Risk Factors for Failure After Open Reduction for DDH

Abstract

Level III (case-controlled study).

Developmental dysplasia of the hip: What has changed in the last 20 years?

“…A recent retrospective match-controlled study examined those risk factors which were: right side (or bilateral) involvement, greater pubic width, and decreased abduction in the spica cast. In several cases, dysplasia of the femoral head or an insufficiently corrected femoral version were thought to be the reason for the failure of the primary surgery [131] . Procedures are being developed in the effort to reduce the rate of redislocation.…”

Retrospective analysis of the radiographic indicators for peri-acetabular osteotomy of developmental dysplasia in children

“…The sideways and superior shifting of the femoral head impacts the development of acetabular cup, affecting its depth and shape. The acetabulum needs the femoral head to develop normally [5]. Our study is unique in addressing the multiple issues involved.…”

“…This study sought, as Brougham et al [17] recommended, to develop early radiological guideline markers for the requirement of subsequent acetabular operations surgery dysplasia, to enable early rather than late surgery to be performed to assist clinical decision making. Several studies have attempted to determine the predictors of outcome or prognosis factors, or evaluation of specific indicators for the need for pelvic osteotomy [5,10,17] . Our study, as other researchers have proposed [18,19], to assess the value of imaging features of DDH after birth up to two to three years using pelvic plain film, in order to develop a simple, reliable indicator to predict radiological DDH and its association with the requirements of salvage osteotomy.…”

“…Prolonged periods of dislocation of the acetabulum and femoral head and delayed restoration of their dynamic interaction will impair normal hip joint modeling and shaping. Conservative approaches and surgical procedures are widely used to restore the normal anatomical relationship of the acetabulum and femoral head [3][4][5]. Surgical procedures pioneered by Smith-Petersen in 1948 was later improved by several others [6], and have shown that surgical repositioning of the hip to its normal anatomical position is possible [8].…”

Have Changes in Treatment of Late-detected Developmental Dysplasia of the Hip During the Last Decades Led to Better Radiographic Outcome?

“…Despite a vast number of clinical studies, no consensus has been reached on the optimal management to obtain these goals. Whereas closed reduction was common in the past [13,27], open reduction has become more frequently used during the recent decades [2,14,21]. Both closed and open reduction has been supplemented with additional procedures like femoral and pelvic osteotomies, either at the time of hip reduction or at a later stage.…”