Objective: To evaluate the success rate and subsequent
restoration of normal acetabular angle (AC°), and
associated growth changes secondary to avascular
necrosis of the proximal femur in cases of developmental
dysplasia of the hip (DDH) treated during the first six
months of life
Design: Retrospective study from 1998 to 2006
Setting: Department of Pediatric Orthopedics, Altona
Children Hospital, Hamburg, Germany
Subjects: Twenty six patients with twenty nine dysplastic
hips were evaluated regarding grade of hip dysplasia. The
success rate of closed reduction, postoperative restoration
of normal acetabular coverage (AC angle) and associated
complication were noted.
Intervention: Closed reduction of DDH with intraoperative
arthrogram followed by spica cast
Main Outcome Measures: Success rate of closed reduction
and restoration of normal acetabular index.
Results: Closed reduction could be achieved in twenty two hips
(76%). Out of those twenty two hips fifteen (68%) developed
normal acetabular index, six (27%) showed persistent acetabular
dysplasia and one (5%) had border -line measurement.
Closed reduction was not successful in seven hips.
Those seven hips were treated by open reduction and
capsulorrhaphy.
Conclusion: Closed reduction of DDH in the first six
months of life was achieved in (76%) of dislocated hips,
and did not show any significant growth changes in the
proximal femur.
The early changes in the ossific nucleus of capital femoral
epiphysis (CFE) alone were found to be of very little value
in predicting the nature of development of the hip.