Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction
Background Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH). Objective To review a single institutional experience with post-spica MRI in children undergoing closed or...
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| Veröffentlicht in: | Pediatric radiology 2018-08, Vol.48 (8), p.1096-1100 |
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| creator | Jadhav, Siddharth P. More, Snehal R. Shenava, Vinitha Zhang, Wei Kan, J. Herman |
| description | Background
Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH).
Objective
To review a single institutional experience with post-spica MRI in children undergoing closed or open hip reduction and describe the utility of MRI in directing the need for re-intervention.
Materials and methods
Seventy-four patients (52 female, 22 male) who underwent post-spica hip MRI over a 6-year period were retrospectively reviewed. One hundred and seven hips were included. Data reviewed included age at intervention, gender, type of intervention performed, MRI findings, the need for re-intervention and the interval between interventions. Gender was compared between the closed and open reduction groups via the Fisher exact test. Age at the first procedure was compared via the Wilcoxon rank test. Rates of re-intervention after closed and open reduction were calculated and the reasons for re-intervention were reviewed.
Results
The mean age at the time of the first intervention was 16.4 months (range: 4 to 63 months). Mean age for the closed reduction group was 10.5 months (range: 4–24 months) and for the open reduction group was 23.7 months (range: 5–63 months), which was significant (
P
-value |
| doi_str_mv | 10.1007/s00247-018-4143-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2031421325</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2030543084</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-6d867044f767d28c3b93c13435aa2e9711465aa1bf5133609eebcb16839ae94f3</originalsourceid><addsrcrecordid>eNp1kUFv1DAQhS0EotvCD-CCLHHhkjJje-OYG6poqVRUqaJny0km4CqJg-2stP8eb7eAhMRpLM33nmfmMfYG4RwB9IcEIJSuAJtKoZKVfsY2pYoKjWmesw1IwAqUMifsNKUHAJBblC_ZiTC1qRXChvX32Y8-73kYuJ8m6r3LxJeQclgouux3xH_4hX-9u-Z-5j3taAzLRHN242Oj36dldMm7j7wbQ6Ke79I5L-KZR-rXLvswv2IvBjcmev1Uz9j95edvF1-qm9ur64tPN1UntchV3Te1LuMOuta9aDrZGtmhVHLrnCCjEVVdntgOZQtZgyFquxbrRhpHRg3yjL0_-i4x_FwpZTv51NE4upnCmqwAiUqgFNuCvvsHfQhrnMt0Bwq2SkKjCoVHqoshpUiDXaKfXNxbBHuIwB4jsCUCe4jA6qJ5--S8tuWefxS_b14AcQRSac3fKf79-v-uvwAh7pBm</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2030543084</pqid></control><display><type>article</type><title>Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Jadhav, Siddharth P. ; More, Snehal R. ; Shenava, Vinitha ; Zhang, Wei ; Kan, J. Herman</creator><creatorcontrib>Jadhav, Siddharth P. ; More, Snehal R. ; Shenava, Vinitha ; Zhang, Wei ; Kan, J. Herman</creatorcontrib><description>Background
Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH).
Objective
To review a single institutional experience with post-spica MRI in children undergoing closed or open hip reduction and describe the utility of MRI in directing the need for re-intervention.
Materials and methods
Seventy-four patients (52 female, 22 male) who underwent post-spica hip MRI over a 6-year period were retrospectively reviewed. One hundred and seven hips were included. Data reviewed included age at intervention, gender, type of intervention performed, MRI findings, the need for re-intervention and the interval between interventions. Gender was compared between the closed and open reduction groups via the Fisher exact test. Age at the first procedure was compared via the Wilcoxon rank test. Rates of re-intervention after closed and open reduction were calculated and the reasons for re-intervention were reviewed.
Results
The mean age at the time of the first intervention was 16.4 months (range: 4 to 63 months). Mean age for the closed reduction group was 10.5 months (range: 4–24 months) and for the open reduction group was 23.7 months (range: 5–63 months), which was significant (
P
-value <0.0001). Of the 52 hips that underwent closed reduction, 16 (31%) needed re-intervention. Of the 55 hips that underwent open reduction, MRI was useful in deciding re-intervention in only 1 (2%). This patient had prior multiple failed closed and open reductions at an outside institute.
