Evaluation of the Clinical and Radiological Findings of Open Reduction in Developmental Dysplasia of the Hip

Abstract

Background: Developmental dysplasia of the hip (DDH) is a prevalent disease, and the lack of timely treatment has many complications. Proper positioning and its maintenance are very important in terms of treatment success and prognosis. Objectives: The present study aimed to determine the clinical and radiological findings of anterior open reduction in DDH patients. Methods: In this retrospective descriptive-analytical study, 36 DDH patients undergoing open reduction surgery referred to Golestan Hospital, Ahvaz, from 2022 to 2024 were included. Eligible patients underwent clinical and radiological examinations before surgery and at least 9 months after open reduction. Results: The mean age of participants was 34.36 ± 16.34 months. During the clinical evaluation of patients based on McKay’s criteria, excellent, good, and moderate results were seen in 44.44%, 50%, and 5.56%, respectively. The values of the acetabular angle before and after the surgery were 39.67 ± 4.37 and 24.28 ± 5.96, respectively (P = 0.001). The central edge angle (CEA) before and after the operation was 0.39 ± 2.33 and 33.56 ± 8.12, respectively. The results indicate a significant effect of the operation on the CEA. Before open reduction, Tonnis grades 1, 2, 3, and 4 were reported in 2.78%, 19.44%, 5.56%, and 72.22% of patients, respectively. After surgery, all patients had Tonnis grade 1. The incidence of avascular necrosis (AVN) during the minimum follow-up period of 9 months was 2.78%. Conclusions: Open reduction was associated with significant improvements in the Acetabular Index (AI) and CEA. In addition, our findings indicate a low rate of AVN and satisfactory short-term outcomes after open reduction. With open reduction, no re-dislocation was observed. Further multicenter investigations with higher sample sizes and longer follow-up are essential to confirm the results.