The Ilizarov technology of closed reduction of hip dislocation in children with developmental hip dysplasia
https://doi.org/10.18019/1028-4427-2021-27-3-345-350
Abstract
Introduction. The possibility of gradual closed reduction of hip dislocation in children over 1.5 years old is considered doubtful.
Purpose. Analysis of long-term results of applying the Ilizarov technique of gradual closed reduction in combination with the reconstruction of the hip joint components.
Methods. The outcomes of treatment of 62 children (81 joints) with congenital hip dislocation in the follow-up period from 5 to 16 years were studied. The treatment method included closed reduction of the dislocation using the technology proposed by G.A. Ilizarov and subsequent reconstruction of the joint components. The patients are divided into two groups based on their age. The first group included 33 patients (43 joints) under the age of 5 years. The second group consisted of 29 patients (38 joints) aged 5–8 years.
Results. Closed reduction failed in five cases. The recurrence of dislocation after closed reduction was 5.3 %. The rate of aseptic necrosis after closed reduction was 9.7 %. Good functional outcomes were reported in 87.7 %. They were significantly better in the younger group. The proportion of good anatomical results did not depend on age and was 77 % in general. Poor results were obtained in 8.8 %.
Conclusion. The anatomical and functional outcomes and the number of complications by using the technique described were comparable to other methods of gradual closed reduction of hip dislocation. But the technique we have described expands the age restrictions for its use.
About the Authors
M. P. Teplenky
Ilizarov National Medical Research Centre for Traumatology and Orthopedics
Russian Federation
Russian Federation
M.D., Ph.D.,
Kurgan
E. V. Oleinikov
Ilizarov National Medical Research Centre for Traumatology and Orthopedics
Russian Federation
Russian Federation
M.D., Ph.D.,
Kurgan
V. S. Bunov
Ilizarov National Medical Research Centre for Traumatology and Orthopedics
Russian Federation
Russian Federation
M.D., Ph.D.,
Kurgan
References
1. Ganger R., Radler C., Petje G., Manner H.M., Kriegs-Au G., Grill F. Treatment options for developmental dislocation of the hip after walking age. J. Pediatr. Orthop. B, 2005, vol. 14, no. 3, pp. 139-150. DOI: 10.1097/01202412-200505000-00001
2. Morin C., Bisogno J., Kulkarni S., Morel G. Treatment of late-presenting developmental dislocation of the hip by progressive orthopedic reduction and innominate osteotomy. Our results with more than 30 years of follow up. J. Child. Orthop., 2011, vol. 5, no. 4, pp. 251-260. DOI 10.1007/s11832-011-0346-2
3. Wicart P., Seringe R., Glorion C., Brassac A., Rampal V. Closed reduction in late-detected developmental dysplasia of the hip: indications, results and complications. J. Child. Orthop., 2018, vol. 12, no. 4, pp. 317-322. DOI 10.1302/1863-2548.12.180088
4. Morel G. The treatment of congenital dislocation and subluxation of the hip in the older child. Acta Orthop. Scand., 1975, vol. 46, no. 3, pp. 364-399.
5. Shevtsov V.I., Makushin V.D., Teplenky M.P., Atmansky I.A. Lechenie vrozhdennogo vyvikha bedra. Novye tekhnologii osteosinteza moduliami apparata Ilizarova [Treatment of congenital dislocation of the hip. New osteosynthesis technologies with the Ilizarov fixator modules]. Kurgan, Zaurale, 2006, 1000 p. (in Russian)
6. Tönnis D. Surgical treatment of congenital dislocation of the hip. Clin. Orthop. Relat. Res., 1990, no. 258, pp. 33-40.
