Iranian Journal of Orthopedic Surgery

Abstract Abstract
Background: Developmental dysplasia of the hip (DDH) includes a wide range of abnormalities of the hip that can emerge at any time including embryonic period, infancy, or childhood. The purpose of this study was to examine the clinical and radiographic outcomes of patients with DDH, treated with adductor tenotomy and closed reduction.
Methods: The study was retrospectively performed on 30 children (33 joints) with DDH,who were treated with adductor tenotomy, closed reduction and SpicaCast in Ahvaz Razi Hospital during 2015-2017. Inclusion criteria were patients diagnosed with DDH and below 2 years of age. Exclusion criteria were connective tissue diseases, secondary dislocation due to previous infection and acetabulum dysplasia in the context of specific syndrome. After the operation, the patients were evaluated for the severity of injuries associated with dislocation or subluxation of hip joint and hip joint congruity. Theradiographic results were studiedbased on Severin, Tonnis grading, McKay and acetabularindices.
Results: The preoperative mean acetabular index of36.54 ± 3.27 degrees significantly dropped to postoperativeof 27.06 ± 2.15 degrees. According to McKay criteria, 90.9% of the patients had excellent and good therapeutic results after the surgery. According to Tonnis criteria, 93.9% of patients were in Class I and II after the surgery. Moreover, in radiographic evaluations,96.9% of the patients were in Class Ia and Ib  based on Severin criteria.In 1 patient (3.03%), osteonecrosis of the head was found, in 2 patients (6.06%), walking and lameness impaired walking, and in 3 patients (9.09%), sitting was reported. All patients were female in this study.
Conclusion: According to the clinical results and evaluations of this study, closed reduction along with adductor tenotomy can be used as an appropriate technique for the treatment of patients with DDH at an early age.
 
 

Abstract Background: The open fracture of femur and leg is one of the most common fracture of orthopedic injuries. Utilization of external fixator has worldward acceptance. Pin tract infection, neurovascular injuries, compartment syndrome are common complication of this injuries. In this research complication and other pitfall treatment of has external fixator insertion were studied. Material and Method: Is this study the patients with open fracture of periarticular fracture of knee and ankle were studied. One day after surgery the neurovascular injury has studied and when patients referred for exchange of external fixator the pin tract infection has studied.After data gathering by observation and checklist they analyzed by means of independent t-test and spss20. Results: The rate of infection was %52. The rate of neurovascular injuries was %6. The rate of compartment syndrome and vascular injury was zero and the rate of tendon injury was %5.7. In comparison between pin tract infection and neurovascular injuries and tendon injury in open and close fracture only the injury of nerve has meaningful differences( P=0/049). In our study the kind of dressing (with Betadine) and kind of pin (stainless steel) was appreciated. Conclusion: External fixator placement for open or comminuted fractures of the femur and leg is associated with a considerable degree of pin tract infection, but neurovascular effects and complications of tendon muscle, compartment syndrome is uncommon.