Analysis of radiographic measurements as prognostic indicators of treatment success in patients with developmental dysplasia of the hip.
Measurements were taken and statistically analyzed from the initial radiographs, the 1-year follow-up radiographs, and the most recent radiographs of 81 patients (103 hips) to determine which measurements could predict the success of treatment. The average follow-up was 49 months (range, 12-139 months), and the average age of the patients at the last follow-up was 65 months (range, 15-190 months). Analysis of the data showed that the measurement with statistically significant predictive value was the Tonnis grade of dislocation determined from the initial radiograph. A single unit increase in the Tonnis grade was associated with a doubling of the odds of failure in patients treated with a Pavlik harness (P < 0.04, odds ratio = 2.2) or a closed reduction (odds ratio = 2.0).
Rosen
A
A
Division of Orthopaedic Surgery, Stanford University School of Medicine, Stanford University Medical Center, California, USA.
Gamble
J G
JG
Vallier
H
H
Bloch
D
D
Smith
L
L
Rinsky
L A
LA
D000293:Adolescent; D000367:Age Factors; D001915:Braces; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D008349:Manipulation, Orthopedic; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016896:Treatment Outcome