Mahdi M. Alqarni
Department of Orthopedics, King Saud University, Saudi ArabiaTitle : Simultaneous bilateral single-stage combined open reduction and pelvic osteotomy for the treatment of developmental dysplasia of the hip
Abstract
Children older than 18 months with developmental
dysplasia of the hip (DDH) for the first time or who do not
respond to closed treatment require open reduction with/
without acetabuloplasty. We determined whether open
reduction and pelvic acetabuloplasty using the Pemberton
or Dega technique for both hips simultaneously was well
tolerated and offered better outcomes. A total of 140
hips of 70 patients with bilateral DDH were identified.
All patients were diagnosed after they started walking.
Patients were treated with bilateral single-stage open
reduction with acetabuloplasty using the Pemberton or
Dega procedure. All patients were prospectively followed
up between 2007 and 2018. Results were considered
satisfactory if the acetabular index was <24°. Hemoglobin
levels were evaluated in all patients. At the final follow-up,
the results were evaluated radiologically and clinically
based on the modified Severin’s classification and
modified McKay criteria, respectively. The mean age
at surgery was 20.3 months (range, 16–24). The mean
operative time was 228 minutes. The mean postoperative
hemoglobin level was 90.5 g/L (range, 61–122; SD, ±13.4).
The mean differences between the preoperative and
postoperative acetabular index values for both hips were
22.36° (SD, ±6.69°) and 22.64° (SD, ±6.69°) for the right
and left hips, respectively. Open reduction with pelvic
acetabuloplasty using the Pemberton or Dega technique
simultaneously in both hips was well tolerated, costeffective,
had excellent outcomes, and posed no additional
risk to patients with DDH younger than 24 months. J
Pediatr Orthop B XXX:000–000 Copyright © 2019 Wolters
Kluwer Health, Inc. All rights reserved.