Treatment of developmental dysplasia of the hip (DDH) between the age of 18 and 24 months

Alassaf, Nabil

doi:10.1007/s00590-019-02601-5

Cited by 17 publications

(21 citation statements)

References 22 publications

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“…Closed reduction (CR) plus immobilization with a plaster cast could be appropriate management in patients younger than 24 months 7 , while open reduction (OR) with pelvic osteotomies (PO) might be the treatment of choice in older patients 8 . However, results and comparisons of CR and OR plus PO in patients aged 18-36 months, appear to have equivalent and not well-de ned or discrepant long-term results 9 . Thus, children of these ages are still disputable if CR increases the probability of avascular necrosis (AVN) or unsatisfactory radiological results.…”

Section: Introductionmentioning

confidence: 95%

Closed reduction evaluation in dysplastic hip with the Ömeroğlu system in children aged 24-36 months

Charles-Lozoya

Chávez-Valenzuela

Cobos-Aguilar

et al. 2022

Preprint

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Background Closed reduction (CR) as an initial treatment for developmental hip dysplasia of the hip (DDH) in children aged 24–36 months is debatable; however, it could have better results than open reduction (OR) because it is minimally invasive. The purpose of this study was to evaluate the radiological results in children (24–36 months) with DDH initially treated with CR. Methods Retrospective analysis of initial, subsequent, and final anteroposterior (AP) pelvic radiological records. The International Hip Dysplasia Institute (IHDI) was used to classify the initial dislocations. To evaluate the final radiological results after CR (initial treatment) or additional treatment (CR failed), the Ömeroğlu system was used (6 points excellent, 5 good, 4 fair-plus, 3 fair-minus, ≤2 poor). The degree of acetabular dysplasia was estimated using the initial acetabular index (IAI) and the final acetabular index (FAI), Buchholz-Ogden classification was used to measure avascular necrosis (AVN). Results 98 radiological records were reviewed, including 53 patients (65 hips). Fifteen hips (23.1%) were redislocated and OR with femoral and pelvic osteotomy (13.8%) was the preferred secondary treatment. The IAI vs. FAI was (38.9º ± 6.8º) and (31.9º ± 6.8º), respectively (t = 6.5, p < 0.001). The prevalence of AVN was 40% (OR 73.3% vs. CR 30%, P = 0.003). Unsatisfactory results (≤ 4 points on the Ömeroğlu system) were observed in all hips that required secondary treatment. Conclusions Hips with DDH treated with CR initially had better radiological results than those treated with additional treatments, although with a predominance of regular results (four points) with the Ömeroğlu system. AVN is frequently observed in hips with failed CR.

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Section: Introductionmentioning

confidence: 95%

Closed reduction evaluation in dysplastic hip with the Ömeroğlu system in children aged 24-36 months

Charles-Lozoya

Chávez-Valenzuela

Cobos-Aguilar

et al. 2022

Preprint

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“…Charles-Lozoya et al • Medicine (2023) 102: 9 Medicine treatment protocols, their choice depends on patients ages. [6] Closed reduction (CR) plus immobilization with a plaster cast could be appropriate management in patients younger than 24 months, [7] while open reduction (OR) with pelvic osteotomies (PO) might be the treatment of choice in older patients.…”

Section: Introductionmentioning

confidence: 99%

“…[8] However, results and comparisons of CR and OR plus PO in patients aged 18 to 36 months, appear to have equivalent and not well-defined or discrepant long-term results. [9] Thus, children of these ages are still disputable if CR increases the probability of avascular necrosis (AVN) or unsatisfactory radiological results. In children older than 4 years who are undergoing OR and PO, the risk of AVN is high, with poor clinical and radiological results.…”

Section: Introductionmentioning

confidence: 99%

Closed reduction evaluation in dysplastic hip with the Ömeroğlu system in children aged 24 to 36 months

et al. 2023

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Closed reduction (CR) as an initial treatment for developmental hip dysplasia of the hip (DDH) in children aged 24 to 36 months is debatable; however, it could have better results than open reduction (OR) or osteotomies, because it is minimally invasive. The purpose of this study was to evaluate the radiological results in children (24–36 months) with DDH initially treated with CR. Initial, subsequent, final anteroposterior pelvic radiological records were retrospectively analyzed. The International Hip Dysplasia Institute was used to classify the initial dislocations. To evaluate the final radiological results after CR (initial treatment) or additional treatment (CR failed), the Ömeroğlu system was used (6 points excellent, 5 good, 4 fair-plus, 3 fair-minus, and ≤2 poor). The degree of acetabular dysplasia was estimated using the initial acetabular index and the final acetabular index, Buchholz–Ogden classification was used to measure avascular necrosis (AVN). A total of 98 radiological records were eligible, including 53 patients (65 hips). Fifteen hips (23.1%) were redislocated, OR with femoral osteotomy and pelvic osteotomy was the preferred surgical treatment 9 (13.8%). The initial acetabular index versus final acetabular index in total population was (38.9º ± 6.8º) and (31.9º ± 6.8º), respectively (t = 6.5, P < .001). The prevalence of AVN was 40%. Overall AVN in OR, femoral osteotomy and pelvic osteotomy were 73.3% versus CR 30%, P = .003. Unsatisfactory results ≤ 4 points on the Ömeroğlu system were observed in hips that required OR with femoral and pelvic osteotomy. Hips with DDH treated with CR initially might had better radiological results than those treated with OR and femoral and pelvic osteotomies. Regular, good, and excellent results, ≥4 points on the Ömeroğlu system, could be estimated in 57% of the cases, in whom CR was successful. AVN is frequently observed in hips with failed CR.

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“…It was previously referred to as congenital dysplasia of the hip (CDH), however, it has since been renamed as the deformity may occur at any point from conception till skeletal maturity. 1,2 The presentation of this condition varies from simple instability to dysplastic acetabulum to complete dislocation and psudoarthrosis of the femoral head.…”

Section: Introductionmentioning

confidence: 99%

A pilot study to assess justification of radiographic evaluation for developmental dysplasia of the hip.

Siddiqui¹,

Ali

Khan³

2023

TPMJ

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Objective: To evaluate justification of radiography in patients referred for the evaluation of Developmental dysplasia of the hip (DDH). Study Deign: Retrospective Cross Sectional study. Setting: Department of Radiology, Northwest School of Medicine, Peshawar. Period: Jan 2020 till Dec 2021. Material & Methods: Patient database was searched for paediatric patients (<18 years old) who underwent plain radiography for the purpose of diagnosis of DDH over a period of 2 years. The basic demographics including age of the patient at the time of the investigation were abstracted and analysed. X-rays performed on a patient younger than 6 months were deemed as ‘Not Justified’. Results: The frequency of positive cases was 12.5%. Radiography was deemed not justified in 5.4% of the cases. Conclusion: There is need to create further awareness among referring physicians regarding modalities employed in assessment of DDH in order to avoid unjustified radiation exposure.

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Treatment of developmental dysplasia of the hip (DDH) between the age of 18 and 24 months

Cited by 17 publications

References 22 publications

Closed reduction evaluation in dysplastic hip with the Ömeroğlu system in children aged 24-36 months

Closed reduction evaluation in dysplastic hip with the Ömeroğlu system in children aged 24-36 months

Closed reduction evaluation in dysplastic hip with the Ömeroğlu system in children aged 24 to 36 months

A pilot study to assess justification of radiographic evaluation for developmental dysplasia of the hip.

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