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Risk factors for failed closed reduction in dislocated developmental dysplastic hips

AIM OF THE STUDY: The present study aimed to identify risk factors for unsuccessful CR. INTRODUCTION: Closed reduction (CR) represents the gold standard for treatment of developmental dysplasia of the hip (DDH), but to a minor percentage, it fails to reduce dysplastic hips successfully. METHODS: Sev...

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Autores principales: Walter, Sebastian Gottfried, Endler, Christoph Hans-Jürgen, Remig, Anna Christina, Luetkens, Julian A., Bornemann, Rahel, Placzek, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275556/
https://www.ncbi.nlm.nih.gov/pubmed/32488566
http://dx.doi.org/10.1007/s00264-020-04655-1
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author Walter, Sebastian Gottfried
Endler, Christoph Hans-Jürgen
Remig, Anna Christina
Luetkens, Julian A.
Bornemann, Rahel
Placzek, Richard
author_facet Walter, Sebastian Gottfried
Endler, Christoph Hans-Jürgen
Remig, Anna Christina
Luetkens, Julian A.
Bornemann, Rahel
Placzek, Richard
author_sort Walter, Sebastian Gottfried
collection PubMed
description AIM OF THE STUDY: The present study aimed to identify risk factors for unsuccessful CR. INTRODUCTION: Closed reduction (CR) represents the gold standard for treatment of developmental dysplasia of the hip (DDH), but to a minor percentage, it fails to reduce dysplastic hips successfully. METHODS: Seventy-three dysplastic hips underwent closed reduction and post-interventional MRI of the pelvis. MRIs were evaluated for successful reduction of the hip, volumes of femoral heads, and acetabular diameter. Initial treatment results were correlated to AC angles at two years of follow-up. Contralateral, healthy hips served as control. RESULTS: Out of 73 instable, dysplastic hips, there were nine cases of CR failure. These cases showed significantly increased femoral head volumes (p = 0.002) and a significantly (p = 0.02) larger ratio of femoral head volume to acetabular opening area. There was no significant difference (p = 0.15) in acetabular diameter between both groups. At two years of follow-up, AC angles were significantly (p = 0.003) larger and pathologic in cases of CR failure. CONCLUSION: Exclusive enlargement of the femoral head is a risk factor for unsuccessful reduction and its ratio to the acetabular opening surface is predictive for CR success in DDH.
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spelling pubmed-82755562021-07-20 Risk factors for failed closed reduction in dislocated developmental dysplastic hips Walter, Sebastian Gottfried Endler, Christoph Hans-Jürgen Remig, Anna Christina Luetkens, Julian A. Bornemann, Rahel Placzek, Richard Int Orthop Original Paper AIM OF THE STUDY: The present study aimed to identify risk factors for unsuccessful CR. INTRODUCTION: Closed reduction (CR) represents the gold standard for treatment of developmental dysplasia of the hip (DDH), but to a minor percentage, it fails to reduce dysplastic hips successfully. METHODS: Seventy-three dysplastic hips underwent closed reduction and post-interventional MRI of the pelvis. MRIs were evaluated for successful reduction of the hip, volumes of femoral heads, and acetabular diameter. Initial treatment results were correlated to AC angles at two years of follow-up. Contralateral, healthy hips served as control. RESULTS: Out of 73 instable, dysplastic hips, there were nine cases of CR failure. These cases showed significantly increased femoral head volumes (p = 0.002) and a significantly (p = 0.02) larger ratio of femoral head volume to acetabular opening area. There was no significant difference (p = 0.15) in acetabular diameter between both groups. At two years of follow-up, AC angles were significantly (p = 0.003) larger and pathologic in cases of CR failure. CONCLUSION: Exclusive enlargement of the femoral head is a risk factor for unsuccessful reduction and its ratio to the acetabular opening surface is predictive for CR success in DDH. Springer Berlin Heidelberg 2020-06-01 2020-11 /pmc/articles/PMC8275556/ /pubmed/32488566 http://dx.doi.org/10.1007/s00264-020-04655-1 Text en © The Author(s) 2020, corrected publication 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Walter, Sebastian Gottfried
Endler, Christoph Hans-Jürgen
Remig, Anna Christina
Luetkens, Julian A.
Bornemann, Rahel
Placzek, Richard
Risk factors for failed closed reduction in dislocated developmental dysplastic hips
title Risk factors for failed closed reduction in dislocated developmental dysplastic hips
title_full Risk factors for failed closed reduction in dislocated developmental dysplastic hips
title_fullStr Risk factors for failed closed reduction in dislocated developmental dysplastic hips
title_full_unstemmed Risk factors for failed closed reduction in dislocated developmental dysplastic hips
title_short Risk factors for failed closed reduction in dislocated developmental dysplastic hips
title_sort risk factors for failed closed reduction in dislocated developmental dysplastic hips
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275556/
https://www.ncbi.nlm.nih.gov/pubmed/32488566
http://dx.doi.org/10.1007/s00264-020-04655-1
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