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although its incidence has decreased significantly &#40;2&#46;38&#37; of cases treated with conservative approaches&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> The developed complications are usually related to the type of treatment used or the difficulty of hip stabilisation&#46; Many studies in the literature have found factors that influence the prognosis of conservative treatment and the development of complications&#44; such as delayed diagnosis&#44; bilaterality&#44; hip luxation versus preluxation&#44; teratologic dislocations&#44; adduction contracture of the hip or the initial position of the femoral head&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#8211;7</span></a> However&#44; few studies in the literature have analysed the impact of comorbidities such as psychomotor delays&#44; behavioural disorders or cerebral palsy on DDH&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to analyse the cases of DDH that did not respond well to conservative treatment and the possible influence of psychomotor disorders&#44; which could be risk factors contributing to these poor outcomes&#46; To do so&#44; we conducted a retrospective study of patients that received a diagnosis of psychomotor disorder when treatment for DDH had already started&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a retrospective observational study of the cases of DDH treated in our hospital between January 2002 and December 2012 &#40;325 cases of DDH in 293 patients&#41;&#46; Orthopaedic treatment failed in 44 of the cases under study &#40;13&#46;5&#37;&#41;&#44; with failure defined as not achieving concentric reduction of the hip or the persistence of a residual hip dysplasia with an acetabular index &#40;AI&#41; greater than 30&#176; that did not resolve after the patient began walking&#46; Psychomotor delays were detected in 10 of these patients &#40;16 hips&#41;&#44; months after treatment of DDH had been initiated&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Of the total cases of DDH that we found&#44; 309 &#40;283 patients&#41; were free of psychomotor comorbidity&#44; and the initial orthopaedic treatment failed in 34 cases &#40;10&#37;&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Of the 16 cases &#40;10 patients&#41; with a psychomotor comorbidity&#44; 75&#37; &#40;12 cases&#41; were refractory to treatment&#44; while the outcome of conservative treatment of DDH was successful in the remaining 25&#37; &#40;4 cases&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We collected data for the following variables for the 10 patients included in the analysis&#58; sex&#44; side involved&#44; gestational age at birth&#44; type of delivery &#40;caesarean or vaginal&#41;&#44; birth weight&#44; age at diagnosis of DDH&#44; type of treatment received&#44; and complications&#46; These patients were evaluated on the basis of clinical features and&#47;or magnetic resonance imaging by the Paediatric Neurology Unit to confirm the presence of brain lesions or behavioural disorders&#46; We collected data on the age at diagnosis&#44; neurologic disease&#44; ability to walk&#44; and age at which patients began walking&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The radiologic followup consisted of anteroposterior pelvis radiographs and axial hip radiographs&#46; In cases treated with spica casts or with a high degree of hip instability&#44; the followup also included a computed axial tomography scan in the early postoperative period to confirm the correct reduction of the dislocated hip&#46; The radiographic parameters that were documented were the location of the ossification centre in the femoral head based on the Ombredanne quadrants &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; and the AI before and after orthopaedic treatment&#46; These values were measured in digital radiographs using the Centricity application developed by General Electrics&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">We analysed the data using SPSS version 18&#46; We conducted a descriptive study&#44; expressing quantitative variables as medians and qualitative variables as absolute frequencies and percentages &#40;&#37;&#41;&#46; We determined the statistical significance of qualitative variables by means of the chi square test&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Of the 325 cases treated conservatively in our hospital&#44; 44 had poor outcomes &#40;failure to achieve concentric reduction of the hip or evidence of residual dysplasia with an AI greater than 30&#176;&#41; on follow-up imaging tests that did not resolve fully after the patient began walking&#41;&#46; Psychomotor disorders were diagnosed in 16 cases of DDH &#40;36&#37;&#41; that corresponded to 10 patients&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Sixty percent of the patients &#40;6 cases&#41; were female&#44; and 40&#37; male&#46; As for laterality&#44; six patients had bilateral involvement &#40;60&#37; of patients&#41;&#44; three had unilateral involvement of the right hip &#40;30&#37; of patients&#41; and one had unilateral involvement of the left hip &#40;10&#37; of patients&#41;&#46; Four patients &#40;40&#37;&#41; were delivered by caesarean section&#44; three due to breech presentation and one due to foetal distress&#46; Three patients &#40;30&#37;&#41; were born preterm &#40;before 38 weeks&#8217; gestation&#41;&#46; The mean birth weight for the 10 patients was 2967<span class="elsevierStyleHsp" style=""></span>g &#40;range&#44; 2250&#8211;4410&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Developmental dysplasia of the hip was detected during the physical examination of the newborn in five patients&#44; and late in the other five &#40;at ages 6&#8211;10 months&#41;&#44; although it was detected before the diagnosis of psychomotor disorder in all&#46; The mean age at diagnosis of DDH was 3&#46;3 months &#40;range&#44; 0&#8211;10 months&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the treatments received by each patient with their duration and outcomes&#46; Conservative treatment was only successful in four cases&#44; while in the remaining cases&#44; the persistence of luxation or subluxation or an elevated AI called for surgical