Open Reduction with Femoral Shortening, Derotation Osteotomy, and Acetabuloplasty in a Walking Age Developmental Dysplasia of Hip – A Surgical Video Technique

Abstract

Introduction: It is very common for pediatric orthopedic surgeon to encounter developmental dysplasia of hip (DDH) in walking age, especially in developing countries. The conservative options of management are almost over by this age and most require open reduction (OR) with various adjunct procedures. The most preferred approach for OR in this age group is anterior Smith-Peterson approach to hip joint. These neglected cases also require femoral shortening ± derotation osteotomy and acetabuloplasty. Case Presentation: In this surgical video technique, we demonstrate OR + femoral shortening and derotation osteotomy and acetabuloplasty, step by step, in a neglected, walking age DDH in a 3-year-old child. We hope that the detailed demonstration and tricks at various surgical steps will benefit our readers and viewers. Conclusion: Step-wise surgical execution as per demonstrated technique makes the procedure easily reproducible with fairly good outcomes. In this case example, with demonstrated surgical technique, we were able to achieve a good outcome at short-term follow-up.