Key result
Salter osteotomy resulted in a significantly greater reduction in acetabular index compared to varus derotational osteotomy with femoral shortening (p<0.011), though clinical outcomes were similar and Salter had a higher complication rate.
Why the study?
Surgical treatment of patients with developmental dysplasia of the hip remains controversial in cases with late diagnosis or unsuccessful nonsurgical treatment.
Does Salter osteotomy improve radiographic and clinical outcomes compared to varus derotational with femoral shortening in children with late-diagnosed DDH?
Cross-Sectional (n=52)
No
Does Salter osteotomy improve radiographic and clinical outcomes compared to varus derotational with femoral shortening in children with late-diagnosed DDH?
Both Salter osteotomy and varus derotational with femoral shortening are effective for late-diagnosed DDH, though Salter provides greater acetabular index reduction at the cost of higher complication rates.
Answers are grounded in this paper and cite their sources.
Salter may yield better radiographic correction but higher complications with similar clinical results; leaves open optimal osteotomy selection in late DDH pending prospective trials.
Surgical treatment of patients with Developmental Dysplasia of Hip (DDH) always remains controversial in cases with late diagnosis or unsuccessful in nonsurgical treatment. This cross-sectional and retrospective study was conducted on 52 patients aged over 18 months with late diagnosis of DDH. The patients were treated either with Salter osteotomy or Varus derotational with femoral shortening methods. The patients' data were collected from the medical records of the hospital archive and the patients who underwent surgery more than 1 year ago were called to attend the clinic for assessment. For each patient, acetabular index (AI), hip dislocation or subluxation were graded using Tonnis classif ication and congruity of the hip using Severin classif ication. The AI score reduction in the Salter osteotomy group was signif icantly greater than the Varus derotational group. But, in the last clinical evaluation, no signif icant difference between the distribution of patients according to the Tonnis classif ication was found. In general, the prevalence of complications in Salter group was statistically higher. No statistical difference was evidenced in terms of the distribution of patients according to the disease class and Severin classif ication after treatment. Finally, both approaches could be useful and safe for the treatment of children with DDH with late diagnosis.
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Moosavi et al. (2019) conducted a cross-sectional in Developmental Dysplasia of the Hip (DDH) (n=52). Salter osteotomy vs. Varus derotational osteotomy with femoral shortening was evaluated on Mean reduction in Acetabular Index (AI) score (p=<0.011). Salter osteotomy resulted in a significantly greater reduction in acetabular index compared to varus derotational osteotomy with femoral shortening (p<0.011), though clinical outcomes were similar and Salter had a higher complication rate.
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