Transient inferior over-reduction after open reduction in walking-age DDH: A retrospective analysis of 42 Hips

Due to various policy and health infrastructure issues, it is not uncommon to present developmental dysplasia of hip(DDH) at walking-age in India. The purpose of this study was retrospective analysis of operated cases of walking-age DDH with “inferior over-reduction”. “Inferior over-reduction” was defined as break in the Shenton's arc inferiorly in an operated hip which otherwise appears reduced. After Ethical Committee approval, we searched children operated for walking-age DDH. Children suggestive of syndromic association were excluded. We collected demographic data, follow-up, procedures performed, inferior over-reduction and complications. The IHDI grade, Acetabular Index(AI), Smith's ratio for superior (h/b) & lateral displacement(c/b) of femur, and clinical outcome (Modified McKay criteria) were evaluated. The outcomes of cases with inferior over-reduction(Group A) were compared with those without(Group B). 42 patients with average follow-up of 23 months were enrolled. 21 hips belonged to Group A. By 6 months follow up, all these cases recovered. On comparison of Smith's ratio, group A had significantly higher c/b for the operated hip at 3-month follow-up(p