Open Reduction of Developmental Dislocation of the Hip in Patients Older than Eight Years / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To evaluate the outcome and effectiveness of an open reduction in DDH for the patients 8 years and older. MATERIALS AND METHODS: Fourteen patients older than 8 years and diagnosed with DDH were treated by an open reduction, femoral shortening, and varus derotational osteotomy, combined with or without a Chiari osteotomy from August, 1981 to November, 2002 However, one patient was treated without femoral shortening. The mean age of the patients besides the 2 patients of failure at the time of surgery was 13.1 years (range 8-23), the mean follow up duration was 9.1 years (range 1-22 years). There were 6 cases of left side involvement of DDH, and 5 cases of right side involvement, while the remaining were both sides. One case was male and the others were female, and all hips were dislocated completely. RESULTS: One hip out of 14 patients was not unreduced intraoperatively. One hip showed a redislocation during the follow up period. Eleven patients gained almost the full range of motion of the affected hip except for one patient. Five out of the 12 patients showed a normal gait without limping and pain, and 3showed a slight limping gait but was much improved compared with the preoperative state. Four patients showed a limping gait due to a leg length discrepancy, and the limping gait of one patient was corrected by femoral lengthening. The average Harris hip score among the patients except for 2 cases of failure was 94.6. Nine patients were excellent and 3 patients were good. CONCLUSION: A neglected DDH should be treated positively Because a functionally good hip joint can be obtained after an open reduction of a developmentally dislocated hip, even after the age of 8.