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[Long-term Follow-up of Acetabular Dysplasia.]
1Ortopedické oddelení, Jindrichův Hradec.
Insights
Acetabular dysplasia without decentration in infants can lead to permanent hip damage. Early diagnosis and re-examination before skeletal maturity are crucial for managing this condition.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Developmental Dysplasia of the Hip
Context:
- Early diagnosis of acetabular dysplasia without decentration is critical.
- Roentgenographic evaluation at 3 months identified ossification defects in the acetabular roof.
- Treatment involved Frejka pillow application from birth or early infancy.
Purpose:
- To evaluate the long-term outcomes of acetabular dysplasia without decentration diagnosed in early infancy.
- To assess the efficacy of early intervention with Frejka pillows.
- To determine if this condition is benign or requires ongoing monitoring.
Summary:
- 111 children diagnosed with acetabular dysplasia without decentration at 3 months were followed until adolescence.
- While initial ossification defects often resolved, some hips developed into shallow acetabula.
- Marked dysplasia (CE angle ≤14°) was found in 2.7% and mild dysplasia (CE angle 15-18°) in 9.46% at final assessment.
Impact:
- Acetabular dysplasia without decentration is not benign and can result in permanent hip damage.
- Hips diagnosed in infancy require re-examination before skeletal maturity.
- Findings emphasize the importance of long-term follow-up for pediatric hip conditions.
Abstract:
Acetabular dysplasia without decentration was established on roentgenograms at 3 months in 111 children. The diagnosis was based on the existence of ossification defects, parcial or total, at the end of the acetabular roof, regardless of the acetabular angle values. All children were treated with Frejka pillow from birth or from 3 months at the latest. The children were followed at irregular intervals with final assessement at the mean age of 10,5 years (9,5 - 19 years). The hips at that time were evaluated according to Wilberg's CE angles. 6 hips (2,70 %) in 5 children were concluded to have a marked acetabular dysplasia with the CE angles of 14 degrees or less (more than 2 SD). A mild dysplasia with angles between 15 to 18 degrees was found in another 21 hips (9,46 %) of 13 children (more than 1 SD). It was observed that all acetabular defects, either parcial or total, seen in infancy disappeared but in some individuals they gradually transformed into shallow acetabula. It is concluded that acetabular dysplasia without decentration found at the age of 3 or 4 months is not to by regarded as a benign affection since some hips treated or not may remain more or less damaged permanently. It is suggested that the hips with this affection found in infancy should be re-examined before maturity. Key words: acetabular dysplasia, roentgen diagnosis, early infancy, adolescence.
