Comparison of the efficacy of native radiography and computed tomography in the evaluation of the closed reduction in developmental dysplasia of the hip

Introduction : Developmental dysplasia of the hip (DDH) is a common orthopedic disorder in infants, and accurately assessing the success of reduction is critical for achieving positive outcomes. While native radiography has traditionally been the standard postoperative imaging modality, its diagnostic limitations have prompted consideration of computed tomography (CT) as an alternative. Aim : The goal was to compare the diagnostic efficacy of native radiography and CT in evaluating the success of closed reduction in DDH. Materials and methods : A total of 50 patients (100 hips) who underwent closed reduction for DDH were divided into two groups: 25 evaluated by postoperative CT and 25 by native anteroposterior pelvic radiography. The adequacy of reduction was assessed using standardized radiological parameters. Results : Statistical analyses included comparisons of sensitivity, specificity, and overall accuracy between the two techniques. CT achieved perfect diagnostic performance (100% sensitivity, specificity, and accuracy), while radiography showed lower sensitivity (28.6%), specificity (86.0%), and accuracy (77.6%). The difference between the methods was statistically significant ( p <0.001). This study demonstrates that computed tomography is clinically superior to native radiography for postoperative evaluation after closed reduction in DDH, offering significantly higher diagnostic accuracy and reliability, especially when radiographs are equivocal, while justifying the selective or exclusive use of low-dose CT protocols despite radiation concerns. Conclusion : Incorporating low-dose CT protocols can enhance diagnostic confidence while minimizing radiation exposure, ensuring better long-term clinical outcomes.