Closed Reduction, Arthrogram And Hip Spica As A Modality Of Treatment Of Dd
|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
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.|