Medial approach without opening the joint capsule for developmental dislocation of the hip

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Developmental hip dysplasia

Background:

• Developmental dislocation of the hip (DDH) is a common pediatric orthopedic condition.
• Current treatment strategies for DDH vary, with some involving surgical hip dislocation.
• Minimally invasive techniques are being explored to improve outcomes and reduce complications.

Purpose of the Study:

• To evaluate the safety and efficacy of a medial approach without capsular opening for treating developmental dislocation of the hip in infants and young children.
• To determine the rate of successful outcomes and complications associated with this technique.
• To assess whether avoiding capsular opening influences the risk of avascular necrosis.

Main Methods:

• Seventy-one hips in 47 children (average age 11 months) with DDH were treated.
• A medial surgical approach was utilized, deliberately avoiding opening the hip joint capsule.
• Patients were immobilized for 6 months post-procedure using a hip spica cast.

Main Results:

• At follow-up, 63 out of 71 hips (88.7%) achieved excellent or good outcomes.
• Eight hips (11.3%) demonstrated subluxation.
• No cases of avascular necrosis were reported in the treated hips.

Conclusions:

• The medial approach without capsular opening is a safe and effective treatment for developmental dislocation of the hip in this pediatric age group.
• Avoiding capsular opening appears to prevent avascular necrosis, a serious complication.
• This technique offers a viable alternative to more invasive procedures, potentially reducing morbidity.