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Simultaneous bilateral single-stage combined open reduction and pelvic osteotomy for the treatment of developmental dysplasia of the hip. | LitMetric

Children older than 18 months with developmental dysplasia of the hip (DDH) for the first time or who do not respond to closed treatment require open reduction with/without acetabuloplasty. We determined whether open reduction and pelvic acetabuloplasty using the Pemberton or Dega technique for both hips simultaneously was well tolerated and offered better outcomes. A total of 140 hips of 70 patients with bilateral DDH were identified. All patients were diagnosed after they started walking. Patients were treated with bilateral single-stage open reduction with acetabuloplasty using the Pemberton or Dega procedure. All patients were prospectively followed up between 2007 and 2018. Results were considered satisfactory if the acetabular index was <24°. Hemoglobin levels were evaluated in all patients. At the final follow-up, the results were evaluated radiologically and clinically based on the modified Severin's classification and modified McKay criteria, respectively. The mean age at surgery was 20.3 months (range, 16-24). The mean operative time was 228 minutes. The mean postoperative hemoglobin level was 90.5 g/L (range, 61-122; SD, ±13.4). The mean differences between the preoperative and postoperative acetabular index values for both hips were 22.36° (SD, ±6.69°) and 22.64° (SD, ±6.69°) for the right and left hips, respectively. Open reduction with pelvic acetabuloplasty using the Pemberton or Dega technique simultaneously in both hips was well tolerated, cost-effective, had excellent outcomes, and posed no additional risk to patients with DDH younger than 24 months.

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http://dx.doi.org/10.1097/BPB.0000000000000713DOI Listing

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