title: Outcome of one-stage treatment of developmental dysplasia of hip in older children.
abstract: BACKGROUND
  The principles of treatment of congenital dislocation of hip in old children are different than those of infants and neonates. The purpose of this study is to evaluate the radiographic and functional results of one-stage treatment (open reduction, femoral shortening derotation, and Salter's osteotomy) of DDH in older children.
  
  
  METHODS
  Between January 2005 and June 2010, 25 patients (30 hips) underwent one-stage triple procedure of open reduction, femoral shortening derotation, and Salter's osteotomy for the treatment of DDH. Preoperatively, they were classified according to the Tönnis class. Clinical outcomes were assessed using the modified McKay's criteria to measure pain symptoms, gait pattern, Trendelenburg sign status, and the range of hip joint movement. Radiographic assessment was made using Severin's scoring method to measure the centre-edge angle and dysplasia.
  
  
  RESULTS
  The mean age at the time of operation was 3.9 years (range 1.6-8 years), and the average duration of followup was 4.1 years (range 2-7.6 years). The McKay's score was excellent in 13 hips, good in 14 hips, fair in 2, and poor in 1 hip. The Severin's class I and II was found in 25 (83.3%) hips at the time of final evaluation as compared to none at the time of presentation.
  
  
  CONCLUSIONS
  Young children having DDH can safely be treated with an extensive one-stage triple procedure of open reduction, femoral shortening derotation, and Salter's osteotomy, without increasing the risk of AVN. Early diagnosis and intervention is the successful treatment of patients suffering from DDH.
authors.affiliation: Department of Orthopaedics, R. D. Gardi Medical College and C. R. G. Hospital, Ujjain - 456 006, Madhya Pradesh, India.
authors.forename: Basant Kumar
authors.initials: BK
authors.lastname: Bhuyan