Patient-specific proximal femoral plate combined with a modular 3D-printed osteotomy guide system in children with developmental dysplasia of the hip: a retrospective comparative study.

BACKGROUND

To evaluate the clinical value of a patient-specific proximal femoral plate combined with a modular 3D-printed osteotomy guide system in children with developmental dysplasia of the hip (DDH) undergoing proximal femoral osteotomy.

MATERIALS AND

METHODS

This retrospective study included children with DDH who underwent proximal femoral osteotomy assisted by a modular 3D-printed osteotomy guide system. Patients were divided into a customized plate group and a conventional locking compression pediatric hip plate (LCP-PHP) group. Perioperative outcomes, including blood loss, operative time for the femoral procedure, and fluoroscopy frequency, were compared. Radiographic parameters, including neck-shaft angle (NSA), femoral anteversion angle (FAA), acetabular index (AI), and center-edge (CE) angle, were assessed postoperatively and at final follow-up. Functional outcomes, complications, and measurement reliability were also evaluated.

RESULTS

A total of 40 patients were included. The mean follow-up duration was 32.32 ± 4.18 months in the customized plate group and 31.39 ± 3.88 months in the conventional LCP-PHP group. No major complications were observed in either group. Compared with the conventional LCP-PHP group, the customized plate group showed a significantly smaller loss of planned NSA correction, whereas FAA correction loss was similar between groups. No significant between-group differences were found in blood loss, operative time, fluoroscopy frequency, postoperative radiographic parameters, final follow-up outcomes, or functional results. Reliability analysis demonstrated excellent reproducibility of radiographic measurements, supporting the validity of the difference in NSA correction loss.

CONCLUSIONS

A patient-specific proximal femoral plate combined with a modular 3D-printed osteotomy guide system appears to be a feasible and safe option for proximal femoral osteotomy in children with DDH. Compared with the conventional LCP-PHP, the customized plate more accurately maintained the planned NSA correction and may help improve correction accuracy in pediatric hip reconstruction.