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Children's Orthopaedics: R. Angliss, G. Fujii, E. Pickvance, A. M. Wainwright, and M. K. D. Benson Surgical treatment of late developmental displacement of the hip: RESULTS AFTER 33 YEARS J Bone Joint Surg Br 2005; 87-B: 384-394 [Abstract] [Full text] [PDF]

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Response to the letter from Gavrankapetanovic and Vukasinovic

Andrew M Wainwright, Richard Angliss, Michael Benson   (3 June 2005)

Letter from Gavrankapetanovic and Vukasinovic

Ismet Gavrankapetanovic, Zoran Vukasinovic   (20 April 2005)

Response to the letter from Gavrankapetanovic and Vukasinovic 3 June 2005
Andrew M Wainwright, Orthopaedic Surgeon Nuffield Orthopaedic Centre, Richard Angliss, Michael Benson Send letter to journal: Re: Response to the letter from Gavrankapetanovic and Vukasinovic wainwrighta{at}noc.anglox.nhs.uk Andrew M Wainwright, et al.	Sir, We thank Drs Gavrankapetanovic and Vukasinovic for their comments. We recognise the importance of the iliopsoas in DDH management, but we are not clear how their comments relate to our paper, which describes the long-term results of a particular technique and not our current practice. A. M. WAINWRIGHT R. ANGLISS M. K. D. BENSON Nuffield Orthopaedic Centre, Oxford, UK.
Letter from Gavrankapetanovic and Vukasinovic 20 April 2005
Ismet Gavrankapetanovic, Professor of Orthopaedic Surgery , Zoran Vukasinovic Send letter to journal: Re: Letter from Gavrankapetanovic and Vukasinovic ismetcap{at}ortotrauma.com.ba Ismet Gavrankapetanovic, et al.	Sir, We read this article with much interest and would like to congratulate the authors upon their excellent results. We consider iliopsoas to be a key factor in both operative and non-operative treatment of DDH. According to conservative treatment, we always use vertical instead of longitudinal traction. Operative hip reduction and visualisation of the joint through the Smith-Petersen approach without exposure of iliopsoas is almost impossible. Iliopsoas is always shortened and it should be lengthened. This can be done using by the transverse two-incision technique, strictly in the zone of tendinous fibres. Meticulous protection of the medial circumflex artery is vital.1 The majority of revisions we performed were caused by unresolved pathology of iliopsoas. With adequate exposure and meticulous surgical technique there is no reason to damage the circumflex vessels. I. GAVRANKAPETANOVIC, MD, PhD Sarajevo Orthopaedic Clinic, Sarajevo, Bosnia and Herzegovina. Z. VUKASINOVIC, MD, PhD Institute of Orthopaedic Surgery, Belgrade, Serbia and Montenegro. 1. Herring JA, ed. Tachdjian's Pediatric Orthopedics. Vol. 1, Second ed. Philadelphia: W.B. Saunders, 2001:383.