Mid-term Follow-Up after Closed Reduction in Developmental Dysplastic Hips.

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Developmental Dysplasia of the Hip (DDH)

Background:

• Closed reduction with spica casting is the standard treatment for unstable or dislocated developmental dysplastic hips (DDHs).
• Limited data exists on the mid-term outcomes of closed reduction for DDH.

Purpose of the Study:

• To evaluate the mid-term clinical and radiological results of closed reduction and spica casting for developmental dysplastic hips (DDHs).

Main Methods:

• Thirty-one patients (36 hips) with unstable or dislocated DDHs underwent fluoroscopic, contrast-assisted closed reduction and spica casting.
• Clinical and radiological assessments were performed at 2 and 5 years post-treatment.

Main Results:

• No significant differences in acetabular coverage (AC) angle, center-edge angle, or clinical stability were found between successfully treated and healthy hips at 2 and 5 years.
• A significant difference in the AC angle was observed at 2 years between healthy hips and those requiring secondary open reduction (p < 0.001).

Conclusions:

• Closed reduction for DDH yields acceptable mid-term clinical and radiological results.
• The reasons for secondary deterioration and recurrence of dysplasia in some patients require further study.