These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Open reduction after failure of conservative treatment for congenital dislocation of the hip initiated before the age of six months].
    Author: Wicart P, Ghanem I, Seringe R.
    Journal: Rev Chir Orthop Reparatrice Appar Mot; 2003 Apr; 89(2):115-24. PubMed ID: 12844055.
    Abstract:
    PURPOSE OF THE STUDY: The aim of this study was to present the indications, technique and results of open reduction for congenital hip dislocation performed after failure of conservative treatment. MATERIAL AND METHODS: Criteria of inclusion in the series were: congenital dislocation of the hip treated conservatively before the age of six months requiring open reduction for failure of initial treatment between 1978 and 1998. During this period, 3000 hips sustained conservative treatment. The series counted 33 hips in 29 children. Mean number of different conservative methods used for one hip was 2.6. One-third of the hips had had previous surgery. Avascular necrosis was noticed in 17 cases (51.5%). Mean age at open reduction was 2 years. Pelvic (61%) and/or femoral (79%) osteotomies were combined with open reduction. RESULTS: Mean follow-up was 9.5 years. Among the complications, minor avascular necrosis was noticed in five hips without preoperative lesions. Hip joint congruency was excellent or good in 80.7% of the cases. There were no recurrent dislocations. Ten hips (32.3%) were free of avascular necrosis but 4 presented severe avascular necrosis (13%). DISCUSSION: Indications for open reduction are exceptional, attesting to the efficacy of conservative treatment. This salvage procedure achieves good results in the hands of experienced surgeons. The quality of the reduction depends not only on the intra- and extra-articular excision, but also on the stability achieved with peri-articular osteotomies. The main factor of prognosis is avascular necrosis induced by previous treatment.
    [Abstract] [Full Text] [Related] [New Search]