Abstract
Purpose
Following closed or open reduction for developmental dysplasia of the hip (DDH), assessment of reduction is essential. With potentially poor accuracy in confirming reduction, the risk of abnormal hip development and ultimately poor outcome exists if reduction is not achieved. Computed tomography (CT) has been used in recent years to assess reduction. The aim of this study was to compare the accuracy in confirming hip reduction following closed or open reduction in children with DDH, using CT and plain radiographs and to decide whether CT scans improved the assessment of reduction.
Methods
We retrospectively reviewed 6 patients treated for DDH at an Academic Hospital. The patients were treated with either closed or open reduction. Post operatively radiographs and CT scans were obtained to assess reduction. Reduction was assessed using Shenton's line, medial joint space, a femoral mid-cervical line through the tri-radiate cartilage and a tri-radiate intersectional line on axial CT. The CT scans were analyzed using Osirix on an Apple Macintosh computer.
Results
We were able to obtain measurements in all parameters in only one radiograph, whereas in the CT images all parameters were determined. One patient had radiographs in which no values could be measured. The CT scan however confirmed reduction of that hip. In one patient we assessed a hip as reduced using all the parameters, whereas the tri-radiate intersectional line on axial CT and the Shenton's line on the coronal slice showed that in fact the head was posteriorly subluxed.
Conclusion
We conclude that although CT scans did not change our management in this small patient series, CT scans did provide a better means of confirming hip reduction than plain radiographs for patients with DDH following closed or open reduction in a hip spica.
NO DISCLOSURES
