Evaluation of high cut Dega osteotomy for management of developmental hip dysplasia in children

Abstract

Background: Developmental dysplasia of the hip (DDH) is a spectrum of pathologic changes affect the developing hip. Dega acetabuloplasty is considered one of the favorable reshaping procedures and it is most valuable in severe dysplasia without need for internal fixation. High cut Dega osteotomy is a modification for the typical Dega procedure by making the osteotomy at a higher level close to salter osteotomy. So, it facilitates the basic Dega procedure and produces a Salter-like effect. Objectives: to evaluate theclinical and radiological outcomes of the management of DDH by high cut Dega osteotomy. Patients and Methods: This prospective study included 20 patients with 25 involved hips who presented with DDH between walking age and under 3 years of age, High cut Dega osteotomy were conducted in 13 patients in Abo-Elreesh-Hospital and 7 patients in Qena University Hospital between March 2017 and March 2021. Clinical status was assessed using modified McKay criteria; radiological evaluations were assessed using the modified Severinclassification, the mean acetabular index (AI),and centeredge (CE) angles. Results: The final clinical resultswere satisfactory in 24 hips (96%) and unsatisfactory in one (4%), there was a statistically significant improvement in acetabular index and center edge at the final follow up. Conclusions: Our modified technique gives similar results to the Dega procedure but avoid iatrogenic insults to the acetabulum and rare early closure of the triradiated cartilage, which might lead to acetabular dysplasia.

Keywords

• ddh; high cut dega; pelvic osteotomy