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J Child Orthop. 2012 Dec;6(6):471-7. doi: 10.1007/s11832-012-0451-x. Epub 2012 Nov 28.

The effect of Dega acetabuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age: short- to middle-term follow-up.

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1
Department of Pediatric Orthopedic Surgery, and Limb Reconstructive Surgeries, Tanta University, 96, Hasan Radwan St., Dr. Mostafa Hosny Building, Tanta, Gharbia 3111 Egypt.

Abstract

INTRODUCTION:

The surgical management of neglected developmental dysplasia of the hip (DDH) in walking children has always been a challenge to orthopedic surgeons. The aim of this study was to evaluate the short- to middle-term clinical and radiographic results of the management of DDH.

PATIENTS AND METHODS:

Patients less than 6 years old using two of the most commonly used osteotomies, namely, Salter innominate osteotomy and the Dega acetabuloplasty. Special attention was paid to acetabular remodeling after concentric reduction, which was monitored by the acetabular index, that, in turn, was measured preoperatively, immediately postoperatively, every 6 months, and at the final follow-up examination.

RESULTS:

The final overall clinical end results were favorable (excellent or good) in 93 hips (85.3 %). There was a marked improvement of the acetabular coverage during the follow-up period, which proved the good remodeling potential of the acetabulum for this particular age group after concentric reduction was achieved and maintained.

CONCLUSION:

Both osteotomy types were found to be adequate for the management of neglected walking DDH patients under the age of 6 years.

KEYWORDS:

DDH; Dega; Dislocation; Femoral shortening; Open; Pelvic osteotomy; Reduction; Salter

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