Skip to main content

Advertisement

SpringerLink
Log in

Long-term outcome of medial open reduction in developmental dysplasia of hip

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Long-term outcome of medial open reduction (MOR) was examined. We aimed to evaluate the effects of MOR on hip development in developmental dysplasia of hip (DDH).

Methods

One hundred and ten hips of 74 patients that admitted to our clinic were evaluated. 15 (20.27 %) were male, 59 (79.73 %) were female. The mean age at the time of MOR was 17.71 ± 7.71 months (range 6–48 months). The mean duration of follow-up was 13.97 ± 4.89 years (range 5–24 years).

Results

Radiological results were Severin 1 and 2 in 86.37 % of the hips, Severin 3 in 10.0 % of the hips and Severin 4 in 3.63 % of the hips. Functional results were excellent (94.55 %) or good (5.45 %) according to modified McKay’s criteria. When we excluded the hips that underwent additional operations, radiological results were Severin 1 and 2 in 82.05 % of the hips, and Severin 3 and 4 in 17.95 % of the hips. Acetabular angles and ACM, CE, Sharp angles were evaluated at last follow-up. Acetabular development was better in patients that were treated before the age of 18 months. Additional operations were performed to 32 hips (29.09 %). No additional operation was performed to the patients that were treated with MOR before the age of 12 months. The patients that were treated with MOR between 19 and 24 months of age had a higher proportion (47.61 %) for additional operations. Avascular necrosis rate was 17.27 %. Avascular necrosis rate was decreased to 6.3 % when type 1 differences were excluded. Avascular necrosis rate was 12.82 % when the hips that underwent additional operations were excluded.

Conclusions

Medial open reduction is effective and safe treatment method in DDH. Early concentric stable reduction with MOR improved results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Tönnis D (1987) Reports on the results of the closed treatment of congenital hip dislocation at different ages using various methods. In: Tönnis D (ed) Congenital dysplasia and dislocation of the hip in children and adults. Springer-Verlag, Berlin/Heidelberg, pp 302–311

    Chapter  Google Scholar 

  2. Muratli HH, Yüksel HY, Akşahin E, Hapa O, Günal T, Çelebi L (2009) Does salter innominate osteotomy with transiliac lengthening effect triradiate cartilage or cause posterior coverage insufficiency? Arch Orthop Trauma Surg 129:1607–1611

    Article  PubMed  Google Scholar 

  3. Lindstrom JR, Ponseti IV, Wenger DR (1979) Acetabular development after reduction in congenital dislocation of the hip. J Bone Jt Surg Am 61(1):112–118

    CAS  Google Scholar 

  4. Holman J, Carroll KL, Murray KA, Macleod LM, Roach JW (2012) Long term follow-up of open reduction surgery for developmental dislocation of the hip. J Pediatr Orthop 32:121–124

    Article  PubMed  Google Scholar 

  5. Ferguson AB (1973) Primary open reduction of congenital dislocation of the hip using a median adductor approach. J Bone Jt Surg Am 55(4):671–689

    Google Scholar 

  6. Mankey MG, Arntz CT, Staheli LT (1993) Open reduction through a medial approach for congenital dislocation of the hip: a critical review of the Ludloff approach in sixty-six hips. J Bone Jt Surg Am 75(9):1334–1345

    CAS  Google Scholar 

  7. Baki C, Sener M, Aydin H, Yildiz M, Saruhan S (2005) Single stage open reduction through a medial approach and innominate osteotomy in developmental dysplasia of hip. J Bone Jt Surg Br 87(3):380–383

    CAS  Google Scholar 

  8. Severin E (1941) Contribution to the knowledge of congenital dislocation of hip joint: late results of closed reduction and arthrographic studies of recent cases. Acta Chir Scand 84:1–142

    Google Scholar 

  9. Berkeley ME, Dickson JH, Cain TE, Donovan MM (1984) Surgical therapy for congenital dislocation of the hip in patients who are twelve to thirty-six months old. J Bone Jt Surg Am 66(3):412–420

    CAS  Google Scholar 

  10. Tönnis D (1987) Nomenclature and classification of congenital hip dislocation. In: Tönnis D (ed) Congenital dysplasia and dislocation of the hip in children and adults. Springer-Verlag, Berlin/Heidelberg, pp 80–83

    Chapter  Google Scholar 

  11. Tönnis D (1987) General radiography of hip joint. In: Tönnis D (ed) Congenital dysplasia and dislocation of the hip in children and adults. Springer-Verlag, Berlin/Heidelberg, pp 99–142

    Chapter  Google Scholar 

  12. Kalamchi A, Mac Ewen GD (1980) Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Jt Surg Am 62(6):876–887

    CAS  Google Scholar 

  13. Visser JD (1984) Functional treatment of congenital dislocation of the hip. Acta Orthopaedica Scandinavia Suppl 206:1–109

