OUTCOMES OF TREATMENT OF DEVELOPMENTAL DYSPLASIA

Zein Alabdin Alhraysheh*, Ali Yousef and Safwan Yousef

ABSTRACT

Objective: Evaluating the clinical and radiological outcomes of treatment of Developmental dysplasia of the hip
(DDH) with open reduction and Salter innominate osteotomy at the walking age, over a mean 22.93 months followup.
Additionally, evaluating postoperative complications. Methods: A retrospective analysis of pre-, postoperative,
and last follow-up outcomes was conducted on 27 cases of (DDH) in 24 patients who underwent open
reduction and Salter osteotomy at Tishreen University Hospital between 2018 and 2022. Detailed documentation of
complications such as avascular necrosis, infection, redislocation, and k-wires migration was performed. Results:
The modified McKay clinical criteria indicated that 92.6% of cases were satisfactory, while the modified Severin
radiological criteria indicated that 85.2% of cases were satisfactory. The center edge angle (CEA) measurments
pre-, post-operative, and at the last follow-up, respectively, were 7.33, 25.04, and 23.81. The acetabular index (AI)
measurments pre-, post-operative, and at the last follow-up, respectively, were 33.56, 18.22, and 17.41. In both
(CEA) and (AI), a statistically significant improvement was observed. Shenton's line continuity was restored in
88.9% cases. A femur shortening was required in 11.1% of cases. The study revealed one case of avascular
necrosis, two cases of superficial infection, two cases of K-wire migration, and two cases of re- dislocation that
required a second surgery. Conclusions: Open reduction and Salter innominate osteotomy, is an appropriate
treatment for developmental dysplasia of the hip (DDH) in patients who have been diagnosed after the age of
walking, or who have not responded to previous treatment.

Keywords: Developmental dysplasia of the hip, open reduction, Salter innominate osteotomy, walking age.