One-stage bilateral open reduction using the anterior iliofemoral approach in developmental dysplasia of the hip


Published online: Jun 27 2014

Mehmet GEM, Hüseyin ARSLAN, Emin ÖZKUL, Celil ALEMDAR, ?brahim AZBOY, Abdullah DEMIRTA?

From Dicle University Medical Faculty, Diyarbakir, Turkey

Abstract

The aim of this study was to investigate the safety of one-stage bilateral open reduction using the anterior approach in the treatment of patients with bilateral ToÅNnnis Type III and IV Developmental Dysplasia of the Hip (DDH). Forty-six patients were retrospectively evaluated. Thirty-eight were female, eight were male. The mean age was 16.63 (11-29) months. The mean follow-up period was 27.18 (12-65) months. The mean hospitalization period after surgery was 1.91 (1-5) days. The mean pre-operative hematocrit level was 35.14% (28.1-44.1) and the mean pre-operative hemoglobin level was 11.75 g/dl (9.3-13.6). The mean post-operative hematocrit level was 32.54% (26.7- 40.4) and the mean post-operative hemoglobin level was 10.80 g/dl (8.78-12.3). None of the patients required blood transfusion. The mean anesthesia duration was 133.30 (95-180) minutes, and the mean operation duration was 107.58 (70-145) minutes. According to the modified scoring system by Trevor et al, excellent results were obtained in 66 hips of 46 patients (71.8%), and good results were obtained in 26 hips (28.2%). Twenty two hips (23.91%), which developed acetabular dysplasia in the follow-up period required a secondary acetabular intervention. According to the Kalamchi and MacEwen classification, Type I avascular necrosis developed in ten hips, Type II in one hip, and Type IV in two hips. One-stage bilateral open reduction using the anterior iliofemoral approach in ToÅNnnis Type III and IV DDH at walking age is a safe, time-saving treatment method that shortens the hospitalization and immobilization periods.