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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 7, 858-863.
doi: 10.1302/0301-620X.90B7.20041  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Closed reduction with traction for developmental dysplasia of the hip in children aged between one and five years

V. Rampal, MD, Orthopaedic Surgeon1; M. Sabourin, MD, Orthopaedic Surgeon2; E. Erdeneshoo, MD, Orthopaedic Surgeon2; G. Koureas, MD, PhD, Orthopaedic Surgeon3; R. Seringe, MD, Professor, Head of Service2; and P. Wicart, Professor2

1 Service d’orthopedie, pédiatrique, Hopital Saint Vincent-de-Paul, 74–82 avenue Denfert, Rochereau, 75014 Paris, France.
2 Department of Pediatric, Orthopaedic Surgery (APHP), René Descartes University, (Paris V), Saint-Vincent-de-Paul Hospital, 74–82 avenue Denfert-Rochereau, 75674 Paris Cedex, 14, France.
3 Kokkinou 12–14 Zaimi Street, TK, 27100 Pyrgos, Ilias, Greece.

Correspondence should be sent to Professor P. Wicart; e-mail: p.wicart{at}svp.aphp.fr

The treatment of developmental dysplasia of the hip diagnosed after the first year of life remains controversial. A series of 36 children (47 hips), aged between one and 4.9 years underwent gradual closed reduction using the Petit-Morel method. A pelvic osteotomy was required in 43 hips (91.5%). The patients whose hips did not require pelvic osteotomy were among the youngest. The mean age at final follow-up was 16.1 years (11.3 to 32). The mean follow-up was 14.3 years (10 to 30).

At the latest follow-up, 44 hips (93.6%) were graded as excellent or good according to the Severin classification. Closed reduction failed in only two hips (4.3%) which then required open reduction. Mild avascular necrosis was observed in one (2.1%).

The accuracy of the reduction and associated low complication rate justify the use of the Petit-Morel technique as the treatment of choice for developmental dysplasia of the hip in patients aged between one and five years.






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