Single-stage medial open reduction and Pemberton acetabuloplasty in developmental dysplasia of the hip

Background: Hip arthrography in developmental dysplasia of the hip (DDH) has the advantages of viewing the shape and size of the cartilaginous part of both the femoral head and acetabulum, besides the soft tissue obstacles. The aim of the work was to assess the role of arthrogram in evaluation of closed reduction of developmental dysplasia of the hip.Methods: This prospective study included 30 patients with 36 involved hips who presented with DDH. This study included 7 males (23.3%) and 23 females (76.7%). There were 6 patients with bilateral hip involvement (20.0%) and 24 patients with unilateral involvement (80.0%). In this study we used 3 ml Urografin 76% diluted in 7 ml saline and 3 to 5 ml of diluted Urografin was injected into the hip joint.Results: Out of the 36 hips, closed reduction was successful in 33 hips (91.7%) and failed in 3 (8.3%). After the interpretation of the arthrogram we considered the reduction of 7 (21.2%) reduced hips nonconcentric because of the soft tissue obstacles. In the 7 hips with nonconcentric reduction besides the 3 hips with failed closed reduction, we proceeded to open reduction of the hip through medial approach. At the end of follow up, all hips (100%) showed concentric reduction without re-dislocation in any case.Conclusions: Hip arthrogram is a very reliable method in diagnosing hip concentricity and the presence of soft tissue obstacles in management of DDH by closed reduction. Arthrogram helps the operator to decide open reduction in such cases achieving excellent results in all cases.

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The incidence of avascular necrosis and the radiographic outcome following medial open reduction in children with developmental dysplasia of the hip

The Bone & Joint Journal ◽

10.1302/0301-620x.96b2.32361 ◽

2014 ◽

Vol 96-B (2) ◽

pp. 279-286 ◽

Cited By ~ 27

Author(s):

R. O. E. Gardner ◽

C. S. Bradley ◽

A. Howard ◽

U. G. Narayanan ◽

J. H. Wedge ◽

...

Keyword(s):

Avascular Necrosis ◽

Open Reduction ◽

Developmental Dysplasia ◽

Radiographic Outcome ◽

Medial Open Reduction ◽

Dysplasia Of The Hip

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Single-stage open reduction, Salter innominate osteotomy, and proximal femoral osteotomy for the management of developmental dysplasia of the hip in children between the ages of 2 and 4 years

Journal of Pediatric Orthopaedics B ◽

10.1097/bpb.0b013e32832bf618 ◽

2009 ◽

Vol 18 (4) ◽

pp. 188-196 ◽

Cited By ~ 11

Author(s):

Mohamed M.H. El-Sayed

Keyword(s):

Open Reduction ◽

Developmental Dysplasia ◽

Femoral Osteotomy ◽

Single Stage ◽

Proximal Femoral Osteotomy ◽

Innominate Osteotomy ◽

Dysplasia Of The Hip

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Prediction of the requirement of open reduction for developmental dysplasia of the hip

Journal of International Medical Research ◽

10.1177/0300060517717357 ◽

2017 ◽

Vol 46 (1) ◽

pp. 54-61 ◽

Cited By ~ 8

Author(s):

Nabil Alassaf

Keyword(s):

Open Reduction ◽

Area Under The Curve ◽

Internal Validity ◽

Developmental Dysplasia ◽

Estimation Model ◽

Cross Sectional ◽

Noninvasive Treatment ◽

Dysplasia Of The Hip ◽

Logistic Regression Equation ◽

Objective Tool

Objective Closed reduction (CR) is a noninvasive treatment for developmental dysplasia of the hip (DDH), and this treatment is confirmed intraoperatively. This study aimed to develop a preoperative estimation model of the probability of requiring open reduction (OR) for DDH. Methods The study design was cross-sectional by screening all patients younger than 2 years who had attempted CR between October 2012 and July 2016 by a single surgeon. Potential diagnostic determinants were sex, age, side, bilaterality, International Hip Dysplasia Institute (IHDI) grade, and acetabular index (AI). An intraoperative arthrogram was the reference standard. A logistic regression equation was built from a reduced model. Bootstrapping was performed for internal validity. Results A total of 164 hips in 104 patients who met the inclusion criteria were analysed. The prevalence of CR was 72.2%. Independent factors for OR were older age, higher IHDI grade, and lower AI. The probability of OR = 1/[1 + exp − (−2.753 + 0.112 × age (months) + 1.965 × IHDI grade III (0 or 1) + 3.515 × IHDI grade IV (0 or 1) − 0.058 × AI (degrees)]. The area under the curve was 0.79. Conclusion This equation is an objective tool that can be used to estimate the requirement for OR.

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