Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparison of Clinical Results of Two Surgical Techniques in Patients with Developmental Dysplasia of Hip: Open Reduction with and without Salter Osteotomy

Document Type : Original Article (s)

Authors
Mohammad Ali Tahririan 1
Hojjat Cheragh-Sahar 2
Reza Mohammadi 2
1 Associate Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Resident, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v38i568.12464
Abstract
Background: Developmental dysplasia of hip (DDH) encompass a wide range of hip disorders initiated from neonatal or infantile period. Since in some studies there are reports of high rate of hip dislocation cases in which osteotomy has not been performed, this study aimed to compare the results of open reduction with and without Salter osteotomy in patients with DDH.Methods: In a prospective cohort study on two groups of 24 patients with DDH and age of less than 3 years, the recovery outcomes and complications of open reduction with and without Salter osteotomy were postoperatively evaluated and compared 12 months after the surgery.Findings: 100% in open reduction group and 90.9% in Salter group had hip joint stability (P = 0.13). Avascular necrosis was seen in one (4.2%) and two cases (9%) in open reduction without and with Salter osteotomy groups, respectively (P = 0.49). Improvement of ossification center was seen in 95.8% and 90.9% of patients in open reduction without and with Salter groups, respectively (P = 0.49).Conclusion: The findings of our study showed that both open reduction with and without Salter osteotomy groups had good therapeutic effects and low incidence of postoperative complications; therefore, delay in treatment due to performing osteotomy is not recommended.
Keywords
Hip dysplasia
Avascular necrosis of bone
Open fracture reduction
Hip dislocation
Osteotomy
  1. Noordin S, Umer M, Hafeez K, Nawaz H. Developmental dysplasia of the hip. Orthop Rev (Pavia) 2010; 2(2): e19.
  2. Wicart P, Seringe R, Glorion C, Brassac A, Rampal V. Closed reduction in late-detected developmental dysplasia of the hip: indications, results and complications. J Child Orthop 2018; 12(4): 317-22.
  3. Vaquero-Picado A, Gonzalez-Moran G, Garay EG, Moraleda L. Developmental dysplasia of the hip: Update of management. EFORT Open Rev 2019; 4(9): 548-56.
  4. Miao M, Cai H, Hu L, Wang Z. Retrospective observational study comparing the international hip dysplasia institute classification with the Tonnis classification of developmental dysplasia of the hip. Medicine (Baltimore) 2017; 96(3): e5902.
  5. Vafaee AR, Baghdadi T, Baghdadi A, Jamnani RK. DDH epidemiology revisited: Do we need new strategies? Arch Bone Jt Surg 2017; 5(6): 440-2.
  6. Agarwal A, Gupta N. Risk factors and diagnosis of developmental dysplasia of hip in children. J Clin Orthop Trauma 2012; 3(1): 10-4.
  7. Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: What has changed in the last 20 years? World J Orthop 2015; 6(11): 886-901.
  8. Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop 2011; 2011: 238607.
  9. Heeres RH, Witbreuk MM, van der Sluijs JA. Diagnosis and treatment of developmental dysplasia of the hip in the Netherlands: National questionnaire of paediatric orthopaedic surgeons on current practice in children less than 1 year old. J Child Orthop 2011; 5(4): 267-71.
  10. Esmaeilnejad-Ganji SM, Esmaeilnejad-Ganji SMR, Zamani M, Alitaleshi H. A newly modified salter osteotomy technique for treatment of developmental dysplasia of hip that is associated with decrease in pressure on femoral head and triradiate cartilage. Biomed Res Int 2019; 2019: 6021271.
  11. Bhuyan BK. Outcome of one-stage treatment of developmental dysplasia of hip in older children. Indian J Orthop 2012; 46(5): 548-55.
  12. Bolland BJ, Wahed A, Al-Hallao S, Culliford DJ, Clarke NM. Late reduction in congenital dislocation of the hip and the need for secondary surgery: Radiologic predictors and confounding variables. J Pediatr Orthop 2010; 30(7): 676-82.
  13. Carsi MB, Clarke NM. Acetabuloplasties at open reduction prevent acetabular dysplasia in intentionally delayed developmental dysplasia of the hip: A case-control study. Clin Orthop Relat Res 2016; 474(5): 1180-8.
  14. Castaneda P, Masrouha KZ, Ruiz CV, Moscona-Mishy L. Outcomes following open reduction for late-presenting developmental dysplasia of the hip. J Child Orthop 2018; 12(4): 323-30.
  15. Murphy RF, Kim YJ. Surgical management of pediatric developmental dysplasia of the hip. J Am Acad Orthop Surg 2016; 24(9): 615-24.
  16. Kothari A, Grammatopoulos G, Hopewell S, Theologis T. How does bony surgery affect results of anterior open reduction in walking-age children with developmental hip dysplasia? Clin Orthop Relat Res 2016; 474(5): 1199-208.
  17. Tuhanioglu U, Cicek H, Ogur HU, Seyfettinoglu F, Kapukaya A. Evaluation of late redislocation in patients who underwent open reduction and pelvic osteotomy as treament for developmental dysplasia of the hip. Hip Int 2018; 28(3): 309-14.
  18. Umer M, Nawaz H, Kasi PM, Ahmed M, Ali SS. Outcome of triple procedure in older children with developmental dysplasia of hip (DDH). J Pak Med Assoc 2007; 57(12): 591-5.
  19. Karami M, Radyn MA, Tahririan MA, Badiei S, Karimi A. Iliac pedicle wedge graft as a new modification for iliac osteotomies in young adolescents: A single-blind randomized clinical trial. Arch Bone Jt Surg 2019; 7(4): 331-8.
  20. Subasi M, Arslan H, Cebesoy O, Buyukbebeci O, Kapukaya A. Outcome in unilateral or bilateral DDH treated with one-stage combined procedure. Clin Orthop Relat Res 2008; 466(4): 830-6.
Journal of Isfahan Medical School
Volume 38, Issue 568 - Serial Number 568
January and February 2020
Pages 180-185

  • Receive Date 14 November 2019
  • Accept Date 06 April 2022