What is the role of pelvic osteotomy in the treatment of developmental dysplasia of the hip (DDH)?

Updated: Feb 26, 2018
  • Author: Junichi Tamai, MD; Chief Editor: William L Jaffe, MD  more...
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Answer

Pelvic osteotomy may be needed for residual hip dysplasia. [48, 75, 76, 77] The recommended timing for the pelvic osteotomy varies among surgeons. Some authors suggest pelvic osteotomy in children as young as 18-24 months, whereas others suggest waiting until the children are at least 4 years old.

If open reduction is performed in a child older than 4 years with significant hip dysplasia, an acetabular procedure should be considered at the time of open reduction. If a closed reduction is performed earlier, at least 12-18 months of acetabular remodeling should be allowed before an acetabular procedure is undertaken. At that time, if no evidence of acetabular modeling is noted, a pelvic osteotomy should be considered.

When open reduction is performed, the patient wears a hip spica cast for 6-12 weeks, then is placed in an abduction orthosis. The length of time for which a child remains in a hip orthosis is quite controversial and depends on the treating physician's experience and on the individual patient.


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