intervention &#40;surgery has already been performed in eight of these cases&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The changes in the documented radiologic parameters showed improvement after treatment&#44; with the average AI changing 38&#46;2&#8211;30&#46;6&#176; &#40;IAs were greater than 30&#176; in seven cases&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">As for the position of the centres of ossification before treatment&#44; they were located in the lower inner quadrant in four cases&#44; in the lower outer quadrant in eight cases&#44; and in the upper outer quadrant in four cases&#46; After conservative treatment&#44; the position of the centres had shifted&#44; with ten of them located in the lower inner quadrant and the remaining six in the lower outer quadrant&#46; The hips that were positioned normally at the outset were treated due to the presence of marked acetabular dysplasia&#44; with a mean AI of 38&#176;&#44; as they were not likely to correct spontaneously when the patient started walking&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The complications that developed during treatment included a femoral head fracture and three cases of avascular necrosis of the femoral head &#40;18&#37;&#41;&#44; two of which were partial &#40;of which one resulted in a residual coxa magna deformity&#41; and one of which involved the entire epiphysis&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The mean age at which these patients started ambulating was 2&#8211;3 years&#44; and eight of them succeeded in achieving independent walking &#40;four patients are unable to walk unassisted&#41;&#46; The patient with hypoplasia of the corpus callosum has achieved an assisted gait with double support&#44; as has one of the patients with a pervasive developmental disorder&#44; which in this case was secondary to hydrocephalus&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The evaluation in the Unit of Paediatric Neurology took place at a mean age of 2&#46;5 years &#40;range&#44; 0&#46;7&#8211;7 years&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the aetiological diagnoses of the patients&#46; Pervasive developmental disorders were diagnosed in 80&#37;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In our series&#44; poor outcomes occurred in 75&#37; of patients with DDH and psychomotor comorbidities&#44; compared to 10&#37; of patients in whom such a comorbidity was not detected&#46; The relative risk of a poor outcome was 7&#46;2 times higher in patients with psychomotor disorders&#44; and the difference was statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">Appropriate and early treatment of DDH succeeds in resolving 85&#37; of cases with conservative approaches&#44;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1&#44;2</span></a> but certain circumstances may be associated with poor outcomes&#46; There are articles in the literature that refer to factors that may contribute to poor outcomes&#44; such as hip luxation compared to subluxation&#44; a delay in diagnosis or initiation of treatment&#44; and others&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#8211;7</span></a> However&#44; few studies have mentioned psychomotor disorders as potential risk factors for poor outcomes of orthopaedic treatment&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">As we mentioned above&#44; 16 &#40;36&#37;&#41; of the total hips that were refractory to conservative orthopaedic treatment corresponded to patients with psychomotor disorders that had been detected after treatment initiation&#46; In 75&#37; of these cases &#40;12 hips&#41;&#44; there was residual dysplasia or hip migration after completion of conservative treatment that was an indication for surgery &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; In our series&#44; this amounted to a probability of poor outcome in patients with DDH and a psychomotor disorder of 75&#37; compared to 10&#37; in patients that did not have this comorbidity&#44; with a relative risk that was 7&#46;2 times greater&#44; a difference that was statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; Despite the small number of cases&#44; these findings seem to support the hypothesis that the psychomotor disorders observed in our study&#44; which did not involve significant abnormalities in muscle tone that would hinder the restoration of the optimal biomechanical conditions to achieve adequate joint stability &#40;as observed in patients with cerebral palsy or flaccid paralysis&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">8&#44;9</span></a> contribute to the poor prognosis for treatment of DDH&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">It is important to differentiate between DDH and neuromuscular dislocation of the hip&#44; as explained by Luther and Clarke&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> Developmental dysplasia of the hip has been thoroughly investigated and documented&#44; and it characteristically presents with hip instability affecting both acetabular and femoral development&#46; It is detected in the neonatal period&#44; and usually responds well to early conservative treatment&#46; Neuromuscular dislocation results from an imbalance in muscular forces across the hip joint&#44; which gradually affects the position of the femoral head and subsequently impairs acetabular development in the growth period&#46; This type of dislocation generally presents later and requires primary surgical treatment&#46; Although the two are separate entities&#44; DDH may also occur in patients with underlying neurologic disease&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Of the ten patients studied in our series&#44; seven had a pervasive developmental disorder&#46; This type of disorder is not usually accompanied by significant abnormalities in muscle tone that would predispose the individual to late-onset neuromuscular dislocations&#44; although it is frequently associated with mild degrees of hypotonia and abnormalities in motor coordination that are detected in early childhood&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">11&#8211;13</span></a> Of the three remaining patients&#44; one received a diagnosis of Prader-Willi syndrome&#44; which is