THE COMPLICATIONS OF OPEN REDUCTION AND SALTER INNOMINATE OSTEOTOMY IN THE TREATMENT OF DEVELOPMENTAL DISLOCATION OF THE HIP
Yılmaz TOMAK1, Nevzat DABAK1, Köksal TİLKİ2, Birol GÜLMAN1, T Nedim KARAİSMAİLOĞLU1
1Ondokuz Mayıs Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı
2Sağlık Bakanlığı Ünye Devlet Hastanesi Ortopedi ve Travmatoloji
Keywords: Developmental Dislocation of the Hip, Salter’s Innominate Osteotomy, Open Reduction, Complication.
Abstract
Introduction: The treatment of developmental dislocation of the hip (DDH) is concentric reduction of the hip following by realignment of the femoral head and acetabulum to maintain stability and encourage normal development. Although many methods of treatment of developmental dislocation of the hip have been described, all have complications and failed results.
Patients and methods: We studied on 128 hips of 102 patients, applied open reduction + Salter’s innominate osteotomy for developmental dislocation of the hip. The preoperative, intraoperative and postoperative complications were recorded.
Results: Avascular necrosis was the most frequent complication established in 37 cases (%28.9). We thought that conservative treatment procedures, applied preoperatively, effected the avascular necrosis frequency. It was seen pin migration in 9 cases (7.0%), resubluxation in 6 cases (4.7%), redislocation in 5 cases (3.9%), slippage of graft in 4 cases (3.2%), infection in 3 cases (2.3%), contracture of hip joint in 2 cases (%1.6), ankylosis in 2 cases (1.6%), femur diaphysis fracture in 1 cases (0.8%) and limb length discrepancy in 1 cases (0.8%). The frequency of other complications were correlated with literature.
Conclusion: The combined use of open reduction and Salter’s innominate osteotomy is a technically demanding operation. The most important criteria in avoiding the complications in open reduction and Salter’s innominate osteotomy are surgical experience and accordance with indications, prerequisites and postoperative care principles.