Contemplate iliosacral screw in patients with developmental dysplasia of the hip

Journal of Orthopaedic Surgery and Research

Research Article

Nazım Karahan¹  Ahmet Oztermeli²  Ahmet Aktan³ 

[1] Corlu State Hospital, Orthopaedic and Traumatology, Zafer St, Bülent Ecevit Bvd. No:33, 59850, ÇorluTekirdağ, Turkey;Gebze State Hospital, Osman Yılmaz, 1, İstanbul St. No:127, 41400, GebzeKocaeli, Turkey;Gebze Fatih State Hospital, Orthopaedic and Traumatology, Zafer, Bülent Ecevit Blv. No:33, 59850, ÇorluTekirdağ, Turkey;Taksim Gaziosmanpaşa Education Research Hospital, Osmanbey Bvd. 621 St, 34255, Gaziosmanpaşa, Istanbul, Turkey;

关键词: Iliosacral screw;    Developmental dysplasia of the hip;    Sacral dysplasia;    Cross-sectional area;    Hartofilakidis;   

DOI  :  10.1186/s13018-023-03606-x

 received in 2022-02-07, accepted in 2023-02-12,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesOur aim in the study was evaluating sacroiliac morphology in patients with DDH and its possible effect on appropriate iliosacral screw fixation.DesignRetrospective cohort study.SettingLevel of evidence 3.Patients/participantsWe evaluated the anteroposterior pelvis X-ray and pelvic CT scans of patients. We mainly divided the patients into two groups: DDH group (n:105) and control group (n:105).InterventionThe presence of the five qualitative characteristics of sacral dysplasia evaluated according to Route in both groups. The DDH group was divided into four subgroups according to the degree of hip dysplasia.Main outcome measurementThe cross-sectional area, length of the osseous corridor, coronal and vertical angulation evaluated in both groups.ResultsThe DDH group also exhibited a significantly higher S1 coronal and axial angulation, lower S1 cross-sectional area and S1 iliosacral screw length than the control group (p:0.033, p:0,002, p:0.006, p:0,019, respectively). According to the Rout classification, 9% were normal, 31% transient, 58% dysplastic in the DDH group. 45.7% were normal, 38% transient, 17% dysplastic in the control groups. These differences between the groups were statistically significant (p < 0.001). When the DDH groups were evaluated within themselves; no statistically significant difference was observed in S1 and S2 cross-sectional area, S1 and S2 maximum estimated iliosacral screw length, S1 and S2 axial and coronal angles assessment.ConclusionSacral dysplasia was more common, narrower and more angled osseous canal for the iliosacral screw was found in the DDH group. There was no relation between the degree of hip dysplasia and sacrum morphology in the DDH group. Thus, we suggest the surgeons be aware of iatrogenic injury even in constrained dysplastic hips.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 4