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The value of preliminary overhead traction in the closed management of DDH
Marcin Sibiński1, Claire Murnaghan, Marek Synder
1Clinic of Orthopaedics and Paediatric Orthopaedic, Medical University of Lodz, Lodz, Poland. sibinek@poczta.onet.pl
Insights
Overhead traction before hip reduction surgery for developmental dislocation of the hip (DDH) in children over one year old may reduce growth disturbances and improve long-term outcomes.
Area of Science:
- Pediatric Orthopedics
- Developmental Dysplasia of the Hip
- Growth Disturbance Research
Background:
- Developmental dislocation of the hip (DDH) can lead to significant orthopedic issues.
- Proximal femoral epiphysis growth disturbances are a known complication.
- Treatment outcomes for DDH vary, necessitating further investigation into optimal methods.
Purpose of the Study:
- To compare the incidence of proximal femoral epiphysis growth disturbances and long-term outcomes in children with DDH treated with and without overhead traction.
- To evaluate the efficacy of pre-reduction overhead traction in managing DDH.
Main Methods:
- A retrospective study comparing two groups of children with DDH.
- Group 1: 107 hips treated with overhead traction prior to reduction.
- Group 2: 48 hips treated without overhead traction, followed until age 14.
Main Results:
- Overhead traction was associated with a reduced incidence of growth disturbances.
- Children receiving pre-reduction traction demonstrated more favorable long-term results.
- The benefit was most pronounced in children over one year of age with high-dislocated hips.
Conclusions:
- Pre-reduction overhead traction is recommended for non-operative DDH treatment in children over one year old and/or with high-dislocated hips.
- This approach can mitigate severe growth disturbances and enhance favorable long-term outcomes in late-diagnosed DDH cases.
Abstract:
We aimed to discover whether there is a difference in incidence of growth disturbances of the proximal femoral epiphysis and final results in two similar groups of children with developmental dislocation of the hip (DDH) treated with (107 hips) and without (48 hips) overhead traction. The only variable between the groups was the use of preliminary traction. All children were followed up until at least the age of 14 years. Pre-reduction traction should be used among children treated non-operatively for DDH who are older than one year of age and/or have high-dislocated hips. In cases that are diagnosed late, this treatment would reduce the risk of severe growth disturbances and increase the probability of a favourable long-term outcome.