characterised by obesity&#44; hypogonadism&#44; cognitive delay and hypotonia&#44; and in which DDH occurs up to 10 times more than in the general population&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> a fact that may be related to the reduced muscle tone&#46; No studies have been published on the specific subject of the treatment and outcomes of hip dysplasia in these patients&#46; In our study&#44; despite early diagnosis and treatment&#44; the poor outcome of orthopaedic treatment led to the surgical correction by osteotomy of both hips&#46; Another of our patients received a diagnosis of spastic diplegia after the neonatal diagnosis of DDH&#46; This patient is scheduled to undergo bilateral periacetabular osteotomy because the AIs and femoral head coverage have improved very little since the beginning of treatment&#46; The patient in our series that had hypoplasia of the corpus callosum&#44; which was diagnosed late &#40;at age 11 months&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a> had mild axial hypotonia with normal muscle tone in the extremities&#46; Despite treatment with a series of spica body casts&#44; there has been little improvement and the patient is currently awaiting surgery for bilateral hip subluxation&#46; The purpose in delaying surgical treatment in the last two patients is to allow them to develop a stable unassisted gait before the procedure&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The diagnosis of DDH was made in the neonatal period in six of the patients in our study&#46; The delay in the diagnosis of the remaining patients &#40;after age 6 months&#41; could be associated with a poorer prognosis of orthopaedic treatment&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#44;6</span></a> but in our series we did not observe any differences between patients with a delayed diagnosis compared to those with an early diagnosis&#46; Of the 16 hips in our series&#44; 12 required invasive intervention for complete resolution&#46; As for the degree of coverage of the femoral head&#44; six of the hips continued to show some degree of migration&#44; although the position of the femoral head improved in all&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Wilkinson and Sedgwick reviewed a series of 130 hips with DDH in which primary surgical treatment had failed&#44; and found that 11&#37; of these patients had occult spinal dysraphism or mild joint laxity&#46; These authors suggested that weakness of the internal rotators of the hip might have been the cause of the observed residual subluxation that was refractory to treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a> It may be possible to extrapolate these findings to our case series&#44; although we would need to obtain electromyographic data to confirm it&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The complications that developed during conservative treatment in our patients included avascular necrosis of the femoral head in three cases&#8212;a patchy necrosis in two cases that progressed to coxa magna in one&#44; and total avascular necrosis in one case&#8212;with the incidence of this complication reaching 18&#37;&#44; substantially exceeding the rates reported in other published studies&#44; which are of approximately 2&#46;4&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> Another patient had a femur fracture during treatment with the Pavlik harness&#44; which caused a significant deformity that hindered the reduction of the dislocation and the subsequent outcome&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Patients with DDH that receive conservative treatment tend to have mild delays in achieving unassisted walking compared to the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> However&#44; our cases reached this milestone with a considerable delay&#44; at a mean age of 2&#46;4 years&#44; although earlier than the mean age in patients with cerebral palsy&#44; many of whom reach it past age 5 years&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">17</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Psychomotor disorders were diagnosed after initiation of treatment for DDH in all patients in our series at a mean age of 2&#46;5 years&#46; The main challenge in this type of disorders is the difficulty in making an early diagnosis&#46; With the exception of those affected by Prader-Willi syndrome&#44; these patients do not have distinctive features to guide the diagnosis&#44; and exhibit normal psychomotor development at early ages in most cases&#44; with the disorder manifesting gradually as they grow&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In our series of 325 cases treated for DDH we only found 16 hips &#40;5&#37;&#41; in 10 patients that had a psychomotor disorder&#46; While it would not be counterproductive to keep in mind this possibility in the early weeks of life of a patient with DDH&#44; we do not think that families should be informed of it&#44; as the presence or absence of neurologic disease in these patients is not known at the outset and it would create unnecessary alarm in most of the families&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Conversely&#44; being aware of it may be useful if conservative orthopaedic treatment is completed and the outcome is not satisfactory&#44; with the patient requiring surgery&#46; We believe that it is when failure of treatment for DDH is accompanied by a delay in achieving motor or cognitive milestones &#40;speech&#44; crawling&#44; walking&#8230;&#41; that the child should be referred for evaluation by a paediatric neurologist and the family informed of this possibility&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The limitations of our study are those inherent in its retrospective design&#44; the small number of patients that met the inclusion criteria&#44; having different periods of followup&#44; and lack of a standard protocol for imaging tests&#46; However&#44; it seems evident that the outcomes of conservative treatment in these patients are poor&#44; which opens up a new line of research on the impact of psychomotor disorders as risk factors for a poor prognosis in DDH that could be subject to further study&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interests</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare</p></span></span>"
