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Simultaneous bilateral single-stage combined open reduction and pelvic osteotomy for the treatment of developmental dysplasia of the hip.

07:00 EST 30th December 2019 | BioPortfolio

Summary of "Simultaneous bilateral single-stage combined open reduction and pelvic osteotomy for the treatment of developmental dysplasia of the hip."

Children older than 18 months with developmental dysplasia of the hip (DDH) for the first time or who do not respond to closed treatment require open reduction with/without acetabuloplasty. We determined whether open reduction and pelvic acetabuloplasty using the Pemberton or Dega technique for both hips simultaneously was well tolerated and offered better outcomes. A total of 140 hips of 70 patients with bilateral DDH were identified. All patients were diagnosed after they started walking. Patients were treated with bilateral single-stage open reduction with acetabuloplasty using the Pemberton or Dega procedure. All patients were prospectively followed up between 2007 and 2018. Results were considered satisfactory if the acetabular index was <24°. Hemoglobin levels were evaluated in all patients. At the final follow-up, the results were evaluated radiologically and clinically based on the modified Severin's classification and modified McKay criteria, respectively. The mean age at surgery was 20.3 months (range, 16-24). The mean operative time was 228 minutes. The mean postoperative hemoglobin level was 90.5 g/L (range, 61-122; SD, ±13.4). The mean differences between the preoperative and postoperative acetabular index values for both hips were 22.36° (SD, ±6.69°) and 22.64° (SD, ±6.69°) for the right and left hips, respectively. Open reduction with pelvic acetabuloplasty using the Pemberton or Dega technique simultaneously in both hips was well tolerated, cost-effective, had excellent outcomes, and posed no additional risk to patients with DDH younger than 24 months.

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This article was published in the following journal.

Name: Journal of pediatric orthopedics. Part B
ISSN: 1473-5865
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A complex network of nerve fibers in the pelvic region. The hypogastric plexus distributes sympathetic fibers from the lumbar paravertebral ganglia and the aortic plexus, parasympathetic fibers from the pelvic nerve, and visceral afferents. The bilateral pelvic plexus is in its lateral extent.

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