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Published on: September 7, 2022
Acetabular dysplasia following closed reduction of developmental dislocation of the hip
1Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NY 03756-0124, USA. cminter@shrinenet.org
Insights
Acetabular dysplasia occurred in 69% of children after closed reduction for developmental hip dislocation. This incidence was not significantly linked to the child's age at reduction or the presence of the ossific nucleus.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Developmental Dysplasia of the Hip
Background:
- Developmental dislocation of the hip (DDH) is a common pediatric orthopedic condition.
- Acetabular dysplasia, a potential long-term complication, can lead to hip osteoarthritis.
- Early intervention through closed reduction is a standard treatment for DDH.
Purpose of the Study:
- To determine the incidence of acetabular dysplasia after closed reduction for DDH.
- To investigate the relationship between acetabular dysplasia and age at reduction.
- To assess the influence of the ossific nucleus on post-reduction acetabular dysplasia.
Main Methods:
- Retrospective review of 35 children with unilateral DDH undergoing closed reduction.
- Analysis of medical records for age at reduction, Pavlik harness use, pre-reduction traction, ossific nucleus presence, and adductor tenotomy.
- Measurement of the acetabular index to assess for dysplasia.
Main Results:
- The mean age at reduction was 10 months, with a mean follow-up of 91 months.
- Acetabular dysplasia was observed in 69% (24 hips) following closed reduction.
- No statistically significant correlation was found between acetabular dysplasia and age at reduction or the presence of the ossific nucleus.
Conclusions:
- A high incidence of acetabular dysplasia persists after closed reduction for DDH.
- Age at reduction and the presence of the ossific nucleus do not appear to be significant predictors of post-reduction acetabular dysplasia in this cohort.
- Further research may be needed to identify risk factors and optimize management strategies for preventing long-term acetabular dysplasia in DDH patients.
Abstract:
The purpose of this study was to determine the incidence of acetabular dysplasia following closed reduction of developmental dislocation of the hip, particularly as it relates to the age at reduction and the presence of the ossific nucleus. Thirty-five children with unilateral developmental dislocation of the hip underwent closed reduction. Medical records were reviewed for gender, side, age at reduction, use of Pavlik harness, prereduction traction, presence/absence of the ossific nucleus, and whether adductor longus tenotomy was performed. Acetabular index was measured. The mean age at reduction was 10 months. The mean length of follow-up was 91 months. Following closed reduction, the incidence of acetabular dysplasia was 69% (24 hips). No statistically significant relationship between acetabular dysplasia and age at reduction or presence of the ossific nucleus was demonstrated.
