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Dega Osteotomy for the Correction of Acetabular Dysplasia of the Hip: A Radiographic Review of 21 Cases

Al-Ghamdi, Ahmed MD, FRCSC*; Rendon, Juan Sebastian MD; Al-Faya, Fareed MD, FRCSC*; Saran, Neil MD, MSc, FRCSC*,†,‡; Benaroch, Thierry MD, MSc, FRCSC*,†,‡; Hamdy, Reggie C. MD, MSc, FRCSC*,†,‡

Journal of Pediatric Orthopaedics: March 2012 - Volume 32 - Issue 2 - p 113–120
doi: 10.1097/BPO.0b013e31823f0b8c
Hip/Femur

Background: The Dega osteotomy is a versatile procedure that is widely used to treat neuromuscular hip dysplasia. There is a paucity of the English language literature on its use in acetabular dysplasia seen in developmental dysplasia of the hip (DDH).

Methods: A retrospective radiographic and chart review was performed for all patients diagnosed with DDH who underwent a modified Dega osteotomy between March 1995 and December 2008 at the Shriners Hospital for Children or the Montreal Children’s Hospital (Montréal, Canada) by 2 orthopaedic surgeons. Radiographic parameters were measured at the preoperative, immediate postoperative, and final follow-up time points. These parameters included the acetabular index, center edge angle, Reimer’s extrusion index, Shenton line, and grading by the Severin classification.

Results: A total of 20 patients (21 hips), of which 18 were female, underwent a modified Dega osteotomy at an average age of 55.6 months (range, 20 to 100 mo). Of the 21 hips (1 bilateral and 19 single cases), 9 hips involved the right side and 12 hips involved the left side. Before surgery, 9 patients had a subluxated hip, 7 patients had a dislocated hip, and 5 patients had a dysplastic hip. Ten hips underwent concomitant procedures including 10 open reductions with capsulorraphy. The acetabular index improved from 37 degrees (SD 8) preoperatively to 19 degrees (SD 8) on the date of last visit. The center edge angle improved from 2 (SD 17) to 25 degrees (SD 12).

Conclusions: The results of this study demonstrate that the modified Dega osteotomy produces near-normal lateral coverage parameters in children with DDH.

Level of Evidence: Therapeutic study, clinical case series: level IV.

* McGill University-Orthopaedic Surgery

Shriners Hospital for Children

The Montreal Children’s Hospital, Montreal-QC, Canada

None of the authors received financial support for this study.

The authors declare no conflict of interest.

Reprints: Reggie C. Hamdy, MD, MSc, FRCSC, McGill University-Orthopaedic Surgery, Shriners Hospital for Children and The Montreal Children’s, 1529 Cedar Avenue, Montreal-QC, Canada H3G 1A6. E-mail: rhamdy@shriners.mcgill.ca.

© 2012 Lippincott Williams & Wilkins, Inc.