Outcome at Forty-five Years After Open Reduction and Innominate Osteotomy for Late-Presenting Developmental Dislocation of the Hip

Cove, Richard

doi:10.2106/00004623-200911000-00044

Cited by 2 publications

(7 citation statements)

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“…In various studies, the redislocation rate after PA has been reported to be low (13,19). In the current study, although the difference was not statistically significant, redislocation was determined at a lower rate in the PA group.…”

Section: Discussioncontrasting

confidence: 63%

“…In addition, because the osteotomy applied in the Pemberton technique is an incomplete osteotomy, there is a lesser negative effect on the biomechanics of the pelvis. On the other hand, the Salter osteotomy, which is of historical importance, is an osteotomy which has been reported with positive long-term results in literature and is still successfully applied by many authors (13,20,21). As a result no superiority of either technique was seen statisticaly in the radiological and functional results of the current study.…”

Section: Discussionmentioning

confidence: 52%

“…The degree of correction in the inclination angle of the acetabulum has been reported to be higher in PA than in SO (12,13). Therefore, in patients with a preoperative inclination angle of >35˚, the application of PA is generally preferred to SO.…”

Section: Discussionmentioning

confidence: 99%

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Comparıson Of The Results Of Pemberton And Salter Osteotomıes Applıed In Developmental Dysplasıa Of The Hıp

Tuhanioğlu¹,

Gültekin²,

Oğur³

et al. 2018

Kocaeli Med J

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 52%

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Comparıson Of The Results Of Pemberton And Salter Osteotomıes Applıed In Developmental Dysplasıa Of The Hıp

Tuhanioğlu¹,

Gültekin²,

Oğur³

et al. 2018

Kocaeli Med J

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show abstract

“…28 Therefore, if reduction is not achieved within several weeks after PH reapplication, then cessation of PH is recommended so that CR or OR may be attempted. [29][30][31][32] Although CR after traction is a safe method with a low necrosis rate, it requires prolonged hospitalization of ~6 weeks, increasing the cost of hospitalization and the time commitment for caregivers. 29,33 In this regard, PH does not require hospitalization and is a simple method.…”

Section: Discussionmentioning

confidence: 99%

“…OR which is essential for irreducible cases, is an invasive treatment compared with PH and is associated with concerns of coxa magna and cartilage damage. 18,32,34,35 Therefore, the reapplication method is worth considering for babies who fail the initial PH treatment. Left-side dislocation and a positive Ortolani sign during the initial application were found to be favorable signs for successful reapplication.…”

Section: Discussionmentioning

confidence: 99%

Reapplication of the Pavlik Harness for Treatment of Developmental Dysplasia of the Hip After Initial Pavlik Harness Failure

Tomaru,

Kamegaya,

Saisu

et al. 2023

Journal of Pediatric Orthopaedics

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Objective: The Pavlik harness (PH) has been widely used as the standard treatment for infants with developmental dysplasia of the hip (DDH). When the initial application of the PH fails, alternative treatments, such as closed reduction, open reduction, and reapplication of the PH will be considered. Compared with other treatments, reapplication of the PH offers certain advantages, including simplicity and reduced physical, and psychological stress, on both infants and caregivers. This study aims to investigate the effectiveness of reapplying the PH in patients with DDH. Methods: This study included patients with DDH (complete dislocation) who were treated by reapplication of PH between 1988 and 2012. Patients who were able to follow-up for more than 5 years were included. We examined the reduction rate and several factors to identify indicators associated with successful reduction during reapplication, including age, sex, side of hip dislocation, and the presence of the Ortolani sign. At the final follow-up, hip development was assessed using the Severin classification, whereas avascular necrosis (AVN) was evaluated using the Kalamchi classification and the Salter criteria. Results: A total of 56 patients (48 females and 8 males) and 57 hips were included in this study. The mean age at first and second application of PH was 4.2 months old (range: 0.12 to 6.4), and 5.8 months old (3.0 to 11.4), respectively. The reduction rate was 49% (28 out of 57 hips). Among the successfully reduced hips, the AVN rate was 3.6% (1 out of 28 hips). The Severin classification revealed 27 hips in class I and 1 hip in class III. Statistical analysis indicated a significantly higher proportion of left hip involvement in the reduction group (85% vs 41%, χ2 test, P < 0.001). Although not statistically significant, the rate of positive Ortolani sign tended to be higher in the reduction group (61% vs 38%, χ2 test, P = 0.06). Conclusion: The reapplication method demonstrated a 49% reduction rate and a low AVN rate of 3.6% in our study. It is worth considering for patients who fail the initial PH treatment, particularly in cases of left-side dislocation and a positive Ortolani sign during the initial application.

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Outcome at Forty-five Years After Open Reduction and Innominate Osteotomy for Late-Presenting Developmental Dislocation of the Hip

Cited by 2 publications

References 0 publications

Comparıson Of The Results Of Pemberton And Salter Osteotomıes Applıed In Developmental Dysplasıa Of The Hıp

Comparıson Of The Results Of Pemberton And Salter Osteotomıes Applıed In Developmental Dysplasıa Of The Hıp

Reapplication of the Pavlik Harness for Treatment of Developmental Dysplasia of the Hip After Initial Pavlik Harness Failure

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