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. 2021 Oct 23;55(6):1490-1502.
doi: 10.1007/s43465-021-00550-y. eCollection 2020 Dec.

Narrative Review of Complications Following DDH Treatment

Raghav Badrinath  1 , Caitlin Orner  1 , James D Bomar  1 , Vidyadhar V Upasani  1
Affiliations

Narrative Review of Complications Following DDH Treatment

Raghav Badrinath et al. Indian J Orthop. .

Abstract

Background: The purpose of this narrative review was to survey the literature for common complications following treatment of DDH in children less than 4 years old.

Methods: The Pubmed database was queried. Search result titles were reviewed to identify papers that were pertinent to the topic. Abstracts for these papers were obtained and read, and a subset of these were selected for review of the complete manuscript.

Results: 92 manuscripts were reviewed. Residual dysplasia, redislocation, and osteonecrosis are the primary complications of treatment in this age group. In the long term, hips without complications related to DDH treatment tend to do well, although a significant percentage of them will inevitably require joint replacement surgery.

Conclusion: Although there is excellent potential for a good outcome when DDH is diagnosed and treated under age 4 years, osteonecrosis continues to be a concern with all treatment methods. A subset of patients from this young cohort will continue to have residual dysplasia or recurrent dislocation requiring return to the operating room.

Keywords: Complications; DDH less than 4 years old; Developmental dysplasia of the hip.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram indicating manuscript selection
Fig. 2
Fig. 2
A Four-month-old first-born female with an Ortolani positive left hip, treated with a Pavlik harness. B After 3.3 weeks of Pavlik harness use, the hip remained IHDI III. C At 5.8 months of age an open reduction via medial approach was performed along with an adductor and psoas release. D At 6 weeks post open reduction, the hip remains reduced with significant dysplasia. E AP and F frog lateral view at age 2.5 years
Fig. 3
Fig. 3
A AP and frog lateral view of a 13.8-month-old female with an IHDI IV left hip. B She was treated with open reduction and femoral shortening. C Three months post open reduction. D 1.4 years post open reduction, AVN is present. E 2.2 years post open reduction, residual dysplasia and femoral head deformity. F At 3.6 years of age she underwent a Salter osteotomy and varus derotational osteotomy. G 3.7 months post Salter procedure. H AP and frog lateral at 5.5 years post Salter osteotomy
Fig. 4
Fig. 4
A A 1.6-month-old female with a Barlow positive right hip and dislocated and irreducible left hip treated with a Pavlik harness. B After 3.5 months of brace wear the left hip failed to reduce. C A closed reduction was attempted at age 4.9 months, this failed and was converted to an open reduction via medial approach with a adductor and psoas release as well as a capsulorrhaphy. D AP and frog 8.5 months post open reduction. E 20 months post open reduction
Fig. 5
Fig. 5
A A 3-year-old female with bilateral hip dislocations. B She was treated with bilateral open reduction and femoral shortening procedures. C The right hip was found to be dislocated posteriorly and was taken back to the operating room and a repeat open reduction was performed, along with a capsulorrhaphy and the hip we held in place with a k-wire. D Six weeks post k-wire fixation. E Six months post k-wire fixation. F AP and frog lateral X-ray 3 years post k-wire fixation
See this image and copyright information in PMC

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