Single Triple Attack for Management of Neglected Developmental Hip dysplasia in Children Between 5 and 9 Years; Short Term Outcome | ||||
| The Egyptian Orthopaedic Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 27 July 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/eoj.2025.397580.1055 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Islam Sameeh Abdelfattah   1; Ahmed Elsayed Elmalt2; Yehia Elbromboly2; Islam Hamada2; yamen safwat3
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| 1Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Egypt | ||||
| 2Department of Orthopedic Surgery, faculty of medicine, Zagazig University, Sharkia, Egypt | ||||
| 3Zagazig university Hospitals, faculty of medicine, Zagazig University, Sharkia, Egypt. | ||||
| Abstract | ||||
| Background: Growing older makes treatment of DDH more challenging and usually necessitate complex surgical techniques. Achieving a concentric stable reduction without interfering with the vascularity of the femoral head is the aim of treatment. A single triple attack (open reduction, femoral shortening with derotational osteotomy, and acetabulapasty by Dega osteotomy) becomes the optimal option in this age group. Methods: Fourteen patients with neglected DDH (18 hips) were included in a prospective cohort study that was conducted at Zagazig University Hospitals between May 2019 and February 2022. The patients had a follow-up period ranging from 12 to 24 months. It included children aged >5 and <9 years who underwent the triple procedure of open reduction, femoral shortening and Dega pelvic osteotomy. Results: All patients were assessed radiologically using Severin grading and clinically using modified McKay criteria at the last follow-up visit. Severin's classification was used to document the postoperative radiographic results. The acetabular index on preoperative X-rays and on postoperative X- rays, the center edge angle and acetabular index were measured. Using the modified McKay criteria, the clinical outcome at the final follow-up was excellent in two patients (11.1%), good in six (3.3%), and fair in ten (55.5%). Three patients (16.6%) had excellent radiological results using the Severin classification, while 15 patients (83.3%) had good results. Conclusion: The single stage triple attack provides favourable outcomes for managing neglected and late diagnosed DDH among children aged 5-9 years. Key words: Developmental dysplasia of hip, Triple attack, Femoral shortening, Dega osteotomy. | ||||
| Keywords | ||||
| Developmental dysplasia of hip; Triple attack; Femoral shortening; Dega osteotomy | ||||
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