Khaled Emara1, Mohamed Ahmed Al Kersh2, Fahad Abdulazeez Hayyawi1. 1. Ain Shams University, 2 A Mourad El Sheraey St., Triumph Square, Heliopolis, Cairo, Egypt. 2. Ain Shams University, 2 A Mourad El Sheraey St., Triumph Square, Heliopolis, Cairo, Egypt. dr_mohamed_ortho@hotmail.com.
Abstract
BACKGROUND: There is no consensus about the duration of post-operative immobilization in the treatment of DDH (developmental dysplasia of hip). Our aim in this study is to compare between two post-operative immobilization protocols for patients undergoing open reduction. MATERIALS AND METHODS: Thirty-eight hips in 32 patients assigned to group A were immobilized in hip spica for four weeks followed by abduction brace application which was gradually weaned through the periods of several months and 29 hips in 24 patients assigned to group B immobilized in hip spica for 12 weeks without further bracing. Both groups were surgically reduced using anterior approach between the ages of 12-24 months. RESULTS: There were non-significant statistical difference between both groups as regards clinical and radiological outcome but there is significant statistical difference as regards AVN (avascular necrosis) on follow-up between both groups. The rate of AVN cannot be related to the method of immobilization, as there are many factors can lead to AVN of the hip as immobilization in an extreme position and tight reduction. CONCLUSION: Group A post-operative immobilization protocol is safer and associated with less complications and more comfortable to the patient and parents than that used in group B. Early removal of hip spica cast and application of hip abduction brace does not increase the rate of re-dislocation. LEVEL OF EVIDENCE: Level III Retrospective comparative study.
BACKGROUND: There is no consensus about the duration of post-operative immobilization in the treatment of DDH (developmental dysplasia of hip). Our aim in this study is to compare between two post-operative immobilization protocols for patients undergoing open reduction. MATERIALS AND METHODS: Thirty-eight hips in 32 patients assigned to group A were immobilized in hip spica for four weeks followed by abduction brace application which was gradually weaned through the periods of several months and 29 hips in 24 patients assigned to group B immobilized in hip spica for 12 weeks without further bracing. Both groups were surgically reduced using anterior approach between the ages of 12-24 months. RESULTS: There were non-significant statistical difference between both groups as regards clinical and radiological outcome but there is significant statistical difference as regards AVN (avascular necrosis) on follow-up between both groups. The rate of AVN cannot be related to the method of immobilization, as there are many factors can lead to AVN of the hip as immobilization in an extreme position and tight reduction. CONCLUSION: Group A post-operative immobilization protocol is safer and associated with less complications and more comfortable to the patient and parents than that used in group B. Early removal of hip spica cast and application of hip abduction brace does not increase the rate of re-dislocation. LEVEL OF EVIDENCE: Level III Retrospective comparative study.
Entities:
Keywords:
Developmental dysplasia of hip; Hip Spica; Open reduction
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