Open hip reduction using a novel transarticular suture stabilisation technique in 24 dogs: a retrospective study of technique, outcome and complications.

CASE HISTORY: Medical records of a single private practice (Illinois, USA) were retrospectively reviewed to identify dogs (n = 24) that had an open hip reduction with a transarticular suture stabilisation technique after presenting with a traumatic coxofemoral luxation between April 2003 and December 2018. CLINICAL FINDINGS: Dogs that met the inclusion criteria were of various breeds with a median body weight of 18.1 (min 4.2, max 54.5) kg and mean age at presentation of 6.5 (min 1, max 11) years. The surgical technique, short-term outcome and complications were extracted from the medical records. Long-term (>2 years) follow-up data was obtained by a telephone interview with each owner. TREATMENT AND OUTCOME: All dogs underwent open hip reduction using a novel transarticular suture stabilisation technique. The outcome was reported by owners to be excellent in 18/24 (75%) dogs with full return of limb function. Sixty-six percent (16/24) of owners reported that no lameness was observed 2 months after surgery. No minor complications were noted in this study. The hips of 6/24 (25%) dogs reluxated after surgery (defined as a major complication), which required femoral head and neck excision surgery. CLINICAL RELEVANCE: Open coxofemoral joint reduction using a novel transarticular suture technique is a viable surgical option to consider in dogs that present with a traumatic coxofemoral luxation.

[Treatment recommendations for protracted hip immaturity in infants : Conservative approach versus open reduction]. / Behandlungsempfehlungen bei fortbestehender Säuglingshüftunreife : Konservatives Vorgehen versus offene Reposition.

The healthy upright posture is a result of a continuous maturation process of the locomotor system throughout skeletal growth rendering muscle strength and stability: The hip joint in its central position plays a key role for unimpaired and pain-free gait. Nonetheless, it is also regularly affected by delayed maturation, thus being of special interest for the disease screening procedures of every newborn child. Structured screening examinations in the first 3 postnatal months will ideally detect any dysplasia, therefore simple conservative interventions will usually accelerate the maturation process. Effective hip screening programs in Austria and Germany have reduced the necessity for open surgical hip reductions to a worldwide all-time low. Perinatal risk factor awareness in doctors and parents triggers an increased sensitivity to possible immature hip structures. Nevertheless, severe hip dysplasia in toddlers is regularly presented in pediatric orthopedic centers with or without hip dislocation, mostly due to the delay of or inefficiency of treatment options. This review deals with highly effective strategies for quick treatment and provides a balanced view on conservative and surgical methods.

A National Database Analysis: Does Cold Weather Affect the Surgical Intervention Rate for Developmental Dysplasia of the Hip in Children Under Five Years?

Background Cold weather in the first few months of life may increase the risk of a late diagnosis of developmental dysplasia of the hip (DDH). Early detection of DDH can often be treated non-surgically. The purpose of this study is to observe whether the rates of surgical intervention for DDH differ based on average outdoor temperatures in the winter months. Methods A retrospective observational study of DDH patients diagnosed from 2010 to 2021 was conducted using a national administrative database. Five geographic regions were defined based on the average temperatures in the coldest quarter of the year. The rates of DDH-related surgeries were compared across these temperature regions. Results A total of 55,911 patients ≤5 years old with a DDH diagnosis from 2010 to 2021 were identified in the database. When compared to the warmest region (Group 5), the coldest region (Group 1) had higher rates of open reduction (4.59% vs. 2.06%, p<0.001), adductor tenotomy (6.95% vs. 2.91%, p<0.001), femoral osteotomy (5.75% vs. 2.04%, p<0.001), pelvic osteotomy (5.27% vs. 2.04%, p<0.001), and total DDH surgeries (11.42% vs. 5.03%, p<0.001). Conclusion Children living in states with an average winter temperature of -6.17°C had an increased likelihood of requiring surgical intervention for DDH within the first five years of life.

Outcome of Open Hip Reduction, Pelvic Osteotomy, and Varus Derotational Osteotomy in Children With Cerebral Palsy: A Retrospective Study.

Introduction For spastic hip dislocations, a variety of operations are available with open hip reduction and varus derotational osteotomy of the proximal femur combined with pelvic osteotomy ± adductor release being a good option with favourable outcomes. This study aims to assess the outcome and complications of combined open hip reduction with pelvic osteotomy and varus derotational osteotomy. Methods In this study, 70 hips in 52 patients with spastic hip dislocation due to cerebral palsy were included. All included patients were treated surgically in our institute between January 2016 and December 2021. There were 31 males and 21 females. For each patient, information was collected about the age at the time of surgery and different radiological parameters at three different time intervals: pre-operatively, immediately post-operatively, and at the final follow-up. We also collected information about any complications arising from the surgery performed. Results The mean duration of follow-up was 19.58 months. The acetabular index decreased from an average of 35.01° to 17.18° with a mean difference of 17.83° (p<0.001). The central edge angle, which averaged -49.13° in the pre-operative period, increased to 26.34° and then marginally decreased to 25.47° at the final follow-up. The average migration index of 80.51% in the pre-operative period improved to 1.4% post-operatively with a mean difference of -79.11% (p<0.01). The migration index increased to 8.54% at the final follow-up. Similarly, the neck-shaft angle, which averaged 160.89° in the pre-operative period, decreased to 125.23° at the time of final follow-up with a percentage change of -22.16%. Conclusion Single-stage combined surgery in the form of combined open hip reduction and pelvic osteotomy with varus derotational osteotomy successfully treats the condition and shows good outcomes in patients with spastic hip dislocations. This treatment is associated with very few complications.