Sarikaya Baran, Sipahioglu Serkan, Sarikaya Zeynep B, Bozkurt Celal, Altay Mehmet A, Isikan Ugur E
Department of Orthopaedics and Traumatology, Harran University School of Medicine.
Department of Radiology, Balikligol State Hospital, Sanliurfa, Turkey.
J Pediatr Orthop B. 2018 May;27(3):250-256. doi: 10.1097/BPB.0000000000000469.
We aimed to investigate the early radiological effects of Dega and Pemberton iliac osteotomies that were performed in patients aged 4-8 years with developmental dysplasia of the hip on development of hip joint. Dega osteotomy or Pemberton osteotomy was performed in 76 hips of 58 patients because of developmental dysplasia of the hip between September 2011 and June 2015 and were evaluated retrospectively. Of a total of 76 hips, Pemberton osteotomy was performed on 39 (19 unilateral) and Dega osteotomy was performed on 37 (21 unilateral). In all hips, the acetabular index, acetabular depth ratio, centre-edge angle of Wiberg, and Reimer's index values were recorded preoperatively and at the final follow-up. We measured the surface areas of the femoral head ossific nucleus in patients with unilateral dysplastic hips and compared results before both osteotomy procedures and at the final follow-up. There were no statistically significant differences between the groups in terms of the acetabular index and acetabular depth ratio values (P>0.05) preoperatively and at the final follow-up, but the mean centre-edge angle of Wiberg and Reimer's index values showed significant statistical differences in favor of the Dega procedure (P<0.05). There was a statistically significant difference in favor of the Pemberton procedure when the mean ratio of the surface area of the femoral head ossific nucleus on the dysplastic side in relation to the normal side was compared preoperatively (P=0.042) and at the final follow-up (P=0.027) in unilateral hips. Although Dega and Pemberton osteotomies produce satisfactory radiological outcomes at early stages in children aged 4-8 years with developmental dysplasia of the hip, a higher rate in the surface area of the femoral head ossific nucleus was observed in the Pemberton osteotomy group, which also had a lower mean age than the Dega osteotomy group.
我们旨在研究对4至8岁发育性髋关节发育不良患者行德加（Dega）截骨术和彭伯顿（Pemberton）髂骨截骨术对髋关节发育的早期放射学影响。2011年9月至2015年6月期间，因发育性髋关节发育不良，对58例患者的76髋进行了Dega截骨术或Pemberton截骨术，并进行回顾性评估。在总共76髋中，39髋（19例单侧）行Pemberton截骨术，37髋（21例单侧）行Dega截骨术。在所有髋关节中，术前及末次随访时记录髋臼指数、髋臼深度比、维伯格（Wiberg）中心边缘角和赖默（Reimer）指数值。我们测量了单侧发育不良髋关节患者股骨头骨化核的表面积，并比较了两种截骨手术前及末次随访时的结果。术前及末次随访时，两组间髋臼指数和髋臼深度比值无统计学显著差异（P>0.05），但维伯格平均中心边缘角和赖默指数值显示Dega手术组有显著统计学差异（P<0.05）。在单侧髋关节中，术前（P=0.042）及末次随访时（P=0.027）比较发育不良侧股骨头骨化核表面积与正常侧的平均比值时，显示彭伯顿手术组有统计学显著差异。虽然Dega截骨术和Pemberton截骨术在4至8岁发育性髋关节发育不良儿童的早期能产生满意的放射学结果，但Pemberton截骨术组观察到股骨头骨化核表面积增加率更高，且其平均年龄也低于Dega截骨术组。
