Essential Surgical Techniques
A Combined Procedure for High Dislocation in Patients with Developmental Dysplasia of the Hip
Ting-Ming Wang, MD, PhD; Kuan-Wen Wu, MD; Shier-Chieg Huang, MD, PhD; Wei-Cheng Huang, MD; Ken N. Kuo, MD

Overview

Introduction A combined procedure including open reduction, femoral shortening osteotomy, and an acetabular procedure is often necessary to obtain a desirable result in children of walking age who have a high-riding hip dislocation.

Step 2: Explore the Hip Joint Make sure to find the true acetabulum and remove all obstacles to femoral head reduction.

Step 3: Femoral Head Reducibility Check the reducibility of the femoral head in different positions through a full range of hip motion.

Step 5: Hip Joint Stability Check femoral head reduction stability with the proximal end of the osteotomized femur.

Step 7: Pemberton Acetabuloplasty In cases with a dysplastic acetabulum and inadequate femoral head coverage after reduction, perform a Pemberton osteotomy.

Step 8: Postoperative Management Apply a hip spica cast, which the patient wears for six weeks; then switch to a hip abduction brace.

Introduction

A combined procedure including open reduction, femoral shortening osteotomy, and an acetabular procedure is often necessary to obtain a desirable result in children of walking age who have a high-riding hip dislocation. Since Klisić and Jancović1,2 first introduced the procedure, femoral shortening has been performed as an adjunct in the …


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