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Dega pelvic osteotomy: indications, results and complications
PURPOSE: Developmental dysplasia of the hip (DDH) after walking age is difficult to treat. Dega pelvic osteotomy is combined with open reduction and femoral osteotomy to obtain concentric stable reduction with good coverage of the femoral head. The purpose of this study is to evaluate the use of the...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The British Editorial Society of Bone & Joint Surgery
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090189/ https://www.ncbi.nlm.nih.gov/pubmed/30154924 http://dx.doi.org/10.1302/1863-2548.12.180091 |
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author | Czubak, J. Kowalik, K. Kawalec, A. Kwiatkowska, M. |
author_facet | Czubak, J. Kowalik, K. Kawalec, A. Kwiatkowska, M. |
author_sort | Czubak, J. |
collection | PubMed |
description | PURPOSE: Developmental dysplasia of the hip (DDH) after walking age is difficult to treat. Dega pelvic osteotomy is combined with open reduction and femoral osteotomy to obtain concentric stable reduction with good coverage of the femoral head. The purpose of this study is to evaluate the use of the Dega osteotomy in the treatment of DDH in two different age groups. METHODS: A total of 45 patients (52 hips) with a mean age of 3.9 years (1.2 to 12.8) were treated with open reduction, Dega osteotomy and femoral osteotomy. There were 38 dislocated and 14 subluxated hips. Bilateral DDH was observed in seven female patients. Radiographic parameters included acetabular index, centre-edge angle of Wiberg and migration percentage. The final radiographic outcome was evaluated according to the Severin classification. RESULTS: The mean follow-up period was four years (3 to 9). According to the Severin criteria 78.8% were types I or II whereas 21.2% showed types III or IV. There was no statistically significant difference in final outcome between children less than three years of age and older children at the time of surgery. One hip in children with unilateral involvement had developed coxa magna, that interfered with hip concentricity. Three hips (5.8%) showed avascular necrosis of the femoral head. CONCLUSION: Dega osteotomy is a safe and adequate procedure for the management of developmental dysplasia of the hip in walking patients with low complication rates. Restoring the acetabulum to normal or nearly normal can result in good medium-term results. LEVEL OF EVIDENCE: III |
format | Online Article Text |
id | pubmed-6090189 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-60901892018-08-28 Dega pelvic osteotomy: indications, results and complications Czubak, J. Kowalik, K. Kawalec, A. Kwiatkowska, M. J Child Orthop Original Clinical Article PURPOSE: Developmental dysplasia of the hip (DDH) after walking age is difficult to treat. Dega pelvic osteotomy is combined with open reduction and femoral osteotomy to obtain concentric stable reduction with good coverage of the femoral head. The purpose of this study is to evaluate the use of the Dega osteotomy in the treatment of DDH in two different age groups. METHODS: A total of 45 patients (52 hips) with a mean age of 3.9 years (1.2 to 12.8) were treated with open reduction, Dega osteotomy and femoral osteotomy. There were 38 dislocated and 14 subluxated hips. Bilateral DDH was observed in seven female patients. Radiographic parameters included acetabular index, centre-edge angle of Wiberg and migration percentage. The final radiographic outcome was evaluated according to the Severin classification. RESULTS: The mean follow-up period was four years (3 to 9). According to the Severin criteria 78.8% were types I or II whereas 21.2% showed types III or IV. There was no statistically significant difference in final outcome between children less than three years of age and older children at the time of surgery. One hip in children with unilateral involvement had developed coxa magna, that interfered with hip concentricity. Three hips (5.8%) showed avascular necrosis of the femoral head. CONCLUSION: Dega osteotomy is a safe and adequate procedure for the management of developmental dysplasia of the hip in walking patients with low complication rates. Restoring the acetabulum to normal or nearly normal can result in good medium-term results. LEVEL OF EVIDENCE: III The British Editorial Society of Bone & Joint Surgery 2018-08-01 /pmc/articles/PMC6090189/ /pubmed/30154924 http://dx.doi.org/10.1302/1863-2548.12.180091 Text en Copyright © 2018, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Original Clinical Article Czubak, J. Kowalik, K. Kawalec, A. Kwiatkowska, M. Dega pelvic osteotomy: indications, results and complications |
title | Dega pelvic osteotomy: indications, results and complications |
title_full | Dega pelvic osteotomy: indications, results and complications |
title_fullStr | Dega pelvic osteotomy: indications, results and complications |
title_full_unstemmed | Dega pelvic osteotomy: indications, results and complications |
title_short | Dega pelvic osteotomy: indications, results and complications |
title_sort | dega pelvic osteotomy: indications, results and complications |
topic | Original Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090189/ https://www.ncbi.nlm.nih.gov/pubmed/30154924 http://dx.doi.org/10.1302/1863-2548.12.180091 |
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