CLINICAL OUTCOMES AND SURGICAL MANAGEMENT OF DEVELOPMENTAL DYSPLASIA OF THE HIP (DDH): A SINGLE-CENTER EXPERIENCE WITH DEGA OSTEOTOMY

Abbas Ali; Mudir Khan; Sikandar Hayat; Rao Erbaz khan; Jawad Ali; Zeeshan khan; Hamza Haroon

doi:10.46903/gjms/24.1.2149

CLINICAL OUTCOMES AND SURGICAL MANAGEMENT OF DEVELOPMENTAL DYSPLASIA OF THE HIP (DDH): A SINGLE-CENTER EXPERIENCE WITH DEGA OSTEOTOMY

Abbas Ali, Mudir Khan, Sikandar Hayat, Rao Erbaz khan, Jawad Ali, Zeeshan khan, Hamza Haroon

Abstract

Background: Developmental Dysplasia of the Hip (DDH) is a significant pediatric orthopedic condition with long-term implications for hip function and mobility. This study aimed to evaluate the clinical outcomes and effectiveness of surgical management, focusing on the Dega osteotomy technique.

Materials & Methods: This retrospective single-center study included 35 patients (49 operated hips) who underwent Dega osteotomy for DDH between January 2020 and December 2024. Demographic, clinical, and surgical data were collected, and functional outcomes were assessed using standardized measures.

Results: The mean age at diagnosis was 1.84 years (±1.2). Dega osteotomy was the most frequently performed procedure (62.9%), often combined with other interventions. Postoperative outcomes were favorable, with 82.9% of patients reporting no or minor pain. Functional outcomes showed that 97.1% of patients did not require mobility support, 77.1% exhibited no limp, and 85.7% could walk unlimited distances. Statistically significant associations were observed between the number of surgeries and hip involvement (p = 0.000), type of harness used (p = 0.032), type of operation (p = 0.016), pain levels (p = 0.042), and walking distance (p = 0.041).

Conclusions: The Dega osteotomy, often combined with other procedures, demonstrated effective surgical management of DDH in this single-center experience. Favorable functional outcomes, including improved mobility and reduced pain, were achieved in the majority of patients. These findings underscore the importance of early diagnosis and tailored interventions to optimize long-term outcomes for DDH patients.

Keywords

Developmental dysplasia of the hip; Dega osteotomy; Surgical management; Functional outcomes; Pediatric orthopedics.

Full Text:

PDF

References

Bakarman K, Alsiddiky AM, Zamzam M, Alzain KO, Alhuzaimi FS, Rafiq Z. Developmental dysplasia of the hip (DDH): etiology, diagnosis, and management. Cureus. 2023;15(8):e43207. https://doi.org/10.7759/cureus.43207

Guarniero R. Dysplasia of hip development: update. Rev Bras Ortop (Engl Ed). 2010;45(2):116–21. https://doi.org/10.1016/S2255-4971(15)30279-2

Pandey RA, Johari AN. Screening of newborns and infants for developmental dysplasia of the hip: a systematic review. Indian J Orthop. 2021;55(6):1388–401. https://doi.org/10.1007/s43465-021-00409-2

Alrashdi N, Alotaibi M, Alharthi M, Kashoo F, Alanazi S, Alanazi A, et al. Incidence, prevalence, risk factors, and clinical treatment for children with developmental dysplasia of the hip in Saudi Arabia: a systematic review. J Epidemiol Glob Health. 2024;14(3):549–60. https://doi.org/10.1007/s44197-024-00217-5

Laskaratou ED, Eleftheriades A, Sperelakis I, Trygonis N, Panagopoulos P, Tosounidis TH, et al. Epidemiology and screening of developmental dysplasia of the hip in Europe: a scoping review. Reports. 2024;7(1). https://doi.org/10.3390/reports7010010

Jaleca PECMR, Liggio DF, Arora S, Lam S, Schaeffer E, Grangeiro PM. Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review. BMJ Open. 2025;15(2):e094660.

Giorgi V, Apostolo G, Bertelè L. Treatment of developmental hip dysplasia with manual therapy following Pavlik harness failure: a case report with long-term follow-up. J Man Manip Ther. 2024;32(3):352–61.

