Original Article

Is a combined proximal femoral osteotomy necessary when performing open reduction and Dega acetabuloplasty in walking-age children with developmental dysplasia of the hip

Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang City, PR China

^* Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Received: 21 January 2026
Accepted: 6 April 2026

Abstract

Purpose: To determine the necessity of simultaneous proximal femoral osteotomy (PFO) during open reduction (OR) and Dega acetabuloplasty (DA) in patients with developmental dysplasia of the hip (DDH) by comparing the clinical and radiographic outcomes of DDH patients who underwent OR and DA with or without PFO. Methods: We retrospectively analyzed 61 DDH patients (72 hips) who underwent OR and DA at our hospital between January 2011 and December 2015. Finally, 52 patients (59 hips) with Tönnis types I, II, and III dislocation were included. We included 28 patients (31 hips) with a median operative age of 19.0 (17.0, 25.0) months (range, 15–36 months) in the PFO group. We included 24 patients (28 hips) with a median operative age of 16.0 (16.0, 23.5) months (range, 14–32 months) in the non-PFO group. Hip joint development was compared by measuring the following indicators: acetabular index (AI), femoral epiphyseal height-to-width index (HWI), et al. In both groups, we calculated changes in AI up to the final follow-up, namely ΔAI (postoperative – final follow-up). Results: Mean follow-up durations of the PFO and non-PFO groups were 42 months (range, 24–70 months). ΔAI (postoperative – final follow-up) was 5.6° (range, −15° to 24°; SD 9.0°) and 4.7° (range, −3° to 13°; SD 4.6°), respectively (t = −0.492, P = 0.625). HWI in both groups at the final follow-up was 55.9 (range, 43–76; SD 7.1) % and 53.1 (range, 43–68; SD 6.1) %, respectively (t = −1.654, P = 0.104). Conclusion: PFO is unnecessary when OR and DA is performed in walking-age children with Tönnis type III DDH or below. Level of evidence: level III.