Radiographic outcome of children older than twenty-four months with developmental dysplasia of the hip treated by closed reduction and spica cast immobilization in human position: a review of fifty-one hips

Li, Yiqiang; Guo, Yunfei; Shen, Xiantao; Liu, Hang; Mei, Haibo; Xu, HongWen; Canavese, Federico

doi:10.1007/s00264-019-04315-z

Cited by 15 publications

(16 citation statements)

References 33 publications

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“…The reports of AVN in children with developmental dysplasia of the hip (DDH) treated by CR varies between 0% and 67% although its cause remains unknown. 1–6 Age, 6 high dislocation 7 and absence of ossific nucleus 8 have been reported as risk factors for AVN in children with DDH treated by CR.…”

Section: Introductionmentioning

confidence: 99%

Does the size of the femoral head correlate with the incidence of avascular necrosis of the proximal femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction?

Yuan

et al. 2020

Journal of Children's Orthopaedics

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Purpose The purpose of this study was to identify if any correlation between size of the proximal femoral epiphysis and avascular necrosis (AVN) exists. Methods We retrospectively reviewed 111 patients with developmental dysplasia of the hip treated by closed reduction (124 hips). The diameter and height of both femoral head and ossific nucleus were assessed on preoperative MRI. Results The diameter and the height of the femoral head as well as of the ossific nucleus of the contralateral side were significantly greater than the dislocated side. AVN occurred in 21 (16.9%) out of 124 hips. The rate of AVN gradually decreased with age: 30.0% at six to 12 months, 18.2% at 12 to 18 months and 3.7% at 18 to 24 months. Spearman correlation analysis showed that age is negatively correlated with the incidence of AVN (r = -0.274; p = 0.002) and the diameter of the femoral head has a significantly negative association with the incidence of AVN (r = -0.287; p = 0.001). No significant association was observed between the incidence of AVN and height of the femoral head or size of the ossific nucleus. Hips with AVN were significantly smaller than hips without AVN. Conclusions The size of both the femoral head and the ossific nucleus increase with age although the dislocated femoral head is smaller compared with the contralateral side. The diameter of the femoral head and not the size of the ossific nucleus negatively correlate with the risk of AVN, with a bigger femoral head showing lower risk of AVN. Level of evidence III

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Section: Introductionmentioning

confidence: 99%

Does the size of the femoral head correlate with the incidence of avascular necrosis of the proximal femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction?

Yuan

et al. 2020

Journal of Children's Orthopaedics

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“…DDH is one of the complex deformities in pediatric orthopedics and a frequent cause of secondary OA. Li Y et al reported that residual acetabular dysplasia developed in 43.6% of the patients aged 24 to 36 months with DDH treated by closed reduction and spica cast immobilization in human position, secondary pelvic surgery without opening the joint usually provided good outcomes in most patients [16]. In terms of relationship between femoral anteversion angle (AA) and redislocation after closed reduction, Hong et al reported that AA was different between affected and unaffected side of patients with unilateral DDH; however, the difference had very limited or no clinical significance because redislocation/subluxation was not influenced by AA values [17].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of computer-assisted peri-acetabular osteotomy compared with conventional osteotomy in hip dysplasia

Imai

Kamada

Miyawaki

et al. 2020

International Orthopaedics (SICOT)

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Aim of the study To compare the outcomes after computer-assisted peri-acetabular osteotomy (PAO) and conventional PAO performed for hip dysplasia (DDH). Methods Ninety-one patients (98 hips) were enrolled in this study. In each case, DDH was treated with either conventional PAO, in which the angle and direction of the osteotomy was determined by intra-operative X-ray examination, or with computer-assisted PAO, which used the 3D navigation system. Forty hips underwent conventional PAO and 58 hips underwent computer-assisted PAO. Results Japanese Orthopaedic Association hip scores improved significantly from 70.0 points pre-operatively to 90.7 points post-operatively in patients with conventional PAO, and from 74.5 points pre-operatively to 94.2 points post-operatively in patients with computer-assisted PAO. In all patients with computer-assisted PAO, the post-operative AHI and VCA angle were within the radiographic target zone. Some patients with conventional PAO had post-operative AHI and VCA angle outside of the target zone. We performed total hip arthroplasty (THA) on five of the 98 PAO hips (5.1%) after an average follow-up period of 5.4 years. None of 58 hips (0%) with computer-assisted PAO was revised. Discussion Computer-assisted PAO enabled intra-operative confirmation of osteotomy sites, and the position of the osteotomized bone fragment could be confirmed in real time. Adequate anterior and lateral coverage of the femoral head in patients with computer-assisted PAO resulted in no need for early conversion to THA, in contrast to conventional PAO. Conclusion Computer-assisted PAO not only improved accuracy and safety but also achieved sufficient anterior and lateral displacement to prevent the progression of DDH.

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“…Li et al published the outcomes of 51 hips between 24 and 36 months of age which were treated by CR and spica. 17 They could get a successful CR in 76.5% of their patients with a 5% AVN rate. They also reported that 43.6% of these patients had residual acetabular dysplasia.…”

Section: Closed Reductionmentioning

confidence: 94%

Short-term outcomes of treatment in children presenting with DDH in walking age - An analysis of 84 hips

Venkatadass

Prasad

Jain

et al. 2022

Journal of Clinical Orthopaedics and Trauma

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Radiographic outcome of children older than twenty-four months with developmental dysplasia of the hip treated by closed reduction and spica cast immobilization in human position: a review of fifty-one hips

Cited by 15 publications

References 33 publications

Does the size of the femoral head correlate with the incidence of avascular necrosis of the proximal femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction?

Does the size of the femoral head correlate with the incidence of avascular necrosis of the proximal femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction?

Outcomes of computer-assisted peri-acetabular osteotomy compared with conventional osteotomy in hip dysplasia

Short-term outcomes of treatment in children presenting with DDH in walking age - An analysis of 84 hips

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