The surgical treatment of developmental dislocation of the hip in older children : A comparative study


Published online: Dec 27 2005

Gunduz Tezeren, Mehmet Tukenmez, Okay Bulut, Sıtkı Percin, Tacettin Cekin

From Cumhuriyet University, Sivas, Turkey

Abstract

The aim of this retrospective study was to compare simultaneous open reduction and Salter innominate osteotomy versus one-stage combined surgical treatment including femoral shortening. A total of 24 patients were studied. Group 1 included 16 hips in 14 patients treated by simultaneous open reduction and Salter innominate osteotomy ; Group 2 included 13 hips in 10 patients treated by one-stage open reduction, Salter innominate osteotomy and femoral shortening. The average age at the time of operation was 4.1 years (range : 3.3 to 5.1). Average follow-up was 5.3 years (range : 2.7 to 9.0). Clinical and radiological assessment at final follow-up showed that the outcome was not significantly different between the two groups. The duration of operation, however, was significant different between the groups. Patients with DDH between 3 and 5 years of age were treated successfully with either simultaneous open reduction and Salter innominate osteotomy or a one-stage combined surgical procedure including femoral shortening. Clinical and radiological outcomes were similar. Nevertheless, after this follow-up period, the rate of avascular necrosis was slightly higher in Group 1 ; on the other hand, one-stage combined surgical treatment including femoral shortening significantly prolonged the operative time.