Evaluation of the results of operative treatment of hip dysplasia in children after the walking age

ABSTRACT

Treatment of neglected developmental dysplasia of the hip [DDH] in children after the walking age has been a challenge to the orthopedic surgeons. It is usually surgical at this age group. The study included 35 patients [42 hips], they had been treated by different combinations of open reduction, femoral [shortening, derotation and varus] and pelvic [Salter or Dega] osteotomy. The age at the time of the operation ranged from 18 to 96 months. At the end of follow-up [a mean of 33.5 months], the overall final clinical result was excellent in 13 [31%] patients, good in 24 [57%] patients, fair in four [9.5%] patients and poor in one [2.5%] patient satisfactory in 37 [88%] patients and unsatisfactory in five [12%] patients. The radiological end result was Class I [excellent] in 26 [62%] patients, Class II [good] in 11 [26%] patients, Class I [fair] in three [7%] patients and Class IV [poor] in two [5%] patients. It was satisfactory in 37 [88%] patients and unsatisfactory in five [12%] patients. We concluded that operative treatment of neglected DDH after the walking age is a technically demanding procedure but when performed properly by an experienced surgeon it gives satisfactory results: