当院における先天股脱遺残性亜脱臼に対する大腿骨減捻内反骨切り術の成績

抄録

We reviewed 19 hips (16 patients) which had been treated by derotation and varus femoral osteotomy (DVO) for residual dysplasia after initial treatment of congenital dislocation of the hip (CDH) and followed up until at least six years of age. Eight of the 19 hips were treated by DVO only, ten by DVO and acetabuloplasty, and one by DVO, acetabuloplasty and open reduction. The mean age at surgery was 24 months (14 to 55) and the mean age at follow-up was 13 years.
Sixteen of the 19 hips (84%) were rated as Severin group I or II, and three (16%) as group III. All hips whose ages at surgery were lower than 24 months were rated as group I or II.
Some of the young patients may have been overtreated, because recent studies show that many with residual dysplasia after initial CDH treatment recover spontaneously without treatment. But we consider DVO to be an effective method for some cases in which valgus and anteversion of the femur is one of the causes of progressive dysplsia.