Association between open or closed reduction and avascular necrosis in developmental dysplasia of the hip

Wang, Yajie; Yang, Fan; Wu, Qi‐Jun; Pan, Shi-nong; Li, Lianyong

doi:10.1097/md.0000000000004276

Cited by 24 publications

(21 citation statements)

References 55 publications

(84 reference statements)

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“…DDH is one of the most common hip disorders seen in children; about one in 100 newborns have hip dysplasia and one to two per 1000 have hip dislocation [2][3][4][5]. Many genetic and environmental factors are responsible for DDH [1][2]. The primary cause is the instability of the joint due to ligamentous laxity, which may be due to genetic or mechanical factors.…”

Section: Discussionmentioning

confidence: 99%

“…Breech presentation has been identified as a major risk factor; others include family history, female gender, birth order (with a higher risk in the firstborn), and oligohydramnios. Early diagnosis and treatment of DDH can ensure a better functional outcome and prevent degenerative joint disease [1]. Clinical screening of newborns for DDH is now universal.…”

Section: Discussionmentioning

confidence: 99%

“…The primary treatment of DDH is with the Pavlik harness application and has a success rate of approximately 90% in infants less than three months of age [1,8]. When Pavlik harness treatment fails, closed or open reduction is undertaken, depending on the severity of the condition and age of the child [1,[9][10]. Avascular necrosis of the femoral head is a serious complication following treatment and is mainly associated with improper hip spica application or iatrogenic by injuring the blood supply of the femoral head such as by utilizing the medial approach in open reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Developmental dysplasia of the hip (DDH), previously known as congenital dislocation of the hip (CDH), is an umbrella term that includes a wide spectrum of disorders in which the femoral head has an abnormal relationship to the acetabulum [1]. These conditions might present with acetabular dysplasia, subluxation, dislocation, or teratologic dislocation of hip (which is frequently seen with arthrogryposis, myelomeningocele, Larsen syndrome, and Ehlers-Danlos syndrome), and adolescent dysplasia [1].…”

Section: Introductionmentioning

confidence: 99%

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Developmental Dysplasia of the Hip with Concurrent Legg-Calvé-Perthes Disease in the Contralateral Hip

Osaimi

Sonbul

Ibrahim

2019

Cureus

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Developmental dysplasia of the hip (DDH) is a common hip disorder in pediatrics; about one in 100 newborns has it due to dysplasia and one to two per 1000 have it due to dislocation. Some factors are responsible for the disease, and breech presentation has been identified as a major risk factor. It might be associated with other conditions too. Patients with Legg-Calvé-Perthes disease present with painless limping gait with idiopathic etiology; it is unilateral in most of the cases. This paper reported a rare scenario of DDH associated with concurrent contralateral Legg-Calvé-Perthes disease. A 5-year-old Saudi male patient, known case of developmental dysplasia of the right hip, which was managed operatively at a different hospital, presented in our outpatients clinic for right hip dysplasia and was found incidentally as having a limping gait due to left hip limited range of motion, following clinical assessment, pelvic radiographs demonstrated presence of subluxation at the right hip in addition to sclerosis, and irregularity of the left femoral head epiphysis. Right pelvic Dega osteotomy, femoral derotation osteotomy, varus osteotomy, and left hip arthrogram was examined under anesthesia with the positioning of the left hip at 45 degrees of abduction and 30 degrees of flexion to achieve the best coverage. Hip spica application was performed to correct DDH of the right hip. Repeated radiography at the subsequent visits showed better coverage of the femoral head on the right side. During a routine follow-up, there were also some osteonecrotic changes of the left femoral head that confirmed the diagnosis of left Legg-Calvé-Perthes disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Developmental Dysplasia of the Hip with Concurrent Legg-Calvé-Perthes Disease in the Contralateral Hip

Osaimi

Sonbul

Ibrahim

2019

Cureus

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“…Певні автори рекомендують застосовувати у таких пацієнтів консервативне лікування [20], проте зі збільшенням віку дитини збільшується і кількість ускладнень після консервативного лікування (у порівнянні з оперативним) та залишається висока вірогідність проведення оперативного втручання надалі (від 38 до 80%) [5,23]. Порівнюючи результати закритого та ізольованого відкритого вправлення у пацієнтів, що почали ходити, виявили більше випадків аваскулярного некрозу головки стегнової кістки після відкритого вправлення, але значно меншу кількість випадків розвитку РАД чи редислокацій та оперативних втручань надалі [24]. Більшість авторів схиляється до того, що лікування пацієнтів, які почали ходити, має бути хірургічним.…”

Section: вступunclassified

Acetabular Dysplasia: a Modern View of the Problem (Literature Review)

Filipchuk

Suvorov

2020

HOTP

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Summary. Hip dysplasia is the most common orthopedic problem in the practice of pediatric orthopedists. A significant problem with hip dysplasia is the divergence of nomenclature units, which is related to different points of view on the pathophysiology of the process. Contemporary conception defines hip dysplasia as a dynamic condition – “developmental dysplasia of the hip (DDH)”, which (in the absence of treatment) worsens with age and leads to the development of early hip osteoarthritis and requires hip replacement in young people. The leading macromorphological substrate of DDH is acetabular dysplasia, which is a spatial and structural change of acetabulum. For the treatment of acetabular dysplasia, conservative or surgical treatment (depending on the age of the child and the presence of previous treatment) is used. The most problematic solution is the treatment tactics for walking-age children. This is due to two factors: 1) increased loading on certain parts of the articular cartilage of the acetabulum during gait, which leads to the progression of deformity of the acetabulum and to progression of pathology; 2) changes in morphology of the intra-articular and extra-articular structures. However, better results with fewer complications are achieved after surgery. Biomechanically justified for acetabular dysplasia are pelvic osteotomies, which are divided into reconstructive and “salvage” procedures (preference is given to reconstructive procedures, which allows saving the native articular cartilage of acetabulum). Each osteotomy has its own advantages and disadvantages. When comparing three pelvic osteotomies commonly used in children (Salter, Pemberton and Dega), it is found that better results are achieved in children younger than 4 years after Salter’s osteotomy, results in older children are better after Dega’s osteotomy, and there is a high risk of femoroacetabular impingement following Pemberton’s osteotomy in the future.

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Radiographic outcome of children older than twenty-four months with developmental dysplasia of the hip treated by closed reduction and spica cast immobilization in human position: a review of fifty-one hips

Guo

Shen

et al. 2019

International Orthopaedics (SICOT)

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Association between open or closed reduction and avascular necrosis in developmental dysplasia of the hip

Abstract: Supplemental Digital Content is available in the text

Cited by 24 publications

References 55 publications

Developmental Dysplasia of the Hip with Concurrent Legg-Calvé-Perthes Disease in the Contralateral Hip

Developmental Dysplasia of the Hip with Concurrent Legg-Calvé-Perthes Disease in the Contralateral Hip

Acetabular Dysplasia: a Modern View of the Problem (Literature Review)

Radiographic outcome of children older than twenty-four months with developmental dysplasia of the hip treated by closed reduction and spica cast immobilization in human position: a review of fifty-one hips

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