Radiological and clinical outcomes of medial approach open reduction by using two intervals in developmental dysplasia of the hip
Objective: To evaluate the midterm clinical and radiological outcomes of the medial approach using twointervals for developmental hip dysplasia (DDH).Methods: The study involved 62 hips of 47 patients (41 girls, 6 boys) treated with medial approach forDDH from 1999 to 2010. The age of the patients at surgery was 18.7± 2.25 months. Follow up of thepatients was 11.3± 3.07 years. The age of the patients at the last follow up was 12.6 ± 1.74 years.According to the TEURonnis classiŞcation, 13 hips were grade II, 27 hips were grade III and 22 hips weregrade IV. Patients were evaluated according to Omeroglu radiological criteria and modiŞed McKayfunctional criteria. The presence of avascular necrosis (AVN) of the hip was questioned using theKalamchiMacEwen classiŞcation.Results: Radiologically, forty eight (77%) hips were evaluated as"excellent", 8 (13%) hips as "good" and 5(8%) hips as"fair plus" and 1 (%2) hip as "fair minus". Two (3%) patients had type 1 temporary AVN and one(1%) patient had type 4 AVN with coxa magna and overgrowth of the greater trochanter. According toMcKay functional criteria, 56 (90%) hips had"excellent" and 6 (10%) had "good" results. Two (3.2%) hips ofone patient had to be reoperated with Salter osteotomy and femoral shortening? derotation osteotomy.Conclusion: Medial approach using two separate intervals for tenotomy and capsulotomy does notjeopardize the medial circumchildren 18 months old with dysplasia of the hip.Level of evidence: Level IV, therapeutic study.
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1. Ludloff K. Zur blutigen Einrenkung der angeborenen Huftluxation. Z Orthop Chir. 1908;22:272e278.2. Ludloff K. The open reduction of the congenital hip dislocation by an anterior incision. Am J Orthop Surg. 1913;210(3):438e454.
3. Ferguson Jr AB. Primary open reduction of congenital dislocation of the hip using a medial adductor approach. J Bone Joint Surg Am. 1973 Jun;55:67le689.
4. Weinstein SL, Ponseti IV. Congenital dislocation of the hip. Open reduction through a medial approach. J Bone Joint Am. 1979 Jan;61(1):119e124.
5. Tumer Y, Bicimoglu A, Agus H. Surgical treatment of hip dysplasia through the medial approach. Acta Orthop Traumatol Turc. 2007;41(1):31e36.
6. Mankey MG, Arntz GT, Staheli LT. Open reduction through a medial approach for congenital dislocation of the hip. A critical review of the Ludloff approach in sixty-six hips. J Bone Joint Surg Am. 1993 Sep;75(9):1334e1345.
7. Iyetin Y, Turkmen I, Saglam Y, Akcal MA, Unay K, Unsac B. A modified surgical approach of the hip in children: is it safe and reliable in patients with developmental hip dysplasia? J Child Orthop. 2015 Jun;9(3):199e207.
8. Omeroglu H, Uçar DH, Tümer Y. A new, objective radiographic classi fication system for the assessment of treatment results in developmental dysplasia of the hip. J Pediatr Orthop B. 2006 Mar;15(2):77e82.
9. Kalamchi A, MacEwen GD. Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1980;62:876e888.
10. McKay DW. A comparision of the innominate and pericapsular osteotomy in the treatment of congenital dislocation of the hip. Clin Orthop Relat Res. 1974;98: 124e132.
11. Staheli LT. Medial approach open reduction for congenitally dislocated hips: a critical review of forty cases. In: Tachdjian MO, ed. Congenital Dislocation of the Hip. New York: Churchill Livingstone; 1982:295e303.
12. Chiari K. Die operative Behandlung am Huftgelenk bie der angeborenen Huftgelenksverrenkung. Wiener Itied Wochenschr. 1957;107:1020e1023.
13. Mau H, Dorr WM, Henkel L. Open reduction of congenital dislocation of the hip EUR by Ludloff's method. J Bone Joint Surg Am. 1971;53(7):1281e1288.
14. Fisher III EH, Beck PA, Hoffer MM. Necrosis of the capital femoral epiphysis andk medial approaches to the hip in piglets. J Orthop Res. 1991;9:203e208.
15. Kalamchi A, Schmidt TL, MacEwen GD. Congenital dislocation of the hip. Open reduction by the medial approach. Clin Orthop Relat Res. 1982 Sep;169: 127e132.
16. Simons GW. A comparative evaluation of the current methods for open reduction of the congenitally displaced hip. Orthop Clin N Am. 1980 Jan;11(1): 161e181.
17. Konigsberg DE, Karol LA, Colby S, O'Brien S. Results of medial open reduction of the hip in infants with developmental dislocation of the hip. J Pediatr Orthop. 2003 Jan-Feb;23(1):9.
18. Koizumi W, Moriya H, Tuchiya K, et al. Ludloff's medial approach for open reduction of congenital dislocation of the hip: a 20-year follow-up. J Bone Joint Surg Br. 1996 Nov;78(6):924e929.
19. Salter RB. Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. J Bone Joint Surg Br. Aug. 1961;43:518e539.
20. Lalonde FD, Frick SL, Wenger DR. Surgical correction of residual hip dysplasia in two pediatric age-groups. J Bone Joint Surg Am. 2002;84(7):1148e1156.
21. Lempicki A, Wierusz-Kozlowska M, Kruczynski J. Abduction treatment in late diagnosed congenital dislocation of the hip. Follow-up of 1,010 hips treated with the Frejka pillow 1967e76. Acta Orthop Scand Suppl. 1990;236:1e30.
22. Fuentes-Nucamendi MA, Martínez-Bonilla E, Bonfil-Ojeda JR, CamarenaHernandez HP. The Ludloff-Ferguson approach for congenital hip dislocation in children ages 2e4 years. Acta Ortop Mex. 2011 Jan-Feb;25(1):21e26.
23. Yamada K, Mihara H, Fujii H, Hachiya M. A long-term follow-up study of open reduction using Ludloff's approach for congenital or developmental dislocation of the hip. Bone Joint Res. 2014 Jan 7;3(1):1e6.
24. Yamada K, Takahashi K, Enomoto H, Osaki M, Shindo H. Long term outcome of Ludloff's medial approach for open reduction of developmental dislocation of the hip in relation to the age at operation. Int Orthop. 2009 Oct;33(5): 1391e1396.
25. Mallon WJ, Fitch RD. The medial approach to the hip revisited. Orthopedics. 1993 Jan;16(1):39e42.
26. Bicimoglu A, Agus H, Omeroglu H. Six years of experience with a new surgical algorithm in developmental dysplasia of the hip in children under 18 months of age. J Pediatr Orthop. 2003;6:693e698.
- ISSN: 1017-995X
- Başlangıç: 2015
- Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
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