The Ilizarov technology for closed reduction of hip dislocation in children with developmental hip dysplasia

Abstract

Introduction The possibility of gradual closed reduction of hip dislocation in children over 1.5 years old is considered doubtful. Purpose Analysis of long-term results of applying the Ilizarov technique of gradual closed reduction in combination with the reconstruction of the hip joint components. Methods The outcomes of treatment of 62 children (81 joints) with congenital hip dislocation in the follow-up period from 5 to 16 years were studied. The treatment method included closed reduction of the dislocation using the technology proposed by G.A. Ilizarov and subsequent reconstruction of the joint components. The patients are divided into two groups based on their age. The first group included 33 patients (43 joints) under the age of 5 years. The second group consisted of 29 patients (38 joints) aged 5–8 years. Results Closed reduction failed in five cases. The recurrence of dislocation after closed reduction was 5.3 %. The rate of aseptic necrosis after closed reduction was 9.7 %. Good functional outcomes were reported in 87.7 %. They were significantly better in the younger group. The proportion of good anatomical results did not depend on age and was 77 % in general. Poor results were obtained in 8.8 %. Conclusion The anatomical and functional outcomes and the number of complications by using the technique described were comparable to other methods of gradual closed reduction of hip dislocation. But the technique we have described expands the age restrictions for its use.

Keywords

• closed reduction
• skeletal traction
• ilizarov technique
• innominate osteotomy
• femoral derotation osteotomy