Purpose: Developmental dysplasia of the hip (DDH) is a term used to cover a broad spectrum of anomalies ranging from mild dysplasia to high-riding dislocations. We report the management of DDH in children using the Dega osteotomy and their long-term follow-up.
Methods: Fifty-eight hips from 48 children younger than 8 years treated using the Dega osteotomy between January 1988 and October 2000 were included in this multcenter study. Both prospective (41 hips) and retrospective (17 hips) cases were included, and follow-up was for a minimum of 13 years. Radiographs were made preoperatively, immediately postoperatively, after 6 weeks or at removal of the spica cast if any, at 6-month intervals and/or as indicated for 3 years postoperatively and then on annual basis until the last follow-up. A single-cut computed tomographic scan was performed for all prospective patients. Special attention was paid to the predictive measures of hip arthrosis and the survival of the hip after Dega osteotomy.
Results: The final clinical outcome was favorable in 44 hips (75.9 %). Eleven hips needed a second surgery (acetabuloplasty and/or arthroplasty) during the follow-up period.
Conclusions: In our pediatric patient population the Dega osteotomy proved to be an adequate measure for the management of this complex condition. The worst complication was avascular necrosis, and all of the affected hips ended with failure (pain, another surgery, or both).
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http://dx.doi.org/10.1007/s11832-015-0665-9 | DOI Listing |
J Orthop Surg Res
December 2024
Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, China.
Background: The muscles that encase the hip serve a crucial role in both joint stability and functional efficacy, and as developmental dysplasia of the hip (DDH) progresses, the surrounding musculature may undergo specific adaptations that reduce joint stability, thereby exacerbating dislocation. Yet, the exact nature of changes in muscle morphology and quality remains inadequately investigated. This study aimed to compare magnetic resonance imaging (MRI) evaluations of the iliopsoas and other hip flexor and extensor muscles in children with unilateral DDH before and after treatment.
View Article and Find Full Text PDFIndian J Orthop
December 2024
Department of Paediatric Trauma and Orthopaedics, Southampton Children's Hospital, Southampton, UK.
Background: Hip surgery is often necessary for children with severe neuromuscular disabilities to avoid chronic pain resulting from hip migration. This study correlated the Surgical Vulnerability Score (SVS), a novel measure of physiological reserve, with reconstructive hip surgery outcomes to improve shared surgical decision-making.
Materials And Methods: Sixty-eight cases performed by a single surgeon were retrospectively evaluated.
Hip Int
December 2024
Department of Orthopaedics, All India Institute of Medical Sciences Rishikesh, Rishikesh, India.
Background: Diagnosis and management of developmental dysplasia of hip (DDH) in underdeveloped regions is frequently delayed, potentially impacting final outcomes. This prospective study was conducted with the aim of answering the question, "Do children <3 years at index surgery for DDH have better outcome at 5-year follow-up in comparison to children >3 years at index surgery?"
Methods: Between 2016 and 2021, all walking-age children with DDH were prospectively enrolled in the study. The study cohort was divided into 2groups: Group 1 ⩽3 years of age, and Group 2 included children >3 years old.
Orthop Rev (Pavia)
June 2024
Department of Surgery, College of Medicine University of Thi Qar, Iraq.
Background: Dega osteotomy is becoming more widely used for the treatment of developmental dysplasia of the hip (DDH).
Objective: A thorough description of this procedure is needed as many of the technical aspects are not fully defined. Moreover, more follow-up series are also needed to evaluate its outcomes.
J Child Orthop
June 2024
Department of Pediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences, Poznań, Poland.
Purpose: This report presents the long-term results of the hip joint reconstruction in patients with spastic hip disease through open reduction, proximal femur varus derotation osteotomy, and Dega transiliac osteotomy.
Methods: We analyzed retrospectively patients diagnosed with a spastic form of bilateral cerebral palsy with painful hip subluxation or dislocation. All patients underwent the same surgical procedure.
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