A comparison of the treatment of DDH in the older children by femoral shortening with a) acetabular shelf and b) innominate osteotomy plus shelf

Abstract

Aim: To examine the surgical outcome of 2 different techniques used in the treatment of developmental dislocation of the hip with delayed diagnosis. Materials and methods: The patients were divided into 2 groups based on the technique applied: 21 hips of 18 patients were included in Group 1 and 20 hips of 16 patients were included in Group 2. Initially, all the patients were subjected to femoral osteotomy, shortening, varization and derotation. In Group 1, additionally extra-articular grafting was performed for acetabulum and in Group 2, acetabular osteotomy and extraarticular grafting were performed. The mean age of Group 1 was 8 years, and the mean age of Group 2 was 7 years. Results: The results were evaluated radiologically and clinically. The mean follow-up time was 4 years. In the patients under 7 years of age, successful results were obtained in both groups. Of 7 patients with poor outcome, 6 were older than 7 years of age. Conclusion: The surgical treatment of childhood developmental dislocation of the hip with delayed diagnosis is difficult. However, it can be concluded that, in patients 7 years old or younger with a diagnosis of developmental hip dislocation, the 2 techniques described here are effective.