One-stage surgical outcomes for bilateral developmental dysplasia of the hip in walking children: A retrospective case series study from the post-war era in a tertiary care hospital at Kabul, Afghanistan

Title : One-stage surgical outcomes for bilateral developmental dysplasia of the hip in walking children: A retrospective case series study from the post-war era in a tertiary care hospital at Kabul, Afghanistan

Abstract:

Purpose: Bilateral surgery for developmental dysplasia of the hip in a single stage represents a significant surgical challenge. The present study, therefore, aimed to evaluate the clinical and radiographic outcomes of one-stage surgical management of bilateral developmental dysplasia of the hip in children after the onset of independent walking. 

Materials and Methods: This retrospective case series was conducted between 2020 and 2024 at the French Medical Institute for Mothers and Children in Kabul, Afghanistan. The study included 36 patients with a mean age of 32 months (range: 18-54 months), all diagnosed with bilateral developmental dysplasia of the hip, accounting for a total of 72 affected hips. Postoperative functional outcomes were assessed using the modified McKay's scoring system, while radiographic evaluation was performed by measuring the acetabular index. The mean follow-up duration was 9.6 months.

Results: In this study, functional outcomes assessed by the modified McKay's criteria demonstrated excellent results in 26 cases (72%), good results in six cases (16.7%), fair results in three cases (8.3%), and poor results
in one case (3%). The mean reduction in the acetabular index between preoperative and postoperative evaluations was 13.78±3.5° for the right hips and 17.29±5° for the left hips. With respect to postoperative complications, the majority of hips (60, 83.3%) showed no adverse effects; however, subluxation occurred in three hips (4.2%), avascular necrosis of the femoral head in four hips (5.5%), and acetabular dysplasia in five hips (7%).

Conclusion: A one-stage open reduction combined with Salter's osteotomy, with femoral shortening when indicated, is recommended as an effective management strategy for bilateral developmental dysplasia of the hip in children aged 1.5-4.5 years.

Biography:

Rahim Nawaz Hussain graduated from Cardiff University in 2020 and completed his foundation programme in the West midlands South Deanery. After which he worked as a clinical teaching fellow at Worcester Acute Hospitals NHS trust. During this time he successfully completed his postgraduate certification in medical education. He has recently completed his core surgical training in the West Midlands deanery and has completed his MRCS during this time as well. He has an interest in pursuing higher surgical training in Trauma and Orthopaedics.