Bakti K, Lankinen V, Helminen M, Välipakka J, Laivuori H, Hyvärinen A. Clinical and sonographic improvement of developmental dysplasia of the hip: analysis of 948 patients. J Orthop Surg Res. 2022;17(1):538. https://doi.org/10.1080/10669817.2024.2349334

Swarup I, Penny C, Dodwell E. Developmental dysplasia of the hip: an update on diagnosis and management from birth to 6 months. Curr Opin Pediatr. 2017;30:1. https://doi.org/10.1097/MOP.0000000000000574

Grudziak J, Ward W. Dega osteotomy for the treatment of congenital dysplasia of the hip. J Bone Joint Surg Am. 2001;83-A(6):845–54.

Badrinath R, Jeffords ME, Bomar JD, Ahmed SI, Pennock AT, Upasani VV. 3D characterization of acetabular deficiency in children with developmental dysplasia of the hip. Indian J Orthop. 2021;55(6):1576–82. https://doi.org/10.1007/s43465-021-00458-7

Patel AH, Kreuzer SW, Sherman WF. Bilateral total hip arthroplasty in the setting of developmental dysplasia of the hip and extreme hip flexion requirements due to phocomelia. Arthroplasty Today. 2021;8:262–7.e1. https://doi.org/10.1016/j.artd.2021.01.005

Çiçekli Ö, Doğan M. Evaluation of surgical outcome in advanced age patients with developmental hip dysplasia. Int J Surg. 2018;52:44–9. https://doi.org/10.1016/j.ijsu.2018.02.020

Tao Z, Wang J, Li Y, Zhou Y, Yan X, Yang J, et al. Prevalence of developmental dysplasia of the hip (DDH) in infants: a systematic review and meta-analysis. BMJ Paediatr Open. 2023;7(1). https://doi.org/10.1136/bmjpo-2023-002080

Goiano EO, Akkari M, Pupin JP, Santili C. The epidemiology of developmental dysplasia of the hip in males. Acta Ortop Bras. 2020;28(1):26–30. https://doi.org/10.1590/1413-785220202801215936

Shaw BA, Segal LS. Evaluation and referral for developmental dysplasia of the hip in infants. Pediatrics. 2016;138(6). https://doi.org/10.1542/peds.2016-3107

Agostiniani R, Atti G, Bonforte S, Casini C, Cirillo M, De Pellegrin M, et al. Recommendations for early diagnosis of developmental dysplasia of the hip (DDH): working group intersociety consensus document. Ital J Pediatr. 2020;46(1):150. https://doi.org/10.1186/s13052-020-00908-2

Lv X, Yu S, Zhang T, Yang X, Xu Y, Li T. The outcome of early screening and treatment of developmental dysplasia of the hip in infants and toddlers in the Northern Guizhou region. Medicine (Baltimore). 2024;103(11):e37540. https://doi.org/10.1097/MD.0000000000037540

Zein A, Khalifa A, Elsherif M, Elbarbary H, Badaway M. Are the outcomes of single-stage open reduction and Dega osteotomy the same when treating DDH in patients younger than 8 years old? A prospective cohort study. J Orthop Traumatol. 2023. https://doi.org/10.1186/s10195-023-00725-3

Shen SP, Kuo CC, Cheng HW, Tsai ML, Yang CY, Lin CL, et al. Breaking barriers: a pediatrician’s perspective on enhancing early diagnosis of developmental dysplasia of the hip. J Formos Med Assoc. 2024. https://doi.org/10.1016/j.jfma.2024.07.008

Liu Y, Yang Y, Ding S. Application of 3D navigation for osteotomy of DDH in children: a systematic review and meta-analysis. Front Pediatr. 2022;10. https://doi.org/10.3389/fped.2022.1021981

Tisherman RT, Hoellwarth JS, Mendelson SA. Systematic review of spica casting for the treatment of paediatric diaphyseal femur fractures. J Child Orthop. 2018;12(2):136–44. https://doi.org/10.1302/1863-2548.12.170201

Khan L, Abdullah M, Ullah U, Haider Z, Roghani AS, Hassan RE, et al. The efficacy of thumb spica casting with or without corticosteroid injection for De Quervain’s tenosynovitis. Cureus. 2024;16(7):e65408. https://doi.org/10.7759/cureus.65408

Ömeroglu H. Treatment of developmental dysplasia of the hip with the Pavlik harness in children under six months of age: indications, results and failures. J Child Orthop. 2018;12(4):308–16. https://doi.org/10.1302/1863-2548.12.180055

Novais E, Kestel L, Carry P, Meyers M. Higher Pavlik harness treatment failure is seen in Graf type IV Ortolani-positive hips in males. Clin Orthop Relat Res. 2016;474. https://doi.org/10.1007/s11999-016-4776-5

DOI: https://doi.org/10.46903/gjms/24.1.2149