Abstract:
Background:
Developmental dysplasia of the hip is a challenging surgical problem, there are many controversies regarding its management. Open reduction via medial approach is one of its treatment options.
Patients and methods:
We tried in this study, to identify whether the medial incision of open reduction of developmental dysplasia of the hip is valuable in DDH as regard stability, avascular necrosis, the effect of age and the need for further procedures.
Twenty-five of Children with DDH received within two years needed open reduction through Ludloff’s approach; they were subjected to full assessment including detailed history and clinical examination in addition to radiographic evaluation.
Regarding those patients treated by open reduction, eight were males while seventeen were females, sixteen of them are below one year of age, trials of the closed reduction under general anesthesia with no benefit, so they were operated upon through the medial (Ludloff) approach. All cases selected unilaterally.
Results:
We found that this approach has more easy access to the hip joint, no need for blood transfusion and shorter operating time for each hip in relation to other approaches in the same age group. Serial follows up clinically and radiographically was performed on all patients.
Postoperative complications included six hips with avascular necrosis of femoral head according to Kalmachi and MacEwan classification. No redislocation and infection were recorded.
Conclusion:
This method provides a stable and concentrically reduced hip.
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