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Radiological and clinical outcomes of medial approach open reduction by using two intervals in developmental dysplasia of the hip.

Radiological and clinical outcomes of medial approach open reduction by using two intervals in developmental dysplasia of the hip.

Authors :
Ozkut AT
Iyetin Y
Unal OK
Soylemez MS
Uygur E
Esenkaya I
Source :
Acta orthopaedica et traumatologica turcica [Acta Orthop Traumatol Turc] 2018 Mar; Vol. 52 (2), pp. 81-86. Date of Electronic Publication: 2018 Feb 15.
Publication Year :
2018

Abstract

Objective: To evaluate the midterm clinical and radiological outcomes of the medial approach using two intervals for developmental hip dysplasia (DDH).<br />Methods: The study involved 62 hips of 47 patients (41 girls, 6 boys) treated with medial approach for DDH from 1999 to 2010. The age of the patients at surgery was 18.7 ± 2.25 months. Follow up of the patients was 11.3 ± 3.07 years. The age of the patients at the last follow up was 12.6 ± 1.74 years. According to the Tönnis classification, 13 hips were grade II, 27 hips were grade III and 22 hips were grade IV. Patients were evaluated according to Omeroglu radiological criteria and modified McKay functional criteria. The presence of avascular necrosis (AVN) of the hip was questioned using the KalamchiMacEwen classification.<br />Results: Radiologically, forty eight (77%) hips were evaluated as "excellent", 8 (13%) hips as "good" and 5 (8%) hips as "fair plus" and 1 (%2) hip as "fair minus". Two (3%) patients had type 1 temporary AVN and one (1%) patient had type 4 AVN with coxa magna and overgrowth of the greater trochanter. According to McKay functional criteria, 56 (90%) hips had "excellent" and 6 (10%) had "good" results. Two (3.2%) hips of one patient had to be reoperated with Salter osteotomy and femoral shortening + derotation osteotomy.<br />Conclusion: Medial approach using two separate intervals for tenotomy and capsulotomy does not jeopardize the medial circumflex or the femoral vessels and yields satisfactory midterm results for children 18 months old with dysplasia of the hip.<br />Level of Evidence: Level IV, therapeutic study.<br /> (Copyright © 2018 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
2589-1294
Volume :
52
Issue :
2
Database :
MEDLINE
Journal :
Acta orthopaedica et traumatologica turcica
Publication Type :
Academic Journal
Accession number :
29454563
Full Text :
https://doi.org/10.1016/j.aott.2018.01.006