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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 8, 1173-1177.
doi: 10.1302/0301-620X.85B8.14208  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Closed reduction of developmental dislocation of the hip by prolonged traction

N. Yamada, MD, Orthopaedic Surgeon1; S. Maeda, MD, PhD, Orthopaedic Surgeon1; G. Fujii, MD, PhD, Orthopaedic Surgeon2; A. Kita, MD , PhD, Orthopaedic Surgeon3; K. Funayama, MD, PhD, Orthopaedic Surgeon3; and S. Kokubun, MD, PhD, Professor and Chairman1

1 Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
2 National Sendai Hospital, 2-6-8 Miyagino, Miyagino-ku, Sendai 983-8520, Japan.
3 Sendai Red Cross Hospital, 2-43-3, Yagiyama-honcho, Taihaku-ku, Sendai 982-8501, Japan.

Correspondence should be sent to Dr N. Yamada.

The efficacy of traction before an attempted closed reduction for patients with developmental dislocation of the hip remains controversial. We treated 55 children (62 dislocations of the hip) by preliminary, prolonged traction for a mean of eight weeks. All were followed up for at least two years in order to observe the development of any avascular changes within the femoral head. Of the 55 children, 27 (31 dislocations) were followed up until they were over six years of age. Fifty-seven of the 62 hips (92%) showed a successful closed reduction. Only one had radiological evidence of avascular necrosis of the femoral head. Of the 31 hips which were followed up to over six years of age, 15 (48%) showed residual subluxation. Our method of prolonged preliminary traction leads to a high rate of successful closed reduction, a low incidence of avascular necrosis and a reduced need for secondary operations.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General