Comparison of open reduction alone and open reduction plus Dega osteotomy in developmental dysplasia of the hip

In the treatment of developmental dysplasia of the hip, concentric reduction of the femoral head into the acetabular cavity plays a key role in the natural development of the acetabulum. However, there is still debate on the need for additional acetabular osteotomies and their timing. In this study, we compared open reduction (OR) alone with OR plus Dega osteotomy for acetabular index (AI) development. Twenty patients, 10 in each group, who underwent either OR alone or OR plus Dega osteotomy were studied retrospectively. All patients were diagnosed with developmental dysplasia of the hip and none of them received treatment previously. Preoperative, early postoperative, and follow-up radiographs were gathered, radiological grading was performed according to Tonnis, and AI angles were measured. The OR group had a mean age of 24.5 months, whereas the Dega group had a mean age of 24.8 months. The mean follow-up period of the OR group and Dega group was 57.8 and 66.6 months, respectively. In the OR group, the initial mean AI was 37.5 degrees whereas in the Dega group it was 46 degrees. After the follow-up, despite the acetabular development in the OR group being twice as fast, the final mean AI was 25.5, whereas it was 15.9 in the Dega group. The difference was statistically significant (P<0.05). Using Tonnis' definition, the Dega group ended up with 70% normal hips, 20% mild dysplasia, and 10% severe dysplasia, whereas the OR group had 20% normal hips, 30% mild dysplasia, and 50% severe dysplasia at the final visit. There was no correlation between the initial radiological grading of dislocation and the final result. OR plus Dega osteotomy is a good option to regain acetabular coverage over the femoral head. It provides better radiographic results after a 5-year follow-up period in patients with a mean age of 25 months. OR alone should not be performed unless the child had mildly dysplastic acetabulum according to Tonnis' definition. Level of evidence: Level III, retrospective comparative study.

Yazar Issin, Ahmet
Oner, Ali
Kockara, Nizamettin
Camurcu, Yalkin
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/2274
Tek Biçim Adres 10.1097/BPB.0000000000000227
Konu Başlıkları acetabular index
Dega
dysplasia of the hip
hip
open reduction
pediatric
Tonnis
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
PubMed İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B
Dergi Cilt Bilgisi 25
Dergi Sayısı 1
Sayfalar 1 - 6
Yayın Yılı 2016
Eser Adı
[dc.title]
Comparison of open reduction alone and open reduction plus Dega osteotomy in developmental dysplasia of the hip
Yazar
[dc.contributor.author]
Issin, Ahmet
Yazar
[dc.contributor.author]
Oner, Ali
Yazar
[dc.contributor.author]
Kockara, Nizamettin
Yazar
[dc.contributor.author]
Camurcu, Yalkin
Yayın Yılı
[dc.date.issued]
2016
Yayıncı
[dc.publisher]
LIPPINCOTT WILLIAMS & WILKINS
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
In the treatment of developmental dysplasia of the hip, concentric reduction of the femoral head into the acetabular cavity plays a key role in the natural development of the acetabulum. However, there is still debate on the need for additional acetabular osteotomies and their timing. In this study, we compared open reduction (OR) alone with OR plus Dega osteotomy for acetabular index (AI) development. Twenty patients, 10 in each group, who underwent either OR alone or OR plus Dega osteotomy were studied retrospectively. All patients were diagnosed with developmental dysplasia of the hip and none of them received treatment previously. Preoperative, early postoperative, and follow-up radiographs were gathered, radiological grading was performed according to Tonnis, and AI angles were measured. The OR group had a mean age of 24.5 months, whereas the Dega group had a mean age of 24.8 months. The mean follow-up period of the OR group and Dega group was 57.8 and 66.6 months, respectively. In the OR group, the initial mean AI was 37.5 degrees whereas in the Dega group it was 46 degrees. After the follow-up, despite the acetabular development in the OR group being twice as fast, the final mean AI was 25.5, whereas it was 15.9 in the Dega group. The difference was statistically significant (P<0.05). Using Tonnis' definition, the Dega group ended up with 70% normal hips, 20% mild dysplasia, and 10% severe dysplasia, whereas the OR group had 20% normal hips, 30% mild dysplasia, and 50% severe dysplasia at the final visit. There was no correlation between the initial radiological grading of dislocation and the final result. OR plus Dega osteotomy is a good option to regain acetabular coverage over the femoral head. It provides better radiographic results after a 5-year follow-up period in patients with a mean age of 25 months. OR alone should not be performed unless the child had mildly dysplastic acetabulum according to Tonnis' definition. Level of evidence: Level III, retrospective comparative study.
Açıklama
[dc.description]
WOS: 000365714200001
Açıklama
[dc.description]
PubMed: 26352104
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Konu Başlıkları
[dc.subject]
acetabular index
Konu Başlıkları
[dc.subject]
Dega
Konu Başlıkları
[dc.subject]
dysplasia of the hip
Konu Başlıkları
[dc.subject]
hip
Konu Başlıkları
[dc.subject]
open reduction
Konu Başlıkları
[dc.subject]
pediatric
Konu Başlıkları
[dc.subject]
Tonnis
Haklar
[dc.rights]
info:eu-repo/semantics/closedAccess
ISSN
[dc.identifier.issn]
1060-152X
ISSN
[dc.identifier.issn]
1473-5865
İlk Sayfa Sayısı
[dc.identifier.startpage]
1
Son Sayfa Sayısı
[dc.identifier.endpage]
6
Dergi Adı
[dc.relation.journal]
JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B
Dergi Sayısı
[dc.identifier.issue]
1
Dergi Cilt Bilgisi
[dc.identifier.volume]
25
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.1097/BPB.0000000000000227
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/2274
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
218
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
11 Haziran 2024 07:02
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Tıklayınız
dysplasia acetabular months whereas follow-up osteotomy Tonnis patients development normal severe definition acetabulum reduction femoral developmental according performed grading treatment initial degrees radiological period statistically retrospective significant evidence difference comparative dysplastic radiographic better provides coverage
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