P, Jamison J, Hareke T. Femoral version and neck shaft angle. J Pediatr Orthop 1993; 13:382-388.
14. Serafımov L. Biomechanical influence of the innominate osteotomy on the growth of the upper part of the femur. Clin Orthop 1974; 98:39-40.
15. Peterson HA, Klassen RA, McLeod RA, Hoffman AD.The use of computerised tomography in dislocation of the hip and femoral neck anteversion in children. J Bone Joint Surg (Br) 1981; 63: 198-208.
16. Ruby L, Mital MA, O'Connor J, Patel U. Anteversion of the femoral neck, comparison of methods of measurement in patients. J Bone Joint Surg (Am) 1979; 61: 46-51.
17. Ruwe PA, Gage JR, Ozonoff MB, DeLuca PA. Clinical determination of femoral anteversion, a comparison with established techniques. J Bone Joint Surg (Am) 1992; 74:820-830.
18. Abel MF, Sutherland DH, Wenger DR, Mubarak S J.Evaluation of CT scans and 3-D reformatted images for quantitative assessment of the hip. J Pediatr Orthop 1994;14: 48-53.
19. Lasda NA, Levinsohn EM, Yuan HA, Bunnell WP.Computerized tomography in disorders of the hip. J Bone Joint Surg (Am) 1978; 60: 1099-1102.
20. Lausten GS, Jorgensen F, Boesen J. Measurement of anteversion of the femoral neck. Ultrasound and computerized tomography compared. J Bone Joint Surg (Br) 1989; 71: 237-239.
21. Lehman WL, Grogan DP. Innominate osteotomy and varus derotational osteotomy in the treatment of congenital dysplasia of the hip. Orthopedics 1985; 8: 979-986.