Treatment of late-presenting developmental dislocation of the hip by progressive orthopaedic reduction and innominate osteotomy. Our results with more than 30 years of follow up
Bibliographic record
Abstract
BACKGROUND: The treatment of late-presenting developmental dislocation of the hip (DDH) is still controversial. A consecutive series of 32 patients not previously treated (43 hips, Tönnis grade 3 or 4) underwent progressive closed reduction followed immediately by innominate osteotomy between 1964 and 1976. They were between 1.5 and 5 years old at the time of pelvic osteotomy. This study was designed to check the outcome of these patients more than 30 years later. METHODS: Eight patients living outside of France (North Africa) could not be reached and one patient had died of an unrelated cause. The remaining 23 patients (32 hips) were reviewed with clinical assessment (Merle d'Aubigné, Harris and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] scores) and anteroposterior (AP) pelvic radiograph. This represents a 75% rate of follow up at 31 to 44 years post-operatively. RESULTS: In two patients, surgery was repeated due to residual subluxation. Only one patient needed a total hip replacement (THR) 33 years after initial treatment. The Merle d'Aubigné, Harris and WOMAC scores for the surviving hips were excellent or good in almost 80% of the cases. In four cases, radiographic signs "at risk for" osteoarthritis were present. Regularity of the femoral head was perfect in seven hips, regular in 18 and irregular in six. According to the Severin-Seringe classification, 25 hips could be classified as group I (14 group IA and 11 group IB), three group II and three group VII. CONCLUSION: The long-term results of non-previously treated late-presenting DDH by the technique of progressive closed reduction followed by innominate osteotomy are quite good and compare favourably with the long-term results of open reduction with the same osteotomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".