IJOCP | April 2014 | Volume 1 | Issue 2 | Page 10
Conference: Poona Orthopaedic Society Annual Conference POSAC- 2014, India [Click for Full details]  

Authors: Samir Desai


Abstract                                                                                                                 

Aims and Objectives – To study the results of closed reduction, and hip spica as a modality of treatment of DDH, therole of arthrogram and the pitfalls in treatment.

Material and Methods:  22 consecutive children with 34 hips diagnosed with DDH were studied. USG was performed at the start of treatment along with X ray. Per cutaneous adductor tenotomy was performed under anaesthesia. Arthrogram was done to delineate the head and confirm the adequacy of reduction. Hip spica was given for 1.5-3 months depending on the instability noted. CT scan was performed in 3 children in whome there was a doubt about reduction.This was followed by use of Pavlik harness for 6-9 month. The results were studied after a minimum period of 1 year.

Results: 10 children with 16 hips were idiopathic, 12 children with 18 hips were non idiopathic (10 arthrogryposis and 2 CP) Male : Female 1:2. Age at surgery was between 1 month and 6 months. Followup was between 1-2.5 years. All children in idiopathic type did well, with well contained femoral head and normal acetabular index. We were not able to reduce 4 hips in 2 children in severe arthrogryposis. It was possible to reduce 14 hips under anaesthesia in non-idiopathic group however hip stability was present in only 4 out of the 14 at last follow up. The other associated findings were CVT, CDK, CTEV and hand deformities.CP was diagnosed in 2 children after 4 months after they demonstrated a delay in milestones. Both showed well reduced hips but a delay in appearance of ossific nucleus.

Conclusion:  Idiopathic DDH did well with closed reduction and hip spica. The results of teratogenic dislocation can be variable with a chance of inadequate reduction or redislocation. The need for open reduction hence needs to be explained to the parents.


How to Cite this Abstract
Desai S. Closed Reduction, Arthrogram And Hip Spica As A Modality Of Treatment Of Dd. I J Orthopaedic Conference Proceedings  April 2014;1(2):10.