Outcome of one stage open reduction and salter's osteotomy for Developmental dysplasia of the Hip (ddh) after walking age at French Medical Institute for mothers and Children (FMIC), Kabul, Afghanistan

Abstract

Background: Developmental dysplasia of the Hip (DDH) generally includes subluxation or dislocation of femoral head from acetabulum and acetabular dysplasia. DDH is one of the most common congenital problems and occursin new-borns with different causes such as ligamentous laxity, difficult delivery and postnatal positioning. Estimates of the incidence rate of DDH are 1-2 per 1000 live births. The risk of a second child beingaffected in a family with one child with DDH is approximately 10 times that in the general population.

Objective: The aim of this study is to determine the outcomes of one-stage open reduction and Salter’s osteotomy for Developmental Dysplasia of the Hip (DDH) among children at FMIC. Methodology: A retrospective case series study design was employed. The data was collected from the available records of 150 participants who had undergone one-stage open reduction and Salter’s osteotomy procedures at FMIC hospital at the period of 2011 to 2016. Age of participant was 18-36 months. Majority 112(74.6%) of the participants were female and 38(26.4%) were male. 60 participants (40%) had bilateral DDH, 53(35.3%) had left side and 37(24.7%) were right side. Post operation follow up age was 34.29 months.

Result: In this study the author observed excellent result in 123(82%), good results in 16(10.6%) fair results in 2(1.3%) and poor result in 9(6.1%) patients. Mean difference of pre-operation and post-operation acetabular index was 18.361±5.004 (P-value 0.000).

Conclusion: One-stage open reduction and Salter’s osteotomy was one of the best and effective treatment methods for developmental dysplasia of the hip after walking age. The author strongly support the use of one-stage open reduction and Salter innominate osteotomy at 18 months to 3 years for the treatment of developmental dysplasia of the hip diagnosed late or after failure to respond to previous treatment.

Author(s): Shekaib Rahman Behroz

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