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            0 => "Displasia del desarrollo de la cadera"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Orthopaedic treatment of developmental dysplasia of the hip &#40;DDH&#41; has a high success rate in cases that are diagnosed early&#46; However&#44; the outcomes of these patients are not really known when they are subsequently diagnosed with some type of cerebral impairment&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective observational study was conducted on cases of DDH with a poor outcome after orthopaedic treatment&#44; being unknown if they had any type of psychomotor disorder&#46; The patients were clinically and radiologically assessed&#44; and afterwards received neurological valuation by the Child Neurology Unit&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 325 cases of DDH diagnosed in 293 patients&#44; 10 patients &#40;3&#37;&#41; with 16 hips with DDH were diagnosed of any cerebral impairment&#46; All of them were initially treated orthopedically&#46; Clinical and radiologically evolution was succesful only in 4 cases &#40;25&#37;&#41; being necessary any surgical procedure in the remaining 12 cases&#46; After surgical treatment we got an improvement in the Acetabular Index &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41; and Reimers Extrusion Index &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;042&#41;&#46; Neck-shaft angle and Wiberg CE angle also improved but this difference was not statically significant&#46; Cerebral impairment was diagnosed at 2&#46;5 years of age and the begining of walking was delayed at 2&#46;4 years of age&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cerebral impairment can lead to an unfavourable outcome in the treatment of DDH&#44; with the relative risk of a poor outcome being 7&#46;2 times higher in these patients&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">An unfavourable outcome with conventional treatment of DDH must make us suspect the presence of some type of neurological disorder&#44; particularly if there is a delay in walking&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El tratamiento ortop&#233;dico de la displasia del desarrollo de la cadera &#40;DDC&#41; presenta un alto porcentaje de &#233;xito en casos diagnosticados precozmente o en los primeros meses de vida&#46; Sin embargo&#44; se desconoce qu&#233; resultados presentan estos pacientes cuando posteriormente son diagnosticados de un trastorno psicomotor&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se realiza un estudio observacional retrospectivo de los casos de DDC con mala evoluci&#243;n tras tratamiento ortop&#233;dico&#44; desconoci&#233;ndose si presentaban alg&#250;n tipo de trastorno psicomotor&#46; Los pacientes fueron valorados cl&#237;nica y radiol&#243;gicamente&#44; y por la Unidad de Neurolog&#237;a Infantil&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">De los 325 casos de DDC diagnosticados en 293 pacientes&#44; 10 pacientes &#40;3&#37;&#41; con 16 caderas con DDC fueron diagnosticados de alg&#250;n tipo de trastorno psicomotor&#46; Todos los casos inicialmente fueron tratados ortop&#233;dicamente&#46; La evoluci&#243;n tanto cl&#237;nica como radiol&#243;gica en estos casos fue favorable sOlo en 4 &#40;25&#37;&#41;&#46; En los 12 restantes se indic&#243; quir&#250;rgica para su resoluci&#243;n &#40;75&#37;&#41;&#46; Hubo mejor&#237;a tras tratamiento quir&#250;rgico en el &#237;ndice acetabular &#40;p &#61; 0&#44;005&#41; y en el &#237;ndice de extrusi&#243;n de Reimers &#40;p &#61; 0&#44;042&#41;&#46; El &#225;ngulo c&#201;rvico-diafisario y el &#225;ngulo CE de Wiberg tambi&#233;n mejoraron&#44; pero su diferencia no fue estad&#237;sticamente significativa&#46; El diagn&#243;stico del trastorno psicomotor se realiz&#243; a los 2&#44;5 a&#241;os de edad&#46; El inicio de la deambulaci&#243;n de estos pacientes estaba retrasado&#44; inici&#225;ndose a los 2&#44;4 a&#241;os&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">El trastorno psicomotor puede condicionar una t&#243;rpida evoluci&#243;n en el tratamiento conservador de la DDC&#59; el riesgo relativo de presentar un mal resultado es 7&#46;2 veces mayor en estos pacientes&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Ante una mala respuesta al tratamiento convencional de una DDC&#44; debe sospecharse la existencia de un posible trastorno neurol&#243;gico de base&#44; especialmente si hay un retraso en la deambulaci&#243;n&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Pipa-Mu&#241;iz I&#44; Rodr&#237;guez-Rodr&#237;guez ML&#44; Felgueroso-Juliana MB&#44; Riera-Campillo M&#44; Gonz&#225;lez-Herranz P&#46; Displasia del desarrollo de la cadera en ni&#241;os con trastorno psicomotor&#46; &#191;Factor de riesgo para un mal resultado&#63;&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;85&#58;142&#8211;148&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Ombredanne quadrants&#46; The arrow points at the location of the centre of ossification of the femoral head in quadrant 3&#46;</p>"
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            "imagen" => "gr2.jpeg"
            "Alto" => 1065
            "Ancho" => 1700
            "Tamanyo" => 111833
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        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Clinical case number 12&#46; &#40;A&#41; Diagnosis of DDH at age 8 months treated conservatively with a series of spica casts&#46; &#40;B&#41; Outcome of conservative orthopaedic treatment at age 6 years&#44; with acetabular dysplasia&#44; a coxa valga deformity&#44; and a disrupted Shenton&#39;s line&#46; &#40;C&#41; Surgical treatment with a Salter osteotomy&#44; combining transplantation of an allograft from a tissue bank with a femoral varus derotation osteotomy&#46; &#40;D&#41; Final outcome at age 8 years&#46;</p>"
        ]
      ]
