Department of Orthopedics, Nanjing School of Clinical Medicine Southern Medical University, Nanjing General Hospital of Nanjing Military Region, PLA, Nanjing 210002, China.
Abstract：Objective To evaluate the efficacy and safety of lesser trochanteric osteotomy and subtrochanteric osteotomy for femoral shortening in total hip arthroplasty in treatment of Crowe Ⅳ developmental dysplasia of the hip (DDH).Methods From May 1999 to December 2013, 33 cases (37 hips) with Crowe Ⅳ DDH underwent different methods for femoral shortening with femoral resection in total hip replacement. Twenty-eight patients (30 hips) underwent progressive femoral shortening at the level of lesser trochanteric, 5 patients (7 hips) accepted subtrochanteric shortening osteotomy, 29 cases were unilateral hip and bilateral hip was involved in 4 cases in both packets with an range age of 17-67 years (averaged 35.9 replacement years). A modified Merled Aubigné scale was used in both team ,and the score was 9.4,9.7 preoperatively, and the average leg length discrepancy was 44.7 mm, 57.5 mm. Clinical and radiographical results were collected and evaluated. A regular follow-up was done after surgery.Results The mean follow-up period was 83.6 months, the average leg length discrepancy of lesser trochanteric osteotomy and subtrochanteric shortening osteotomy were 9.2 mm,9.4 mm postoperatively, and Merled Aubigné scale was improved to 15.9 and 15.8. There were two hips with sciatic nerve palsy in lesser trochanteric osteotomy group after surgery.However, resolved completely in six months, and two cases trendelenburg sign was still positive in this group at the final follow-up . No revision of acetabular and femoral components was required by the final follow-up. Compared with pre-and post-operative in each group, the Merled Aubigné scale and Harris score showed significant difference(all P values＜0.05), no difference existed between two groups (all P values＞0.05).Coclusions Transtrochanteric osteotomy and subtrochanteric shortening osteotomy for femoral shortening in total hip arthroplasty in treatment of Crowe Ⅳ DDH are safe and effective.
袁涛, 包倪荣, 孟嘉, 周利武, 郭亭, 赵建宁. 全髋关节置换术中不同截骨方式行股骨短缩治疗Crowe Ⅳ型髋关节发育不良的疗效分析[J]. 中华解剖与临床杂志, 2014, 19(6): 478-482.
Yuan Tao, Bao Nirong, Meng Jia, Zhou Liwu, Guo Ting, Zhao Jianning.. Efficacy of different femoral shortening osteotomy in total hip arthroplasty for treating Crowe type Ⅳ developmental dysplasia of hip. Chinese Journal of Anatomy and Clinics, 2014, 19(6): 478-482.
2014, Vol. 19 
