الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 121 |  |  |
| | | from | 121 | | |
Abstract
The treatment of developmental dysplasia of the hip (DDH) in the after walking age is difficult because of adaptive shortening of the extra-articular soft tissues, acetabular dysplasia, capsular constriction, increased femoral anteversion, and fixed inversion of the limbs.
There are many authors to advise one stage procedure in this age group ( Abdullah et al., 2012 ; Galpin et al., 1989 ; Grudziak et al., 1993 ; Klisic and Jankovic, 1976 ) to: (1) safely reduce the dislocated hip and to surgically recreate normal anatomy (as closely as possible) and (2) to reorient the biomechanical relationships such that the development of degenerative hip disease is delayed or prevented.
The aim of this retrospective study was to compare between the percutaneous femoral derotational osteotomy and fixation by elastic nails and the open femoral derotational osteotomy and fixation by plate and screws in the clinical and radiographic outcomes and results.
Our study included group (A) 14 patients (19 hips): percutaneous derotational femoral osteotomy and fixation by elastic nails were done. group (B) 17 patients (21 hips): open derotational femoral osteotomy and fixation by plate and screws were done. There were 3 patients with bilateral DDH (6 hips): 3 hips were managed as in group (A) and the contralateral hip of each of them was managed as group (B).
We established that group (A) has less operative time, less blood loss, less blood transfusion, shorter healing time and more satisfying post operative scar in comparison to group (B).
The satisfying clinical results in group (A) were 90.9 % and in group (B) were 91.7 %. While the radiological results were the same in both groups . There were no clinical or radiological significant difference between the two groups
Complications: In group (A) there were two cases developed AVN ; one hip was grade II and one hip was grade IV, while in group(B) there were three cases ; one hip was grade I , one hip was grade II and one hip was grade III.
There was only one dislocated hip in each group. 4 cases developed superficial wound infection in (group A), while 2 cases developed superficial wound and only one case developed deep infection in (group B). Only one case with supracondylar fracture was detected in group (B) after removal of the hip spica and managed by above knee cast, while no cases in group (A).
There were 10 patients in group (A) developed knee pain with running and stairs climbing. Elastic nail prominence correlated with increased knee pain. All cases improve completely after removal the elastic nails after establishing the radiological union