This study aims to evaluate the use of closed reduction of hips with developmental dysplasia of the hip (DDH) and medial open reduction of these hips as a subsection of closed reduced hips. The study was a retrospective analysis of treatment of 30 children with developmental dysplasia of the hip (DDH). These children were taken from a consecutive series of children treated over a period from June 2000 to 2011 with closed reduction by a single surgeon. The ages at the time of diagnosis were between 1 day and 13 months (mean 5.25 weeks). Included in this series are 7 patients treated with medial open reduction, all done with the Ludloff approach. Follow up of these patients was from 8 months to 12 years (mean 5 years). All patients needing secondary procedures were noted. The X- rays were evaluated for percentage acetabulum cover in patients over the age of 8 and improvement of the acetabular index in all these patients.Purpose of the study
Methods
We conducted a retrospective audit of the short-term results of 14 patients with adolescent hip dysplasia treated with triple pelvic osteotomy. We compared our results with those in current international literature. The mean age of our patients at the time of surgery was 19 years (11 to 34). The mean follow-up period was 8 months. Preoperatively and postoperatively the patients were graded clinically by the modified Merle d’Aubigne and Postel systems. Radiological evaluation included the centre-edge (CE) angle of Wiberg, the acetabular index (AI) of Sharp and the percentage of femoral head cover. Patient satisfaction was graded out of five points. Clinically 86% of the patients exhibited improvement. The mean preoperative score was 12.3 (fair) and the mean postoperative score was 15.1 (good). Patient satisfaction was high, with a mean 4.75 out of 5 points. Radiologically there were notable improvements: the mean CE angle improved from 2° to 24°, the AI from 52° to 39°, and the percentage femoral head cover from 55% to 80%. Our results in this short-term study compare well with international results. The operation carries known long-term benefits in terms of biomechanics and delayed onset of OA.
