Olalde HM, Hernández CS, Olalde MJC, López RSN, Aguilar AI

Language: Spanish
References: 8
Page: 38-45
PDF size: 357.76 Kb.

ABSTRACT

Introduction: Development dysplasia of the hip is a pathology that has many variants in the treatment from conservative management when diagnosed early, to the realization of iliac and femur osteotomies, when diagnosed late. Objective: Introduce to the medical world the existence of another resource in the yet known array of surgical methods in school age patients with development dysplasia of the hip, without previous treatment, and labeled with a Tonnis IV, through the descent of the femoral component hip to reach a Tonnis 0, with previous adductor myotomy and tenotomy psoas; and then to evaluate the performance of femoral pelvic osteotomies (femur and acetabulum) in order to achieve a proper concentric centering of the hip. Patients and methods: A retrospective, longitudinal and descriptive study was conducted at Hospital Infantil de Morelia «Eva Sámano López Mateos» from January 2000 until now, where 15 patients were treated with development dysplasia of the hip without any treatment, between 6 and 13 years, by placing monoplanar external fixator (Charnley-Müller) in order to descend the femoral component of the hip; all with Tonnis’ grade IV of sickness and measured under Severin’s chart. Results: Until now the progress seen in 5 patients (33.3%) was good, 8 patients (53.3%) acceptable and the remaining 2 patients (13.3%) poor, where joint ankylosis was developed, measured under McKay’s classification. The results were evaluated under Severin’s classification, where a patient was found in the group III (6.6%), four in the group IVa (26.6%), six in the IVb group (40%), two in the V group (13.3%) and two in group VI (13.3%), without obtaining excellent results under this classification. Conclusions: The treatment of developmental dysplasia of the hip by placing the monoplanar external fixator (Charnley-Müller) is an effective alternative in patients without previous management, because through it we place the pelvic and femoral components in ideal conditions for the possible future performance of osteotomies and/or placement of prosthesis.

REFERENCES

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