To compare the rate and severity of avascular necrosis following medial open and closed reduction in developmental hip dysplasia and the resulting influence on femoral and acetabular development. The radiographs and hospital records of 118 patients with dislocation of the hip were reviewed. 57 patients (66 hips) underwent medial open reduction and 61 patients (75 hips) underwent closed reduction. Mean follow-up was 10.9 years (5 years to 17.4 years). Avascular necrosis (AVN) was recorded according to the Bucholz and Ogden classification. The acetabular index was measured pre-operatively, at 1 and 4 years following surgery. The final radiograph was assigned a Severin grade. Sharp and centre-edge angles were recorded at final follow-up. A Severin grade I or II was considered a satisfactory result and a grade III to V an unsatisfactory result. Initial non-operative measures, such as Pavlik harness treatment and traction were documented. Additional surgical interventions were noted.Aim
Method
To establish the incidence of clinically significant avascular necrosis (AVN) and the resultant influence on radiological outcome following medial open reduction for DDH. A systematic review of the literature was performed using Medline and Embase, from 1946 to 2012, to identify all relevant clinical studies. We excluded papers with a mean follow-up under 5 years. The effect of length of follow-up, outcome according to Severin, age at surgery, and type of growth disturbance were reviewed.Aim
Method
