Abstract

Aim: Developmental Hip Dysplasia (DDH) refers to a set of abnormalities involving the developing hip. These abnormalities range from mild instability to overt dislocation of the joint. It is important to treat this condition effectively to promote normal development of the hip and achieve good long-term results. Surgical and non-surgical methods are available as treatment methods. The purpose of this article is to share the clinical and radiological results of the patients we treated with closed reduction and casting in our clinic.
Materials and Methods: Radiological and clinical evaluation of 176 hips of 117 patients who applied to İnönü University Faculty of Medicine Department of Orthopedics and Traumatology between January 2010 and October 2017 and were treated with closed reduction and pelvipedal casting was performed retrospectively. Of the 117 patients participating in the study, 12 were boys and 105 were girls. 19 patients had right involvement, 39 patients had left involvement, and 59 patients had bilateral involvement. The patient age range was between 6-22 months. Pre-reduction radiographs of the patients participating in the study were examined, and the dislocation levels of these hips were grouped according to the Tönnis classification. Modified MacKay criteri were used for postoperative clinical evaluation of the patients, and Kalamchi MacEwen criteria were used for radiological evaluation of avascular necrosis. SPSS program (version: 16) was used for statistical evaluation. Student's t-test, and differences with a "p" value of 0.005 were considered statistically significant.
Results:.The average preoperative acetabular index of the operated hips was 35.88 degrees, and the final follow-up acetabular index values were 22.09 degrees. Avascular necrosis was detected in 2 of the patients. According to the modified McKay classification, very good results were obtained in 105 (90%) of 117 patients followed for closed reduction, good results were obtained in 11 (9%), and fair results were obtained in one. From the patients included in the study, 19 patients had right, 39 patients had left and 59 patients had bilateral involvement. In our study group, 74 patients underwent arthrography and 19 patients underwent tenotomy. When closed reduction and pelvipedal plaster application were started, the mean age of the patients was 7,5 (2 - 22) months. Our mean follow-up was 35,7 (9 - 100) months.

Conclusion: This study shows that closed reduction and pelvipedal hip Spica cast application is a simple, reliable, and successful method for patients who do not respond to conservative treatment and that avascular necrosis rates are very low when excessive strain avoided from.

Key words: Keywords: Developmental Hip Dysplasia; Closed Reduction; Pavlik Harness