Face Off: Early Pelvic Osteotomy for DDH

POINT: Early intervention is appropriate in most instances of residual DDH.
Dennis R. Wenger, MD

The need for intervention—specifically for performing early pelvic osteotomy in young children with radiographic evidence of developmental dysplasia of the hip (DDH)—may be dictated by signs and symptoms. The decision in favor of early osteotomy is easy if the patient has abnormal-looking radiographs, exhibits symptoms, and has a break in Shenton’s line, representing hip subluxation or dislocation as opposed to acetabular dysplasia.

Shenton’s line is a radiographic feature—an imaginary line drawn along the inferior border of the superior pubic ramus (superior border of the obturator foramen) and along the inferomedial border of the neck of the femur. In a normal hip, the line is continuous and smooth.

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