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LATE RESULTS OF OPERATIVE TREATMENT OF DDH USING DEGA’S TRANSILIACAL OSTEOTOMY



Abstract

Introduction: Thanks to early ultrasound diagnosis of DDH the number of late diagnosed cases decreased in the last ten years. The surgical intervention because of dislocated hip is also reduced to the few cases a year. We still however have in our practice patients after operative treatment of DDH. One of the methods used for proper hip reduction is transiliacal pelvic osteotomy described by Dega.

The aim of this study is to evaluate the late results of one stage procedure with Dega transiliacal pelvic osteotomy in the treatment of DDH with dislocation.

Material and Methods: In our Institution 256 dislocated hips were treated surgically by means of open hip reduction, femoral directional osteotomy and Dega’s transiliacal osteotomy. From this group 102 patients (91 female and 11 male), presented 144 operated hips were seen for the final follow-up. The left hip was affected in 45 cases, right in 17, and bilateral in 41 patients. The mean age at the surgery was 23,5 months. Mean follow-up was 19.8 years (minimum 15 years after surgery). Patients were evaluated clinically (Barrett modification of McKay classification) and radiologically using Severin classification. All radiograms from whole period of treatment were collected and evaluated.

Results: In 90 hips the final result was classify as very good (57%), good in 36 hips (23%), satisfactory in 10 hips and poor in 8 hips. Radiologically very good result (group IA) was seen in 51 hips, good in 65 hips (group IB, IIA, IIB), satisfactory in 24 hips and poor in 4 hips. It was a good correlation between clinical and radiographic classification.

Conclusions : The late results after one stage hip reconstruction with Dega’s transiliacal osteotomy gives a long lasting good results and is recommended for operative treatment of DDH with dislocation.

The abstracts were prepared by Mrs Anna Ligocka. Correspondence should be addressed to IX ICL of EFORT Organizing Committee, Department of Orthopaedics, ul. Kopernika 19, 31–501 Krakow, Poland