Clinical and Radiological Outcomes of Dega Pelvic Osteotomy in Developmental Dysplasia of the Hip: A Case Series of 12 Hips in Children

Abstract

Introduction: Developmental dysplasia of the hip (DDH) diagnosed after walking age often requires surgical correction to restore adequate femoral head coverage and prevent long-term joint degeneration. Among pelvic osteotomies, the Dega osteotomy is widely used in skeletally immature patients because it allows controlled acetabular remodeling while preserving pelvic stability. Methods: We conducted a retrospective case series including 12 dysplastic hips in 8 children treated with Dega pelvic osteotomy between December 2020 and December 2023 in a tertiary pediatric orthopedic center. Clinical outcomes were assessed using the modified McKay classification. Radiological evaluation included the acetabular index (AI), lateral center-edge angle (LCEA), Wagner index, and Tönnis and Severin classifications. Results: The mean age at surgery was 4 years (range: 2–6 years) with a female predominance (75%). At final follow-up (mean: 18 months; range: 6–36 months), satisfactory clinical outcomes (McKay grades I and II) were observed in 87.5% of patients. The mean acetabular index improved from 30.9° preoperatively to 11.3°at final follow-up, while the mean lateral center-edge angle increased from 16° to 28.9°. The Wagner index normalized with a mean value of 90%. Radiological outcomes according to the Tönnis and Severin classifications were satisfactory in all hips. Complications were limited and included transient stiffness, one recurrence and one patient presented an avascular necrosis of the hip. Conclusion: In this retrospective case series of 12 hips in 8 children with a mean follow-up of 18 months, Dega pelvic osteotomy proved to be a reliable surgical option for the treatment of pediatric hip dysplasia, providing significant improvement in acetabular coverage and satisfactory clinical outcomes with a low complication rate. Longer follow-up studies are required to confirm the durability of these results.