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Journal of Children's Orthopaedics
Published in: Journal of Children's Orthopaedics 3/2015

Open Access 01-06-2015 | Original Clinical Article

A modified surgical approach of the hip in children: is it safe and reliable in patients with developmental hip dysplasia?

Authors: Yusuf Iyetin, Ismail Turkmen, Yavuz Saglam, Mehmet Akif Akcal, Koray Unay, Bahattin Unsac

Published in: Journal of Children's Orthopaedics | Issue 3/2015

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Abstract

Purpose

Treatment is easier and complications are less likely to occur if developmental dysplasia of the hip (DDH) is diagnosed early. In this study, we examined the early results of open reduction using a medial approach which we had modified for DDH and analyzed the success of this technique and the associated complication rates, with a focus on avascular necrosis (AVN).

Methods

This is an Institutional Review Board-approved retrospective review of all patients diagnosed with DDH and treated with a modified medial approach at a single institution from July 1999 to December 2010. The patients' charts were analyzed for clinical and radiographic features.

Results

Fifty-five hips of 41 patients, all of whom were treated by open reduction using a modified medial approach due to DDH, were evaluated retrospectively. The mean age of the patients at surgery was 19 (range 11–28) months, and the average follow-up was 5.5 (range 3–9.5) years. AVN was the most important complication in terms of radiological outcomes as assessed according to the Kalamchi–McEwen classification. Radiologic results were excellent or good in 51 hips (92.7 %) and fair–plus in four (7.3 %). Type 1 temporary AVN was detected in only two hips (3.6 %), and the lesions had disappeared completely in the final control graphs of these two patients. A secondary intervention was needed for two hips (3.6 %) of the same patients who were operated on due to bilateral DDH. No other complications, such as infection, re-dislocation, or subluxation, were seen in the operated patients.

Conclusions

We believe that treatment for DDH using a modified medial approach during early childhood is an effective and reliable method with low AVN rates. As shown here, this method achieves great success in radiological and clinical outcomes after a minimum 3-year follow-up.
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Metadata
Title
A modified surgical approach of the hip in children: is it safe and reliable in patients with developmental hip dysplasia?
Authors
Yusuf Iyetin
Ismail Turkmen
Yavuz Saglam
Mehmet Akif Akcal
Koray Unay
Bahattin Unsac
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Children's Orthopaedics / Issue 3/2015
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-015-0659-7

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