Letter to the Editor: Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup
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- Citlak, A. & Sener, M. Clin Orthop Relat Res (2015) 473: 3056. doi:10.1007/s11999-015-4409-4
We read the article by Farsetti et al.  with great interest. Their study evaluated the long-term results of medial open reduction in the treatment of developmental dysplasia of the hip. The authors concluded that medial open reduction is a safe procedure with satisfactory results in patients up to the age of 36 months .
Although we appreciate the work by Farsetti and colleagues, we have some concerns. In their study, the age groups lack homogenity. We also found patient selection bias . Group 3 consisted of 11 patients (18 hips) who were 25 to 36 months old at the time of operation, equaling 25% of all hips in the study. The authors observed avascular necrosis in 44% of these hips . This rate is higher than the other groups in the study. Additionally, it is well-known that medial open reduction is associated with a higher incidence of secondary procedures in children older than 18 months to 24 months of age [2, 3].
We would like to thank Farsetti and colleagues for this paper. However, we do not agree with the their conclusions due to the high avascular necrosis rate and need for secondary procedures in children 25 to 36 months old. We believe that medial open reduction should be used in children up to the age of 18 months to 24 months.