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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2000, Number 5

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Acta Ortop Mex 2000; 14 (5)

Treatment of developmental dysplasia of the hip in the ambulatory age

Alcalde-Galván, Cassis-Zacarías, Castro-N S

Language: Spanish
References: 23
Page: 385-389
PDF size: 37.61 Kb.


ABSTRACT

Through the years numerous authors have emphasized in early detection of the developmental dysplasia of the hip (DDH). However, there is still a high rate of cases diagnosed at beginning of gait, when adaptative changes have already established, e.g. acetabular dysplasia and femoral anteversion and valgus. Remodeling capacity has been lost. In the period between 1972 and 1990, 638 cases of DDH were recorded. Cases associated to other congenital malformations and those inveterate were excluded. A series of 210 patients with 264 hips out of 338 remaining cases are reported here as they were treated in the walking period (61.2%). We divided our cases in four groups: Group I, 96 hips (36.3%) only treated by open reduction; Group II, 129 hips (48.8%), treated by means of open reduction and osteotomy of the iliac; Group III, 11 hips (4.1%), treated by open reduction and femoral osteotomy and Group IV, 28 hips (10.6%), treated by means of a single surgical procedure combining open reduction and osteotomy of the femur and iliac. The results were evaluated according to the clinical approaches of Barret and radiological of Severin. In each one of the groups they were hips that required of a second or third surgical intervention due to the presence of residual deformities or prevalences, for what we evaluate the same groups after the first and last treatment. To the moment of the first evaluation, the best results were in the group IV, and a high percentage of regular and bad results in the groups I, II and III, due to the persistence or relapse of the dislocation; in the final evaluation we found decrease from the bad results when having corrected residual or persistent deformities. Therefore, we believe that a single procedure surgical cocktail is already the best treatment for a pathological complex established and accentuated in the ambulatory therapy, without necessity to undertake the child to multiple surgical interventions, also retarding the period of rehabilitation.


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