Abstract
BackgroundAvascular necrosis (AVN) is a significant and potentially devastating complication following the treatment of developmental dysplasia of the hip (DDH). The reported rate of AVN following closed reduction for DDH ranges from 4 to 60%, and the resultant influence on hip development remains unclear.PurposeA systematic review of the literature was undertaken to evaluate the frequency of AVN after more than 5 years of follow-up in children that underwent closed reduction at younger than 2-years of age for DDH.MethodsThe search strategy was formulated with key-concepts and keywords identified using the patient problem, intervention, comparison and outcome process. Searches were undertaken using Pubmed, Scopus and Web of Science up to and including May, 2016 to identify potential studies.ResultsA total of seven papers met the a priori inclusion and exclusion criteria of this review. The overall rate of significant AVN in 441 patients (538 hips) was 10% at a mean length of follow-up of 7.6 years (5–18.8) following closed reduction. This finding can be used to inform the feasibility of future intervention studies, and act as a baseline for which surgeons to compare their results to a ‘standard’.Electronic supplementary materialThe online version of this article (doi:10.1007/s11832-016-0776-y) contains supplementary material, which is available to authorized users.
Highlights
Closed reduction and spica casting is one of the most commonly performed procedures for the treatment of developmentally dislocated hips (DDH)
Background Avascular necrosis (AVN) is a significant and potentially devastating complication following the treatment of developmental dysplasia of the hip (DDH)
A systematic review of the literature was undertaken to evaluate the frequency of AVN after more than 5 years of follow-up in children that underwent closed reduction at younger than 2-years of age for DDH
Summary
Closed reduction and spica casting is one of the most commonly performed procedures for the treatment of developmentally dislocated hips (DDH). The primary complication of closed reduction is avascular necrosis (AVN) of the femoral head that occurs due to diminished blood supply to the femoral epiphysis that can cause devastating clinical outcomes [1,2,3,4,5,6,7]. Reported frequency estimates of AVN following closed reduction vary significantly between 4 and 60% [1,2,3,4,5,6,7]. Avascular necrosis (AVN) is a significant and potentially devastating complication following the treatment of developmental dysplasia of the hip (DDH). The reported rate of AVN following closed reduction for DDH ranges from 4 to 60%, and the resultant influence on hip development remains unclear. Purpose A systematic review of the literature was undertaken to evaluate the frequency of AVN after more than 5 years of follow-up in children that underwent closed reduction at younger than 2-years of age for DDH
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