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        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">DDH&#44; developmental hip dysplasia&#59; Dx&#44; diagnosis&#59; F&#44; female&#59; FVDO&#44; femoral varus derotation osteotomy&#59; HAB&#44; hip abduction brace&#59; HCC&#44; hypoplasia of the corpus callosum&#59; L&#44; left&#59; LB&#44; left bilateral&#59; M&#44; male&#59; m&#44; months&#59; OR&#44; open reduction&#59; PDD&#44; pervasive developmental disorder&#59; R&#44; right&#59; RB&#44; right bilateral&#59; SBC&#44; spica body cast&#59; SD&#44; spastic diplegia&#59; Tx&#44; treatment&#46;</p>"
          "tablatextoimagen" => array:1 [
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Side&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Weeks of gestation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Delivery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Weight &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at Dx of DDH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type and duration of orthopaedic Tx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome of conservative treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Surgical treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Neurologic Dx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at neurologic Dx &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at beginning of walking &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2340&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2340&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2540&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2540&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-3<span class="elsevierStyleHsp" style=""></span>m<br>SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Luxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD &#40;hydrocephalus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-3<span class="elsevierStyleHsp" style=""></span>m<br>SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Luxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD &#40;hydrocephalus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4290&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-1<span class="elsevierStyleHsp" style=""></span>m<br>SBC-3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4290&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-1<span class="elsevierStyleHsp" style=""></span>m<br>SBC-3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Luxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HAB-9<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dega&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HAB-9<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dega&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-1<span class="elsevierStyleHsp" style=""></span>m<br>SBC-3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2550&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBCs-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBCs-6<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>occult spinal dysraphism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">unknown&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-2<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Acetabular dysplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prader-Willi&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-2<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Acetabular dysplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prader-Willi&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4410&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Summary of cases&#46;</p>"
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:17 [
            0 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early failure of Pavlik harness treatment for developmental hip dysplasia&#58; clinical and ultrasound predictors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Lerman"
                            1 => "J&#46;B&#46; Emans"
                            2 => "M&#46;B&#46; Millis"
                            3 => "J&#46; Share"
                            4 => "D&#46; Zurakowski"
                            5 => "J&#46;R&#46; Kasser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "2001"
                        "volumen" => "21"
                        "paginaInicial" => "348"
                        "paginaFinal" => "353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11371819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
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            1 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Pavlik harness in the treatment of congenital dislocating hip&#58; report on a multicenter study of the European Pediatric Orthopedic Society"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Grill"
                            1 => "H&#46; Bensahel"
                            2 => "J&#46; Canadell"
                            3 => "P&#46; Dungl"
                            4 => "T&#46; Matasovic"
                            5 => "T&#46; Vizkelety"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "1988"
                        "volumen" => "8"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3335614"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0100"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differences in risk factors between early and late diagnosed developmental dysplasia of the hip"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Sharpe"
                            1 => "K&#46; Mulpuri"
                            2 => "P&#46;J&#46; Cundy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "2006"
                        "volumen" => "91"
                        "paginaInicial" => "158"
                        "paginaFinal" => "162"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictive factors for unsuccessful treatment of developmental dysplasia of the hip by the Pavlik harness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Kitoh"
                            1 => "M&#46; Kawasumi"
                            2 => "N&#46; Ishiguro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/BPO.0b013e3181b2f200"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "2009"
                        "volumen" => "29"
                        "paginaInicial" => "552"
                        "paginaFinal" => "557"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19700982"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0110"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High failure rate of the Pavlik harness in dislocated hips&#58; is it bilaterality&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Palocaren"
