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Outcome of surgical management of developmental dysplasia of hip in children between 18 and 24 months

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Abstract

Background

Developmental dysplasia of hip (DDH) is a common condition presenting to a pediatric orthopedic surgeon. There is a consensus on the surgical treatment of children with ages ranged from 18 to 24 months where majority agree on open reduction and hip spica. Open reduction was done with an additional pelvic procedure wherever required to get better results and prevent residual acetabular dysplasia (RAD) and early osteoarthritis.

Materials and Methods

35 children with unilateral DDH were operated between 2002 and 2007 at our institute. Open reduction was performed in all using the standard anterior approach and peroperative test for hip stability was done. Nine children got an additional pelvic procedure in the form of Dega acetabuloplasty. All were followed up for a minimal period of 2 years (range 2-7 years).

Results

No hip got redislocated. At the end of 18 months, there were seven cases of RAD with acetabular index (AI) of 35° and above. These were all from the group where open reduction alone was done.

Conclusion

We feel that a preoperative AI of >40° and a per-operative safe-zone <20° increases the need for supplementary pelvic osteotomy in age group of 18 to 24 months because in such cases, the remodeling capacity of the acetabulum is unable to overcome the dysplasia and to form a relatively normal acetabulum.

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Authors and Affiliations

  1. Department of Paediatric Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India

    Narasimhan Ramani, Mithun S. Patil & Madhur Mahna

Authors
  1. Narasimhan Ramani
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  2. Mithun S. Patil
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  3. Madhur Mahna
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Correspondence to Narasimhan Ramani.

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Ramani, N., Patil, M.S. & Mahna, M. Outcome of surgical management of developmental dysplasia of hip in children between 18 and 24 months. IJOO 48, 458–462 (2014). https://doi.org/10.4103/0019-5413.139841

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  • DOI: https://doi.org/10.4103/0019-5413.139841

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