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Femoral overgrowth following surgical treatment of long-established dysplasia of the hip

OBJECTIVE: To measure femoral overgrowth using radiographic scanning in patients with long-established Developmental Dysplasia of the Hip treated with femoral shaft shortening, open reduction and acetabuloplasty. METHODS: We studied 30 children (33 hips) submitted to surgical treatment including femoral shaft shortening, open reduction according to Scaglietti & Calandriello's procedure and Salter acetabuloplasty without preliminary traction. There were 29 females and 1 male, with mean age = 4 years and 5 months at the time of operation. According to Zionts & MacEwen's classification, 23 hips were classified as type III (69.6%), 5 (15.2%) as type I and 5 (15.2%) as type II. The average femoral shortening was 45.12 mm (range: 30.00 mm to 80.00 mm). The mean follow-up time was 10 years and 2 months (range: 2 years and 3 months to 18 years) and we noticed a mean femoral discrepancy of 13.48mm (range: 0.00 mm to 60.00 mm) using plain scanning images. RESULTS: All patients evolved to femoral overgrowth; in 18 cases (54.6%), the leg length discrepancy found was <30 mm, 11 (33.3%) showed no LLD, and 4 (12.1%) presented with a discrepancy >30mm. Conclusion: We noticed a significantly decreased discrepancy of femurs after surgical treatment when compared to the measurements obtained during outpatient follow-up.

Hip dislocation, congenital; Osteotomy; Surgery; Radiography; Evaluation; Follow-up studies


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