[Hip joint development after treatment the developmental dislocation with overhead traction].

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Developmental Dysplasia of the Hip

Background:

• Developmental dislocation of the hip (DDH) remains a significant challenge in pediatric orthopedics despite widespread ultrasound screening.
• Late diagnosis of DDH can complicate treatment and affect long-term outcomes.
• Effective treatment strategies are crucial for improving patient prognosis.

Purpose of the Study:

• To evaluate the long-term clinical and radiological outcomes of treating developmental dislocation of the hip (DDH).
• To assess the efficacy of a treatment protocol involving overhead traction and closed reduction in skeletally mature patients.
• To identify factors influencing treatment success and potential complications.

Main Methods:

• Retrospective review of clinical records and radiograms from 107 hips in 81 children treated for DDH.
• Treatment protocol included overhead traction, closed reduction, modified Lorenz cast, and cast in Lange position.
• Patients were assessed using Severin radiological classification and Harris functional classification, with Bucholz-Ogden classification for avascular necrosis.

Main Results:

• 80% of cases achieved good or very good radiological outcomes (Severin classification).
• 91% of cases achieved good or very good functional outcomes (Harris classification).
• Avascular necrosis of the femoral head was observed in one-third of patients; functional results deteriorated over time, particularly in hips with residual dysplasia and AVN.

Conclusions:

• Overhead traction and closed reduction followed by casting provide favorable short-to-medium term outcomes for DDH.
• Long-term follow-up indicates a risk of early degenerative changes, especially in hips with complications like AVN or residual dysplasia.
• Continuous monitoring is essential for managing long-term sequelae of DDH treatment.