Comparative Study between One or Two Stage Bilateral Open Reduction and Bony Procedures for Neglected Developmental Dysplasia of the Hips
Kirkuk Journal of Medical Sciences,
2014, Volume 2, Issue 1, Pages 7-14
AbstractObjectives: This study aimed at evaluating the surgical management of bilateral developmental dysplasia of the hip (DDH), reducing both sides of the hips in one or two different stages. Patients and Methods: A retrospective sequential comparative study on children with bilateral DDH was carried out in the Azadi Teaching hospital of Kirkuk, in between October 2009 and June 2013. There were two groups of patients. The first group consisted of 10 children (20 hips), with a mean age of 26 months (12-36 months), treated by open reduction of the DDH performing the procedure on each hip at two different occasions. The second group of 13 children with bilateral DDH had a mean age of 26 months (12-48) months, were treated in a single-stage; openely reducing both hips in the same operative session. In the first group in addition to the open reduction of the hips, 8 patients required Salter osteotomy, and 3 patients required femoral shortening in order to achieve concentric stable reduction. In the second group, shortening of four femori, Salter osteotomy of 12 acetabulae was performed for the same purposes. At a mean follow-up of 28 months, clinical and radiological assessment was carried out. Modified McKee and Severin criteria was used, the assessment also included analysis of the operative time, the amount of blood loss and transfusion, duration of analgesia, and record of the complications. Results: There were no significant differences between those who underwent open reduction of the hips with respect to mean age, gender, pre- and postoperative acetabular indices. Mean duration of anaesthesia, analgesia, and the amount of blood transfusion was more in patients of group two compared to group one. Rehabilitation and physiotherapy was needed more in group one. Mean improvement of the acetabular index was 10 degrees in both groups. Conclusion: Single-stage bilateral open reduction of DDH with or without bony surgery in patients with bilateral DDH is safe.
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