[Treatment of developmental dislocation of the hip with improved Pemberton method].

OBJECTIVE

To find a more perfect method of treating developmental dislocation of the hip(DDH).

METHODS

From March 1994 to December 2002, on the basis of the ordinary operative method, Pemberton method was improved for 48 cases of DDH 49 articulatio coxae which had superficial and small acetabula but big heads of femur. Osteotomy points were moved higher to enlarge area of bone flap turned over. A piece of full thickness ilium including periosteum was removed as a free bony graft. Capsula articularis growing thicker was made into 2 layers, of which the inner layer was used to tighten articularis and the outer layer was used to stabilize bone flap.

RESULTS

All patients were followed up for 18 months to 5 years, the function of articulatio coxae and degree of bony union, inclusion area to head of femur and ischemic necrosis of femoral head were observed through X-ray. According to Zhou Yongde's criteria for the curative effect of congenital dislocation of the hip, there were 18 cases of 26-30 scores(3 hips), 27 cases of 21-25 scores, 2 cases of 16-20 scores(3 hips), and 1 case under 15 scores, and the total superior rate was 93.8%.

CONCLUSION

Improved Pemberton method can enlarge inclusion area to head of femur, avoid decreasing acetabular volume, and stabilize articulatio well, which made operative indication bigger than original Pemberton method.