The result of open reduction surgery in developmental dysplasia of the hip after the walking

Objective: Particularly adding pelvic osteotomy in treatment of developmental dysplasia of the hip (DDH) in the ages of 1 and 3 years is still controversial. Our goal is to determine the correlation between the failure of acetabular development and the age of treatment with secondary acetabular intervention (SAI) in the 1-3 year-old children who had DDH and treated only with anterior open reduction.Materials and Methods: The study participants consisted of 53 patients (70 hips) with Tönnis grade III and IV DDH who had undergone anterolateral open reduction after walking and followed up at least two years. Patients divided in two groups according to age (18 months younger group I and older group II) in which they had been operated. Groups were compared in terms of radiologic and functional results and the need for SAI. The functional outcomes of cases were evaluated by the modified score system of Trevor (MSST). Secondary acetabular dysplasia and the need for SAI are decided by fracture of Shenton-Menard line, acetabular index of 35 degrees or higher two years after reduction and the upward slope of acetabular sourcil.Results: After a follow-up of 48,9 months on average, radiological and clinical results were noted in group I ( n=29, average age 16,09 months) and group II ( n=41, average age 23,1 months). The results were scored by the MSST. Excellent (79,3%), good (20,7%) results in Group I and excellent (73,2%), good (24,4%), fair (2,4%) results in Group II were obtained. The differences between groups were not significantly meaningful (p>0,05). 11 (37,9%) and 16 (39%) failure of acetabular development were found in Group I and II respectively. There were no differences between two groups with respect to failure of acetabular development and the need for secondary acetabular intervention (p>0,05).Conclusion: There was no difference in treatment between patients with DDH younger than 18 months and those older than 18 months in terms of poor acetabular development and secondary acetabular intervention. According to these results, open reduction which is done before 18 months does not always need acetabular development; in those who underwent surgery after 18 months don't always need secondary acetabular intervention as well. Decision of primary acetabular intervention with open reduction based on the stability not according to patients whether are smaller than 18 months or older than 18 months and every patient should follow up the regarding acetabular development.