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      Intraoperative medial wall disruption in Dega pelvic osteotomy : Does it effect the radiographic outcome at medium-term?

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          Abstract

          Objectives:

          To compare the radiographic outcomes of our patients who encountered medial wall disruption, with those who did not while undergoing Dega osteotomy.

          Methods:

          We retrospectively reviewed the records of 95 hips with developmental dysplasia of the hip who were treated with Dega pelvic osteotomy. Hips were divided into 2 groups according to medial wall disruption: group A included the hips with medial wall disruption, while group B included the hips without disruption. Preoperative, immediate postoperative, 12 weeks and last follow-up anteroposterior radiographs of the pelvis were reviewed for changes in the acetabular index (AI) between groups.

          Results:

          There were 22 hips in group A and 73 hips in the group B. Preoperative (34.6 versus [vs] 37.2, p=0.231), postoperative (17.9 vs 18.4, p=0.682), 12th week (18 vs 18, p=0.504) and last follow-up (13.3 vs 15.1, p=0.097). The acetabular index measurements were comparable between the groups. Corrections achieved during surgery, and during the follow-up period were also comparable between the two groups, indicating no loss of radiographic correction caused by medial wall disruption. Ninety one percent of the patients in group A and 90% of group B achieved good or excellent results according to the Severin classification ( p=0.944).

          Conclusion:

          Our study shows that disruption of the medial wall did not have a significant detrimental effect on radiographic correction when performing Dega osteotomy.

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          Most cited references34

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          Developmental dysplasia of the hip: What has changed in the last 20 years?

          Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.
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            INNOMINATE OSTEOTOMY IN THE TREATMENT OF CONGENITAL DISLOCATION AND SUBLUXATION OF THE HIP

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              • Abstract: not found
              • Article: not found

              Acetabular index is the best predictor of late residual acetabular dysplasia after closed reduction in developmental dysplasia of the hip

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                Author and article information

                Journal
                Saudi Med J
                Saudi Med J
                smj
                SAMJDI
                Saudi Medical Journal
                Saudi Medical Journal
                0379-5284
                1658-3175
                July 2023
                : 44
                : 7
                : 687-693
                Affiliations
                From the Department of Orthopedics and Traumatology (Danişman), Giresun University, Giresun; from the Department of Orthopedics and Traumatology (Çetik), Sandıklı State Hospital, Afyon; and from the Department of Orthopedics and Traumatology (Tuncay, Yilmaz), Hacettepe University, Ankara,Turkey.
                Author notes
                Address correspondence and reprint request to: Dr. Murat Danşman, Giresun University, Faculty of Medicine, Giresun, Turkey. E-mail: murat.danisman@ 123456yahoo.com
                Author information
                https://orcid.org/0000-0002-7756-7422
                Article
                SaudiMedJ-44-7-687
                10.15537/smj.2023.44.7.20230192
                10370383
                37463700
                66a42b41-50f1-4224-9ee7-7de9e8f8e8b9
                Copyright: © Saudi Medical Journal

                This is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.

                History
                : 18 March 2023
                : 21 June 2023
                Categories
                Original Article

                developmental dysplasia of the hip,dega pelvic osteotomy,intraoperative complications

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