Preliminary Results after Reduction of DDH via Medial Approach / 대한정형외과학회잡지

ABSTRACT

PURPOSE: We report the outcomes of medial open reduction for developmental dysplasia of the hip (DDH). MATERIALS AND METHODS: This study reviewed the medical records and radiographs of 33 DDH cases treated by a medial open reduction and followed for at least two years. The mean age at surgery and follow-up duration was 11.4 months (range, 4 to 22) and 88 months (range, 24 to 168), respectively. The perioperative parameters, maintenance of reduction, and postoperative changes in the acetabular index and center-edge angle were recorded. RESULTS: The acetabular index decreased from a preoperative average of 35degrees to 16degrees at the latest follow-up. The center-edge angle improved from an average of 7degrees at postoperative 1 year to 22degrees at the latest follow-up. A secondary bony procedure was performed in 15 cases at average age of 4.4 years. Avascular necrosis was noted in 8 cases, all of whom belonged to Kalamchi group I. Among the 21 patients over 6 years-old at the latest follow-up, 18 belonged to Severin groups I or II and the remaining 3 to group III. Redislocation occurred in one case. CONCLUSION: A medial open reduction is a minimal surgical procedure that can effectively release the structures obstructing a femoral head reduction. It should be a useful treatment modality for selected cases with DDH.