{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:17:23Z","timestamp":1772255843641,"version":"3.50.1"},"reference-count":21,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"11","license":[{"start":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T00:00:00Z","timestamp":1477958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p> Our aim was to assess the effectiveness of a protocol involving a standardised closed reduction for the treatment of children with developmental dysplasia of the hip (DDH) in maintaining reduction and to report the mid-term results. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> A total of 133 hips in 120 children aged less than two years who underwent closed reduction, with a minimum follow-up of five years or until subsequent surgery, were included in the study. The protocol defines the criteria for an acceptable reduction and the indications for a concomitant soft-tissue release. All children were immobilised in a short- leg cast for three months. Arthrograms were undertaken at the time of closed reduction and six weeks later. Follow-up radiographs were taken at six months and one, two and five years later and at the latest follow-up. The T\u00f6nnis grade, acetabular index, Severin grade and signs of osteonecrosis were recorded. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A total of 67 hips (51%) were T\u00f6nnis grade 3\/4 hips. By 12 months, 20 reductions (15%) had not been maintained, and these required open reduction. In all, 55% of these were Severin 1; the others were Severin 2, due to minor acetabular dysplasia. Of the 113 successful closed reductions, 98 hips (87%) were Severin 1. Surgery for residual DDH was offered for ten hips. Osteonecrosis was seen in 32 hips (29%) but was transient in 28. In total, two children (1.5%) had severe osteonecrosis. Bilateral dislocations were significantly more likely to fail and most T\u00f6nnis 4 hips failed. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Closed reduction, with concomitant adductor and psoas release when required and the use of a short leg plaster of Paris cast for three months, can produce good mid-term results in children with DDH aged less than two years. This protocol is not recommended for T\u00f6nnis 4 hips. Cite this article: Bone Joint J 2016;98-B:1548\u201353. <\/jats:p><\/jats:sec>","DOI":"10.1302\/0301-620x.98b11.36606","type":"journal-article","created":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T09:27:40Z","timestamp":1477992460000},"page":"1548-1553","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["A protocol for the use of closed reduction in children with developmental dysplasia of the hip incorporating open psoas and adductor releases and a short-leg cast"],"prefix":"10.1302","volume":"98-B","author":[{"given":"S. J.","family":"Tennant","sequence":"first","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore, HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. M.","family":"Eastwood","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore, HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Calder","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore, HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Hashemi-Nejad","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore, HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Catterall","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore, HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.00992"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.5301\/hipint.5000348"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-016-0743-7"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3181926c40"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B7.20041"},{"key":"r6","first-page":"82","volume":"36","author":"Murray T","year":"2007","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198062060-00002"},{"key":"r8","first-page":"1","volume":"84","author":"Severin E","year":"1941","journal-title":"Acta Chir Scand Suppl"},{"key":"r9","first-page":"39","volume":"119","author":"T\u00f6nnis D","year":"1976","journal-title":"Clin Orthop Relat Res"},{"key":"r10","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1936.01180240137007"},{"key":"r11","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00954"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800249322"},{"key":"r13","unstructured":"Ortolani M. Un Segno poco noto c sua importanza per la diagnosi precoce di prelussazione congenital dell\u2019anca. Pediatria (Napoli) 1937:45;129\u2013136. (In Italian)"},{"key":"r14","unstructured":"Kim HT. The fate of DDH Hips showing Carilaginous or fibrous tissue filled joint spaces following primary reduction. J Pediatr Orthop 2015 August 11. (Epub ahead of print)"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200011000-00002"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.96B3.32616"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196547040-00005"},{"key":"r18","first-page":"62","author":"Cooperman D","year":"1980","journal-title":"J Bone Joint Surg [Am]"},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.86B6.14441"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.1111\/os.12113"},{"key":"r21","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00096"}],"container-title":["The Bone &amp; Joint Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.98B11.36606","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.98B11.36606","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.98B11.36606","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T03:46:01Z","timestamp":1634615161000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.98B11.36606"}},"subtitle":["Mid-term outcomes in 113 hips"],"short-title":[],"issued":{"date-parts":[[2016,11]]},"references-count":21,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1302\/0301-620X.98B11.36606"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.98b11.36606","relation":{},"ISSN":["2049-4394","2049-4408"],"issn-type":[{"value":"2049-4394","type":"print"},{"value":"2049-4408","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11]]},"assertion":[{"value":"2015-05-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-11-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}