Ultrasound-guided gradual reduction using flexion and abduction continuous traction for developmental dysplasia of the hip: a new method of treatment.
We describe our experience in the reduction of dislocation of the hip secondary to developmental dysplasia using ultrasound-guided gradual reduction using flexion and abduction continuous traction (FACT-R). During a period of 13 years we treated 208 Suzuki type B or C complete dislocations of the hip in 202 children with a mean age of four months (0 to 11). The mean follow-up was 9.1 years (five to 16). The rate of reduction was 99.0%. There were no recurrent dislocations, and the rate of avascular necrosis of the femoral head was 1.0%. The rate of secondary surgery for residual acetabular dysplasia was 19.2%, and this was significantly higher in those children in whom the initial treatment was delayed or if other previous treatments had failed (p = 0.00045). The duration of FACT-R was significantly longer in severe dislocations (p = 0.001) or if previous treatments had failed (p = 0.018). This new method of treatment is effective and safe in these difficult cases and offers outcomes comparable to or better than those of standard methods.
Shiga Medical Center For Children, 5-7-30, Moriyama, Moriyama-city, Shiga Pref., 524-0022, Japan.
K
K
Fukiage
Shiga Medical Center For Children, 5-7-30, Moriyama, Moriyama-city, Shiga Pref., 524-0022, Japan.
T
T
Futami
Shiga Medical Center For Children, 5-7-30, Moriyama, Moriyama-city, Shiga Pref., 524-0022, Japan.
Y
Y
Ogi
Shiga Medical Center For Children, 5-7-30, Moriyama, Moriyama-city, Shiga Pref., 524-0022, Japan.
Y
Y
Harada
Shiga Medical Center For Children, 5-7-30, Moriyama, Moriyama-city, Shiga Pref., 524-0022, Japan.
F
F
Shimozono
SKY Orthopaedic Clinic, 10-1, Futaba-cho, Ibaraki, Osaka, Japan.
N
N
Kashiwagi
Takase Orthopaedic Clinic, 7-3, Misasagikamigobyono-cho, Yamashina, Kyoto, Japan.
T
T
Takase
Mizuno memorial hospital, 6-32-10, Nishiarai, Adachiku, Tokyo, Japan.
S
S
Suzuki
D005260:Female; D006618:Hip Dislocation, Congenital / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D014143:Traction / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
Hip; dislocation; gradual reduction