Conclusion
Post intervention hip spica MRI is useful in determining the need for re-intervention after closed hip reduction, but its role after open reduction is questionable.</description><identifier>ISSN: 0301-0449</identifier><identifier>EISSN: 1432-1998</identifier><identifier>DOI: 10.1007/s00247-018-4143-7</identifier><identifier>PMID: 29696410</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Bone dysplasia ; Casts, Surgical ; Child, Preschool ; Children ; Female ; Hip ; Hip Dislocation, Congenital - diagnostic imaging ; Hip Dislocation, Congenital - surgery ; Hip Dislocation, Congenital - therapy ; Hip joint ; Humans ; Imaging ; Infant ; Intervention ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine & Public Health ; Musculoskeletal diseases ; Neuroradiology ; NMR ; Nuclear magnetic resonance ; Nuclear Medicine ; Oncology ; Original Article ; Orthopedic Procedures - methods ; Pediatrics ; Postoperative Complications - diagnostic imaging ; Radiology ; Retreatment ; Retrospective Studies ; Surgery ; Treatment Outcome ; Ultrasound</subject><ispartof>Pediatric radiology, 2018-08, Vol.48 (8), p.1096-1100</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>Pediatric Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-6d867044f767d28c3b93c13435aa2e9711465aa1bf5133609eebcb16839ae94f3</citedby><cites>FETCH-LOGICAL-c372t-6d867044f767d28c3b93c13435aa2e9711465aa1bf5133609eebcb16839ae94f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00247-018-4143-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00247-018-4143-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29696410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jadhav, Siddharth P.</creatorcontrib><creatorcontrib>More, Snehal R.</creatorcontrib><creatorcontrib>Shenava, Vinitha</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Kan, J. Herman</creatorcontrib><title>Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction</title><title>Pediatric radiology</title><addtitle>Pediatr Radiol</addtitle><addtitle>Pediatr Radiol</addtitle><description>Background
Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH).
Objective
To review a single institutional experience with post-spica MRI in children undergoing closed or open hip reduction and describe the utility of MRI in directing the need for re-intervention.
Materials and methods
Seventy-four patients (52 female, 22 male) who underwent post-spica hip MRI over a 6-year period were retrospectively reviewed. One hundred and seven hips were included. Data reviewed included age at intervention, gender, type of intervention performed, MRI findings, the need for re-intervention and the interval between interventions. Gender was compared between the closed and open reduction groups via the Fisher exact test. Age at the first procedure was compared via the Wilcoxon rank test. Rates of re-intervention after closed and open reduction were calculated and the reasons for re-intervention were reviewed.
Results
The mean age at the time of the first intervention was 16.4 months (range: 4 to 63 months). Mean age for the closed reduction group was 10.5 months (range: 4–24 months) and for the open reduction group was 23.7 months (range: 5–63 months), which was significant (
P
-value <0.0001). Of the 52 hips that underwent closed reduction, 16 (31%) needed re-intervention. Of the 55 hips that underwent open reduction, MRI was useful in deciding re-intervention in only 1 (2%). This patient had prior multiple failed closed and open reductions at an outside institute.
Conclusion
Post intervention hip spica MRI is useful in determining the need for re-intervention after closed hip reduction, but its role after open reduction is questionable.</description><subject>Age</subject><subject>Bone dysplasia</subject><subject>Casts, Surgical</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Female</subject><subject>Hip</subject><subject>Hip Dislocation, Congenital - diagnostic imaging</subject><subject>Hip Dislocation, Congenital - surgery</subject><subject>Hip Dislocation, Congenital - therapy</subject><subject>Hip joint</subject><subject>Humans</subject><subject>Imaging</subject><subject>Infant</subject><subject>Intervention</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Musculoskeletal diseases</subject><subject>Neuroradiology</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Orthopedic Procedures - methods</subject><subject>Pediatrics</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Radiology</subject><subject>Retreatment</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Ultrasound</subject><issn>0301-0449</issn><issn>1432-1998</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kUFv1DAQhS0EotvCD-CCLHHhkjJje-OYG6poqVRUqaJny0km4CqJg-2stP8eb7eAhMRpLM33nmfmMfYG4RwB9IcEIJSuAJtKoZKVfsY2pYoKjWmesw1IwAqUMifsNKUHAJBblC_ZiTC1qRXChvX32Y8-73kYuJ8m6r3LxJeQclgouux3xH_4hX-9u-Z-5j3taAzLRHN242Oj36dldMm7j7wbQ6Ke79I5L-KZR-rXLvswv2IvBjcmev1Uz9j95edvF1-qm9ur64tPN1UntchV3Te1LuMOuta9aDrZGtmhVHLrnCCjEVVdntgOZQtZgyFquxbrRhpHRg3yjL0_-i4x_FwpZTv51NE4upnCmqwAiUqgFNuCvvsHfQhrnMt0Bwq2SkKjCoVHqoshpUiDXaKfXNxbBHuIwB4jsCUCe4jA6qJ5--S8tuWefxS_b14AcQRSac3fKf79-v-uvwAh7pBm</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Jadhav, Siddharth P.