Should I Plan to Open? Predicting the Need for Open Reduction in the Treatment of Developmental Dysplasia of the Hip.

Journal of Pediatric Orthopedics
Nakul S TalathiWudbhav N Sankar

Abstract

Closed reduction is generally attempted on children under 18 months of age who present as older infants or who fail nonoperative management for developmental dysplasia of the hip (DDH). However, many of these patients will not achieve concentric reduction by closed means and will ultimately require open reduction (OR). Limited evidence exists to predict which patients can be adequately closed reduced versus those who will need open treatment. Prospectively collected data from 4 select centers of an international multicenter study group sharing a common treatment approach were reviewed for all DDH infants under 18 months old that required operative management. Patients were categorized into 2 groups: those whose hips were successfully closed reduced or those who ultimately required OR. Factors were compared between the closed reduction and OR groups for 2 separate cohorts-those presenting early in life with ultrasound (US) data, and those presenting later with radiographic data. A total of 154 patients (166 hips) were included in the analysis. Overall, 87.3% were female. In the early-presenting cohort, purposeful entry multivariate regression revealed that patients with Graf IV hips on US had 3.8 times higher odds of requiring a...Continue Reading

References

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Citations

Sep 3, 2020·Journal of Children's Orthopaedics·Terje Terjesen, Joachim Horn
May 22, 2020·Journal of Orthopaedic Surgery and Research·Guoqiang JiaQun Zhao
Dec 29, 2020·The Journal of Bone and Joint Surgery. American Volume·Lindsay M Andras, Oussama Abousamra

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