Congenital dislocation of the hip. A re-appraisal of the upper age limit for treatment Export

@article{313, abstract = {Difficulties posed in managing developmental dysplasia of the hip diagnosed late include a high-placed femoral head, contracted soft tissues and a dysplastic acetabulum. A combination of open reduction with femoral shortening of untreated congenital dislocations is a well-established practice. Femoral shortening prevents excessive pressure on the located femoral head which can cause avascular necrosis. Instability due to a coexisting dysplastic shallow acetabulum is common, and so a pelvic osteotomy is performed to achieve a stable and concentric hip reduction. We retrospectively reviewed 15 patients (18 hips) presenting with developmental dysplasia of the hip aged four years and above who were treated by a one-stage combined procedure performed by the senior author. The mean age at operation was five years and nine months (4 years to 11 years). The mean follow-up was six years ten months (2 years and 8 months to 8 years and 8 months). All patients were followed up clinically and radiologically in accordance with McKay's criteria and the modified Severin classification. According to the McKay criteria, 12 hips were rated excellent and six were good. All but one had a full range of movement. Eight had a limb-length discrepancy of about 1 cm. All were Trendelenburg negative. The modified Severin classification demonstrated four hips of grade IA, six of grade IB, and eight of grade II. One patient had avascular necrosis and one an early subluxation requiring revision. One-stage correction of congenital dislocation of the hip in an older child is a safe and effective treatment with good results in the short to medium term.}, address = {University Hospitals of Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK. vrpdr@yahoo.co.in}, author = {Vallamshetla, V. R. and Mughal, E. and O'Hara, J. N.}, citeulike-article-id = {2867693}, comment = {PUBM: Print; JID: 0375355; ppublish}, issn = {0301-620X}, journal = {The Journal of bone and joint surgery.British volume}, keywords = {complication, ddh, femur-head-necrosis, journal-club-2006, surgery}, number = {8}, pages = {1076--1081}, posted-at = {2008-06-05 21:54:53}, priority = {2}, title = {Congenital dislocation of the hip. A re-appraisal of the upper age limit for treatment}, volume = {88} }

TY - JOUR ID - 313 L3 - citeulike-article-id:2867693 N2 - Difficulties posed in managing developmental dysplasia of the hip diagnosed late include a high-placed femoral head, contracted soft tissues and a dysplastic acetabulum. A combination of open reduction with femoral shortening of untreated congenital dislocations is a well-established practice. Femoral shortening prevents excessive pressure on the located femoral head which can cause avascular necrosis. Instability due to a coexisting dysplastic shallow acetabulum is common, and so a pelvic osteotomy is performed to achieve a stable and concentric hip reduction. We retrospectively reviewed 15 patients (18 hips) presenting with developmental dysplasia of the hip aged four years and above who were treated by a one-stage combined procedure performed by the senior author. The mean age at operation was five years and nine months (4 years to 11 years). The mean follow-up was six years ten months (2 years and 8 months to 8 years and 8 months). All patients were followed up clinically and radiologically in accordance with McKay's criteria and the modified Severin classification. According to the McKay criteria, 12 hips were rated excellent and six were good. All but one had a full range of movement. Eight had a limb-length discrepancy of about 1 cm. All were Trendelenburg negative. The modified Severin classification demonstrated four hips of grade IA, six of grade IB, and eight of grade II. One patient had avascular necrosis and one an early subluxation requiring revision. One-stage correction of congenital dislocation of the hip in an older child is a safe and effective treatment with good results in the short to medium term. IS - 8 JF - The Journal of bone and joint surgery.British volume SN - 0301-620X AD - University Hospitals of Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK. vrpdr@yahoo.co.in EP - 1081 TI - Congenital dislocation of the hip. A re-appraisal of the upper age limit for treatment VL - 88 SP - 1076 KW - complication KW - ddh KW - femur-head-necrosis KW - journal-club-2006 KW - surgery N1 - PUBM: Print; JID: 0375355; ppublish AU - Vallamshetla, VR AU - Mughal, E AU - O'Hara, JN ER -