Predictive Radiographic Factors in DDH Management

ObjectivesThis study aims to assess the value of certain radiographic features of the pelvis associated with developmental dysplasia of the hip (DDH), in predicting the method of treatment; whether conservative or operative, in patients between 12 and 24 months of age where both options are valid.MethodsA retrospective review of the radiographs and the clinical files of children diagnosed with DDH during their second year of life (mean age 18.2 months), including only children who had a follow up of clinically and radiologically for a minimum of 5 years. The initial plain AP pelvic radiograph before commencing any treatment was used to measure 12 different measurements and 2 ratios. Each radiograph was studied individually and blindly, without knowing to which group of patients it belonged.ResultsA total of 72 dislocated hips in 54 patients were studied. The mean, standard deviation and P. values of age and radiographic measurements were calculated. Patients were divided into 2 groups according to the treatment modality used whether conservative or operative then they were compared. The measurement of the width of the femoral head ossific nucleus was significantly higher in the conservative group. The measurements of lateralization, superior migration of the femoral head and the acetabular angle were found to be significantly higher in the operative group.ConclusionStudy results suggest the possibility of using specific radiographic measurements in patients with DDH during the second year of life to determine the most feasible way of management.