Outcome of surgical management of developmental dysplasia of hip in children between 18 and 24 months

Abstract

Background:Developmental dysplasia of hip (DDH) is a common condition presenting to a pediatric orthopedic surgeon. There is a consensus on the surgical treatment of children with ages ranged from 18 to 24 months where majority agree on open reduction and hip spica. Open reduction was done with an additional pelvic procedure wherever required to get better results and prevent residual acetabular dysplasia (RAD) and early osteoarthritis.Materials and Methods:35 children with unilateral DDH were operated between 2002 and 2007 at our institute. Open reduction was performed in all using the standard anterior approach and peroperative test for hip stability was done. Nine children got an additional pelvic procedure in the form of Dega acetabuloplasty. All were followed up for a minimal period of 2 years (range 2-7 years).Results:No hip got redislocated. At the end of 18 months, there were seven cases of RAD with acetabular index (AI) of 35° and above. These were all from the group where open reduction alone was done.Conclusion:We feel that a preoperative AI of >40° and a per-operative safe-zone <20° increases the need for supplementary pelvic osteotomy in age group of 18 to 24 months because in such cases, the remodeling capacity of the acetabulum is unable to overcome the dysplasia and to form a relatively normal acetabulum.

Duration of immobilization after developmental dysplasia of the hip and open reduction surgery

“…While the second group (group B) included 24 patients (29 hips), 16 females and eight males, bilateral affection was seen in five patients and the others were unilateral. In this group, spica cast was removed after 12 weeks then start ambulation with no brace [14,15].…”

The Morphofunctional Condition of Structures of the Hip in Experimental Treatment of Its Dysplasia

“…Комплексное, тщательно подобранное и систематическое лечение может замедлить прогрессирование патологического процесса [4,6,7]. При этом часто на первый план выходят суставсберегающие вмешательства, которые позволяют сдерживать прогрессирование или отсрочить начало развития артроза [8][9][10].…”

Diferencias entre las técnicas quirúrgicas utilizadas sobre el aductor mediano en pacientes entre 18 y 36 meses de edad con displasia del desarrollo de cadera

“…Lo que nos produce una tasa de 8-20% de reluxación en caderas tratadas por primera vez, la falla en la técnica quirúrgica al tratar de obtener una cabeza concéntrica y estable es de las principales causas del fallo del tratamiento. 17,20,21 El objetivo de este estudio fue definir si existen diferencias entre los procedimientos quirúrgicos sobre el aductor mediano que influyan en la recidiva de la luxación de cadera en pacientes mayores de 18 meses.…”