RESEARCH ARTICLE


The Added Value of Postoperative Axial Imaging in Developmental Dysplasia of the Hip



Nabil Alassaf1, *, Joud Abuhaimed2, Nouf Almahmoud2, Rawan Binkhulaif2
1 Department of surgical specialties, King Fahad Medical City, P.O. BOX 59046, Riyadh 11525, Kingdom of Saudi Arabia
2 College of Medicine, Princess Nourah bint Abdulrahman University, P.O. BOX 84428, Riyadh 11671, Kingdom of Saudi Arabia


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© 2017 Alassaf et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of surgical specialties, King Fahad Medical City, P.O.BOX 59046, Riyadh 11525, Kingdom of Saudi Arabia, Tel: +966532001152; E-mail: nalassaf@kfmc.med.sa


Abstract

Background:

Redislocation is a dreaded complication after reduction of developmental dysplasia of the hip (DDH) in young children. While early detection facilitates urgent reoperation, delayed revisions are more complicated. Despite the weak evidence, an axial postoperative imaging tool is recommended. This study’s goal is to compare the effectiveness of conventional pelvic radiography alone and axial imaging.

Methods:

Data were collected retrospectively between 2012 and 2016. One study group comprised consecutive patients who had operative reduction followed by routine low-dose computed tomography (CT). Hips that had anteroposterior pelvic radiographs as the only confirmatory tool were used as a reference group.

Results:

We identified 241 patients (339 hips). The mean age and follow up were 19.6 months ± 9.3, and 15.5 months ± 11.1, respectively. There were 147 hips in the radiography group and 192 in the CT group. Radiography detected only three out of nine redislocations during the same admission; in contrast, 2/2 redislocations in the routine CT group were addressed before hospital discharge (p<0.01). There was no significant delay in hospital discharge when CT was used (p= 0.28).

Conclusion:

Conventional radiography is not as effective as axial imaging in preventing late detection of redislocation.

Level of Evidence:

level III, Diagnostic Study.

Keywords: Hip joint, Hip dysplasia, Hip dislocation, Radiography, Computed tomography, Redislocation.