{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:00:20Z","timestamp":1781848820486,"version":"3.54.5"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,11,28]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Developmental dysplasia of the hip (DDH) affects 4\u20136 per 1000 live births in developed countries. Effective treatment to realign the hip is necessary to avoid long-term morbidities and maximise functional outcome. Treatment options depend on patient age but typically involve hip bracing and\/or reduction under general anaesthetic. Some centres also employ prereduction hip traction. Historical papers suggest traction reduces risk of avascular necrosis (AVN) femoral head and reduces requirement for open reduction. However, several studies including a large retrospective cohort study, dispute this. We propose to perform the first systematic review and meta-analysis to clarify the value of prereduction hip traction in the management of DDH in children under the age of 3\u2009years by identifying whether it impacts on the rate of successful closed reduction (CR) and risk of AVN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will search MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to identify potentially relevant studies. Studies reporting on incidence of successful CR, AVN femoral head and complications associated with prereduction hip traction in children of less than 3\u2009years with DDH will be eligible for inclusion. Only randomised controlled trials, prospective and retrospective case\u2013control and comparative cohort studies will be included in quantitative review. There will be no study design restrictions for inclusion in qualitative review. Following study selection, full-text paper retrieval, data extraction and synthesis, studies will be assessed for risk of bias and heterogeneity. If the included studies are sufficiently homogeneous, then we will perform meta-analysis. A narrative synthesis of the systematic review\u2019s results will also be presented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Formal ethical approval is not required as primary patient data will not be collected. The systematic review\u2019s results will be disseminated through a peer-reviewed publication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"CRD42017064254\" specific-use=\"clinicaltrial pre-results\">CRD42017064254<\/jats:ext-link>\n                      ; Pre-results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019599","type":"journal-article","created":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T00:20:19Z","timestamp":1517271619000},"page":"e019599","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Evaluating the role of prereduction hip traction in the management of infants and children with developmental dysplasia of the hip (DDH): protocol for a systematic review and planned meta-analysis"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-3682","authenticated-orcid":false,"given":"Sarah","family":"Walton","sequence":"first","affiliation":[{"name":"Neonatal Unit, Addenbrooke\u2019s Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"International Hip Dysplasia Institute, Orlando, Florida, USA"},{"name":"Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Department of Orthopaedic Surgery, British Columbia Children\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishore","family":"Mulpuri","sequence":"additional","affiliation":[{"name":"International Hip Dysplasia Institute, Orlando, Florida, USA"},{"name":"Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Department of Orthopaedic Surgery, British Columbia Children\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Cundy","sequence":"additional","affiliation":[{"name":"Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia"},{"name":"Department of Orthopaedic Surgery, Women\u2019s and Children\u2019s Hospital, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Williams","sequence":"additional","affiliation":[{"name":"Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia"},{"name":"Department of Orthopaedic Surgery, Women\u2019s and Children\u2019s Hospital, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,1,29]]},"reference":[{"key":"2025121223095884000_8.1.e019599.1","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jpeds.2016.10.017","article-title":"Relative risk and incidence for developmental dysplasia of the hip","volume":"181","author":"Pollet","year":"2017","journal-title":"J Pediatr"},{"key":"2025121223095884000_8.1.e019599.2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1007\/s11832-016-0798-5","article-title":"Epidemiology of developmental dysplasia of the hip within the UK: refining the risk factors","volume":"10","author":"Woodacre","year":"2016","journal-title":"J Child Orthop"},{"key":"2025121223095884000_8.1.e019599.3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.4.896"},{"key":"2025121223095884000_8.1.e019599.4","doi-asserted-by":"crossref","first-page":"230949901771719","DOI":"10.1177\/2309499017717197","article-title":"Diagnosis and treatment of developmental dysplasia of the hip: a current practice of paediatric orthopaedic surgeons","volume":"25","author":"Al-Essa","year":"2017","journal-title":"J Orthop Surg"},{"key":"2025121223095884000_8.1.e019599.5","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B8.14208"},{"key":"2025121223095884000_8.1.e019599.6","doi-asserted-by":"crossref","unstructured":"DeRosa GP , Feller N . 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