Surgical treatment of developmental dysplasia of the hip presenting in children above 10 years

• Published in: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2011-03, Vol.16 (2), p.165-170
• Main Authors: Zheng, Pengfei, Tang, Kai, Lin, Gang, Pan, Xinhua, Zhang, Zhiqun, Lou, Yue, Lee, Robert, Ji, Chenbo
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Child; Child, Preschool; Female; Follow-Up Studies; Hip Dislocation, Congenital - diagnosis; Hip Dislocation, Congenital - physiopathology; Hip Dislocation, Congenital - surgery; Hip Joint - diagnostic imaging; Hip Joint - physiopathology; Hip Joint - surgery; Humans; Male; Medicine; Medicine & Public Health; Original Article; Orthopedics; Osteotomy - methods; Range of Motion, Articular; Retrospective Studies; Rheumatology; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
• ISSN: 0949-2658; 1436-2023
• DOI: 10.1007/s00776-011-0029-3

Management of developmental dysplasia of the hip in older children remains controversial. The objective of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip in children older than 10 years. Sixty-three patients (75 hips) whose mean age at the time of surgery was 11.5 years (range 10–19 years) were treated using Salter osteotomy, Pemberton acetabuloplasty, Dega osteotomy, or Westin osteotomy. Subtrochanter transverse femoral shortening and derotation osteotomy were performed for all patients. A long leg cast, rather than a spica cast, was applied postoperation, and progressive flexion and extension exercises of the hip joint were initiated 2 weeks after the surgery. All 63 patients (75 hips) were followed for an average of 7.6 years (range 5–10 years) after surgery. According to the McKay criteria and Severin X-ray criteria, the fineness ratios were 82.7 and 82.6%, respectively. After surgery, there were 4 cases of semiluxation (6.3%); 4 of femoral head ischemia necrosis (6.3%), and 9 of hip joint stiffness (14.3%). We believe that preoperation overall evaluation and personalized operation plans, experience with the surgical procedure, and commencement of functional exercise soon after the operation are the main reasons for the satisfactory therapeutic effects achieved in this study after surgery for developmental dysplasia of the hip presenting in children older than 10 years.