Abstract
An open reduction is indicated for those developmental hip dislocations that have failed conservative attempts at reduction including Pavlik harness and closed reduction, or for those children who present initially at an older age. The goal of an open reduction is to remove the obstacles blocking the access of the femoral head to the depths of the acetabulum. Achieving a deep and concentric reduction minimizes the risk of re-dislocation and maximizes future remodeling of the hip joint. The anterior approach is the most common technique used to perform an open reduction. This exposure also allows a pelvic osteotomy to be performed (if necessary) to augment coverage and facilitate acetabular remodeling. A concomitant femoral shortening osteotomy may need to be performed if excessive tension is present at the time of open reduction; doing so reduces the risk of avascular necrosis. In addition, femoral version should be assessed to determine the need for associated femoral derotation.
This is a preview of subscription content, log in via an institution to check access.
References
Galpin RD, Roach JW, Wenger DR, et al. One-stage treatment of congenital dislocation of the hip in older children, including femoral shortening. J Bone Joint Surg Am. 1989;71(5):734–41.
Gholve PA, Flynn JM, Garner MR, Millis MB, Kim YJ. Predictors for secondary procedures in walking DDH. J Pediatr Orthop. 2012;32:282–9.
Haidar RK, Jones RS, Vergroesen DA, et al. Simultaneous open reduction and Salter innominate osteotomy for developmental dysplasia of the hip. J Bone Joint Surg Br. 1996;78(3):471–6.
Holman J, Carroll KL, Murray KA, MacLeod LM, Roach JW. Long term follow-up of open reduction surgery for developmental dislocation of the hip. J Pediatr Orthop. 2012;32:121–4.
Salter RB. Role of innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip in the older child. J Bone Joint Surg Am. 1966;48:1413.
Sankar WN, Neubuerger CO, Moseley CF. Femoral anteversion in developmental dysplasia of the hip. J Pediatr Orthop. 2009;29(8):885–8.
Sankar WN, Young CR, Lin AG, Crow SA, Baldwin KD, Moseley CF. Risk factors for failure after open reduction for DDH: a matched cohort analysis. J Pediatr Orthop. 2011;31:232–9.
Wenger DR, Lee CS, Kolman B. Derotational femoral shortening for developmental dislocation of the hip: special indications and results in the child younger than 2 years. J Pediatr Orthop. 1995;15:768–79.
Zionts LE, MacEwen GD. Treatment of congenital dislocation of the hip in children between the ages of one and three years. J Bone Joint Surg Am. 1986;68(6):829–46.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2021 Springer Science+Business Media, LLC, part of Springer Nature
About this entry
Cite this entry
Sankar, W.N. (2021). Surgical Technique: Anterior Open Reduction for Developmental Dysplasia of the Hip and Salter Innominate Osteotomy. In: Nho, S.J., Asheesh, B., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_31-2
Download citation
DOI: https://doi.org/10.1007/978-1-4614-7321-3_31-2
Received:
Accepted:
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-7321-3
Online ISBN: 978-1-4614-7321-3
eBook Packages: Springer Reference MedicineReference Module Medicine
Publish with us
Chapter history
-
Latest
Surgical Technique: Anterior Open Reduction for Developmental Dysplasia of the Hip and Salter Innominate Osteotomy- Published:
- 08 September 2021
DOI: https://doi.org/10.1007/978-1-4614-7321-3_31-2
-
Original
Surgical Technique: Anterior Open Reduction for Developmental Dysplasia of the Hip and Salter Innominate Osteotomy- Published:
- 04 March 2014
DOI: https://doi.org/10.1007/978-1-4614-7321-3_31-1