Changes in Soft Tissue Interposition After Reduction of Developmental Dislo-cation of the Hip

Reduction by Pelvic External Fixator Followed by Innominate and Derotational Femoral Osteotomies for Late Presenting Bilateral Developmental Dysplasia of the Hip

“…We think that this finding is valid as far as our results are concerned. We also agree with T. Tanaka et al 11 reporting the opportunity of penetration of the femoral head into acetabular cavity 1.5e2 years after closed reduction.…”

“…It is believed that unless open hip reduction is performed, soft tissue interposition prevents full reduction 8,9 although soft tissues will be redistributed and even degenerated in the remodelling phase. 10,11 The addition of femoral shortening is considered an important procedure for soft tissue decompression after open reduction to prevent osteonecrosis. 9 Salter innominate osteotomy proved successful results in the skeletally immature patients.…”

Visualization of developmental dysplasia of the hip in infants by using three-dimensional magnetic resonance imaging

“…It was indicated that AVN and redislocation occurred more commonly in hips in which the medial pool size of contrast material exceeded 7 mm than in those with sizes between 3 and 7 mm by arthrography [18]. Others reported that hardened fibrofatty tissue and inverted labrum persisted in severe cases even after the reduction [19]. To avoid these complications, not only reducibility but also concentricity should be evaluated before the treatment.…”

The Fate of DDH Hips Showing Cartilaginous or Fibrous Tissue-filled Joint Spaces Following Primary Reduction

“…For the 13 patients who underwent secondary treatment, the outcomes were only satisfactory in 4 patients (30.8%). The cause of joint space widening after primary treatment is not clear, but the age at which reduction is performed must be important, 16,17 because more severe pathologic changes can be observed in both the femoral and acetabular sides after patients begin walking. Also, improperly handled intra-articular and extra-articular structures interposed fibrous tissues between the femoral head and the acetabulum during closed reduction (hypertrophied ligamentum teres or pulvinar), or during open reduction and capsulorrhaphy (iatrogenic), or persistent abnormalities in neck-shaft angle, anteversion, acetabular slope, and/or femoral head coverage may induce subsequent acetabular cartilage hypertrophy by decreasing the medially directed force of the femoral head into the acetabulum.…”