Presentation Pattern and Early Surgical Outcomes of Developmental Dysplasia of the Hip among Bangladeshi Children

Open Access

Abstract

Introduction: Developmental dysplasia of the hip (DDH) is an important pediatric orthopedic condition that can lead to persistent hip instability, deformity, gait abnormality, and early degenerative changes if diagnosis and treatment are delayed. Therefore, this study was conducted to assess the presentation pattern, clinical and radiological severity, surgical management, and early postoperative outcomes of DDH among Bangladeshi children. Methods & Materials: This cross-sectional, descriptive observational study was conducted in the Department of Orthopaedic Surgery of National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh from January 2025 to December 2025. A total of 100 children were enrolled using consecutive purposive sampling. Data were analyzed using SPSS version 26.0. Results: Radiological acetabular dysplasia was present in 84.0%, while 47.0% had Tönnis grade III/IV dislocation. Open reduction was performed in 82.0%, with pelvic osteotomy required in 48.0% and femoral shortening in 20.0%. At 3-month follow-up, 92.0% achieved stable/concentric reduction and 74.0% had favorable functional outcomes; AVN occurred in 7.0% and redislocation/subluxation in 4.0%. Older age at presentation was significantly associated with poorer functional outcomes (p=0.002). Conclusion: The study demonstrated that DDH in Bangladeshi children was commonly diagnosed at a delayed age, with 65.0% diagnosed after 12 months and 60.0% presenting after walking age. Despite the late presentation and considerable radiological involvement, surgical management resulted in 92.0% stable/concentric reductions and 74.0% favorable early functional outcomes, with a relatively low incidence of postoperative complications. Notably, increasing age at presentation was significantly associated with less favorable functional outcomes (p=0.002), emphasizing the importance of early diagnosis and timely intervention.