Comparison of results of patients who underwent femoral shortening osteotomy and patients who underwent preoperative skeletal traction for surgical treatment of developmental hip dislocation with salter innominate osteotomy

In this study, we evaluated 52 hips of 40 patients who underwent surgery and controlled due to developmental hip dislocation between 2008 and 2012. 37 of patients (92.5%) were female and 3 of patients (7.5%) were male those included in the study. 28 of patients had natural birth, 11 of patients had cesarean delivery, and 1 of patients had breech presentation histories. 23 cases had bilateral involvement, 9 cases had involvement of the left hip, and 8 cases had involvement of the right hip. In the same session, open reduction and Salter innominate osteotomy procedure was performed to 24 hips of 20 patients included in the study (Group I) after preoperative skeletal traction. Open reduction, Salter innominate osteotomy and proximal femoral shortening ? derotation osteotomies were performed to 28 hips of 20 patients in the same session (Group II). In the same session, preoperative skeletal traction, open reduction and Salter innominate osteotomy was performed to 11 hips which were not included in the study. The mean age of the patients during the surgical procedure was 27.7 months (range, 18-38 months). Mean follow-up time was 32.7 months (range, 12-51 months). Clinical and radiological evaluation was performed according to modified scoring system of Trevor et al. (MTS). According to MTS; the average score was 17.92 (15-20) in group I, and was 17.43 (13-20) in group II. Differences of application of preoperatively skeletal traction or femoral shortening were not significant according to MTS in patients with developmental hip dislocation (p=0.290). According to our findings, application of preoperative skeletal traction or femoral shortening did not affect the results of treatment. According to avascular necrosis classification of Kalamachi ? MacEwen, there was no significant difference between preoperative skeletal traction (20.8%) group and femoral shortening (21.4%) group in terms of incidence of avascular necrosis. According to our results, there is no superiority skeletal traction or femoral shortening to each other in terms of incidence of avascular necrosis Keywords: Preoperative skeletal traction, Proximal femoral shortening, Developmental dislocation of the hip, Avascular necrosis.