Atilla Cıtlak1, Sertaç Saruhan, Celal Baki. 1. Department of Orthopaedics and Traumatology, School of Medicine, Giresun University, Giresun, Turkey. atillacitlak@yahoo.com
Abstract
INTRODUCTION: Long-term outcome of medial open reduction (MOR) was examined. We aimed to evaluate the effects of MOR on hip development in developmental dysplasia of hip (DDH). METHODS: One hundred and ten hips of 74 patients that admitted to our clinic were evaluated. 15 (20.27 %) were male, 59 (79.73 %) were female. The mean age at the time of MOR was 17.71 ± 7.71 months (range 6-48 months). The mean duration of follow-up was 13.97 ± 4.89 years (range 5-24 years). RESULTS: Radiological results were Severin 1 and 2 in 86.37 % of the hips, Severin 3 in 10.0 % of the hips and Severin 4 in 3.63 % of the hips. Functional results were excellent (94.55 %) or good (5.45 %) according to modified McKay's criteria. When we excluded the hips that underwent additional operations, radiological results were Severin 1 and 2 in 82.05 % of the hips, and Severin 3 and 4 in 17.95 % of the hips. Acetabular angles and ACM, CE, Sharp angles were evaluated at last follow-up. Acetabular development was better in patients that were treated before the age of 18 months. Additional operations were performed to 32 hips (29.09 %). No additional operation was performed to the patients that were treated with MOR before the age of 12 months. The patients that were treated with MOR between 19 and 24 months of age had a higher proportion (47.61 %) for additional operations. Avascular necrosis rate was 17.27 %. Avascular necrosis rate was decreased to 6.3 % when type 1 differences were excluded. Avascular necrosis rate was 12.82 % when the hips that underwent additional operations were excluded. CONCLUSIONS: Medial open reduction is effective and safe treatment method in DDH. Early concentric stable reduction with MOR improved results.
INTRODUCTION: Long-term outcome of medial open reduction (MOR) was examined. We aimed to evaluate the effects of MOR on hip development in developmental dysplasia of hip (DDH). METHODS: One hundred and ten hips of 74 patients that admitted to our clinic were evaluated. 15 (20.27 %) were male, 59 (79.73 %) were female. The mean age at the time of MOR was 17.71 ± 7.71 months (range 6-48 months). The mean duration of follow-up was 13.97 ± 4.89 years (range 5-24 years). RESULTS: Radiological results were Severin 1 and 2 in 86.37 % of the hips, Severin 3 in 10.0 % of the hips and Severin 4 in 3.63 % of the hips. Functional results were excellent (94.55 %) or good (5.45 %) according to modified McKay's criteria. When we excluded the hips that underwent additional operations, radiological results were Severin 1 and 2 in 82.05 % of the hips, and Severin 3 and 4 in 17.95 % of the hips. Acetabular angles and ACM, CE, Sharp angles were evaluated at last follow-up. Acetabular development was better in patients that were treated before the age of 18 months. Additional operations were performed to 32 hips (29.09 %). No additional operation was performed to the patients that were treated with MOR before the age of 12 months. The patients that were treated with MOR between 19 and 24 months of age had a higher proportion (47.61 %) for additional operations. Avascular necrosis rate was 17.27 %. Avascular necrosis rate was decreased to 6.3 % when type 1 differences were excluded. Avascular necrosis rate was 12.82 % when the hips that underwent additional operations were excluded. CONCLUSIONS: Medial open reduction is effective and safe treatment method in DDH. Early concentric stable reduction with MOR improved results.