Bilateral One-half Spica Cast After Open Reduction and Pelvic Osteotomy in the Developmental Dislocation of the Hip

Abstract

Background:The prevalence of DDH ranges from 1 per1000 to 3.4 per 100 live- births. One- and-one-half hip spica cast is the conventional technique of immobilization after the open reduction with or without osteotomy.Objectives:In this study, we evaluated the preference of bilateral one-half spica cast over the one-and-one-half spica cast.Materials and Methods:Eight hips in five patients with developmental dislocation of the hip have undergone open reduction. Salter osteotomy, Pemberton osteotomy and femoral shortening were done on two, two and six hips, respectively. Bilateral one-half spica cast with trochanteric molding was applied for all of the hips.Results:The patients’ age ranged from 1.5 to 7 years old. The only complications consisted of two osteonecrosis of the head and one superficial infection. No dislocation, graft displacement, nonunion and device failure was occurred.Conclusions:Bilateral one-half spica cast is sufficient after the open reduction with or without osteotomy in DDH patients and we can substitute the bilateral one-half spica cast above the knee cast for the conventional one and one-half spica cast.

International variance in the treatment of developmental dysplasia of the hip

“…Post-operative immobilisation has traditionally been achieved with a spica cast [ 26 ]. This is borne out by our study, with 88 % of surgeons using this mode of immobilisation.…”