title: Long-term outcome of Ludloff's medial approach for open reduction of developmental dislocation of the hip in relation to the age at operation.
abstract: We reviewed long-term outcomes after open reduction by the medial approach for developmental dislocation of the hip (DDH). Forty-five hips in 43 patients with more than ten years of follow-up were assessed clinically and radiologically. The mean age at surgery was 14.0 (range 6-31) months, and the follow-up period ranged from ten to 28 years (mean 16.4 years). We compared the good (18 hips) and poor groups (27 hips) as classified by the Severin classification. The mean age at surgery was significantly older in the poor group than the good group (17.1 and 9.4 months, respectively, P < 0.001). Thirteen (29%) of 45 hips had avascular necrosis (AVN) of the femoral head. The mean age at surgery was significantly older in the patients with AVN than without AVN (20.0 and 11.6 months, respectively, P < 0.001). Another approach, such as the wide exposure method, should be selected for DDH with increased age at operation.
authors.affiliation: Department of Orthopaedic Surgery, Nagasaki Medical Center, 2-1001-1 Kubara, Omura, 852-8562, Japan. kunidon@wm.pdx.ne.jp
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Okano
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamada
authors.forename: Katsuro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Enomoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Osaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shindo
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D005260:Female; D005271:Femur Head Necrosis / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome