[Persistent dysplasia in preschool children : Dega acetabuloplasty].

OBJECTIVE

Restoration of a congruent, stable, mobile hip joint with normal function.

INDICATIONS: Persistent acetabular dysplasia of congenital or neuromuscular origin in children with still open triradiate cartillage.

CONTRAINDICATIONS: Age under 18 months, closed triradiate cartilage, femoral head deformity.

SURGICAL TECHNIQUE: Incomplete supraacetabular transiliac osteotomy, the correction is performed by reshaping the acetabulum taking advantage of the inherent flexibility of the triradiate cartilage and the periacetabular bone. A triangular bioresorbable xenograft is used to maintain the correction until bony healing.

POSTOPERATIVE MANAGEMENT: Cast immobilization is not necessary, non-weight bearing for 4 weeks after surgery, then full weight bearing.

RESULTS

In all, 31 hips in 20 patients were surgically treated for persistent acetabular dysplasia with the Dega acetabuloplasty. The results were retrospectively studied. The mean age at surgery was 42 months (range 31-67 months). The mean follow-up was 31 months (range 12-60 months). The acetabular angle before surgery measured 31.5° (range 27-44°) and was corrected to 14° (range 8-20°) at last follow-up. All patients showed at last presentation normal hip range of motion and had no complaints. None of the patients had functional restrictions. Severe complications were not observed. Transitory inguinal swelling was observed in only 3 cases in the immediate postoperative period and resolved completely without sequelae.