International variance in the treatment of developmental dysplasia of the hip

Feeley, Iain; Green, C. J.; Rowan, Fiachra; Moore, David P.

doi:10.1007/s11832-014-0622-z

Cited by 18 publications

(20 citation statements)

References 25 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is widely accepted that a HTE greater than 20° after the age of four is defined as RHD [29], but we do not dispose of any precise radiological tool to help clinicians to decide whether a correction surgery of the acetabulum in those specific borderline cases of RDH is necessary or not [14, 30, 31]. Although we know that results of surgery for RHD are better in younger patients, there are still controversies over the indication for acetabular osteotomy in borderline cases of RHD [32, 33].…”

Section: Discussionmentioning

confidence: 99%

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

et al. 2019

View full text Add to dashboard Cite

PurposeIn case of residual hip dysplasia (RHD) in children, pelvic radiographs are sometimes insufficient to precisely evaluate the entire coverage of the femoral head, when trying to decide on the need for further reconstructive procedures.MethodsThis study retrospectively compares the bony and the cartilaginous acetabular angle of Hilgenreiner (HTE) of 60 paediatric hips on pelvic MRI separated in two groups. Group 1 included 31 hips with RHD defined by a bony HTE > 20°. Group 2 included 27 hips with a HTE < 20°. They were compared by introducing a new ratio calculated from the square of cartilaginous HTE above the bony HTE on frontal MRI. The normal upper limit for this acetabular angle ratio was extrapolated from the published normal values of cartilaginous HTE and bony HTE in children.ResultsThe acetabular angle ratio was statistically significantly increased in the hips with RHD with a mean value of 7.1 ± 4.7 compared to the hips in the control group presenting a mean value of 2.1 ± 1.9 (p < 0.00001).ConclusionsThis newly introduced ratio seems to be a helpful tool to orientate the further treatment in children presenting borderline RHD.

show abstract

Section: Discussionmentioning

confidence: 99%

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Developmental dysplasia of the hip (DDH) is one of the most common limb deformities in children, with an incidence of 1 to 35% depending on age and diagnostic method [1]. Early diagnosis and concentric reduction are the essential elements of successful treatment, thereby increasing the chance of a functional and anatomical hip joint [2]. Radiographical assessments in combination with medical history and clinical examination are assumed to make the diagnosis of DDH [3], among which a plain anteroposterior radiograph of the pelvis is the most frequently used due to low cost, limited radiation, and repeatability [4].…”

Section: Introductionmentioning

confidence: 99%

How to judge pelvic malposition when assessing acetabular index in children? Three simple parameters can determine acceptability

et al. 2020

View full text Add to dashboard Cite

Background: The acetabular index (AI) is the most commonly used parameter for diagnosing hip dysplasia. Pelvic malposition can result in misinterpretation of AI measurement especially in younger children. We aimed to investigate the correlation between pelvic orientation and acetabular index (AI) by using digital reconstructed radiographs (DRRs) and identify reliable parameters predictive of pelvic orientation on plain radiographs. Methods: We retrospectively identified 33 children (52 hips) who received dual source CT examinations. Virtual pelvic models were reconstructed after scanning. After orientating in the standard neutral position, the models were rotated and tilted around corresponding axes. DRRs were generated at every 3°during the process. The acetabular index, the horizontal diameter (Dh) and vertical diameter (Dv) of bilateral obturator foramina, the vertical distance (h) between upper border of pubic symphysis, and Hilgenreiner's line were measured on each DRR by two independent observers. Rotation index (Rr = right Dh/left Dh), tilt index (Rt = h/Dv), intra-observer error, and interobserver error of AI were calculated. Results: For tilt and rotation up to 12.0°, AI increased with anterior tilt and decreased with posterior tilt. And for rotation, it increased on the side toward which the pelvis rotated and decreased on the opposite side. AI varied dramatically if angulation exceeded 6.0°. Malposition below this limit demonstrated the intra-and inter-observer errors were ± 2.0°and ± 3.0°respectively and caused no significant effect on AI measurement. Conclusions: For children up to age 6 years, an acceptable pelvic plain radiograph can be determined when Rt is approximately between 0.9 and 1.4 and Rr between 0.7 and 1.5. For the first time, we have identified parameters derived from a group of subjects which can predict this degree of malposition. The parameters obturator diameters (Dh), obturator height (Dv), and distance (h) between symphysis and Hilgengreiner's line can be feasibly measured on X-ray and employed in clinical practice to assess the acceptability of the pediatric pelvic radiograph prior to measurement of the AI.

show abstract

“…The treatment method used for 12- to 18-month-old paediatric patients with developmental dysplasia of the hip (DDH) has become controversial. For example, increasingly more surgeons advocate an early operation, 1 but reports on the long-term effects of the conservative treatment for patients older than 12 months are very rare. 2 As a noninvasive treatment method, conservative treatment results in less trauma, so it is easier for patients and their families to accept, but the applicable age has been a controversial issue.…”

Section: Introductionmentioning

confidence: 99%

Dynamic long leg casting fixation for treating 12- to 18-month-old infants with developmental dysplasia of the hip

Cai

Zhang

et al. 2016

J Int Med Res

View full text Add to dashboard Cite

ObjectiveTo evaluate the effect of dynamic long leg casting in paediatric patients with developmental dysplasia of hip (DDH) diagnosed at 12–18 months.MethodsThe adductor tenotomy, closed reduction, and dynamic long leg casting method was adopted to treat paediatric patients with DDH. The hips were divided into four groups according to the Tonnis radiographic dislocation classification. Groups were also classified according to the baseline acetabular index (AI): 30°–35°, 36°–40°, and > 40°. The outcomes of the reductions were evaluated according to McKay’s hip function criteria and Severin’s radiological criteria.ResultsA total of 246 patients (339 hips) had complete follow-up data. After 3 months of orthosis fixation, the results were satisfactory in 264 hips (77.88%). Hip function was rated as ‘excellent’ or ‘good’ in 43 of 51 (84.31%) Tonnis type 1 hips, 125 of 155 (80.65%) type 2 hips, 70 of 90 (77.78%) type 3 hips, and 34 of 43 (79.07%) type 4 hips. The higher the baseline AI, the lower the rates of ‘excellent’ and ‘good’ hip function. Favourable radiological results (Severin types I and II) were found in 266 of 339 (78.47) hips.ConclusionsDynamic long leg casting is an effective method for treating patients with DDH aged 12–18 months at diagnosis.

show abstract

International variance in the treatment of developmental dysplasia of the hip

Cited by 18 publications

References 25 publications

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

How to judge pelvic malposition when assessing acetabular index in children? Three simple parameters can determine acceptability

Dynamic long leg casting fixation for treating 12- to 18-month-old infants with developmental dysplasia of the hip

Contact Info

Product

Resources

About