title: Outcome of triple procedure in older children with developmental dysplasia of hip (DDH).
abstract: OBJECTIVE
  To evaluate the radiographic and functional results of the triple procedure (open reduction, femoral shortening and Salter's Osteotomy) in the treatment of Developmental Dysplasia of the Hip (DDH) disease in older children.
  
  
  METHODS
  This case-series comprising 23 patients (29 hips) underwent the triple procedure of open reduction, femoral shortening and Salter osteotomy, at Aga Khan University Hospital between June 1995 and June 2005. Patients were classified pre-operatively according to the Tonnis class. Postoperative functional evaluation was performed using Modified MacKay's scoring system and radiographic assessment using Severin's scoring method.
  
  
  RESULTS
  The mean age of patients at presentation was 6.84 years and the average follow-up was 19.6 months. The MacKay score was 'Good' to 'Excellent' in 25 hips; we had a failure in 1 hip joint. The Severin's class was I in 15 (51.7%) hips at the time of final evaluation as compared to none at the time of presentation. Patients younger than 5.6 years of age had a better radiological and clinical outcome as compared to older patients (p-value < 0.05).
  
  
  CONCLUSIONS
  The triple procedure of open reduction, femoral shortening and Salter osteotomy gives best results in younger children. Early diagnosis and intervention is therefore imperative in the successful treatment of patients suffering from DDH.
authors.affiliation: Department of Surgery, The Aga University, Medical College, Karachi.
authors.forename: Masood
authors.initials: M
authors.lastname: Umer
authors.forename: Haq
authors.initials: H
authors.lastname: Nawaz
authors.forename: Pashtoon Murtaza
authors.initials: PM
authors.lastname: Kasi
authors.forename: Mahmood
authors.initials: M
authors.lastname: Ahmed
authors.forename: Syed Sohail
authors.initials: SS
authors.lastname: Ali
mesh_terms: D000367:Age Factors; D002648:Child; D006305:Health Status Indicators; D006615:Hip / Q000473:pathology*; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome