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用于治疗发育性髋关节发育不良的戴加截骨术:基于X线和CT扫描的临床评估及解剖学研究

Dega Osteotomy for the Treatment of Developmental Dysplasia of the Hip, a Clinical Evaluation and an Anatomic Study based on X-ray and CT Scan.

作者信息

Shaty Wahby

机构信息

Department of Surgery, College of Medicine University of Thi Qar, Iraq.

出版信息

Orthop Rev (Pavia). 2024 Jun 30;16:120304. doi: 10.52965/001c.120304. eCollection 2024.

Abstract

BACKGROUND

Dega osteotomy is becoming more widely used for the treatment of developmental dysplasia of the hip (DDH).

OBJECTIVE

A thorough description of this procedure is needed as many of the technical aspects are not fully defined. Moreover, more follow-up series are also needed to evaluate its outcomes.

METHODS

In this study, we gave a detailed anatomic description for this procedure and also presented our experience as a retrospective radiographic and case-note study. We examined the clinical and radiographic records of 44 patients (48 hips) with varying degrees of DDH.

RESULTS

The average age of the patients was 2 months and 7 months while the average follow up period was 41 months. Clinical and radiographic assessment including CT with 3D reconstruction to examine the anatomic characteristics of the osteotomy were undertaken. We found that concentric reduction was achieved in 93.7% with excellent clinical and radiographic outcomes. Only 3 cases needed revision of the Dega osteotomy. The re-operation rate was 12.5%. CT scan revealed that the arcuate line was crossed by the osteotomy in the majority of cases. In 20.7% of cases, a bone cut that was intended to be a Dega osteotomy was found to have been inadvertently implemented as another osteotomy variant. However, this bore no significant effect on the outcome.

CONCLUSION

We found that a well-implemented Dega osteotomy is a reliable tool to cope with the acetabular changes in DDH.

摘要

背景

德加截骨术在发育性髋关节发育不良(DDH)的治疗中应用越来越广泛。

目的

由于许多技术方面尚未完全明确,因此需要对该手术进行全面描述。此外,还需要更多的随访系列来评估其疗效。

方法

在本研究中,我们对该手术进行了详细的解剖学描述,并作为一项回顾性影像学和病例记录研究介绍了我们的经验。我们检查了44例(48髋)不同程度DDH患者的临床和影像学记录。

结果

患者的平均年龄为2个月零7个月,平均随访期为41个月。进行了临床和影像学评估,包括采用CT三维重建来检查截骨的解剖特征。我们发现93.7%的患者实现了同心圆复位,临床和影像学结果均极佳。只有3例需要对德加截骨术进行翻修。再次手术率为12.5%。CT扫描显示,大多数病例中截骨线穿过了弓状线。在20.7%的病例中,发现本应进行德加截骨术的骨切口却无意中实施为另一种截骨术式。然而,这对结果没有显著影响。

结论

我们发现,实施良好的德加截骨术是应对DDH髋臼变化的可靠工具。

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The Dega osteotomy: a versatile osteotomy in the treatment of developmental and neuromuscular hip pathology.
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