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 Table of Contents    
LETTER TO EDITOR  
Year : 2013  |  Volume : 47  |  Issue : 2  |  Page : 217-218
Author reply


Department of Orthopaedics and Trauma, R. D. Gardi Medical College and C. R. G. Hospital, Ujjain, Madhya Pradesh, India

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Date of Web Publication16-Mar-2013
 

How to cite this article:
Bhuyan BK. Author reply. Indian J Orthop 2013;47:217-8

How to cite this URL:
Bhuyan BK. Author reply. Indian J Orthop [serial online] 2013 [cited 2020 Jan 25];47:217-8. Available from: http://www.ijoonline.com/text.asp?2013/47/2/217/108949
Sir,

Thank you for reading my article [1] with interest. I appreciate your efforts in bringing out certain details. [2]

Radiographic analysis of the hip in young children is unsatisfactory due to predominance of cartilage; hence, surgical plan for femoral derotation was based upon the intraoperative assessment. It is estimated by the angle between axis of knee joint (with the knee flexed to 90°) and axis of femoral neck by palpating the anterior aspect of femoral neck. [3] This can also be estimated by CT or MRI analysis, but these investigations are costly and not routinely performed at our institute.

We found femoral neck anteversion more than 60° and difficulty in reduction of the hip joint in all of our cases. Hence, derotation component was added apart from femoral shortening in all of our cases. It facilitates reduction of the hip joint and is more effective in reducing the joint pressure, and hence in decreasing the rate of AVN and chondrolysis. [4] After triple procedure, there is no need for forced internal rotation as the hip is stable in neutral position.

 
   References Top

1.Bhuyan BK. Outcome of one-stage treatment of developmental dysplasia of hip in older children. Indian J Orthop 2012;46:548-55.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Mootha AK, Saini R. Outcome of one-stage treatment of developmental dysplasia of hip in older children. Indian J Orthop 2013;47:217.  Back to cited text no. 2
  Medknow Journal  
3.Weinstein SL, Mubarak SJ, Wenger DR. Developmental hip dysplasia and dislocation: Part II. Instr Course Lect 2004;53:531-42.  Back to cited text no. 3
[PUBMED]    
4.Browne RS. The management of late diagnosed congenital dislocation and subluxation of the hip with special reference to femoral shortening. J Bone Joint Surg Br 1979;61:7-12.  Back to cited text no. 4
[PUBMED]    

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Correspondence Address:
Basant Kumar Bhuyan
Department of Orthopaedics and Trauma, R. D. Gardi Medical College and C. R. G. Hospital,Ujjain, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


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