    Article  CAS  Google Scholar 

  14. Weinstein SL (1992) Congenital hip dislocation. Long range problems, residual signs, and symptoms after successful treatment. Clin Orthop Relat Res 281:69–74

    PubMed  Google Scholar 

  15. Bache CE, Graham HK, Dickens DR, Donnan L, Johnson MB, Nattrass G, O’Sullivan M, Torode IP (2008) Ligamentum teres tenodesis in medial approach open reduction for developmental dislocation of the hip. J Pediatr Orthop 28:607–613

    Article  PubMed  Google Scholar 

  16. Konigsberg DE, Karol LA, Colby S, O’Brien S (2003) Results of medial open reduction of the hip in infants with developmental dislocation of the hip. J Pediatr Orthop 23:1–9

    PubMed  Google Scholar 

  17. Biçimoğlu A, Ağuş H, Ömeroğlu H, Tümer Y (2008) Posteromedial limited surgery in developmental dysplasia of the hip. Clin Orthop Relat Res 466:847–855

    Article  PubMed  Google Scholar 

  18. Roose PE, Chingren GL, Klaaren HE, Broock G (1979) Open reduction for congenital dislocation of the hip using the Ferguson procedure. J Bone Jt Surg Am 61:915–921

    CAS  Google Scholar 

  19. Malvitz TA, Weinstein SL (1994) Closed reduction for congenital dysplasia of the hip. J Bone Jt Surg Am 76:1777–1792

    CAS  Google Scholar 

  20. Kiely N, Younis U, Day JB, Meadows TM (2004) The Ferguson medial approach for open reduction of developmental dysplasia of the hip. J Bone Jt Surg Br 86:430–433

    Article  CAS  Google Scholar 

  21. Morcuende JA, Meyer MD, Dolan LA, Weinstein SL (1997) Long term outcome after open reduction through an anteromedial approach for congenital dislocation of the hip. J Bone Jt Surg Am 79(6):810–817

    CAS  Google Scholar 

  22. Okano K, Enomoto H, Osaki M, Takahashi K, Shindo H (2008) Femoral head deformity after open reduction by Ludloff’s medial approach. Clin Orthop Relat Res 466:2507–2512

    Article  PubMed  Google Scholar 

  23. Ucar H, Isıklar ZU, Stanitski CL, Kandemir U, Tümer Y (2004) Open reduction through a medial approach in developmental dislocation of the hip. J Pediatr Orthop 24(5):493–500

    Article  PubMed  Google Scholar 

  24. Gholve PA, Flynn JM, Garner MR, Millis MB, Kim YJ (2012) Predictors for secondary procedures in walking DDH. J Pediatr Orthop 32:282–289

    Article  PubMed  Google Scholar 

  25. Tümer Y, Ward WT, Grudziak J (1997) Medial open reduction in the treatment of developmental dislocation of the hip. J Pediatr Orthop 17(2):176–180

    PubMed  Google Scholar 

  26. Mootha AK, Saini R, Dhillon M, Aggarwal S, Wardak E, Kumar V (2010) Do we need femoral derotation osteotomy in DDH of early walking age group? A clinico-radiological correlation study. Arch Orthop Trauma Surg 130:853–858

    Article  PubMed  Google Scholar 

  27. Roposch A, Ridout D, Protopapa E, Nicolaou N, Gelfer Y (2013) Osteonecrosis complicating developmental dysplasia of the hip compromises subsequent acetabular remodeling. Clin Orthop Relat Res. doi:10.1007/s11999-013-2804-2

    Google Scholar 

  28. Pospischill R, Weninger J, Ganger R, Altenhuber J, Grill F (2012) Does open reduction of the developmental dislocated hip increase the risk of osteonecrosis? Clin Orthop Relat Res 470:250–260

    Article  PubMed  Google Scholar 

  29. Okano K, Yamada K, Takahashi K, Enomoto H, Osaki M, Shindo H (2009) Long term outcome of Ludloff’s medial approach for open reduction of developmental dislocation of the hip in relation to the age at operation. Int Orthop 33:1391–1396

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, School of Medicine, Giresun University, 28100, Giresun, Turkey

    Atilla Çıtlak

  2. Department of Orthopaedics and Traumatology, Ödemiş State Hospital, 35750, Izmir, Turkey

    Sertaç Saruhan

  3. Department of Orthopaedics and Traumatology, School of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey

    Celal Baki

Authors
  1. Atilla Çıtlak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sertaç Saruhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Celal Baki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Atilla Çıtlak.

Additional information

C. Baki is a senior author.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Çıtlak, A., Saruhan, S. & Baki, C. Long-term outcome of medial open reduction in developmental dysplasia of hip. Arch Orthop Trauma Surg 133, 1203–1209 (2013). https://doi.org/10.1007/s00402-013-1793-7

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-013-1793-7

Keywords

Search

Navigation