Soft-tissue interposition after closed reduction in developmental dysplasia of the hip

1999 ◽  
Vol 81-B (3) ◽  
pp. 385-391 ◽  
Author(s):  
T. Hattori ◽  
Y. Ono ◽  
T. Kitakoji ◽  
S. Takashi ◽  
H. Iwata
Keyword(s):  
Soft Tissue ◽  
Closed Reduction ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

Outcomes of closed reduction in patients with developmental dysplasia of the hip incorporating open psoas and adductor release and using short leg cast

2021 ◽  
Vol 15 (5) ◽  
pp. 1529-1532
Author(s):  
M. S. Abdulqader ◽  
L. J. Khorsheed ◽  
Hwaizi .
Keyword(s):  
Soft Tissue ◽  
Closed Reduction ◽  
Case Series ◽  
Developmental Dysplasia ◽  
Soft Tissue Release ◽  
Plaster Of Paris ◽  
Dysplasia Of The Hip ◽  
Mid Term Results ◽  
Tönnis Grade

Background and objectives: Closed reduction and short leg spica casting are the preferred treatment options for children with developmental dysplasia of the hip. This study aimed to show the efficacy behind a standardized closed reduction for managing patients with developmental dysplasia of the hip with concomitant soft tissue releases when indicated and using a short leg plaster of Paris cast to maintain reduction and reporting mid-term results. Methods: A case series of 95 hips in 84 children aged 6-18 months who had closed reduction, with five years follow up or until next operation, involved in this study. The protocol defines acceptable concentric reduction criteria and the indications for an associated soft tissue release. All the patients were immobilized in a short leg cast for three months. Multiple follow-up radiographs were taken to assess Tönnis grade, Severin grade, acetabular index, and osteonecrosis signs. Results: A total of 48 hips were Tönnis grade 3/4 hips. At one year, 15 reductions couldn’t be maintained, and these patients needed open reduction. Of these 15 failed reductions, 7 patients were Severin 1; others were Severin 2. Of the 80 successful closed reductions, 70 hips were Severin 1. Surgical management for residual dysplasia was offered for 8 hips. Osteonecrosis was seen in 23 hips but was transient in 20. Bilateral hip dislocations and most Tönnis 4 hips were more likely to fail. Two children had severe osteonecrosis. Conclusions: Closed reduction, with subsequent adductor and psoas releases, when indicated and using a short leg plaster of Paris cast for three months, brings about good mid-term results in children with developmental dysplasia of the hip aged 6-18 months. Keywords: Developmental dysplasia of the hip, closed hip reduction, open psoas release, short leg cast.

scholarly journals Role of intraoperative arthrogram in decision making of closed versus medial open reduction of developmental hip dysplasia

2019 ◽  
Vol 5 (6) ◽  
pp. 1037
Author(s):  
Amin A. Ahmed ◽  
Mohie El Din Fadel
Keyword(s):  
Soft Tissue ◽  
Closed Reduction ◽  
Open Reduction ◽  
Developmental Dysplasia ◽  
Developmental Hip Dysplasia ◽  
Hip Arthrography ◽  
Unilateral Involvement ◽  
Medial Open Reduction ◽  
Dysplasia Of The Hip

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals The potential role of the Alsberg angle as a predictor of lateral growth disturbance of the capital femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction

2020 ◽  
Vol 14 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Ronghua Gui ◽  
Federico Canavese ◽  
Shuang Liu ◽  
Lianyong Li ◽  
Lijun Zhang ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Normal Values ◽  
Developmental Dysplasia ◽  
Lateral Growth ◽  
Growth Disturbance ◽  
Level Of Evidence ◽  
Normal Children ◽  
One Year ◽  
Dysplasia Of The Hip

