Background: Reports of the efficacy of open reduction and Zigzag Osteotomy combined Fibular\nAllograft (ZOFA) for developmental dysplasia of the hip. The purposes of this study were to evaluate\nthe long-term outcomes and complications after surgery. Methods: We performed a retrospective\nmatch-controlled study in which 158 patients had 181 hips with developmental dysplasia\nof the hip. Radiographs were found of acetabular index, height of dislocation, \n\n\n-\ntion angle in the spica cast, and Severin grade. At final follow-up, deformity of femoral head or\nneck or acetabulum was evaluated according to the Severin. Avascular necrosis was rated according\nto Kalamchi. Clinical evaluation was made according to modified McKay criteria. Results:\nBetween 2009 and 2012, 133 girls (84.2%) and 25 boys (15.8%) with developmental dysplasia of\nthe hip underwent open reduction and ZOFA; 135 (85.4%) were unilateral, and 23 (14.6%) were\nbilateral. Patients were divided into 2 groups: group 1 included 54 patients (62 hips) aged 12\nmonths - \n ed 84 patients (119 hips), aged >18 months - ths.\nAccording to T�¶nnis system: type 3 appeared in 127 hips (70.2%), and Type 4 in 54 hip (29.8%).\nThe anterior approach was used to expose inner table of the ilium and ZOFA in all cases. Acetabular\nindex was improved; preoperation was 42.95, and latest follow-up 17.26. The Kirschner\nWires (KW) were not used to fix the fibular allograft at the pelvic osteotomy site. All of the fibular\nallografts were completely incorporated in mean time of 14 weeks (range, 12 weeks - 17 weeks)\npost-surgery. Clinical evaluation according to modified McKay criteria: satisfactory result (excellent\nand good) was achieved in 141 hips (77.9%). Avascular Necrosis (AVN) happened in 61 hips\n(33.7%), redislocation in 18 hips (9.9%), coxa vara in 4 hips (2.2%), trendelenburg gait in 4 hips\n(2.2%), and supracondylar femoral fractures in 2 hips (1.1%). Conclusions: On the basis of this study, ZOFA was strength and graft was not resorption, graft problems; without medial displacement\nof the distal fragment. Acetabular index was improved, without KW problem. Surgical technique\nwith ZOFA did not expose outer table of the illium, limiting abductor muscle injury with\nnegative trendelenburg gait; on the other hand, the blood loss from this procedure is acceptable.\nSome complications have been seen in this study: AVN, redislocation, coxa magna, coxa vara,\ntrendelenburg gait, and distal femoral fracture.
Loading....