One-Stage Treatment of Congenital Dislocation of the Hip in Children Three to Ten Years Old. Functional and Radiographic Results*

Outcome in Unilateral or Bilateral DDH Treated with One-stage Combined Procedure

“…We also observed a negative correlation between patients' ages and their scores in Group II. Our results are similar to other reports [16,17,19,20]. The followup period in our study has not been long enough to provide an adequate long-term evaluation of the primary operation.…”

“…Our patients who had bilateral DDH and were treated with a one-stage combined operation before the age of 5.5 years had better results in regard to ON than did patients who had the operation after the age of 5.5 years. These data support those of other investigators [14,19]. Ryan et al [19] reported 13 patients (three of 15 hips) younger than 7 years old suffered ON, whereas this ratio increased to 70% in 5 patients (10 hips) older than 7 years old.…”

“…These data support those of other investigators [14,19]. Ryan et al [19] reported 13 patients (three of 15 hips) younger than 7 years old suffered ON, whereas this ratio increased to 70% in 5 patients (10 hips) older than 7 years old. However, the ON outcome shows the patients with DDH treated by one-stage combined operations before the age of 8 years were not different from patients who had the operation after age 8.…”

“…The age at which open reduction is no longer reasonable in a child is unknown, although the indications for surgery appear to broaden every few years [19]. We believe the one-stage approach to all hip abnormalities in late-diagnosed DDH is reasonable; there remains some potential for growth and remodeling [4,8,14], although the potential decreases by age 8.…”

“…Treatment modalities include various nonoperative or operative approaches (open reduction, and pelvic or femoral osteotomies) [6,12,18]. We believe a one-stage surgical approach in late-diagnosed DDH seems the most reasonable treatment based on our review of the literature [6,8,12,19]. However, there is considerable variability in the anatomy of older children with DDH and lesser ability of their bones to remodel.…”