{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T01:40:07Z","timestamp":1760578807764,"version":"build-2065373602"},"reference-count":21,"publisher":"Baishideng Publishing Group Inc.","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Orthop"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Developmental dysplasia of the hip (DDH) remains a significant public health challenge, particularly in developing countries where cultural factors and limited access to appropriate medical equipment complicate optimal management.<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To evaluate the difficulties encountered in the management of DDH in our healthcare setting.<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>A retrospective, single-center study was conducted over nine years (2015-2023), including 20 patients (26 hips) with idiopathic DDH. Patients with post-traumatic or post-infectious hip dislocations were excluded. Data collected included age at diagnosis, laterality, T\u00f6nnis classification, duration of traction, and surgical interventions.<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>The mean age at diagnosis was 35.6 months (4 months to 10.8 years). Dislocation was unilateral in 70% of cases; 69.2% were classified as T\u00f6nnis stage 3 or 4. The average traction duration was 57.5 days. Surgery was performed in 8 hips. Among 16 patients with regular follow-up, 10 showed good outcomes, 3 excellent, and 3 fair according to the McKay score. Older age at treatment (&gt; 1 year), bilateral dislocation, and higher severity (T\u00f6nnis stages 3 and 4) were associated with worse functional outcomes. No significant correlation was found between functional and radiological results. Residual dysplasia occurred in 3 patients, and 1 re-dislocation was noted.<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>Delayed diagnosis and advanced severity at presentation are key challenges in managing DDH in our context. Nevertheless, appropriate management can achieve generally favorable outcomes, despite complications linked to prolonged treatment and resource limitations.<\/jats:p>","DOI":"10.5312\/wjo.v16.i10.112086","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:58:17Z","timestamp":1760576297000},"source":"Crossref","is-referenced-by-count":0,"title":["Challenges in the management of hip dislocation disease in Madagascar"],"prefix":"10.5312","volume":"16","author":[{"given":"Herijaona","family":"Manasse","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Poiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Moullac","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamisoa Bodohasina","family":"Rasamoelina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Daoulas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ga\u00ebtan Duval","family":"Solofomalala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.48087\/bjmsoa.2019.6205"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jradio.2011.07.013"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jidi.2017.11.003"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.sagf.2024.03.009"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/b978-2-294-75215-5.00014-2"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000733"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197401000-00013"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199705000-00004"},{"key":"B9","doi-asserted-by":"crossref","unstructured":"Classic. Translation: Hilgenreiner on congenital hip dislocation. J Pediatr Orthop 1986; 202-214","DOI":"10.1097\/01241398-198603000-00016"},{"key":"B10","doi-asserted-by":"crossref","unstructured":"Salter RB. The classic. Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip by Robert B. Salter, J. Bone Joint Surg. (Brit) 43B:3:518, 1961. 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