Surgical Treatment of Developmental Dysplasia of the Hip in Children Aged 2-8 Years by Modified Dega Osteotomy

Background: The management of developmental dysplasia of the hip (DDH) in walking children is challenging. In older children, a pelvic osteotomy is needed to achieve a stable concentric reduction. Much confusion still surrounds the Dega osteotomy. However, it is one of the most commonly used osteotomies in the management of DDH. Aims and objectives: This study aimed to evaluate clinical and radiological outcomes of DDH management in children 2-8 years of age by modified Dega osteotomy. Subjects and methods: This study was a quasi-experimental interrupted time series analysis. The study was carried out in the department of orthopedic surgery at Al-Azhar University Hospital in Damietta. Forty patients were included who were presented with DDH between 2- 8 years of age; the surgeries were done between March (2022) and March (2023). Result: The mean age was 3.77 years, 30% were males, and 27.5% were bilateral. The outcome, according to the McKay score, was excellent, good, fair and poor in 30.0%, 47.5%, 7.5% and 15.0% respectively. But Severin classifications showed that, there was 27 of patients (67.5%) had grade I, 5 of the patients (12.5%) had grade II, 2 of the patients (5%) had grade III, 5 of the patients (12.5%) had grade IV, and 1 of the patients (2.5%) had grade V, with progressive significant improvement over the follow-up period. Complications were injury of the superficial cutaneous nerve of the thigh (7.5%), superficial wound infection (5.0%), limb-length discrepancy of 2 cm (15.0%), avascular necrosis (15.0%), and 20% needing another surgery. Conclusion: The use of the Dega osteotomy is a useful alternative in the treatment of patients with DDH, especially in children 2-8 years old.