Document Type : Original research
Consultant Orthopaedic Surgeon, Lecturer in College of Medicine - Hawler Medical University, Erbil – Iraq.
Background: Developmental Dysplasia of the hip is common problem, both severe acetabular dysplasia and proximal femoral ante-version are the main pathology that should be managed as early as possible. Treatment of Developmental Dysplasia of the hip (DDH) should be commenced after delivery, during infancy and in very young children because maximum potential for development and remodeling of the acetabulum and proximal femur were encountered up to the age of 4 years. Surgical correction of idiopathic developmental dysplasia of the hip (DDH) is one of the most challenging problems in pediatric orthopedic surgery.
Method and patient: Between June 1994 and December 2018, a total of 626 hips with Developmental Dysplasia were treated according to their age at presentation.
Result: In 110 hips (out of the total 132 hips, underwent surgery) treated by open reduction with or without salter innominate osteotomy, the following results were achieved: A – In all these cases , there was severe degree of femoral ante-version (Intra-operative evaluation) and this was found in 100% of the patients with developmental dysplasia (DDH), especially in those children above 2 years of age. B – Open reduction with Salter Innominate Osteotomy gave excellent results in 72 hips within the age group 18 month-2.5 years. There was no indication for femoral shortening to be performed in these patients – All these hips showed spontaneous correction of extreme degree of femoral ante-version, this was seen in all patients underwent open reduction with or without Salter Osteotomy and there was no need for Derotation Osteotomy in all these children with developmental dysplasia of the hip (DDH) in the age group 18 months-2.5 years.
Conclusions: In all children with developmental dysplasia of the hip younger than 2.5 years of age, there will be spontaneous correction of femoral ante-version and there was no indication for de-rotational osteotomy of the proximal femur even in extreme degree of femoral ante-version.