Closed reduction with traction for developmental dysplasia of the hip in children aged between one and five years

J Bone Joint Surg Br. 2008 Jul;90(7):858-63. doi: 10.1302/0301-620X.90B7.20041.

Abstract

The treatment of developmental dysplasia of the hip diagnosed after the first year of life remains controversial. A series of 36 children (47 hips), aged between one and 4.9 years underwent gradual closed reduction using the Petit-Morel method. A pelvic osteotomy was required in 43 hips (91.5%). The patients whose hips did not require pelvic osteotomy were among the youngest. The mean age at final follow-up was 16.1 years (11.3 to 32). The mean follow-up was 14.3 years (10 to 30). At the latest follow-up, 44 hips (93.6%) were graded as excellent or good according to the Severin classification. Closed reduction failed in only two hips (4.3%) which then required open reduction. Mild avascular necrosis was observed in one (2.1%). The accuracy of the reduction and associated low complication rate justify the use of the Petit-Morel technique as the treatment of choice for developmental dysplasia of the hip in patients aged between one and five years.

Publication types

  • Evaluation Study

MeSH terms

  • Acetabulum / surgery
  • Age Factors
  • Casts, Surgical
  • Child, Preschool
  • Female
  • Femur Head / surgery
  • Femur Head Necrosis / prevention & control
  • Hip Dislocation, Congenital / diagnostic imaging
  • Hip Dislocation, Congenital / surgery*
  • Humans
  • Infant, Newborn
  • Male
  • Osteotomy / methods*
  • Radiography
  • Traction / adverse effects
  • Traction / methods*
  • Treatment Outcome