Clinical And Radiological Results Of Ludloff Medial Open Reduction Technique In Patients Wıth Developmental Hip Dysplasia

Abstract

Aim: The aim of this study was to evaluate the clinical and radiological results of Ludloff medial open reduction surgery in patients with the developmental of hip dysplasia, younger than 18 months old. Methods: The radiological and clinical results of 35 patients (49 hips), younger than 18 months of age treated with Ludloff medial approach due to DDH between the years 2013 and 2020 were retrospectively evaluated. Preoperative, final control acetabular index angles and medial apertures were measured according to the McCay criteria, Tönnis classification, Kalamchi-MacEwen classification, IHDI classification and Severin classification were analysed. Results: At the last control, the youngest age was 27 months, the oldest was 88 months and the mean age was 43.90 ± 14.17 months. The follow-up period was performed at a minimum age of 12 months, a maximum age of 72 months, and the mean follow-up period was 24.81 ± 17.17 months. According to the Tönnis classification, 40 hips were Tönnis classification type 1 (81.63%), 4 hips were Type 2 (8.16%), 3 hips were Type 3 (6.12%) and 2 hips were Type 4 (4.08%) in the follow-up visit. According to McCay clinical evaluation criteria, 38 hips (79.59%) were grade 1 which equates to excellent results. Grade 0 (no necrosis) was detected in 38 (77.55%) of 49 hips according to the Kalamchi and MacEwen AVN clinical evaluation criteria. According to the Severin classification, type 1 results were observed in 32 (65.31%) of 49 hips, type 2 in 9 hips (18.37%), type 3 in 1 hip (2.04%) and type 4 in 7 hips (14.29%). The mean CE angle was found to be 18.56 ± 9.93. Additional surgical intervention was required in 8 hips of 6 patients. Conclusion: Clinically and radiologically satisfactory results were obtained in DDH patients with Ludloff medial open reduction technique, below the age of 18 months.