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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_VI | Pages 5 - 5
1 Mar 2012
EXTERNAL FIXATION FOR FEMORAL DEROTATION OSTEOTOMY IN DDH SURGERY
Syed M Cornell M Damodaran P Chowdhry M
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Purpose of Study

To evaluate the results of using external fixation to stabilise femoral derotation osteotomy involved in DDH surgery.

Methods and results

A retrospective analysis was performed on 44 patients undergoing 48 femoral osteotomies for DDH surgery between the years 2001 and 2009 by a single surgeon (senior author MC). The external fixator was used either during the primary procedure involving femoral shortening to aid in hip reduction (4 patients) or to correct femoral malrotation in a reduced hip as a secondary procedure(40 patients). As the external fixator frame was within the hip spica it was not a cause of concern to the parents or the child.

There was no evidence of any pin tract infection and all patients eventually progressed to satisfactory bony union. One patient had delayed union which was treated successfully with conservative management and one patient had a malunion requiring a further osteotomy and extended treatment with the external fixator.

Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 267 - 267
1 May 2006
RESULTS OF A SELECTIVE ULTRASOUND SCREENING PROGRAMME FOR NEONATAL HIP INSTABILITY
Forder J Mathew S Cornell M
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Introduction: Ideally any screening system should use a simple reliable test with good intraobserver reproducibility. This is important in DDH as once there is an established abnormality surgical intervention is frequently required. The aim of early detection (within six weeks) is to increase the number of children that may be treated nonoperatively. We have evaluated the effectiveness of our selective screening program by determining the late presentation rate of DDH in our region.

Methods: Between January 2001 and December 2003 we looked retrospectively at all patients presenting with DDH in our region. We recorded their age at scan and presentation, the Graf classification if recorded, their management, the presence of risk factors for DDH, referral source and presence of a positive clinical examination. All these were entered into a database and analyzed specifically with regard to patients presenting late.

Results: In the period between January 2001 and June 2002 prior to selective ultrasound screening (Group 1) there were 9441 live births and 26 cases of DDH (incidence of 2.75). There were 11 late presenters with an incidence of 1.12 per 1000 per year. Between July 2002 and December 2003 (Group 2) there were 9428 live births and 20 cases of DDH (incidence of 2.12). There were 3 late presenters with an incidence of 0.3 per 1000 per year.

Discussion: We have shown that a program of selective ultrasound screening in our region has decreased the number of children presenting late with DDH. It must be remembered however, that in the absence of any risk factors, clinical examination remains critical in identifying those with DDH in a selective screening program.