Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Department of Pediatric Orthopaedic Ward 1, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
J Orthop Surg Res. 2020 May 11;15(1):169. doi: 10.1186/s13018-020-01683-w.
Developmental dysplasia of the hip (DDH) is a common disease in infants and children, and the treatment of bilateral DDH remains controversial. This study aimed to evaluate the stability of one-stage bilateral Salter pelvic osteotomy for bilateral DDH in patients of walking age.
In total, nine child cadavers aged 2-6 years were included. A universal mechanical testing machine was used for stability test. We performed two different surgical procedures on the specimens: nine child cadavers underwent unilateral Salter pelvic osteotomy, and six child cadavers were randomly selected to undergo Salter pelvic osteotomy again to simulate one-stage bilateral Salter pelvic osteotomy. The stability of the bilateral sacroiliac joints, local stability of the operation area, ultimate load test, and axial stiffness were evaluated.
Both unilateral and bilateral Salter osteotomy could destroy the integrity of the pelvic ring and increase the risk of pelvic instability. In this study, compared with unilateral Salter osteotomy, bilateral Salter osteotomy had similar pelvic stability, and there was no significant difference between unilateral and bilateral Salter osteotomy in sacroiliac joint stability (p > 0.05), local stability (p = 0.763), ultimate load (p = 0.328), and axial stiffness (p = 0.480).
One-stage bilateral Salter pelvic osteotomy as a potential surgical method is viable and stable for children with bilateral DDH.
发育性髋关节发育不良（DDH）是婴幼儿常见疾病，双侧 DDH 的治疗仍存在争议。本研究旨在评估行走年龄患儿一期双侧 Salter 骨盆截骨术治疗双侧 DDH 的稳定性。
共纳入 9 例 2-6 岁儿童尸体标本。采用万能力学试验机进行稳定性测试。我们对标本进行了两种不同的手术：9 例儿童尸体行单侧 Salter 骨盆截骨术，随机选择 6 例儿童尸体再次行 Salter 骨盆截骨术，以模拟一期双侧 Salter 骨盆截骨术。评估双侧骶髂关节稳定性、手术区域局部稳定性、极限载荷试验和轴向刚度。
单侧和双侧 Salter 截骨均可破坏骨盆环的完整性，增加骨盆不稳定的风险。在本研究中，与单侧 Salter 截骨术相比，双侧 Salter 截骨术具有相似的骨盆稳定性，双侧 Salter 截骨术与单侧 Salter 截骨术在骶髂关节稳定性（p＞0.05）、局部稳定性（p=0.763）、极限载荷（p=0.328）和轴向刚度（p=0.480）方面无显著差异。
一期双侧 Salter 骨盆截骨术作为一种潜在的手术方法，对于双侧 DDH 患儿是可行且稳定的。
