title: Surgical treatment of developmental hip dislocation in children aged 1 to 3 years: a mean 18-year, 9-month follow-up study.
abstract: Forty-six consecutive patients with 57 congenitally dislocated hips were treated with open reduction and femoral or acetabular procedures as indicated. Patient age ranged from 12 to 36 months at the time of surgery. We evaluated the outcome of 38 of the 46 patients (83%) with 47 hips (83%) at a mean follow-up of 18 years, 9 months (range, 13 years, 7 months to 24 years, 7 months) after all patients had reached skeletal maturity.Using Severin's radiographic classification, 24 hips (52%) were rated as class I, 12 (26%) as class II, 8 (17%) as class III, 2 (4%) as class IV, and 0 as class V. The mean Iowa Hip Score was 92 points. One patient had significant abductor weakness and a Trendelenburg gait. The mean leg-length discrepancy was <1 cm. Disturbance in growth of the proximal aspect of the femur occurred in 10 hips (22%).In our experience, open reduction of the congenitally dislocated hip in children aged 1 to 3 years, combined with femoral or acetabular procedures, leads to successful clinical and radiographic results in most cases. These patients have an opportunity for normal hip function during childhood and the potential for a straightforward reconstructive procedure should they develop severe degenerative hip arthrosis.
authors.affiliation: Department of Orthopedic Surgery and Sports Medicine, The Methodist Hospital System, 6550 Fannin, Ste 2500, Houston, TX 77030, USA. kevarner@tmhs.org
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Varner
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Incavo
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Haynes
authors.forename: Jesse H
authors.initials: JH
authors.lastname: Dickson
mesh_terms: D000293:Adolescent; D001178:Arthroplasty / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010027:Osteotomy / Q000706:statistics & numerical data*; D015995:Prevalence; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult