BACKGROUND Salter osteotomy (SO) and Pemberton acetabuloplasty (PA) are procedures to treat skeletally immature patients with developmental dysplasia of the hip (DDH). The purpose of this study was to compare the radiographic results and rate of residual dysplasia (RD) after treatment with SO and with PA. METHODS This was a retrospective analysis of pediatric patients treated with either SO or PA for DDH between 1980 and 2013 who were skeletally mature at the time of follow-up. The preoperative and postoperative acetabular index (AI) and postoperative lateral center-edge angle (LCEA) and anterior center-edge angle (ACEA) were collected. RD was defined as an LCEA or ACEA of <20° or an acetabular inclination (AIn) of >15° at skeletal maturity. Continuous variables were compared between treatment groups with 2-sample t tests, and categorical variables were compared using chi-square tests. Multivariable analysis was used to identify risk factors for RD with p < 0.05. RESULTS The study included 113 hips in 102 patients with a mean follow-up of 10.5 years. The SO group had 73 hips treated at a mean patient age of 5.4 years, and the PA group had 40 hips treated at a mean age of 5.3 years. The preoperative AI did not differ between the treatment groups (32.2° versus 31.3°, p = 0.658), nor did the immediate postoperative AI (20.0° versus 20.2°, p = 0.459). At the time of final follow-up, the SO group had a significantly smaller AIn (8.6° versus 13.2°, p = 0.001), a trend toward a greater LCEA (26.2° versus 21.6°, p = 0.056), and a similar ACEA (24.1° versus 26.1°, p = 0.808). By the abovementioned definition, 36 hips (31.9%) had evidence of RD, with a lower rate in the SO group (26.0% versus 42.5%, p = 0.07). Patients who had a positive family history of hip dysplasia were more likely to have RD (odds ratio = 4.311, 95% confidence interval = 1.125 to 16.528). CONCLUSIONS Patients with RD could be effectively treated with either SO or PA, with overall good radiographic outcomes. However, SO achieved a better AI and may thus yield better long-term health of the affected hip. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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Pemberton 与 Salter 截骨术治疗残余髋关节发育不良后的影像学结果：骨骼成熟度随访患者的结果比较。


背景 Salter 截骨术 （SO） 和 Pemberton 髋臼成形术 （PA） 是治疗患有髋关节发育不良 （DDH） 的骨骼未成熟患者的手术。本研究的目的是比较 SO 和 PA 治疗后的影像学结果和残余异型增生 （RD） 发生率。方法 这是对 1980 和 2013 年接受 SO 或 PA 治疗 DDH 的儿科患者进行的回顾性分析，这些患者在随访时骨骼成熟。收集术前和术后髋臼指数 （AI） 和术后外侧中缘角 （LCEA） 和前中缘角 （ACEA）。RD 定义为骨骼成熟时 LCEA 或 ACEA 为 <20° 或髋臼倾斜度 （AIn） 为 >15°。用 2 样本 t 检验比较治疗组之间的连续变量，并使用卡方检验比较分类变量。采用多变量分析确定 RD 的危险因素，p < 0.05。结果 该研究包括 102 例患者的 113 个髋关节，平均随访 10.5 年。SO 组有 73 个髋关节接受治疗，患者平均年龄为 5.4 岁，PA 组有 40 个髋关节接受治疗，平均年龄为 5.3 岁。治疗组之间的术前 AI 没有差异 （32.2° vs 31.3°，p = 0.658），术后即刻 AI 也没有差异 （20.0° vs 20.2°，p = 0.459）。在最终随访时，SO 组的 AIn 显著较小 （8.6° vs 13.2°，p = 0.001），LCEA 趋于增大 （26.2° vs 21.6°，p = 0.056），以及相似的 ACEA （24.1° vs 26.1°，p = 0.808）。根据上述定义，36 个臀部 （31.9%） 有 RD 的证据，SO 组的发生率较低 （26.0% 对 42.5%，p = 0.07）。 有髋关节发育不良阳性家族史的患者更可能发生 RD （比值比 = 4.311,95% 置信区间 = 1.125 至 16.528）。结论 RD 患者可使用 SO 或 PA 进行有效治疗，总体影像学结局良好。然而，SO 实现了更好的 AI，因此可能会使受影响的髋关节长期健康状况更好。证据级别 治疗 III 级。有关证据级别的完整描述，请参阅作者说明。