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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
BONE AND JOINT DEFORMITIES - SCIENTIFIC PAPERS 100° CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPAEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Pavia, June 20-21, 2003
Minerva Ortopedica e Traumatologica 2003 April;54(2):101-6
“One stage” reconstruction of inveterate hip dislocation in the developing age
Origo C., Cattaneo P., Rocca G.
U.O.A. Ortopedia e Traumatologia Pediatrica, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria
Aim. The authors present a retrospective study in order to evaluate the indications and results of the inveterate dislocated hip reconstruction (congenital or spastic) in one only surgical time.
Methods. Nine patients with unilateral dislocation, have been treated (3 CHD and 6 CP) through open reduction, femoral varus-derotational interthrocanteric osteotomy with associated femoral shortening and acetabular reconstruction. In the cases of CHD a pelvic Chiari’s osteotomy was preferred (in 1 case with “augmentation” from the iliac wing). In the cases of cerebral palsy dislocation the osteotomy according to Dega was preferred. A plaster cast has been applied in average for 25 days.
Results. The follow up is of 2 year average. Only one hip presented reluxation and required a new femoral osteotomy and a new reduction. All the osteotomies are consolidated and the synthesis devices have been removed after 1 year and a half (average).
Complications as infections, decubitus or ankylosis have not been observed.
All the cases have shown a good motion and, in the cases presenting preoperative pain, this was reduced or disappeared at the follow up.
Conclusions. It’s a difficult surgical intevention but it may give satisfactory results.
According to the most recent published studies the best results are obtained when every anticipated or predictable surgical time is gathered in only one operating session, with the aim to reduce the risk of reluxations and to guarantee a stable result over time.
Nearly mandatory in the results of LCA and in walking patients, it has to be attentively valued in tcase of total body involvement or in myelomeningocele.