Radiological results of our patients who are five years and over diagnosed of developmental hip dysplasia and that we treated with salter innominate osteotomy

Developmental hip dysplasia(DDH) has been an important issue in orthopedics for many years in terms of diagnosis and treatment. Treatments vary according to the age of diagnosis of the disease. Having different treatments at different ages makes orthopedic surgeons' work difficult and attracts their attention. While conservative monitoring of the disease may be sufficient at an early age, successful results can be obtained with surgical methods in advanced ages. In this study, we evaluated the radiological results of our patients who were five(5) years old and older who were diagnosed with DDH and underwent Salter Innominate Osteotomy in our clinic. 19 hips of 18 patients who were diagnosed with advanced age developmental hip dysplasia in Gaziantep University Faculty of Medicine Şahinbey Training and Research Hospital Orthopedics and Traumatology Clinic, and who underwent Salter innominate osteotomy between March 2009 and December 2016, were included in our study. 14 hips wa applied femoral shortining. The measurements were made comparatively on the preoperative and the most recent postoperative radiological examinations taken from the hospital archive. The data of our patients who were followed for at least 18 months were analyzed retrospectively. Twelve(66.7%) of our patients included in the study were female and 6(33.3%) were male. Six of the patients included in the study had right, 11 left, and 1 had bilateral hip involvement. The mean age of our patients at the time of surgery was 8.63±2.91 years. The mean follow-up period of the patients included in our study was 59.11±39.96 months. Preoperative anterior posterior(AP) radiography of our patients; Acetabular Index angle, Sharp angle, Central neck body(Collodiaphyseal) angle and Tönnis staging were measured. Postoperative anterior posterior(AP) radiography; Acetabular index angle, Sharp angle, Central neck body(Collodiafizer) angle, Wiberg CE angle, Kalamchi Maceven classification, Bucholz Ogden classification, Severin classification were measured. SPSS for Windows version 22.0 package program was used for statistical analysis and P<0.05 was considered statistically significant. The mean preoperative Acetabular Index angle was 39.05±4.56 degrees. Postoperative first control mean Acetabular Index angle was 25.21±4.7 degrees. Postoperative last control mean Acetabular Index angle was 21.79±4.48. It was found to be statistically significant(p=0.001). The mean preoperative Sharp angle was 56.32±6.33. Postoperative first control Sharp angle mean was 45.47±2.95. Postoperative last control Sharp angle mean was 44.95±4.21. It was found to be statistically significant(p=0.001). The mean preoperative Collodiaphyseal angle was 141.39 ± 7.64°. In the postoperative first control graph, the mean Collodiaphyseal angle was 134.47±10.23º. In the postoperative last control graph, the mean Collodiaphyseal angle was 129.16±8.19°. It was found to be statistically significant(p=0.001). According to Severin classification, 5 hips(26.3%) were stage 1, 10 hips(52.6%) were stage 2, and 4 hips(21.1%) were stage 3. The primary goal of child developmental hip dysplasia(DDH) treatment is concentric reduction. It has been reported that femoral shortening, varization and derotation osteotomies facilitate concentric reduction in advanced age DDH. These osteotomies also reduce the rate of AVN development by reducing stress on the femoral head. In late-diagnosed advanced age DDH cases, acetabular insufficiency corrective osteotomies can be successfully applied with open reduction, femoral shortening and appropriate pelvic osteotomy performed in the same operation and can give good clinical and radiological results. In this study, in which we evaluated the radiological results of our patients who were diagnosed with Developmental Hip Dysplasia at the age of five(5) and who were treated with Salter İnominate Osteotomy, it is necessary to increase the number of patients in studies and to perform longer follow-up studies in order to reveal the radiological results more accurately and reliably. Key Words: Developmental hip dysplasia, Salter osteotomy, dysplasia