title: Surgical treatment of developmental dysplasia of the hip presenting in children above 10 years.
abstract: BACKGROUND
  Management of developmental dysplasia of the hip in older children remains controversial. The objective of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip in children older than 10 years.
  
  
  METHODS
  Sixty-three patients (75 hips) whose mean age at the time of surgery was 11.5 years (range 10-19 years) were treated using Salter osteotomy, Pemberton acetabuloplasty, Dega osteotomy, or Westin osteotomy. Subtrochanter transverse femoral shortening and derotation osteotomy were performed for all patients. A long leg cast, rather than a spica cast, was applied postoperation, and progressive flexion and extension exercises of the hip joint were initiated 2 weeks after the surgery.
  
  
  RESULTS
  All 63 patients (75 hips) were followed for an average of 7.6 years (range 5-10 years) after surgery. According to the McKay criteria and Severin X-ray criteria, the fineness ratios were 82.7 and 82.6%, respectively. After surgery, there were 4 cases of semiluxation (6.3%); 4 of femoral head ischemia necrosis (6.3%), and 9 of hip joint stiffness (14.3%).
  
  
  CONCLUSIONS
  We believe that preoperation overall evaluation and personalized operation plans, experience with the surgical procedure, and commencement of functional exercise soon after the operation are the main reasons for the satisfactory therapeutic effects achieved in this study after surgery for developmental dysplasia of the hip presenting in children older than 10 years.
authors.affiliation: Department of Orthopaedic, Nanjing Children's Hospital and Affiliated Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, People's Republic of China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Zheng
authors.forename: Kai
authors.initials: K
authors.lastname: Tang
authors.forename: Robert
authors.initials: R
authors.lastname: Lee
authors.forename: Chenbo
authors.initials: C
authors.lastname: Ji
authors.forename: Gang
authors.initials: G
authors.lastname: Lin
authors.forename: Xinhua
authors.initials: X
authors.lastname: Pan
authors.forename: Zhiqun
authors.initials: Z
authors.lastname: Zhang
authors.forename: Yue
authors.initials: Y
authors.lastname: Lou
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult