Radiological and clinical outcomes of medial approach open reduction by using two intervals in developmental dysplasia of the hip

Abstract

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.