title: Chronic hip dislocations: a rarity. How should we treat them?
abstract: BACKGROUND
  Chronically dislocated hips (>6 weeks) are usually the consequence of difficulties accessing appropriate healthcare in a timely fashion after dislocation; this explains why they are more common in developing countries. Due to a lack of research, there is currently no consensus on the best treatment available for patients presenting with this condition. Therefore, it is important to assess the treatments available so as to ensure that doctors adequately manage those presenting with this debilitating condition in the future.
  
  
  OBJECTIVE
  To identify the best treatment strategy for chronic hip dislocations based on the treatment outcomes achieved by a free surgical clinic in Phnom Penh, Cambodia.
  
  
  METHODS
  A retrospective analysis of the surgical centre's electronic records was conducted. Patients presenting with hips dislocated for >6 weeks were included whilst congenitally dislocated hips were excluded. Treatment outcomes, based on follow up notes, were then assessed. Data abstracted during chart review was analysed using descriptive and comparative statistics.
  
  
  RESULTS
  72 patients presented to the clinic with chronic hip dislocations. 42 patients received recorded treatment and 32 were followed up. Among patients with follow-up, 63% experienced 'good' outcomes after treatment. Open reductions, the most common treatment, were successful 65% of the time. The use of preoperative traction increased the success of open reductions by 13%, however, this result was not statistically significant (p= 0.64).
  
  
  CONCLUSIONS
  Open reductions with pre-operative traction seem to be an acceptable treatment in this setting.
authors.affiliation: University of Cambridge, Cambridge, England, United Kingdom.
authors.forename: V
authors.initials: V
authors.lastname: Selimi
authors.affiliation: Children's Surgical Centre, Phnom Penh, Cambodia.
authors.forename: O
authors.initials: O
authors.lastname: Heang
authors.affiliation: Children's Surgical Centre, Phnom Penh, Cambodia.
authors.forename: Y
authors.initials: Y
authors.lastname: Kim
authors.affiliation: WWAMI (Washington, Alaska, Montana and Idaho), USA.
authors.forename: E
authors.initials: E
authors.lastname: Woelber
authors.affiliation: Children's Surgical Centre, Phnom Penh, Cambodia.
authors.forename: J
authors.initials: J
authors.lastname: Gollogly
keywords: Chronic; Hip dislocation