To compare one-stage combined surgery with and without preoperative traction, in older children with developmental dislocation of the hip (DDH).
Methods.
Records of 9 children who underwent combined surgery for DDH with preoperative traction in 12 hips (group 1) and 12 undergoing the same procedure without preoperative traction in 16 hips (group 2) were retrospectively reviewed. The surgery consisted of open reduction, Salter's innominate osteotomy and femoral shortening with derotation varus osteotomy. The mean age of the patients at the time of operation was 5.8 years. The mean follow-up period was 5.9 years.
Results.
At final follow-up, clinical outcome in group 1 was worse than that in group 2, though radiographic assessment demonstrated no significant difference between the groups.
Conclusion.
One-stage combined surgery without preoperative traction is effective in the treatment of DDH in older children, and has a lower complication rate, but radiographically the groups did not differ.
MorcuendeJAMeyerMDDolanLAWeinsteinSL. Long-term outcome after open reduction through an anteromedial approach for congenital dislocation of the hip. J Bone Joint Surg Am1997;79:810–7.
2.
GabuzdaGMRenshawTS. Reduction of congenital dislocation of the hip. J Bone Joint Surg Am1992;74:624–31.
3.
WeinsteinSL. Natural history of congenital hip dislocation (CDH) and hip dysplasia. Clin Orthop Relat Res1987;225:62–76.
4.
RamseyPLLasserSMacEwenGD. Congenital dislocation of the hip. Use of the Pavlik harness in the child during the first six months of life. J Bone Joint Surg Am1976;58:1000–4.
5.
MillisMBKocherMS. Hip, pelvis, and femur: Pediatric aspects. In: KovalKJ, editor. Orthopaedic knowledge update 7. Rosemont: Am Acad Orthop Surg2002:387–91.
6.
KarakasESBaktirAArgunMTurkCY. One-stage treatment of congenital dislocation of the hip in older children. J Pediatr Orthop1995;15:330–6.
7.
DimitriouJKCavadiasAX. One-stage surgical procedure for congenital dislocation of the hip in older children. Long-term results. Clin Orthop Relat Res1989;246:30–8.
8.
KlisicPJankovicLBasaraV. Long-term results of combined operative reduction of the hip in older children. J Pediatr Orthop1988;8:532–4.
9.
ShihCHShihHN. One-stage combined operation of congenital dislocation of the hips in older children. J Pediatr Orthop1988;8:535–9.
10.
MacEwenGD. Treatment of congenital dislocation of the hip in older children. Clin Orthop Relat Res1987;225:86–92.
11.
AshleyRKLarsenLJJamesPM. Reduction of dislocation of the hip in older children: A preliminary report. J Bone Joint Surg Am1972;54:545–50.
12.
BrowneRS. The management of late diagnosed congenital dislocation and subluxation of the hip: With special reference to femoral shortening. J Bone Joint Surg Br1979;61:7–12.
13.
GalpinRDRoachJWWengerDRHerringJABirchJG. One-stage treatment of congenital dislocation of the hip in older children, including femoral shortening. J Bone Joint Surg Am1989;71:734–41.
14.
HeroldHZDanielD. Reduction of neglected congenital dislocation of the hip in children over the age of six years. J Bone Joint Surg Br1979;61:1–6.
15.
WengerDRLeeCSKolmanB. Derotational femoral shortening for developmental dislocation of the hip: Special indications and results in the child younger than 2 years. J Pediatr Orthop1995;15:768–9.
16.
WillamsonDMGloverSDBensonMK. Congenital dislocation of the hip presenting after the age of three years. A long-term review. J Bone Joint Surg Br1989;71:745–51.
17.
McKayDW. A comparison of the innominate and the pericapsular osteotomy in the treatment of congenital dislocation of the hip. Clin Orthop Relat Res1974;98:124–32.
18.
BarrettWPStaheliLTChewDE. The effectiveness of the Salter innominate osteotomy in the treatment of congenital dislocation of the hip. J Bone Joint Surg Am1986;68:79–87.
19.
SharpIK. Accetabular dysplasia: The acetabular angle. J Bone Joint Surg Br1961;43:268–72.
20.
WibergG. Studies on dysplastic acetabula and congenital subluxation of the hip joint: With special reference to the complications of osteoarthritis. Acta Chir Scand Suppl1941;83(Suppl58).
21.
SeverinE. Contribution to the knowledge of congenital dislocation of the hip joint. Late results of closed reduction and arthrographic studies of recent cases. Acta Chir Scand Suppl1941;84(Suppl 63):1–142.
22.
KalamchiAMacEwenGD. Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Joint Surg Am1980;62:876–88.
23.
OmbredanneL. Precis clinique et operatoire de chirurgie infantile. Paris: Masson et Cie; 1932.
24.
ChakirgilGS. Radical reduction operation in the treatment of congenital dislocation of the hip. An analysis of 2,789 cases. Orthopedics1987;10:711–20.
25.
MorelG. The treatment of congenital dislocation and subluxation of the hip in the older child. Acta Orthop Scand1975;46:364–99.
26.
SchoeneckerPLStreckerWB. Congenital dislocation of the hip in children. Comparison of the effects of femoral shortening and of skeletal traction in treatment. J Bone Joint Surg Am1984;66:21–7.
27.
BeatyJH. Congenital and developmental dislocation of hip. In: CrenshawAH, editor. Campbell's operative orthopaedics. Vol III, 8th ed.St Louis: CV Mosby; 1992:2159–92.
28.
SalterRBDubosJP. The first fifteen year's personal experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. Clin Orthop Relat Res1974;98:72–103.
29.
DegaWKrolJPolakowskiL. Surgical treatment of congenital dislocation of the hip in children: A one-stage procedure. J Bone Joint Surg Am1959;41:920–34.
30.
ThomsonJE. The Jan Zahradnicek surgical approach to the problem of congenital hip dislocation. Clin Orthop1956;8:237–43.
31.
WadaAFujiiTTakamuraKYanagidaHTaketaMNakamuraT. Pemberton osteotomy for developmental dysplasia of the hip in older children. J Pediatr Orthop2003;23:508–13.
32.
AlbeeFH. The bone graft wedge. Its use in the treatment of relapsing, acquired and congenital dislocation of the hip. NY Med J1915;102:433.
