For instance, there is associated adaptive shortening of the soft tissues, capsular constriction, increased femoral anteversion, acetabular dysplasia, presence of obstructing structures such as the fibrofatty tissue in the acetabulum, hypertrophied ligamentum teres, the
transverse acetabular ligament and fixed inversion of limbus.1-4,13,14 Femoral diaphyseal shortening is superior to traction as an aid in operative reduction of DDH in older children.
The acetabular labrum is a triangular fibrocartilaginous structure that forms a horseshoe-shaped attachment to the acetabular rim, which connects the acetabulum to the underlying
transverse acetabular ligament [Figure 1]a.[sup][1] Up to 90% of symptomatic patients with developmental dysplasia of the hip (DDH) are found to combine with lesions of acetabular labrum.[sup][2] The most common presentations of the acetabular labrum lesions are hypertrophy, laceration, and/or cyst formation.[sup][3],[4] Nevertheless, a unique hip joint condition is observed recently in several symptomatic DDH patients [Figure 1]b.
The ligament, which is pyramidal in shape, may consist of multiple bundles, and blends with the
transverse acetabular ligament. It plays a minor role in (i) maintaining hip stability by reducing excessive movement, (ii) nociception via type iva somatosensory fibres and (iii) minimal femoral head perfusion.(1)
Otherwise, through the same incision, the inferomedial hip joint capsule was opened, the ligamentum teres was excised, and the
transverse acetabular ligament was sectioned to obtain an anatomic reduction during the same operative session.
(3,9) It is triangular in cross-section, thinner antero-inferiorly, thicker and rounded posteriorly and merges with the
transverse acetabular ligament at the inferior border of the acetabular rim.