7. McKay D.W. A comparison of the innominate and the pericapsular osteotomy in the treatment of congenital dislocation of the hip. Clin. Orthop. Relat. Res., 1974, no. 98, pp. 124-132. DOI: 10.1097/00003086-197401000-00013
8. Teplenky M.P., Makushin V.D., Chirkova N.G. Zakrytoe vpravlenie vyvikha bedra apparatom Ilizarova u detei doshkolnogo vozrasta [Closed reposition of the hip dislocation using the Ilizarov fixator in children of pre-school age]. Genij Ortopedii, 2011, no. 2, pp. 65-69. (in Russian)
9. Ezirmik N., Yildiz K. Advantages of single-stage surgical treatment with Salter innominate osteotomy and Pemberton pericapsular osteotomy for developmental dysplasia of both hips. J. Int. Med. Res., 2012, vol. 40, no. 2, pp. 748-755. DOI: 10.1177/147323001204000240
10. Guarniero R. Dysplasia of hip development: Update. Rev. Bras. Ortop., 2015, vol. 45, no. 2, pp. 116-121. DOI: 10.1016/S2255-4971(15)30279-2
11. Danielsson L. Late-diagnosed DDH: a prospective 11-year follow-up of 71 consecutive patients (75 hips). Acta Orthop. Scand., 2000, vol. 71, no. 3, pp. 232-242. DOI: 10.1080/000164700317411816
12. Salter R.B., Dubos J.P. The first fifteen year’s personal experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. Clin. Orthop. Relat. Res., 1974, no. 98, pp. 72-103. DOI: 10.1097/00003086-197401000-00009
13. Weinstein S.L., Dolan L.A. Proximal femoral growth disturbance in developmental dysplasia of the hip: what do we know? J. Child. Orthop., 2018, vol. 12, no. 4, pp. 331-341. DOI: 10.1302/1863-2548.12.180070
14. Thomas S.R., Wedge J.H., Salter R.B. Outcome at forty-five years after open reduction and innominate osteotomy for late-presenting developmental dislocation of the hip. J. Bone Joint Surg. Am., 2007, vol. 89, no. 11, pp. 2341-2350. DOI: 10.2106/JBJS.F.00857
15. Rampal V., Sabourin M., Erdeneshoo E., Koureas G., Seringe R., Wicart P. Closed reduction with traction for developmental dysplasia of the hip in children aged between one and five years. J. Bone Joint Surg. Br., 2008, vol. 90, no. 7, pp. 858-863. DOI: 10.1302/0301-620X.90B7.20041
16. Angliss R., Fujii G., Pickvance E., Wainwright A.M., Benson M.K. Surgical treatment of late developmental displacement of the hip. Results after 33 years. J. Bone Joint Surg. Br., 2005, vol. 87, no. 3, pp. 384-394. DOI: 10.1302/0301-620x.87b3.15247
17. Terjesen T., Horn J., Gunderson R.B. Fifty-year follow-up of late-detected hip dislocation: clinical and radiographic outcomes for seventy-one patients treated with traction to obtain gradual closed reduction. J. Bone Joint Surg Am., 2014, vol. 96, no. 4, pp. e28. DOI: 10.2106/JBJS.M.00397
18. Morin C., Rabay G., Morel G. Retrospective review at skeletal maturity of the factors affecting the efficacy of Salter's innominate osteotomy in congenital dislocated, subluxed, and dysplastic hips. J. Pediatr. Orthop., 1998, vol. 18, no. 2, pp. 246-253.
