RISK FACTORS LEADING TO DEVELOPMENTAL COMPLICATIONS AFTER OPEN REDUCTION IN DEVELOPMENTAL DYSPLASIA OF HIP
Abstract
Background: The developmental dysplasia of the hip (DDH) is regarded as one of the commonest congenital deformities. Its incidence has been estimated to be one in 60 live births according to some estimates. Different forms of treatment modalities have been suggested and their success depends on the age of the patient. The study was done with the objectives to observe the post-operative complications of open reduction in patients with DDH and to determine the possible risk factors associated with these complications. Methods: A total of 60 patients were enrolled with DDH in this descriptive cross-sectional study from August 2013 to November 2015. After obtaining an informed consent, the patients underwent open reduction and in some cases, subsequent osteotomy. The patients were followed-up at three months intervals for at least 9 months to look for development of complications, if any. Results: The mean age of the patients was 31.32±2.52 months. Majority 45 (75%) of the study population was female. The most common complication observed was osteonecrosis (5 patients; 8.33%) followed by residual dysplasia and re-dislocation in 3 (5%) patients each. Infection was identified as a complication in 2 (3.33%) patients. When stratified with complications of open reduction, female sex and bilateral hip involvement were found to have a significant association with the development of complications. Conclusion: Female sex and bilateral hip involvement confer a greater risk of developing a complication following open reduction for DDH.References
Graf R. DDH: Diagnosis and Treatment Strategies. In: Bentley G, editor. European Instructional Lectures [Internet]. Berlin, Heidelberg: Springer Berlin Heidelberg; 2009 [cited 2015 Feb 24]. p. 41–6. Available from: http://link.springer.com/10.1007/978-3-642-00966-2_5
Adams F. The genuine works of Hippocrates: Translated from the Greek with a Preliminary Discourse and Annotations, Vol 1, Sydenham society, 1849.
McCarthy JJ, Scoles PV, MacEwen GD. Developmental dysplasia of the hip (DDH). Curr Orthop 2005;19(3):223–30.
Ziegler J, Thielemann F, Mayer-Athenstaedt C, Günther KP. [The natural history of developmental dysplasia of the hip. A meta-analysis of the published literature]. Orthopade 2008;37(6):515–6, 518–24.
Wilkinson JA. A post-natal survey for congenital displacement of the hip. J Bone Joint Surg Br 1972;54(1):40–9.
Salter RB. Etiology, pathogenesis and possible prevention of congenital dislocation of the hip. Can Med Assoc J 1968;98(20):933–45.
Ramsey PL, Lasser S, MacEwen GD. Congenital dislocation of the hip. Use of the Pavlik harness in the child during the first six months of life. J Bone Joint Surg Am 1976;58(7):1000–4.
Getz B. The hip joint in Lapps and its bearing on the problem of congenital dislocation. Acta Orthop Scand Suppl 1955;18:1–81.
Rabin DL, Barnett CR, Arnold WD, Freiberger RH, Brooks G. Untreated congenital hip disease. a study of the epidemiology, natural history, and social aspects of the disease in a navajo population. Am J Public Health Nations Health 1965;55:Suppl:1–44.
Weiner DS. Congenital dislocation of the hip associated with congenital muscular torticollis. Clin Orthop Relat Res 1976;(121):163–5.
Kumar SJ, MacEwen GD. The incidence of hip dysplasia with metatarsus adductus. Clin Orthop Relat Res 1982;(164):234–5.
Kutlu A, Memik R, Mutlu M, Kutlu R, Arslan A. Congenital dislocation of the hip and its relation to swaddling used in Turkey. J Pediatr Orthop 1992;12(5):598–602.
Barlow T. Early diagnosis and treatment of congenital dislocation of the hip. J Bone Joint Surg Br 1962;44(2):292–301.
Sankar WN, Young CR, Lin AG, Crow SA, Baldwin KD, Moseley CF. Risk factors for failure after open reduction for DDH: a matched cohort analysis. J Pediatr Orthop 2011;31(3):232–9.
Chang CH, Kao HK, Yang WE, Shih CH. Surgical results and complications of developmental dysplasia of the hip–one stage open reduction and Salter’s osteotomy for patients between 1 and 3 years old. Chang Gung Med J 2011;34(1):84–92.
Schoenecker P, Lesker P, Ogata K. A dynamic canine model of experimental hip dysplasia. Gross and histological pathology, and the effect of position of immobilization on capital femoral epiphyseal blood flow. J Bone Joint Surg Am 1984;66(8):1281–8.
Salter RB. Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. J Bone Joint Surg Br 1961;43(3):518–39.
Gage JR, Winter RB. Avascular necrosis of the capital femoral epiphysis as a complication of closed reduction of congenital dislocation of the hip. A critical review of twenty years' experience at Gillette Children's Hospital. J Bone Joint Surg Am 1972;54(2):373–88.
Morcuende JA, Meyer MD, Dolan LA, Weinstein SL. Long-term outcome after open reduction through an anteromedial approach for congenital dislocation of the hip. J Bone Joint Surg Am 1997;79(6):810–7.
Suzuki S, Yamamuro T. Avascular necrosis in patients treated with the Pavlik harness for congenital dislocation of the hip. J Bone Joint Surg Am 1990;72(7):1048–55.
Haidar RK, Jones RS, Vergroesen DA, Evans GA. Simultaneous open reduction and Salter innominate osteotomy for developmental dysplasia of the hip. J Bone Joint Surg Br 1996;78(3):471–6.
Ramani N, Patil MS, Mahna M. Outcome of surgical management of developmental dysplasia of hip in children
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
