Predictive Factors for Requiring Salter Osteotomy in DDH

Abstract

Purpose: Developmental dysplasia of the hip (DDH) is a wide spectrum condition, ranging from stable acetabular dysplasia to irreducible dislocation, with a variety of different treatment approaches. We aim to find any correlation between some of the most in use pre-operative values and requiring a concomitant salter osteotomy (SO). Methods: In our retrospective cohort study, all defined DDH over 12 months old, assessed between the years of 2017 and 2021 in our orthopedic hospital and categorized under two groups: open reduction, and salter group. Retrospectively, we compared age, gender, pre-operative acetabular index (AI) and medial gap (MG) between two groups. Results: There was no relationship between SO requirement and patient’s gender (p=0.186). There was a higher chance of requiring SO in bilateral cases without any significance (p=0.11). Also, the difference between the two groups, in MG terms, was not significant (p=0.91). With an AI over 30°, salter osteotomy requirement would increase 2.5-fold and 4.8-fold, with each year (age) and degree (AI) increase, respectively. And if we include age over 3.5 years in the matter, SO requirement would increase by 15.7-fold and 5.8-fold with each year and degree increase, respectively. Conclusions: OR with wide safe zone would be a safe treatment method. According to our analysis, pelvic osteotomy would be done more often when age or pre-operative AI increases, but exact determination of osteotomy requirement pre-operatively, is considered highly difficult.