Preliminary Results of Early Open Reduction by an Anterior Approach for Congenital Dislocation of the Hip

Szepesi, K; B, Biró; Fazekas, Katalin; Szűcs, Gabriella

doi:10.1097/01202412-199504020-00009

Cited by 19 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Early hip subluxation after open reduction and/or redislocation while wearing the plaster cast has been reported in a range of 0% to 11% with a mean of 2.4% for anterior and medial open reductions [7,10,11,16,18,20,21,23,31,37,40,46,50,52,69,70,[77][78][79]88]. Our patients had a redislocation rate of 2.8%.…”

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Farsetti

Caterini

Potenza

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background During the last 35 years, the medial approach has been reported more frequently than the anterior approach for open reduction of developmental dislocation of the hip (DDH), however, few studies have followed children treated by medial open reduction to adulthood. Questions/purposes The purposes of our study were: (1) to assess the development of 71 completely dislocated hips after medial open reduction, the incidence of additional surgery and avascular necrosis during the followup period, and the long-term radiographic and functional results; and (2) to compare our results with those obtained by others who performed open reduction either by the medial or anterior approach. Patients and Methods We retrospectively evaluated, after the end of growth, 71 hips in 52 patients who underwent open reduction by the medial approach. The mean age of the patients was 16 months (range, 3-36 months). After surgery, the hips were immobilized in 100°flexion, 60°a bduction, and neutral rotation for an average of 6 months. All patients had staged clinical and radiographic followups until skeletal maturity. The length of followup averaged 22 years (range, 13-32 years). Results In all the surgically treated hips, the acetabular index normalized by the end of growth, the incidence of avascular necrosis was 18%, and additional surgery was required in 15% of our cases. At the last followup, 93% of the hips were classified as Severin Classes I or II and 7% as Class III; 76% of the hips had an excellent result, 17% had a good result, and 7% had a fair result according to the McKay scale as modified by Barrett and colleagues. Conclusions Open reduction of DDH through a medial approach provided good long-term radiographic and functional results in patients 3 to 36 months old and it was the only surgery performed in 85% of our cases. Future comparative studies are needed to confirm our results, especially in older children. Level of evidence Level IV, therapeutic study.

show abstract

Section: Discussionmentioning

confidence: 82%

“…During the last 36 years, the anterior approach has been reported less frequently [1,10,17,18,20,23,25,30,31,47,58,70,71,73,79,80] than the medial approach [4, 6, 7, 11, 16, 21, 22, 33, 36, 37, 39, 40, 46, 48-50, 52-54, 60, 69, 77, 78, 85, 88], especially in younger children.…”

Section: Introductionmentioning

confidence: 99%

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Farsetti

Caterini

Potenza

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Its disadvantages include a lengthier operation, more dissection of the soft tissues, increased blood loss and it is more difficult to reach the structures which hinder reduction in medial approach. [6,8,[12][13][14] Successful results have been reported in various studies using both approaches. [9,13,[15][16][17][18] Avascular necrosis (AVN) and the need for revision surgery are reported at various rates.…”

mentioning

confidence: 74%

Comparison of the clinical and radiological outcomes of open reduction via medial and anterior approach in devleopmental dysplasia of the hip

