[Follow-up results of adduction-derotation osteotomies in hip dysplasia]

The first part of the investigation was concerned with the evaluation of radiographs of 64 children in whom 97 intertrochanteric adduction-derotation osteotomies were performed when the patients were between two and ten years old. Prior to surgery, immediately thereafter and two and six years later, the CCD, AC, ACM and CE angles of all the patients were measured on plain pelvic radiographs. On the radiographs made after six years 70% of the CCD angles were normal, while pathologic coxa valga was found in 15% and coxa vara also in 15%. The AC angle was normal in 32% , the ACM angle in 31%; however, these normal groups were only 76% identical. The CE angle had normalized in 32% of the cases. The second part of the paper deals with clinical and radiological follow-up findings in 46 of these patients in whom 64 hips had been treated. The follow-up period varied between six and 13 years. On clinical examination the result was found to be satisfactory in 59% and unsatisfactory in 41%. A comparison with radiological-anatomical findings showed that in 32% of the radiologically satisfactory cases there were some considerable functional limitations and subjective complaints. The author's own results are compared with communications in the literature, in particular with the Swiss collective statistics published by Jani (1973) and Reichelt and Hansen's publication (1975). To provide the reader with a survey of the number of cases, age at operation and periods of observation quoted by different authors, these data are presented synoptically in tabular form. Another table lists the criteria investigated by the individual authors (AC, ACM, CE, CCD and AT angles). The discussion is completed with conclusions relevant to clinical practice.