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Doğuştan Kalça Çıkığının Tedavisinde Salter Osteotomisinin Klinik ve Radyolojik Sonuçları

The clinical and the radiological results of salter osteotomy in congenital dislocation of hip treatment

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Abstract (2. Language): 
In this manuscript, functional and radiologic results of twentysixpatients between eighteen months- four years of age, to whom open reduction and innominate osteotomy was performed as primary therapy are reviewed. All the patients had congenital dislocation of hip (CDH) and no previous therapeutic application due to this pathology. Due to increased femoral anteversion found with CT measurements, femoral shortening and derotetional osteotomy was added to standard surgical procedure in five patients. The mean follow-up time was 36 (13-62) months. The clinical and radiological results were analized according to modified McKay and to Severin criteria respectively. The patients were also examined for aseptic necrosis of the femoral head, which was defined by Salter and Kostuik. Our clinical ( 86% excellent/good) and radiological (76% excellent/good) results were found to be in corelation with the literature and we believe that this surgical technique, even when femoral shortening and derotetional osteotomy was added, can safely be performed witout an increase in the risk of aseptic necrosis of the femoral head. [Journal of Turgut Özal Medical Center 1997;4(2):175-181]
Abstract (Original Language): 
Bu çalışmada onsekiz ay- dört yaş arasında doğuştan kalça çıkığı bulunan, yirmialtı hasta (otuz sekiz kalça) da, primer tedavi olarak uyguladığımız açık redüksüyon ve innominate osteotomisinin fonksiyonel ve radyolojik sonuçlarını gözden geçirdik. Hastalarımıza doğumsal kalça çıkığı nedeniyle daha önce herhangi bir tedavi uygulanmamıştı. Ameliyat öncesi CT ölçüm ile femur boyun anteversiyonu artmış olarak saptanan beş hastaya femoral kısaltma ve derotasyon osteotomisi ekledik. Ortalama üç yıllık izlem sonunda (bir - beş yıl) hastalar modifıye McKay kriterlerine göre klinik olarak ve modifiye Severin sınıflama sistemine göre radyolojik olarak değerlendirildiler. Hastalar ayrıca Salter ve Kostuik'in tanımladığı şekilde avaskuler nekroz yönünden değerlendirildiler. Hastalarımızda benzer çalışmalarla uyumlu klinik (%86 çok iyi ve iyi) ve radyolojik (%76 çok iyi ve iyi) sonuç elde ettik. Sonuç olarak, onsekiz ay- dört yaş arasında doğuştan kalça çıkığı bulunan çocuklarda uyguladığımız açık redüksüyon ve inominate osteotomisi ile ve gerektiğinde femoral kısaltma ve derotasyon osteomisi eklenmesi ile avaskuler nekroz riskinde artış olmadan tatminkar sonuç elde ettik. [Turgut Özal Tıp Merkezi Dergisi 1997;4(2):175-181]
175-181

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