title: Ossification of the femoral head at closed reduction for developmental dysplasia of the hip and its influence on the long-term outcome.
abstract: The management of developmental dysplasia of the hip, particularly the timing of closed reduction with regard to the presence of the femoral head ossific nucleus, is controversial. The clinical and radiological outcome was assessed in a strictly defined group of 48 hips in 42 patients with an average of 11.1 years follow-up. One hundred percent of patients had an excellent or good result at final follow-up; 8.3% showed evidence of avascular necrosis and six hips underwent further surgery after closed reduction. There was no relationship between the presence or absence of an ossific nucleus at the time of closed reduction and the final outcome. In this well-defined group, closed reduction is safe and provides excellent results in the long term.
authors.affiliation: Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, UK. s.j.cooke@virgin.net
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Cooke
authors.forename: Robin
authors.initials: R
authors.lastname: Rees
authors.forename: Dai L
authors.initials: DL
authors.lastname: Edwards
authors.forename: Nigel T
authors.initials: NT
authors.lastname: Kiely
authors.forename: Gwyn A
authors.initials: GA
authors.lastname: Evans
mesh_terms: D001175:Arthrography; D002370:Casts, Surgical; D005260:Female; D005270:Femur Head / Q000473:pathology*; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008349:Manipulation, Orthopedic; D010012:Osteogenesis / Q000502:physiology*; D011183:Postoperative Complications / Q000473:pathology; D016896:Treatment Outcome