Research Article
Volume 11 Issue 7 - 2020
Outcomes with Early Removal of Spica Cast, Following Open Reduction in Developmental Dysplastic Hips and Evaluation on New Functional Score System
Asad Aziz1*, Anisuddin Bhatti2 and Ata Ur Rahman2
1Department of Orthopaedic and Spine Surgery, Dr. Ziauddin University Hospital, Clifton, Karachi, Pakistan
2NMI Orthopaedic and Ponseti Clinic, Neuromedical Cancer Care Institute, Depot lane, Saddar, Karachi, Pakistan
*Corresponding Author: Asad Aziz, Department of Orthopaedic, Ziauddin University, Pakistan.
Received: May 26, 2020; Published: June 20, 2020




Abstract

Background: The purpose of this study is to elicit the outcomes of open reduction in developmental dysplastic hips, after a minimal duration of post-operative cast immobilization. The outcome measures included risk of re-subluxation, re-dislocation, stiffness and psycho-social impact with early mobilization.

Methodology: This prospective cohort study includes Idiopathic, Developmental Dysplastic of Hips, in walking age group with Tonnis stage III and IV height of dislocation. The dislocated hips were reduced with an open reduction, release of soft tissue obstacles and correction of the structural abnormalities, by additional femoral and pelvis osteotomies. The outcome was measured with reference to duration of immobilization in cast spica for 6 and 7 weeks, recovery from stiffness and psycho-social impact. The study duration included from January 2017 to December 2019 with minimum follow up duration of 1 year. The clinic-radiological assessment was made with a newly designed Bhatti’s functional score system and Severin’s radiological classification.

Results: The overall outcome is assessed by combination of Bhatti’s Functional score and Severin’s Radiological classification. The results with 6 and 7 weeks cast immobilization in 90 hips of 67 patients were found very encouraging. None of these patients developed re-subluxation during removal of spica cast and thereafter. Moreover, the patients achieved full range of motion very early, with a better mobility and weight bearing. The families were also found to have significantly better psychosocial impact of early cast removal.

Conclusion: The outcome of this study favors, post-operative spica cast immobilization for 6 weeks being the best practice to achieve satisfactory results without significant risk of complications. The new functional score system found a better indicator to assess patient’s limitations and have significantly better psychosocial impact.

Keywords: Developmental Dysplastic Hip; Duration Immobilization; Functional Score; Psycho-Social Impact

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Citation: Asad Aziz., et al. “Outcomes with Early Removal of Spica Cast, Following Open Reduction in Developmental Dysplastic Hips and Evaluation on New Functional Score System”. EC Orthopaedics 11.7 (2020): 73-84.

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