RISK FACTORS LEADING TO DEVELOPMENTAL COMPLICATIONS AFTER OPEN REDUCTION IN DEVELOPMENTAL DYSPLASIA OF HIP.

BACKGROUND: The developmental dysplasia of the hip (DDH) is regarded as one of the commonest congenital deformities. Its incidence has been estimated to be one in 60 live births according to some estimates. Different forms of treatment modalities have been suggested and their success depends on the age of the patient. The study was done with the objectives to observe the post-operative complications of open reduction in patients with DDH and to determine the possible risk factors associated with these complications. METHODS: A total of 60 patients were enrolled with DDH in this descriptive cross-sectional study from August 2013 to November 2015. After obtaining an informed consent, the patients underwent open reduction and in some cases, subsequent osteotomy. The patients were followed-up at three months intervals for at least 9 months to look for development of complications, if any. RESULTS: The mean age of the patients was 31.32 ± 2.52 months. Majority 45 (75%) of the study population was female. The most common complication observed was osteonecrosis (5 patients; 8.33%) followed by residual dysplasia and re-dislocation in 3 (5%) patients each. Infection was identified as a complication in 2 (3.33%) patients. When stratified with complications of open reduction, female sex and bilateral hip involvement were found to have a significant association with the development of complications. CONCLUSION: Female sex and bilateral hip involvement confer a greater risk of developing a complication following open reduction for DDH.

Outcome of cervical disectomy and fusion with stabilization in single level cervical disc.

BACKGROUND: Cervical radiculopathy is a common and distressing problem. Only those patients who failed conservative treatment should undergo surgery. The anterior cervical disectomy is the procedure which offers maximal exposure of the disc space. It easily removes the portion of disc which compresses the nerve root. Possibility of developing late kyphosis from disc space collapse supported the fusion procedure after single level disectomy. The goal of instrumentation is to provide immediate stability, increase fusion rate, prevent graft failure, improve rehabilitation process and possibly no need for external orthosis. Objective of study was To see the results and complications of cervical disectomy thru anterior approach and fusion and stabilisation with titanium made plate. METHODS: This was a prospective study, comprised of 32 patients admitted during period from 2005-2008. Patients presented with radiculopathy or radiculo-myelopathy were evaluated. MRI was carried out in all the cases. Each patient was carefully evaluated to confirm clinico-radiological correlation and patients with significant disc and failure of conservative treatment were included in the study. RESULTS: Males were 28 (87.5%) and female were 4 (12.5%). Twenty patients (62.5%) were in fourth decade. C5-6 was involved in 18 (56.25%) patients. No significant postoperative complications noted. Persistent neck and back pain noted in patients in disectomy group without plating. CONCLUSION: Anterior cervical disectomy, fusion and stabilisation with plating is a safe and easy procedure in single level cervical disc disease without significant complications.