Gelişimsel kalça displazisi tedavisinde Salter osteotomisi
Gelişimsel kalça displazisi tedavisinde Salter osteotomisi
Yazar: Sipahioğlu, Serkan; Aşkar, Hüseyin; Zehir, Sinan; Işıkan, Uğur
Dergi: Cumhuriyet Tıp Dergisi, Vol. 36 No. 4, 2014
Anahtar kelimeler: Hip dislocation, congenital; osteotomy ; Kalça çıkığı, doğumsal, osteotomi

ÖzetAmaç. Gelişimsel kalça displazisi bulunan olgularda Salter pelvik osteotomi uygulaması sonrası erken dönem sonuçlarını radyolojik ve klinik olarak değerlendirmek. Yöntem. Kliniğimize 2002-2008 yılları arasında başvuran ve daha önce herhangi bir tedavi uygulanmamış GKD tanısı konmuş, açık redüksiyon ve Salter İnnominate osteotomi ile tedavi edilmiş 51 kalça (44 hasta,12 erkek,32 kız, ortalama yaş 30.7 ay) ortalama 25 aylık takip sonucunda retrospektif olarak değerlendirildi. Olgular klinik olarak McKay sınıflamasına, radyolojik olarak Severinin kriterlerine ve avasküler nekroz (AVN) varlığı ise Kalamchi-MacEwen kriterlerine göre değerlendirildi. Bulgular. Preoperatif asetabular indeksi ortalama 37,4 (29-50) derece olan hastaların en son takibi sırasında alınan postoperatif asetabular indeks değerleri ortalama 24,1 (12-32) derece bulundu. MacKay ın klinik değerlendirme sistemine göre 51 kalçanın 43’ü (%84) mükemmel, 7’si (%13,7) iyi, 1’i (%2) orta idi. Severinin radyolojik sınıflamasına göre 26 kalça (%51) çok iyi, 15 kalça (%29,4) iyi, 8 kalça (%15,7) orta ve 2 kalça (%3,9) kötü olarak değerlendirildi Postoperatif AVN oranı yaklaşık %17,6 (9 kalça) idi. Sonuç. Onsekiz ay sonrası GKD tedavisinde Salter innominate osteotomisi etkin bir yöntem olarak pelvis osteotomisi seçenekleri arasında değerlendirilebilir. İleri yaşlarda artan komplikasyon riskini düşürmek için osteotomi tekniğine uygun yapılmalıdır.Anahtar sözcükler: Kalça çıkığı, doğumsal, osteotomi AbstractAim. We evaluated the short-term results of Salter pelvic osteotomy for the treatment of developmental dysplasia of the hip (DDH). Methods. Forty four patients (32 girls, 12 boys; mean age 30.7months) with DDH underwent Salter innominate osteotomies in 51 hips were evaluated retrospectively. Clinical evaluations were made according to the McKay criteria, radiologic assessment was made using Severin criteria and avascular necrosis of the femoral head was assessed using the Kalamchi-MacEwen criteria. The mean follow-up period was 25 month. Results. The mean acetabular index which was 37.4o (29-50) preoperatively decreased to 24.1o (12-32) postoperatively. Clinical results were excellent in 43 hips (84%), good in 7 (13.7%) and moderate in one(2%) patient. 26 hips (51%) were excellent, 15 hips (29.4%) were good, 8 hips (15.7%) were moderate and 2 hips (3.9%) were bad according to Severin radiologic classification. According to the Kalamchi-MacEwen criteria, there was avascular necrosis in nine hips (17.6%) postoperatively. Conclusion. Salter innominate osteotomy can be evaluated as one of the effective method among pelvic osteotomies in the treatment of DDH patients older than eghteen years old.For reducing complication risk which increases age osteotomy should be done in a proper technique.Keywords: Hip dislocation, congenital; osteotomy

Aim. We evaluated the short-term results of Salter pelvic osteotomy for the treatment of developmental dysplasia of the hip (DDH). Methods. Forty four patients (32 girls, 12 boys; mean age 30.7months) with DDH underwent Salter innominate osteotomies in 51 hips were evaluated retrospectively. Clinical evaluations were made according to the McKay criteria, radiologic assessment was made using Severin criteria and avascular necrosis of the femoral head was assessed using the Kalamchi-MacEwen criteria. The mean follow-up period was 25 month. Results. The mean acetabular index which was 37.4o  preoperatively decreased to 24.1o  postoperatively. Clinical results were excellent in 43 hips (84%), good in 7 (13.7%) and moderate in one (2%) patient. 26 hips (51%) were excellent, 15 hips (29.4%) were good, 8 hips (15.7%) were moderate and 2 hips (3.9%) were bad according to Severin radiologic classification. According to the Kalamchi-MacEwen criteria, there was avascular necrosis in nine hips (17.6%) postoperatively. Conclusion. Salter innominate osteotomy can be evaluated as one of the effective method among pelvic osteotomies in the treatment of DDH patients older than eghteen years old.For reducing complication risk which increases age osteotomy should be done in a proper technique