Treatment perspective after failed open reduction of congenital hip dislocation. A systematic review

Frontiers in Pediatrics

Pediatrics

Sophie Merckaert¹  Pierre-Yves Zambelli² 

[1] Correspondence:;Unit of Pediatric Orthopedics, Department of Women-Mother – Child’s Care, Centre Hospitalier Universitaire Vaudois (CHUV, ), Lausanne, Switzerland;

关键词: avascular necrosis of the femoral head;    congenital hip dislocation;    DDH;    failed open reduction;    revision;   

DOI  :  10.3389/fped.2023.1146332

 received in 2023-01-17, accepted in 2023-07-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundFailure of open reduction of developmental hip dislocation is a serious complication and revision surgery appear to be technically demanding with high complication rates. Little attention has been given in literature to patients in whom open reduction of developmental hip dislocation has failed. We present a systematic review about current perspectives and timing when to perform surgical revision after failed open reduction of developmental hip dislocation in children.MethodsFollowing the recommendations of the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) statements we performed a comprehensive search of the PubMed and Google Scholar bibliographic database in order to select all studies published between 1980 and 2022. Studies were screened for the reasons for failure of open reduction, timing when revision surgery was performed, and for the surgical techniques used for revision.ResultsA total of 10 articles including 252 patients and 268 hips has been recorded. The most common causes of re-dislocation after open reduction are inadequate exposure and failure to release the obstructing soft tissues inside and around the hip. In 90% of the cases the anterolateral approach was performed for revision surgery. Avascular necrosis occurred in 5%–67% of cases and was the most encountered complication.ConclusionRedislocation of developmental hip dislocation after an open reduction has poor long-term outcomes mainly due to a high rate of avascular necrosis of the femoral head. It is mandatory to obtain a stable reduction at the second surgery combining soft tissue release, capsulorrhaphy, pelvic and femoral osteotomies.

【 授权许可】

Unknown   
© 2023 Merckaert and Zambelli.