Do we need femoral derotation osteotomy in DDH of early walking age group? A clinico-radiological correlation study

Abstract

As the surgical treatment of DDH involves complex osteotomies around the hip and these surgeries have effect on long term outcome, MRI evaluation of femoral anteversion as a part of pre operative evaluation is advised. Also, as the intra operative evaluation needs enough clinical experience and it can not be performed in cases requiring femoral shortening for reduction, we consider pre operative evaluation of femoral anteversion by MRI as essential rather than adjunctive.

Arthroscopic reduction and acetabuloplasty for the treatment of dislocated hips in children of walking age: a preliminary report

“…This is comparable with the findings of Mootha et al The authors did not perform a femoral osteotomy on 12 of the 15 hips in a comparable cohort. Open reduction through an anterior approach (the Sommerville approach) and acetabuloplasty were sufficient in achieving a stable positioning of the hip joints [3].…”

“…While most cases of hip dislocation can be easily treated in infancy using a retention therapy, such as a plaster cast or a Pavlik harness, more extensive measures are needed for children of walking age. Children of walking age are treated through open reduction, possibly with acetabuloplasty, with or without femoral osteotomy [3][4][5][6][7]. The necessity of and the type of femoral osteotomy are controversially debated [3][4][5].…”

“…Children of walking age are treated through open reduction, possibly with acetabuloplasty, with or without femoral osteotomy [3][4][5][6][7]. The necessity of and the type of femoral osteotomy are controversially debated [3][4][5]. Complications include avascular necrosis, repeat dislocation, differences in leg lengths and muscular insufficiency.…”

Review Outcome of Combined Open Reduction and Femoral Shortening Osteotomy for Developmental Dysplasia of the Hip in Children

“…Once the child achieves walking age, treatment becomes more extensive. In the management of age group 18-24 months, majority of surgeons agree on open reduction and hip spica cast and a supplementary procedure like a proximal femoral osteotomy is usually not necessary in this age group [6] . The purpose of this study was reviewed the clinical and radiological outcome following Open reduction, and femoral shortening osteotomy.…”

Outcome of surgical management of developmental dysplasia of hip in children between 18 and 24 months

“…Once the child achieves walking age, treatment becomes more extensive. In the management of age group 18-24 months, majority of surgeons agree on open reduction and hip spica and a supplementary procedure like a proximal femoral osteotomy is usually not necessary in this age group 12. This study aims to recognize situations where an additional procedure may be required in a patient with DDH between 18 and 24 months to prevent a possible acetabular dysplasia.…”