| Popis: |
Background Closed reduction (CR) as an initial treatment for developmental hip dysplasia of the hip (DDH) in children aged 24–36 months is debatable; however, it could have better results than open reduction (OR) because it is minimally invasive. The purpose of this study was to evaluate the radiological results in children (24–36 months) with DDH initially treated with CR. Methods Retrospective analysis of initial, subsequent, and final anteroposterior (AP) pelvic radiological records. The International Hip Dysplasia Institute (IHDI) was used to classify the initial dislocations. To evaluate the final radiological results after CR (initial treatment) or additional treatment (CR failed), the Ömeroğlu system was used (6 points excellent, 5 good, 4 fair-plus, 3 fair-minus, ≤2 poor). The degree of acetabular dysplasia was estimated using the initial acetabular index (IAI) and the final acetabular index (FAI), Buchholz-Ogden classification was used to measure avascular necrosis (AVN). Results 98 radiological records were reviewed, including 53 patients (65 hips). Fifteen hips (23.1%) were redislocated and OR with femoral and pelvic osteotomy (13.8%) was the preferred secondary treatment. The IAI vs. FAI was (38.9º ± 6.8º) and (31.9º ± 6.8º), respectively (t = 6.5, p vs. CR 30%, P = 0.003). Unsatisfactory results (≤ 4 points on the Ömeroğlu system) were observed in all hips that required secondary treatment. Conclusions Hips with DDH treated with CR initially had better radiological results than those treated with additional treatments, although with a predominance of regular results (four points) with the Ömeroğlu system. AVN is frequently observed in hips with failed CR. |
