Evaluation of the Results of Dega Acetabuloplasty in Management of DDH in Walking Children under 4 Years

Background: Developmental dysplasia of the hip (DDH) in walking-age children presents unique surgical challenges. One-stage open reduction combined with Dega pelvic osteot-omy, with or without femoral shortening and varusderotation osteotomy, has been proposed to restore hip stability and ace-tabular coverage. Aim of Study: The aim of this study is to evaluate the re-sults of Degaacetabuloplasty in treatment of DDH in walking children under 4 years of age. Patients and Methods: A prospective case series was con-ducted on 24 patients (30 hips) between March 2012 and March 2015. All patients underwent open reduction and Dega pelvic osteotomy, with femoral shortening and/or varusderotation osteotomy performed as indicated. Preoperative and postoper-ative evaluations included acetabular index (AI), center-edge angle (CEA), modified McKay clinical criteria, and Severin radiological classification. The mean follow-up period was 24 months (range, 18–36). Results: At final follow-up, 28 hips (93.33%) achieved satisfactory clinical outcomes (excellent or good) and 28 hips (93.33%) achieved satisfactory radiological outcomes (Sev-erin grades I–II). The mean AI improved from 47.28°±3.36° preoperatively to 16.07°±2.42° postoperatively (p<0.001). The mean postoperative CEA was 32.97°±5.88°, with higher CEA values significantly associated with better clinical re-sults (p=0.002). Younger age at surgery correlated with supe-rior clinical outcomes (p=0.013). No redislocations occurred. Complications included two superficial wound infections, one transient femoral nerve palsy, and radiographic avascular ne-crosis in a small proportion of hips. Conclusions: One-stage open reduction with Dega pelvic osteotomy, supplemented by femoral shortening and varus-derotation osteotomy when required, yields excellent short-term stability and acetabular remodeling in walking-age chil-dren with DDH, especially when performed before the age of two years.