Related Experiment Video
Updated: Oct 15, 2025
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
Petit-Morel method for hip development dysplasia in toddlers: A retrospective observational study in 34 patients
Matthieu Mazaleyrat1, Richard Lacroix1, Walid Lakhal2
1Service de chirurgie orthopédique pédiatrique, Hôpital Gatien de Clocheville, CHU de Tours - Université François Rabelais de Tours, PRES Centre-Val de Loire Université, Tours, France.
Insights
The Petit-Morel method offers reliable treatment for developmental hip dysplasia, showing good clinical and radiographic outcomes with low avascular necrosis rates. Some patients experienced adult walking pain linked to overcorrected hip angles.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Radiology
Background:
- Developmental hip dysplasia (DDH) is a common pediatric condition requiring effective treatment.
- The Petit-Morel method combines gradual traction, pelvic osteotomy, and immobilization for DDH treatment in toddlers.
- Assessing long-term outcomes of this method is crucial for clinical practice.
Purpose of the Study:
- To evaluate the radiographic and clinical outcomes of the Petit-Morel method for treating developmental hip dysplasia.
- To determine the incidence of avascular necrosis and acetabular dysplasia at skeletal maturity.
- To assess functional hip outcomes using the Postel-Merle d'Aubigné (PMA) score.
Main Methods:
- Retrospective cohort study of 34 patients (35 hips) treated between 1997 and 2014.
- Radiographic assessment included avascular necrosis (Kalamchi and MacEwan), vertical centre edge (VCE) angle, femoral head sphericity (Mose), and acetabular dysplasia (Severin).
- Clinical outcomes were evaluated using the PMA score.
Main Results:
- Mean follow-up was 11 years; 97% achieved Severin Class I at skeletal maturity.
- Low rates of avascular necrosis (3%) and excellent PMA scores (17-18) were observed.
- Overcorrection of the VCE angle was associated with pain during long walks in adulthood.
Conclusions:
- The Petit-Morel method is a reliable treatment for developmental hip dysplasia, yielding favorable long-term clinical and radiographic results.
- While effective, careful monitoring of VCE angle is important to prevent potential long-term complications like pain.
- This method demonstrates low rates of avascular necrosis and residual dysplasia, supporting its use in pediatric hip treatment.
Background:
The Petit-Morel method allows the treatment of developmental hip dysplasia in toddlers by combining gradual traction to achieve reduction followed by immobilisation during which pelvic osteotomy is performed. The objective of this study was to assess the radiographic and clinical outcomes in a retrospective cohort of patients.
Hypothesis:
The Petit-Morel method is associated with low rates of avascular necrosis and residual acetabular dysplasia at skeletal maturity, as well as with satisfactory medium-term clinical outcomes.
Material And Methods:
We conducted a single-centre retrospective study of 34 patients (35 hips) treated between 1997 and 2014. The radiological assessment criteria included an evaluation for avascular necrosis classified according to Kalamchi and MacEwan, the vertical centre edge (VCE) angle, femoral head sphericity according to Mose, and acetabular dysplasia at skeletal maturity according to Severin. Hip function was assessed by determining the Postel-Merle d'Aubigné (PMA) score.
Results:
Mean age at treatment was 19±4 months (range, 14-29). Mean follow-up was 11 years (range, 5-20). There were two failures including one case of recurrent dislocation requiring surgical reduction. Group II avascular necrosis occurred in 1 (3%) patient. Tönnis Grade IV dysplasia was significantly associated with resolving irregularity of the ossification centre, seen in 19 (54%) cases (p=0.002). In the 18 patients followed-up to skeletal maturity, with a mean follow-up of 15 years (range, 12-20 years), 17 hips were Severin Class I. The mean VCE angle was 29° (range, 15°-38°), and the head was spherical for 34 (98%) hips. The PMA score at last follow-up was excellent (17-18). The mean VCE angle was greater in all 5 patients who experienced pain during long walks (35° [range, 32°-37°]) than in the asymptomatic patients (28° [range, 15°-38°]) (p=0.009).
Discussion:
The Petit-Morel method is a reliable treatment that provides good clinical and radiological outcomes. Overcorrection of the VCE angle was noted in the patients who experienced walking-related pain in adulthood.
Level Of Evidence:
IV, retrospective observational cohort study.
More Related Videos
08:40Author Spotlight: A Novel 3D-Printed Titanium Implant for Minimally Invasive Treatment of Hip Dysplasia in Young Dogs
Published on: April 19, 2024
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022