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One-stage combined surgery with or without preoperative traction for developmental dislocation of the hip in older
G Tezeren1, M Tukenmez, O Bulut
1Department of Orthopaedics and Traumatology, School of Medicine, Cumhuriyet University, Sivas, Turkey. gtezeren@cumhuriyet.edu.tr
Insights
One-stage combined surgery for developmental dislocation of the hip (DDH) in older children is effective without preoperative traction, showing better clinical outcomes and fewer complications. Radiographic results were similar between groups.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Developmental Dysplasia of the Hip
Background:
- Developmental dislocation of the hip (DDH) requires effective surgical interventions in older children.
- One-stage combined surgery is a common approach for treating DDH.
- The role of preoperative traction in conjunction with this surgery is debated.
Purpose of the Study:
- To compare the efficacy and outcomes of one-stage combined surgery for DDH in older children, with and without preoperative traction.
- To evaluate clinical and radiographic results between the two surgical approaches.
Main Methods:
- Retrospective review of 9 children (12 hips) who underwent one-stage combined surgery with preoperative traction (Group 1).
- Comparison with 12 children (16 hips) who had the same surgery without preoperative traction (Group 2).
- Surgical procedure included open reduction, Salter's osteotomy, and femoral osteotomy; mean follow-up was 5.9 years.
Main Results:
- Clinical outcomes were worse in the group that received preoperative traction (Group 1) compared to the group without traction (Group 2).
- Radiographic assessments showed no significant differences between the two groups at final follow-up.
- The group without preoperative traction exhibited a lower complication rate.
Conclusions:
- One-stage combined surgery without preoperative traction is an effective treatment for DDH in older children.
- This approach offers improved clinical outcomes and a reduced complication rate compared to surgery with preoperative traction.
- Radiographic outcomes do not differ significantly between the two methods.
Purpose:
To compare one-stage combined surgery with and without preoperative traction, in older children with developmental dislocation of the hip (DDH).
Methods:
Records of 9 children who underwent combined surgery for DDH with preoperative traction in 12 hips (group 1) and 12 undergoing the same procedure without preoperative traction in 16 hips (group 2) were retrospectively reviewed. The surgery consisted of open reduction, Salter's innominate osteotomy and femoral shortening with derotation varus osteotomy. The mean age of the patients at the time of operation was 5.8 years. The mean follow-up period was 5.9 years.
Results:
At final follow-up, clinical outcome in group 1 was worse than that in group 2, though radiographic assessment demonstrated no significant difference between the groups.
Conclusion:
One-stage combined surgery without preoperative traction is effective in the treatment of DDH in older children, and has a lower complication rate, but radiographically the groups did not differ.
