Adductor tenotomy versus preliminary traction for prevention of complications of closed reduction of the developmental dysplasia of the hip

الملخص EN

Closed reduction and spica cast application in the treatment of developmental dysplasia of the hip specially before walking age has risk of complications, specially avascular necrosis and redisplacement of the femoral head out of the acetabular socket.

Different measures were tried to improve the outcome of the treatment.

The present study aimed to evaluate the effect of two of these methods (adductor tenotomy and preliminary traction).

Methods: The outcome were retrospectively reviewed after one year from completing the program of treatment.

The patients were divided into two groups: Group 1 were those for whom adductor tenotomy were done before closed reduction and casting, while Group 2 were those for whom preliminary traction done for 3 weeks before closed reduction and casting.

Results: The cases were 223 patients, with 357 affected hips.

The complications occurred in 142 hips (39.8%), 30% developed avascular necrosis and 9.8% end with re-displacement.

In Group 1, those who developed complications were 113 out of 287 (39.3%), while in Group 2, 29 out of 70 hips (41.4%) developed complications.

There was no statistical significant difference between two groups.

Conclusions: There is no clear superiority of either method, adductor tenotomy or preliminary traction, but the former is preferred.

A single measure is not enough to decrease the complications rates.

Combination of different measures may overcome a percent of this complications.