Classification and other evaluations in DDH. Graf’s standard coronal section through the deepest...

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Classification and other evaluations in DDH

Graf’s standard coronal section through the deepest part of the acetabulum illustrating key structures (A), the angle (B), and the femoral head coverage

(C).

Rosendahl’s modification of the Graf classification based on the standard coronal section:A, normal, 60°;B, immature, 50° <60°;C, mild dysplasia 43° <50°;D, significant dysplasia, <43°.

On the basis of the AI, the hips were radiographically classified asnormal (A),having delayed acetabular ossification (B), ordysplastic (C).

Severin,s classification systemC E angle

19 degree Ia Class I

16 degree Ib Norma

19 degree IIa Class II

15 – 19 degree IIb Moderate deformity

15 degree IIIa Class III

IIIb Dysplasia without subluxation

0 IVa Class IV

0 IVb Subluxation Pseudoacetabulum Class V

Redislocation Class VI

1. Hip stable in neutral position—no osteotom2. Hip stable in flexion and abduction innominate osteotomy 3. Hip stable in internal rotation and abduction—proximal femoral derotational varus osteotomy 4. “Double-diameter” acetabulum with anterolateral deficiency—Pemberton-type osteotomy

A-one-stage-open-reduction-with-salter-s-innominate-osteotomy-and-corrective-femoral-osteotomy-for-the-treatment-

of-congenital-dysplasia-of-the-hip