Purpose Early diagnosis and prevention of lateral growth disturbance of the capital femoral epiphysis is challenging after treatment for developmental dysplasia of the hip (DDH). The aim of the study was to evaluate the radiographic changes of the Alsberg angle (AA) in normal children and those with DDH, and to assess the role of AA as a potential predictor of lateral growth disturbance of the capital femoral epiphysis. Methods AA was measured on the anterior-posterior pelvic radiographs of 1000 normal children ranging in age from one to ten years and in 66 children (92 hips) with DDH treated by closed reduction (CR). A comparative analysis was performed. Results In the normal children, mean AA decreased linearly with age, from 76° at age one year to 65° at age ten years, irrespective of gender and laterality. In children with DDH, the average AA was 81.5°(sd 3.9°; 74° to 87°) prior to CR; it was 75.9° (sd 4.5°; 68° to 83°) in normal children of the same age (p < 0.001). Among the 42 children (64 hips) with successfully and uneventfully treated DDH, AA reached normal values between the ages of five and six years. In contrast, children with lateral growth disturbance of the proximal femur physis (24 children, 28 hips) showed significantly higher AA values in comparison with the age-matched controls. Conclusion In DDH patients with successful CR, AA could be expected to match normal values in children between the ages of five and six years. On the other hand, AA can be used as an early predictor for lateral growth disturbance of the capital femoral epiphysis. Level of Evidence Level III

scholarly journals Closed Reduction for Developmental Dysplasia of the Hip

2019 ◽  
Vol 39 (3) ◽  
pp. 111-118 ◽  
Author(s):  
Wudbhav N. Sankar ◽  
Alex L. Gornitzky ◽  
Nicholas M.P. Clarke ◽  
José A. Herrera-Soto ◽  
Simon P. Kelley ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

The ‘clicky hip’

2018 ◽  
Vol 100-B (9) ◽  
pp. 1249-1252 ◽  
Author(s):  
S. Humphry ◽  
D. Thompson ◽  
N. Price ◽  
P. R. Williams
Keyword(s):  
Service Provision ◽  
Closed Reduction ◽  
Developmental Dysplasia ◽  
Ultrasound Screening ◽  
Ultrasound Scan ◽  
Type Iv ◽  
Referral Practices ◽  
Adductor Tenotomy ◽  
The Mean ◽  
Dysplasia Of The Hip

Aims The significance of the ‘clicky hip’ in neonatal and infant examination remains controversial with recent conflicting papers reigniting the debate. We aimed to quantify rates of developmental dysplasia of the hip (DDH) in babies referred with ‘clicky hips’ to our dedicated DDH clinic. Patients and Methods A three-year prospective cohort study was undertaken between 2014 and 2016 assessing the diagnosis and treatment outcomes of all children referred specifically with ‘clicky hips’ as the primary reason for referral to our dedicated DDH clinic. Depending on their age, they were all imaged with either ultrasound scan or radiographs. Results There were 69 ‘clicky hip’ referrals over the three-year period. This represented 26.9% of the total 257 referrals received in that time. The mean age at presentation was 13.6 weeks (1 to 84). A total of 19 children (28%) referred as ‘clicky hips’ were noted to have hip abnormalities on ultrasound scan, including 15 with Graf Type II hips (7 bilateral), one Graf Type III hip, and three Graf Type IV hips. Of these, ten children were treated with a Pavlik harness, with two requiring subsequent closed reduction in theatre; one child was treated primarily with a closed reduction and adductor tenotomy. In total, 11 (15.9%) of the 69 ‘clicky hip’ referrals required intervention with either harness or surgery. Conclusion Our study provides further evidence that the ‘clicky hip’ referral can represent an underlying diagnosis of DDH and should, in our opinion, always lead to further clinical and radiological assessment. In the absence of universal ultrasound screening, we would encourage individual units to carefully assess their own outcomes and protocols for ‘clicky hip’ referrals and tailor ongoing service provision to local populations and local referral practices. Cite this article: Bone Joint J 2018;100-B:1249–52.

scholarly journals Biomechanical evaluation of femoral anteversion in developmental dysplasia of the hip and potential implications for closed reduction

2020 ◽  
Vol 72 ◽  
pp. 179-185
Author(s):  
Victor Huayamave ◽  
Blake Lozinski ◽  
Christopher Rose ◽  
Hessein Ali ◽  
Alain Kassab ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Femoral Anteversion ◽  
Developmental Dysplasia ◽  
Biomechanical Evaluation ◽  
Dysplasia Of The Hip
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