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ISSN 2007-087X (Print)
Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2016, Number 2

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Rev Mex Ortop Ped 2016; 18 (2)

Is there a difference in the complication rate after reducing hip through a medial or an anterior approach?

Redon TA, Arana CE, Rodríguez BC

Language: Spanish
References: 28
Page: 72-82
PDF size: 297.20 Kb.


ABSTRACT

Introduction: Surgery for dysplastic and dislocated hips can be complicated by necrosis and redislocation no matter what treatment is implemented. Objectives: We sought to determine if there was a difference in the rate of complications for open reduction of the hip through an inguinal approach compared to an anterior approach. Material and methods: A comparative study of two unrelated series of hips which had undergone an open reduction was performed. Group A (95 hips with a mean age of 22.4 months) underwent an inguinal approach and group B (58 hips with a mean age of 12.8 months) underwent an anterior approach. Necrosis was graded using the Kalamchi and McEwen system and redislocation rate was determined on radiographs. Results: The incidence of necrosis in group A was 25.2% whereas in group B it was 24.1%. As far as the severity of necrosis, in group A 84.7% of the cases were graded as type I or II whereas in group B only 28.6% were type I or II. The incidence of redislocation in group A was 5.2%, whereas in group B it was 57%. There was no difference in the age and the rate of complications between the groups (p = 0.31). Conclusion: In our limited series of open reductions of dislocated hips the rate of necrosis was higher when an inguinal approach was used, however the severity was greater when an anterior approach was used. The rate of redislocation was much higher in the group undergoing an anterior approach. The inguinal approach for open reduction of a dislocated hip in our series had a lower rate of complications compared to the anterior approach.


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