Evaluation of femoral head Retinacula exploration on femoral head avascular necrosis in developmental dysplasia of the hip surgery-A Case Control Study

Abstract

Developmental dysplasia of the hip (DDH) is an instability or dislocation of the hip at birth that has a prevalence of one in a thousand live births. There are several procedures to achieve a stable hip joint. Among these methods, surgical treatment is preferable to closed reduction. The primary complication of DDH treatment is femoral head avascular necrosis (AVN), which is due to reduced blood flow to the femoral epiphysis, which can lead to devastating clinical outcomes. Due to the high prevalence of AVN and lack of studies to investigate the effect of vascular exploration on reducing it, therefore, this study was performed to investigate the effect of vascular exploration on AVN in DDH surgery.

Material and method In this case-control study, children with DDH with positive radiographic symptoms referred to Shohada Hospital in Tabriz were randomly divided into two groups: open reduction with retinal artery exploration and open reduction without retinal artery exploration. The follow-up period of patients was at least 24 months for AVN. All information was entered into SPSS version 22 software and analyzed.

Result In this study, 134 hip joints underwent open surgery, of which 50 hips (37.3%) developed AVN. The mean age of patients at diagnosis of DDH was 27.1 ± 16.4 months. Vascular exploration was performed in 50 hip surgeries, of which 32 (40%) developed AVN. Out of 84 patients who did not undergo vascular intervention, 48 patients (60%) developed AVN. Statistical analysis did not show a significant relationship between vascular intervention and the occurrence of AVN (P value=0.4).