Acetabular remodeling after graft extrusion, rotation or impaction in Dega and Pemberton acetabuloplasties for developmental dysplasia of the hip
| Autor: | Khalid A. Bakarman, Zulqurnain Rafiq |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Rotation medicine.medical_treatment Acetabuloplasty medicine Internal fixation Humans Orthopedics and Sports Medicine Acetabular index Child Hip Dislocation Congenital Retrospective Studies Impaction business.industry Developmental dysplasia Spica cast Infant Retrospective cohort study Acetabulum University hospital Acetabuloplasties Surgery Osteotomy Radiography Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Developmental Dysplasia of the Hip Female Hip Joint business |
| Zdroj: | Journal of pediatric orthopedics. Part B. 31(4) |
| ISSN: | 1473-5865 |
| Popis: | PURPOSE Traditionally graft displacement following Pemberton and Dega acetabuloplasties involves internal fixation for treatment of developmental dysplasia of hip (DDH). This study was performed to assess the acetabular remodeling by conservative management of graft displacement among patients with DDH. MATERIALS AND METHODS This was a retrospective study of 20 patients 17 (85%) women and 3 (15%) men; mean age 22.90 ± 6.96 months with DDH who underwent Pemberton and Dega acetabuloplasties at King Khalid University Hospital, Riyadh between January 2013 and January 2018. All patients after losing acetabular correction during immediate postoperative period were treated by conservative management. The management involved application of Spica cast for 6 weeks that was trimmed to broomstick cast for an extended period of time and finally replaced by nocturnal abduction brace until normal acetabular index (AI) was achieved. The patients were followed up for a mean period of 44.60 ± 12.36 months. RESULTS Out of the total, 18 (90%) patients with DDH were successfully treated by conservative management. The mean preoperative AI of 43.70° ± 5.91° improved to 21.35o ± 6.32o at the final follow-up (P < 0.001) which was no different when compared to the mean of unaffected hips (19.70o ± 2.96o; P < 0.44). The mean preoperative CEA of all the patients was negative that improved during the conservative treatment to 29.20° ± 10.0° which was no different when compared with the mean of unaffected (31.70° ± 4.64o; P = 0.32) hips at the final follow-up. CONCLUSION Adoption of less aggressive approach for management of displaced, rotated or impacted autograft following acetabuloplasties among children with DDH was not only a useful conservative approach for remodeling of hips but also obviated the need for additional surgical intervention. |
| Databáze: | OpenAIRE |
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