Congenital Hip dislocation: Anterior open reduction and Dega acetabuloplasty
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Developmental dysplasia of the hip (DDH) is a spectrum of deformity ranging from a shallow acetabulum to a fully dislocated hip. Mild dysplasia is generally asymptomatic in childhood and presents in adulthood with pain eventually processing to osteoarthritis.
Ideally fully dislocated hips are identified in the neonatal period when treatment in harness or brace is often effective. If not detected by the standard baby hip checks (Ortolani/Barlow) dislocated hips generally present at around walking age when children present with a limp.
After 12 months of age open surgical reduction is usually necessary and after 18 months a pelvic procedure is often indicated because residual acetabular dysplasia is unlikely to spontaneously resolve.
Readers will also find the following OrthOracle operative techniques of interest:
Medial Approach Open Reduction hip (MAOR)
The Birmingham Interlocking Pelvic (Triple) osteotomy
Proximal femoral varus osteotomy using angled Blade plate fixation
Author: Ed Bache FRCS (Tr & Orth)
Institution: The Birmingham Childrens hospital, Birmingham, UK.
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