Yada Bhanu Tej1, Atmananda S Hegde2, Chethan B Shetty2
1Department of Orthopaedics, Russh Hospital, Kamareddy, Telangana, India
2Department of Orthopaedics, Kasturba Medical College, Mangalore; Department of Orthopaedics, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Background: Developmental dysplasia of the hip (DDH) is the second-most common pediatric orthopedic condition in our country. The management of children presenting with DDH in the walking stage is primarily by surgical approach due to the changes in the femoral head, acetabulum, and other soft tissues surrounding the joint. This study evaluated the functional and radiological outcome of children with DDH in the walking age group who underwent open reduction with or without femur or pelvic osteotomy. Materials and Methods: Retro-prospective Cohort Study was conducted in tertiary care hospital. All children underwent open reduction through a standard anterior approach. The hip was reduced, and stability was assessed intraoperatively, and osteotomy was performed. The functional and radiological outcome was assessed at the end of follow-up; various variables which influence the outcome were looked. Chi-square test was used to measure the association between the types of surgery with the outcome, Tonnis grade with the outcome, and these are expressed as frequency and percentage. Results: Sixty-six percent of hips in our study had excellent functional outcomes, 27% had a good outcome. About 68% of hips in our study had excellent, and 2.5% of hips in our study had a poor radiological outcome. Conclusions: The assessment of outcomes suggested that appropriate surgery based on age and intraoperative assessment will give satisfactory functional outcome, irrespective of whether acetabular/femoral procedures are done. The re-surgeries rate in our study was low as all of them had single staged combined surgical intervention.
Keywords: Acetabulum, hip dislocation, hip joint, osteotomy, pediatric hip.