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Medial open reduction of developmental dysplasia of the hip using the Weinstein-Ponseti approach
Cemil Erturk1, Mehmet A Altay, Raci Yarimpapuc
1Department of Orthopedic Surgery, Faculty of Medicine, Harran University, Yenisehir 63100, Sanliurfa, Turkey. erturkc@yahoo.com
Insights
The Weinstein-Ponseti approach effectively treats developmental dysplasia of the hip (DDH) in children up to 16 months. This study found no significant difference in outcomes or avascular necrosis rates when comparing treatment before and after 12 months of age.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Developmental Dysplasia of the Hip
Background:
- Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition.
- Early diagnosis and treatment are crucial for optimal outcomes.
- Medial open reduction is a surgical technique used for DDH treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of the Weinstein-Ponseti approach for medial open reduction in treating DDH.
- To compare treatment outcomes in children younger than 12 months versus those 12 months or older.
Main Methods:
- Retrospective study of 35 hips in 24 children (mean age 10.8 months) treated with medial open reduction.
- Pre-operative radiological assessment using Tonnis grading and acetabular index.
- Clinical and radiographic evaluations post-operatively using McKay and Severin criteria; avascular necrosis assessed by Kalamchi and Mac Ewen classification.
Main Results:
- Average follow-up was 5.6 years.
- Five hips (14.2%) required a second procedure.
- Avascular necrosis (AVN) occurred in 6 hips (17.1%), with similar rates between age groups.
Conclusions:
- The Weinstein-Ponseti approach is effective for DDH treatment up to 16 months of age.
- No significant difference in clinical or radiological outcomes was observed between children treated before or after 12 months.
- The method demonstrates comparable safety and efficacy across the studied age range.
Objective:
To evaluate the efficacy and safety of medial open reduction using the Weinstein-Ponseti approach to treat developmental dysplasia of the hip (DDH).
Methods:
In this retrospective study, 35 hips were treated in 24 children (one boy and 23 girls, mean age 10.8+/-2.82 months, range 6-16 months) in the Department of Orthopedic Surgery, Medical Faculty, Harran University, Sanliurfa, Turkey, between April 1997 and February 2009. We evaluated radiologically the patient's hip pre-operatively using the Tonnis grading system and acetabular index. Group 1 included 13 patients aged younger than 12 months (19 hips) and Group 2 included 11 patients aged 12 months or older (16 hips). Clinical and radiographic evaluations were made according to the McKay and Severin's criteria, respectively. Avascular necrosis (AVN) was evaluated according to the Kalamchi and Mac Ewen's classification.
Results:
The average follow-up period was 5.6 +/-3.1 years (range, 2-12 years). Five hips (14.2%) required a second procedure. Avascular necrosis was observed in 6 hips (17.1%). Clinical and radiological assessments showed that the outcome was not significantly different between the 2 groups. Furthermore, after this follow up period, the rates of AVN were similar.
Conclusion:
Analyzing retrospectively after comparison of this method before and after the age of 12 months, we found no difference between the 2 groups. Children with DDH can be successfully treated by this method up to 16 months.
