Revision of redislocation after primary surgery of developmental dysplasia of the hip | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 54, Issue 4, October 2019, Pages 315-319 PDF (1.33 M) | ||
| DOI: 10.4103/eoj.eoj_5_21 | ||
| Authors | ||
| Adel M. Salama; Yousuf M. Khira | ||
| Abstract | ||
| Background Revision open reduction following failed open reduction for developmental dysplasia of the hip (DDH) is technically demanding owing to adhesions and secondary changes after redisplacement. Patients and methods A total of 28 hips in 28 children were operated on for redislocation after primary open reduction of DDH. The additional procedures to the open reduction in the first operation were six adductor tenotomies and 12 femoral osteotomies. Bony procedures needed after trial of relocation were femoral derotation osteotomy fixed by small dynamic compression plate (DCP) in all hips (15 with femoral shortening and 13 without femoral shortening). Pelvic osteotomy was added to femoral osteotomy in 16 cases: Salter’s osteotomy in 10 hips and Dega osteotomy in six cases. Results The mean follow-up time after the revision was 66 months. According to McKay’s criteria, 11 (39.27%) hips had excellent results. Seven (25%) hips had good results, six (21.43%) hips had fair results, and four (14.3%) hips were graded as having poor results. Radiologically, 14 (49.9%) hips were Severin types I and II, 10 (35.7%) showed types III and IV, two (7.2%) hips were rated as Severin’s grade VI, and two (7.2%) hips (Severin grade VI). Conclusion Bony procedures such as femoral or acetabular osteotomies can help for coverage and good containment of the femoral head inside the acetabulum in cases of redislocation in DDH. | ||
| Keywords | ||
| developmental; failed reduction; hip; revision | ||
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