A novel method for assessing postoperative femoral head reduction in developmental dysplasia of the hip

Abstract

PurposeDevelopmental dysplasia of the hip (DDH) affects approximately 1 % of live births. Dislocated hips require reduction and stabilisation in a spica cast, and reduction efficacy is assessed radiologically. Numerous measurements are used to ascertain the adequacy of reduction but can be inconsistent in evaluating femoral head position. This study describes the morphology of the developing acetabulum in DDH and validates a novel method to assess adequate reduction of the dysplastic hip following closed or open reduction.MethodsA retrospective review was performed of 66 consecutive patients undergoing reduction of hip dislocation over a 2-year period. Three independent reviewers evaluated postoperative CT scans to assess anterior-posterior (AP) displacement and modified Shenton’s line. Acetabular morphology was also assessed along with hip congruency using a described novel ‘posterior neck line’.ResultsDislocated hips were successfully identified using the posterior neck line with a sensitivity of 0.71 and specificity of 0.88 giving a negative predictive value of 0.97. The interobserver reliability of this technique was higher in comparison against both (AP) displacement and modified Shenton’s line.ConclusionsWe have shown a novel approach in assessing the acetabular morphology of DDH and a novel technique to accurately confirm the reduction of dislocated hips following open or closed reduction.

A Deep-Learning Aided Diagnostic System in Assessing Developmental Dysplasia of the Hip on Pediatric Pelvic Radiographs

“…The Shenton's line, the outside boundary of the acetabulum, and the sourcil of the acetabulum are subjective diagnostic indicators, and the judgment effect are related to clinical experience. It was also found that the inter-class consistency of Shenton's line was low (−0.01–0.33) ( 30 ). CE angle and acetabular index are the main reference indices for diagnosis of DDH, and from the results of this study, it has shown excellent consistency of surgeons whatever their working years are.…”

The Value of Axial Imaging to Check Reduction after Anterior Approach Open Reduction for Developmental Dysplasia of the Hip

“…The incidence of dysplasia of the hip (DDH) is about 1:100 live births [1]. With the introduction of screening programs, the incidence of surgical intervention has significantly dropped.…”

Is Hip Medial Ultrasound More Accurate Than Radiography for Determining the Status of Hip Reduction in Children Treated With a Spica Cast? A Retrospective Diagnostic Accuracy Study

“…During cast immobilization, surgeons need to accurately assess the status of hip reduction to ensure successful treatment and avoid complications [1]. Radiography [21], CT [3,15], and MRI [4,8,11,12,14] have been used to assess reduction status. However, radiography and CT cannot show the details of cartilage very well, and those modalities are associated with radiation; MRI also has disadvantages, such as the need for sedation, high costs, and long scanning times.…”