TREATMENT OF DEVELOPMENTAL DYSPLASIA OF HIP (DDH) USING OPEN REDUCTION THOUGH MEDIAL APPROACH, OUR EXPERIENCE IN ROYAL MEDICAL SERVICES

Ahmed Al Marzouq MD*, Eyas Al Zuqaili MD, Razi Altarawneh MD, Motasem Al Dhoon MD, Deya’a Al Deen Al Rashdan MD and Firas Al Ibraheem MD

ABSTRACT

Objective: To evaluate the outcome and the complications after using medial approach for open reduction of the hip in infants with Developmental Dysplasia of the Hip. Method:This is a retrospective over 36 months from June/2017 to June/2020, on infants operated in Queen Rania Pediatric Hospital and Royal Jordanian Rehabilitation Center under the age of two years with Developmental Dysplasia of the Hip. Fifty children (56 hips), 42 girls and 8 boys. with mean age at operation was 13.2 months (8 to 24) treated with ludloff medial approach and the mean follow-up was 24 months (3 to 36). Results: The acetabular index improved by average 7 degrees in 93%of the operated hips, 78% of the hips were found to good or excellent according to Severin classification, 27% of hips had evidence of AVN, 6% had inferior subluxation which was treated by modifying spica postion,7% needed revision by anterior approach due to persistent instability, 9% had secondary procedure to correct hip coverage, no bleeding or wound complication happened. Conclusion:Open reduction using medial approach is safe method of treatment for Developmental Dysplasia of the Hip below the age of 18 months, good results can be achieved in short term follow up but prolong follow up is still needed to be sure if these results can be maintained in the long run.

Keywords: Developmental Dysplasia of the Hip, DDH, Medial Approach, Acetabular Index.