WOFAPS 2025 8th World Congress of Pediatric Surgery

Yangyang Yao, Yanzhou Wang, Tianyou Li, Jiaqi Wang, Xiaoqing Wang

Shandong Provincial Hospital, Jinan, Shandong, China

Purpose: Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic disease. While widespread ultrasound screening has significantly reduced surgical intervention rates in recent years, increasing attention has been drawn to syndromic DDH. Rare skeletal disorders complicated by DDH present surgical challenges due to underlying pathologies, limited case numbers, and insufficient treatment experience, often leading to complications with unclear prognoses. This study evaluates short-term surgical outcomes in rare skeletal disorders with DDH.

Method: We retrospectively analyzed clinical data and conducted follow-up assessments for children with rare skeletal disorders undergoing hip surgery between 2020-2023. Evaluations included preoperative/postoperative anteroposterior pelvic radiographs, clinical symptoms, and complications.

Results: The cohort comprised 15 DDH patients (12 boys, 3 girls) with rare skeletal disorders: 7 mucopolysaccharidosis (MPS), 2 mucolipidosis (MLS), 2 central core disease (CCD), 2 Prader-Willi syndrome (PWS), 1 osteogenesis imperfecta (OI), and 1 Kabuki syndrome (KS). Mean surgical age was 6.67 years (range 2-12). All patients received individualized surgical plans combining open reduction with or without femoral/pelvic osteotomy.Postoperative radiographs showed no cases of hip redislocation. Adequate femoral head coverage and acetabular development were achieved in 12 patients (5 MPS, 2 MLS, 2 CCD, 2 PWS, 1 OI, 1 KS). Two MPS cases exhibited residual acetabular dysplasia. No complications occurred including anesthesia risks, neurovascular injuries, implant failure, or infections.

Conclusion: When managing DDH patients with systemic comorbidities, clinicians should consider potential rare skeletal disordersBased on our experience, the overall surgical principles align with those for typical DDH cases, demonstrating favorable short-term outcomes. Long-term efficacy requires further observation. Perioperative management must address disease-specific risks: anesthesia challenges in MPS, malignant hyperthermia in CCD, and pathological fractures in OI. Successful management requires thorough understanding of underlying disorders to formulate individualized surgical strategies and rehabilitation protocols.