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Closed reduction with adductor tenotomy as the method of choice for Developmental Dysplasia Hip: A Retrospective cross-sectional study

. Zahoor Illahi Soomro, Niaz Hussain Keerio, Muhammad Noman Iqbal, Muhammad Khan Pahore, Abdul Rehman Khan and Ghazanfar Ali Shah


Abstract

Aim: To assess the radiographic and clinical evaluations of patients who have developmental hip dysplasia and received adductor tenotomy and closed reduction as treatment.

Study Design: Retrospective Cross sectional study

Place and duration:  This Study was conducted in Peoples University of Medical & Health Sciences Nawabshah, Pakistan from 2018 to 2019

Methodology: The study was performed on 35 individuals with hip dysplasia, who were treated with adductor tenotomy, Spica cast and closed reduction in Peoples University of Medical & Health Sciences Nawabshah, Pakistan during the year of 2018 to 2019.  Inclusion criteria had patients who have a diagnosis of developmental hip dysplasia and are under the age of 2 years. Exclusion criteria had patients who were suffering from disease of connective tissue, acetabulum dysplasia because of specific syndrome, and secondary dislocation because of the previous infection. After surgery, the severity of injuries associated with the subluxation and dislocation of hip joint and hip congruity was evaluated. Radiographic results were observed according to the McKay, Tonnis grading, Severin, and acetabular indices.

Results: It was identified that the preoperative mean acetabular index was dropped from 38.54 ± 2.42 to 26.5 ± 1.98º within two years. According to McKay criteria 57% patients were in the excellent category, and 37% were in the good category. Similarly, 80% patients were graded as Class I and 14% patients were graded as Class II according to the Tonnis grading. It was also observed that femoral head osteonecrosis was present in 2 cases, gait abnormities in 3 cases, and difficulty in sitting was observed in 5 cases.

Conclusion: It was concluded that closed reduction with adductor tenotomy is very successful for the treatment of patients with developmental hip dysplasia.

Keywords: Developmental hip dysplasia, Spica cast, adductor tenotomy, closed reduction

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