</creator><creator>More, Snehal R.</creator><creator>Shenava, Vinitha</creator><creator>Zhang, Wei</creator><creator>Kan, J. Herman</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20180801</creationdate><title>Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction</title><author>Jadhav, Siddharth P. ; More, Snehal R. ; Shenava, Vinitha ; Zhang, Wei ; Kan, J. Herman</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-6d867044f767d28c3b93c13435aa2e9711465aa1bf5133609eebcb16839ae94f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Bone dysplasia</topic><topic>Casts, Surgical</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Female</topic><topic>Hip</topic><topic>Hip Dislocation, Congenital - diagnostic imaging</topic><topic>Hip Dislocation, Congenital - surgery</topic><topic>Hip Dislocation, Congenital - therapy</topic><topic>Hip joint</topic><topic>Humans</topic><topic>Imaging</topic><topic>Infant</topic><topic>Intervention</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Musculoskeletal diseases</topic><topic>Neuroradiology</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Orthopedic Procedures - methods</topic><topic>Pediatrics</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Radiology</topic><topic>Retreatment</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jadhav, Siddharth P.</creatorcontrib><creatorcontrib>More, Snehal R.</creatorcontrib><creatorcontrib>Shenava, Vinitha</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Kan, J. 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Herman</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction</atitle><jtitle>Pediatric radiology</jtitle><stitle>Pediatr Radiol</stitle><addtitle>Pediatr Radiol</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>48</volume><issue>8</issue><spage>1096</spage><epage>1100</epage><pages>1096-1100</pages><issn>0301-0449</issn><eissn>1432-1998</eissn><abstract>Background
Magnetic resonance imaging (MRI) of the hips is being increasingly used to confirm hip reduction after surgery and spica cast placement for developmental dysplasia of the hip (DDH).
Objective
To review a single institutional experience with post-spica MRI in children undergoing closed or open hip reduction and describe the utility of MRI in directing the need for re-intervention.
Materials and methods
Seventy-four patients (52 female, 22 male) who underwent post-spica hip MRI over a 6-year period were retrospectively reviewed. One hundred and seven hips were included. Data reviewed included age at intervention, gender, type of intervention performed, MRI findings, the need for re-intervention and the interval between interventions. Gender was compared between the closed and open reduction groups via the Fisher exact test. Age at the first procedure was compared via the Wilcoxon rank test. Rates of re-intervention after closed and open reduction were calculated and the reasons for re-intervention were reviewed.
Results
The mean age at the time of the first intervention was 16.4 months (range: 4 to 63 months). Mean age for the closed reduction group was 10.5 months (range: 4–24 months) and for the open reduction group was 23.7 months (range: 5–63 months), which was significant (
P
-value <0.0001). Of the 52 hips that underwent closed reduction, 16 (31%) needed re-intervention. Of the 55 hips that underwent open reduction, MRI was useful in deciding re-intervention in only 1 (2%). This patient had prior multiple failed closed and open reductions at an outside institute.
Conclusion
Post intervention hip spica MRI is useful in determining the need for re-intervention after closed hip reduction, but its role after open reduction is questionable.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29696410</pmid><doi>10.1007/s00247-018-4143-7</doi><tpages>5</tpages></addata></record> |
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| ispartof | Pediatric radiology, 2018-08, Vol.48 (8), p.1096-1100 |
| issn | 0301-0449 1432-1998 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Age Bone dysplasia Casts, Surgical Child, Preschool Children Female Hip Hip Dislocation, Congenital - diagnostic imaging Hip Dislocation, Congenital - surgery Hip Dislocation, Congenital - therapy Hip joint Humans Imaging Infant Intervention Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Musculoskeletal diseases Neuroradiology NMR Nuclear magnetic resonance Nuclear Medicine Oncology Original Article Orthopedic Procedures - methods Pediatrics Postoperative Complications - diagnostic imaging Radiology Retreatment Retrospective Studies Surgery Treatment Outcome Ultrasound |
| title | Utility of immediate postoperative hip MRI in developmental hip dysplasia: closed vs. open reduction |
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