19. Kershaw C.J., Ware H.E., Pattinson R., Fixsen J.A. Revision of failed open reduction of congenital dislocation of the hip. J. Bone Joint Surg. Br., 1993, vol. 75, no. 5, pp. 744-749. DOI: 10.1302/0301-620X.75B5.8376431
20. Morcuende J.A., Meyer M.D., Dolan L.A., Weinstein S.L. Long-term outcome after open reduction through an anteromedial approach for congenital dislocation of the hip. J. Bone Joint Surg. Am., 1997, vol. 79, no. 6, pp. 810-817. DOI: 10.2106/00004623-199706000-00002
21. Baki M.E., Baki C., Aydin H., Ari B., Özcan M. Single-stage medial open reduction and Pemberton acetabuloplasty in developmental dysplasia of the hip. J. Pediatr. Orthop. B, 2016, vol. 25, no. 6, pp. 504-508. DOI:10.1097/BPB.0000000000000360
22. Ning B., Yuan Y., Yao J., Zhang S., Sun J. Analyses of outcomes of one-stage operation for treatment of late-diagnosed developmental dislocation of the hip: 864 hips followed for 3.2 to 8.9 years. BMC Musculoskelet. Disord., 2014, vol. 15, pp. 401. DOI: 10.1186/1471-2474-15-401
23. Schoenecker P.L., Dollard P.A., Sheridan J.J., Strecker W.B. Closed reduction of developmental dislocation of the hip in children older than 18 months. J. Pediatr. Orthop., 1995, vol. 15, no. 6, pp. 763-767. DOI: 10.1097/01241398-199511000-00008
24. Malvitz T.A., Weinstein S.L. Closed reduction for congenital dysplasia of the hip. Functional and radiographic results after an average of thirty years. J. Bone Joint Surg. Am., 1994, vol. 76, no. 12, pp. 1777-1792. DOI: 10.2106/00004623-199412000-00004
25. Olney B., Latz K., Ashner M. Treatment of hip dysplasia in older children with a combined one-stage procedure. Clin. Orthop. Relat. Res., 1998, no. 347, pp. 215-223.
26. Berkeley M.E., Dickson J.H., Cain T.E., Donovan M.M. Surgical therapy for congenital dislocation of the hip in patients who are twelve to thirty-six months old. J. Bone Joint Surg. Am., 1984, vol. 66, no. 3, pp. 412-420.
27. Huang S.C., Wang J.H. A comparative study of nonoperative versus operative treatment of developmental dysplasia of the hip in patients of walking age. J. Pediatr. Orthop., 1997, vol. 17, no. 2, pp. 181-188. DOI: 10.1097/00004694-199703000-00009
28. Haidar R.K., Jones R.S., Vergroesen D.A., Evans G.A. Simultaneous open reduction and Salter innominate osteotomy for developmental dysplasia of the hip. J. Bone Joint Surg. Br., 1996, vol. 78, no. 3, pp. 471-476.
29. Mazloumi M., Omidi-Kashani F., Ebrahimzadeh M.H., Makhmalbaf H., Hoseinayee M.M. Combined Femoral and Acetabular Osteotomy in Children of Walking Age for Treatment of DDH; A Five Years Follow-Up Report. Iran. J. Med. Sci., 2015, vol. 40, no. 1, pp. 13-18.
30. Wang T.M., Wu K.W., Shih S.F., Huang S.C., Kuo K.N. Outcomes of Open Reduction for Developmental Dysplasia of the Hip: Does Bilateral Dysplasia Have a Poorer Outcome? J. Bone Joint Surg. Am., 2013, vol. 95, no. 12, pp. 1081-1086. DOI: 10.2106/JBJS.K.01324
31. Teplenky M.P., Oleinikov E.V. Rekonstruktsiia tazobedrennogo sustava u detei shkolnogo vozrasta s vrozhdennym vyvikhom bedra [Reconstruction of the hip in school-age children with congenital hip dislocation]. Genij Ortopedii, 2013, no. 1, pp. 36-39. (in Russian)
32. Teplenky M.P., Oleinikov E.V., Bunov V.S. Khirurgicheskoe lechenie detei s displaziei tazobedrennogo sustava, oslozhnennoi asepticheskim nekrozom golovki bedrennoi kosti [Surgical treatment of children with the hip dysplasia, complicated by aseptic necrosis of the femoral head]. Ortopediia, Travmatologiia i Vosstanovitelnaia Khirurgiia Detskogo Vozrasta, 2019, vol. 7, no. 1, pp. 25-34. (in Russian)
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For citations:
Teplenky M.P., Oleinikov E.V., Bunov V.S. The Ilizarov technology of closed reduction of hip dislocation in children with developmental hip dysplasia. Genij Ortopedii. 2021;27(3):345-350. https://doi.org/10.18019/1028-4427-2021-27-3-345-350
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