THE SURGICAL TREATMENT OF C.D.H. DURING INFANCY BY OPEN REDUCTION AND A WEDGE BONE GRAFT

Abstract

Introduction: The open reduction of C.D.H. (Congenital Dislocation of the Hip) during infancy associated with an incomplete osteotomy of the iliac bone in the roof of the acetabulum with a use of a wedge bone graft are described in this study.

Material and Methods: Ten children with C.D.H. (aged from 5 to 12 months) were surgical treatment under gone during the last 2 years in our department. Eight of them were boys and 2 girls. The left hip joint was involved in 7 and the right in 2 while one patient had bilateral C.D.H.Conservative treatment without success was performed in all patients until their admission in our hospital. The treatment’s method was the same in all the patients. By an anterior approach to hip joint with a Smith – Petersen’s skin incision open reduction of the dislocated hip was succeeded. We had to eliminate the teres ligament, cut the insertion part of the iliopsoas tendon and remove the inverted limbus to achieve reduction of the hip.

An incomplete innomitate osteotomy was followed above to the roof of the acetabulum. A corticotrabecular wedge human bone graft .human in 3 cases or a allograft in 7patients ( 8 hips) were used to reconform the acetabulum.

Results: The follow-up time ranged from 1 to 2 years. Normal range of movements was detected during clinical review. The radiological follow-up findings were shown that the bone roof of the acetabulum and the femoral neck anteversion was reconformed. No avascular necrosis of the femoral head was noticed.

Conclusion: The C.D.H. could be perfectly recostucted during infancy by open reduction associated with a use of a corticotrabecular wedge bone graft.