title: Surgical dislocation for pediatric and adolescent hip deformity: clinical and radiographical results at 3 years follow-up.
abstract: BACKGROUND
  The aim of this study is to evaluate the clinical, radiographic short-term results and complications after surgical hip dislocation in young patients (≤18 years).
  
  
  METHODS
  Clinical and radiographic outcomes were assessed in patients who underwent a surgical hip dislocation Ganz-type approach between 2008 and 2012. Diagnosis included Legg-Calvé-Perthes disease, slipped capital femoral epiphysis, femoroacetabular impingement, osteonecrosis of the femoral head, multiple hereditary exostoses and pigmented villonodular synovitis. Clinical data, the modified Harris hip score, nonarthritic hip score, 12-item short form health survey, the Stulberg classification, morphometric indexes, signs of osteonecrosis and osteoarthrosis were used for the evaluation.
  
  
  RESULTS
  After a mean 3 years follow-up (range 0.5-6 years), 53 hips (51 patients) were evaluated. The most common diagnoses were Legg-Calvé-Perthes disease, slipped capital femoral epiphysis, femoroacetabular impingement and multiple hereditary exostoses. Mean age at surgery was 14 years (range 10-18 years). Through this approach femoral head-neck osteoplasty, Dunn-type osteotomy, labrum refixation, synovectomy, femoral head mosaicplasty open reduction and fixation for slipped capital femoral epiphysis were performed, finally in association with pelvic or intertrochanteric osteotomy. At follow-up, better outcome scores were obtained, progression of the osteonecrosis of the femoral head was observed in four cases and three further patients required the implant of a total hip prosthesis.
  
  
  CONCLUSIONS
  After 3 years follow-up, results are comparable to previous studies and patients have a high rate of satisfaction, however the effectiveness of those procedures have to be proved on the long term. Results and complications seem to be related with preoperative lesion(s) and type of treatment.
  
  
  METHODS
  Level IV, retrospective study, case series.
authors.affiliation: Orthopädische Klinik des Olgahospitals, Klinikum Stuttgart (DE), Kriegsbergstrasse 62, 70174, Stuttgart, Germany. nicola.guindani@gmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Guindani
authors.affiliation: Orthopädische Klinik des Olgahospitals, Klinikum Stuttgart (DE), Kriegsbergstrasse 62, 70174, Stuttgart, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Eberhardt
authors.affiliation: Orthopädische Klinik des Olgahospitals, Klinikum Stuttgart (DE), Kriegsbergstrasse 62, 70174, Stuttgart, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wirth
authors.affiliation: Dipartimento Di Biotecnologie e Scienze Della Vita, University Of Insubria, V. le Borri, 57, 21100, Varese, Italy.
authors.forename: Michele F
authors.initials: MF
authors.lastname: Surace
authors.affiliation: Orthopädische Klinik des Olgahospitals, Klinikum Stuttgart (DE), Kriegsbergstrasse 62, 70174, Stuttgart, Germany.
authors.forename: Francisco F
authors.initials: FF
authors.lastname: Fernandez
mesh_terms: D000293:Adolescent; D019644:Arthroplasty, Replacement, Hip; D002648:Child; D005097:Exostoses, Multiple Hereditary / Q000601:surgery*; D005260:Female; D057925:Femoracetabular Impingement / Q000601:surgery*; D005270:Femur Head / Q000601:surgery; D005271:Femur Head Necrosis / Q000601:surgery; D005500:Follow-Up Studies; D006617:Hip Dislocation; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D060048:Slipped Capital Femoral Epiphyses / Q000601:surgery*; D013586:Synovitis, Pigmented Villonodular / Q000601:surgery; D016896:Treatment Outcome
keywords: Modified Dunn osteotomy; Pediatric hip pathology; Surgical hip dislocation; Trochanter flip osteotomy