Yorgancigil

Aslan

2016

Eklem Hastalik Cerrahisi

View full text Add to dashboard Cite

ÖZ Amaç:Bu çalışmada gelişimsel kalça displazisi (GKD) nedeniyle medial veya anterior yaklaşımla açık redüksiyon uygulanan çocuklarda cerrahi yaklaşımın klinik ve radyolojik sonuçlar, avasküler nekroz (AVN) insidansı ve revizyon cerrahisi gerekliliği üzerindeki etkileri araştırıldı. Hastalar ve yöntemler: Ocak 1997 -Aralık 2010 tarihleri arasında GKD tedavisi yapılan, en az dört yıl düzenli takip edilen ve son kontrolde beş yaş ve üzerinde olan 36 hastanın (9 erkek, 27 kız; ort. yaş 13.8 ay; dağılım 6-18 ay) 43 kalçası bu retrospektif çalışmaya dahil edildi. Hastalar cerrahi yaklaşıma göre iki gruba ayrıldı. Grup 1, medial yaklaşımla açık redüksiyon uygulanan 19 hastanın 21 kalçasından oluştu. Grup 2, anterior yaklaşımla açık redüksiyon uygulanan 17 hastanın 22 kalçasından oluştu. Gruplar klinik ve radyolojik sonuçlar ile AVN insidansı ve revizyon cerrahisi gerekliliği bakımından karşılaştırıldı. Bulgular: Klinik ve radyolojik sonuçlar bakımından gruplar arasında istatistiksel olarak anlamlı farklılık yoktu (sırasıyla, p= 0.407 ve p= 0.661). Benzer şekilde, AVN insidansı ve revizyon cerrahisi gerekliliği bakımından da gruplar arasında istatistiksel olarak anlamlı farklılık yoktu (sırasıyla, p= 0.993 ve p= 0.170). Diğer yandan, takipte her iki grubun asetabüler indeksi anlamlı olarak düzelmişti. Sonuç: Bu çalışma, GKD'de medial veya anterior yaklaşım ile açık redüksiyonun klinik ve radyolojik sonuçlarının benzer olduğunu, her iki yaklaşımla da asetabüler indekste anlamlı düzelme elde edildiğini ve AVN insidansı ve revizyon cerrahisi gerekliliği bakımından gruplar arasında anlamlı farklılık olmadığını göstermiştir.Anahtar sözcükler: Anterior açık redüksiyon; avasküler nekroz, gelişimsel kalça displazisi; medial açık redüksiyon; revizyon cerrahisi. ABSTRACT Objectives:This study aims to investigate the effects of surgical approach on the clinical and radiological outcomes, the incidence of avascular necrosis (AVN), and the need for revision surgery in children undergoing open reduction via medial or anterior approach for developmental dysplasia of the hip (DDH). Patients and methods: Forty-three hips of 36 patients (9 males, 27 females; mean age 13.8 month; range 6 to 18 months) treated for DDH, followed-up regularly for at least four years between January 1997 and December 2010, and who were aged five or above in the final control were included in this retrospective study. Patients were divided into two groups according to surgical approaches. Group 1 consisted of 21 hips of 19 patients who underwent open reduction through medial approach. Group 2 consisted of 22 hips of 17 patients who underwent open reduction through anterior approach. Groups were compared in terms of clinical and radiological outcomes as well as the incidence of AVN and the need for revision surgery. Results: There was no statistically significant difference between the groups with respect to clinical and radiological outcomes (p=0.407 and p=0.661, respectively). Similarly, there was no statistically significant difference between the groups in...

show abstract

“…Several observational studies examined the impact of age at the time of intervention. 25,81,95,[110][111][112][113] In 1 small study that included children initiating therapy for DDH from birth through 4 months of age, duration of treatment increased in a dose-response fashion as the age at initiation of treatment increased, holding the severity of DDH steady. 81 In a separate series of patients who underwent surgery for DDH (70% of whom had failed therapy with a Pavlik harness), those who were 6 to 9 months of age (18 patients) required no additional corrective surgeries, whereas 29% of the patients 10 to 11 months of age, 13% of patients 12 to 14 months of age, 26% of patients 15 to 18 months of age, and 30% of patients 19 to 24 months of age required additional surgical interventions.…”

Section: Biological Plausibilitymentioning

confidence: 99%

“…81 In a separate series of patients who underwent surgery for DDH (70% of whom had failed therapy with a Pavlik harness), those who were 6 to 9 months of age (18 patients) required no additional corrective surgeries, whereas 29% of the patients 10 to 11 months of age, 13% of patients 12 to 14 months of age, 26% of patients 15 to 18 months of age, and 30% of patients 19 to 24 months of age required additional surgical interventions. 110 Another study, based on unadjusted analysis, reported that the average age of DDH cases complicated by AVN was Ͼ15 months, whereas uncomplicated cases averaged 11 months of age. 111 Two additional studies found that intervention initiated after 6 months of age was associated with significantly higher rates of AVN.…”

Section: Biological Plausibilitymentioning

confidence: 99%

Screening for Developmental Dysplasia of the Hip: A Systematic Literature Review for the US Preventive Services Task Force

Shipman¹,

et al. 2006

View full text Add to dashboard Cite

show abstract

Preliminary Results of Early Open Reduction by an Anterior Approach for Congenital Dislocation of the Hip

Cited by 19 publications

References 0 publications

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Comparison of the clinical and radiological outcomes of open reduction via medial and anterior approach in devleopmental dysplasia of the hip

Screening for Developmental Dysplasia of the Hip: A Systematic Literature Review for the US Preventive Services Task Force

Contact Info

Product

Resources

About