Add like
Add dislike
Add to saved papers

Fifty-year follow-up of late-detected hip dislocation: clinical and radiographic outcomes for seventy-one patients treated with traction to obtain gradual closed reduction.

BACKGROUND: There is little knowledge concerning outcomes for middle-aged adults who were treated for late-detected developmental dislocation of the hip. The aims of this retrospective study were to evaluate the fifty-year clinical and radiographic results after closed reduction and to identify prognostic factors.

METHODS: Seventy-one patients (ninety hips) with late-detected hip dislocation treated between 1958 and 1962 were assessed clinically and radiographically. The primary treatment was skin traction to obtain a gradual closed reduction. The mean age of the patients at the time of the long-term radiographic examination was 51.6 years (range, forty-four to fifty-five years).

RESULTS: A stable reduction was achieved in eighty-three hips. The mean age at reduction was 1.7 years (range, 0.3 to 5.4 years). Traction failed in six patients (seven hips [8%]), for whom an open reduction was necessary. Twenty-six patients (thirty hips) underwent late surgical procedures because of residual hip dysplasia. A good long-term clinical outcome (a Harris hip score of ≥85 points) after closed reduction was assessed for fifty-two (63%) of the hips. A satisfactory radiographic outcome (no osteoarthritis) was found for fifty-six (67%) of the hips. Osteoarthritis had developed in twenty-seven (33%) of the hips, of which nineteen had undergone total hip replacement, performed at a mean patient age of 43.7 years (range, thirty-one to fifty-four years). Risk factors for osteoarthritis were an older age at the time of reduction, osteonecrosis of the femoral head, residual subluxation, a high acetabular index during childhood, and a classification of Severin grades III or IV at skeletal maturity. A survival analysis showed a reduction in "surviving" hips (no total hip replacement) from 99% at a patient age of thirty years to 74% at the age of fifty-two years.

CONCLUSIONS: With a mean follow-up of fifty years, the clinical and radiographic outcomes after gradual closed reduction by skin traction were satisfactory in approximately two-thirds of eighty-three hips. The most important independent risk factors for a poor long-term outcome were an age of eighteen months or older at the time of reduction, residual subluxation, and osteonecrosis.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

Related Resources

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app