Mohammad Shabir, Muhammad Inam, Abdul Satar, Mohammad Saeed, Imran Khan Wazir, Mohammad Arif, Awal Hakeem.
Five years follow up of one stage surgery for congenital dislocation of hip in children of 2-5 years of age.
J Pak Orthop Assoc Jan ;25(1):20-4.

Objective: To evaluate the results of a single stage combined procedure for congenital dislocation of the hip in 2-5 years group. Material and Methods: This descriptive study was conducted in the Department of Orthopaedics and Spine Surgery, Hayatabad Medical Complex, Peshawar, from September 2003 to December 2011on 25 patients with 30 hips who were operated for congenital dislocation of hip that presented after two years of age. The procedure consisted of arthrotomy, femoral shortening, derotational varus osteotomy and capsulorraphy. Pelvic osteotomy was done as and when required. Pre-operative and post-operative clinical and radiological assessment was done according to modified McKay and Severin criteria. Patients were followed up for five years. Results: There were 17 girls and eight boys in this study. Mean age was 3 years with minimum 2 and maximum 5 years. Five cases had bilateral dislocation. According to modified Severin classification, at the last follow up 7(28.0%) hips were graded as 1A, 4(16.0%) hips were graded as 1B, 11(44.0%) hips were graded as II and 3(12.0%) hips were graded as III. Avascular necrosis (AVN) of the head of femur as classified by Kalamchi and MacEwen at the time of last follow up was graded as I in 1(4%) cases and III in 3(12%) cases. Functional assessment was done according to modified McKay criterion. According to that criterion, in last follow up 15 (60%) were graded excellent 6(24%) good and 4(16.0%) fair. Conclusion: One stage correction of congenital dislocation of the hip in an older child is a safe and effective treatment with good results in the short to medium term.

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