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Comparative Study
. 2021 Jan;55(1):28-32.
doi: 10.5152/j.aott.2021.17385.

Open reduction and Salter innominate osteotomy combined with femoral osteotomy in the treatment of developmental dysplasia of the hip: Comparison of results before and after the age of 4 years

Cenk Köroğlu  1 , Emre Özdemir  1 , Mehmet Çolak  1 , Ersin Şensöz  2 , Fehmi Volkan Öztuna  1
Affiliations
Comparative Study

Open reduction and Salter innominate osteotomy combined with femoral osteotomy in the treatment of developmental dysplasia of the hip: Comparison of results before and after the age of 4 years

Cenk Köroğlu et al. Acta Orthop Traumatol Turc. 2021 Jan.

Abstract

Objective: This study aimed to compare the clinical and radiological findings of radical reduction (open reduction and Salter innominate osteotomy combined with femoral osteotomy) for children of walking age, younger and older than 4 years in the treatment of with developmental dysplasia of the hip (DDH).

Methods: In this retrospective study, children of walking age with DDH who underwent radical reduction between 2008 and 2014 were identified. They were then divided into 2 groups according to the age at which the surgery was performed: before and after the age of 4 years. Improvement in the acetabular index was examined on follow-up radiographs. The presence of avascular necrosis (AVN) was determined and classified on the basis of the Kalamchi-MacEwen classification on final follow-up radiographs. Clinical assessment was performed with the modified McKay criteria at the final follow-up appointment.

Results: A total of 19 children (14 girls, 5 boys; mean age=37.5±21 months) (25 hips) were included. Their mean age was 27.9±4.9 and 63.3±19.7 months in children operated before and after the age of 4 years, respectively. The mean follow-up time was 29.9±19 and 19.6±5 months in children operated before and after the age of 4 years, respectively. No significant difference was observed in improvements in the acetabular index between children younger than 4 years (24±6.9°) and those older than 4 years (20.7±6.7°) (p=0.25). According to the modified McKay criteria, all the children younger than 4 years exhibited excellent or good clinical results compared with those operated after the age of 4 years (67%) (p=0.013). At the final follow-up, 64% of all patients demonstrated no radiographical sign of AVN. The rates of AVN were significantly higher in children operated after the age of 4 years (33%) than in those operated before the age of 4 years (19%) (p=0.049).

Conclusion: Better clinical and radiographical results can be expected from radical reduction in children undergoing surgery before the age of 4 years.

Level of evidence: level III, Therapeutic Study.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1. a–d
Figure 1. a–d
Radiographs of a patient (a) preoperative (b) 3 months postoperative (c) right hip 16 and left hip 11 months postoperative (d) right hip 36 and left hip 31 months postoperative
See this image and copyright information in PMC

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References

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