                            1 => "K&#46; Rogers"
                            2 => "T&#46; Haumont"
                            3 => "L&#46; Grissom"
                            4 => "M&#46;M&#46; Thacker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/BPO.0b013e318287ffc6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "2013"
                        "volumen" => "33"
                        "paginaInicial" => "530"
                        "paginaFinal" => "535"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23752151"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0115"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful Pavlik treatment in late-diagnosed developmental dysplasia of the hip"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;A&#46; Van de Sande"
                            1 => "F&#46; Melisie"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1007/s00264-012-1587-5"
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                        "tituloSerie" => "Int Orthop"
                        "fecha" => "2012"
                        "volumen" => "36"
                        "paginaInicial" => "1661"
                        "paginaFinal" => "1668"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22684545"
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                      "titulo" => "Ultrasonographic findings in hips with a positive Ortolani sign and their relationship to Pavlik harness failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;K&#46; White"
                            1 => "D&#46;J&#46; Sucato"
                            2 => "S&#46; Agrawal"
                            3 => "R&#46; Browne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "2010"
                        "volumen" => "92-A"
                        "paginaInicial" => "113"
                        "paginaFinal" => "120"
                      ]
                    ]
                  ]
                ]
              ]
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                      "titulo" => "Evaluation and treatment of hip dysplasia in cerebral palsy"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;A&#46; Speigel"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ocl.2005.11.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Orthop Clin North Am"
                        "fecha" => "2006"
                        "volumen" => "37"
                        "paginaInicial" => "185"
                        "paginaFinal" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16638449"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0130"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The hip in cerebral palsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;S&#46; Cornell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Dev Med Child Neurol"
                        "fecha" => "1995"
                        "volumen" => "37"
                        "paginaInicial" => "3"
                        "paginaFinal" => "18"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7828785"
                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0135"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Developmental dysplasia of the hip and occult neurologic disorders"
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                        0 => array:2 [
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                          "autores" => array:2 [
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11999-008-0118-6"
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                        "tituloSerie" => "Clin Orthop Relat Res"
                        "fecha" => "2008"
                        "volumen" => "466"
                        "paginaInicial" => "871"
                        "paginaFinal" => "877"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18231844"
                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Protocolos diagn&#243;stico terap&#233;uticos de la AEP&#58; Neurolog&#237;a Pedi&#225;trica&#46; &#91;Internet&#93;"
                    ]
                  ]
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                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0145"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abnormalities on the neurological examination and EEG in young children with pervasive developmental disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Akshoomoff"
                            1 => "N&#46; Farid"
                            2 => "E&#46; Courchesne"
                            3 => "R&#46; Haas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10803-006-0216-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Autism Dev Disord"
                        "fecha" => "2007"
                        "volumen" => "37"
                        "paginaInicial" => "887"
                        "paginaFinal" => "893"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17048091"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of motor impairment in autism spectrum disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "X&#46; Ming"
                            1 => "M&#46; Brimacombe"
                            2 => "G&#46;C&#46; Wagner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                      "Revista" => array:6 [
                        "tituloSerie" => "Brain Dev"
                        "fecha" => "2007"
                        "volumen" => "29"
                        "paginaInicial" => "565"
                        "paginaFinal" => "570"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17467940"
                            "web" => "Medline"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0155"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High incidence of hip dysplasia but not slipped capital femoral epiphysis in patients with Prader-Willi syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;A&#46; West"
                            1 => "R&#46;T&#46; Ballock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "2004"
                        "volumen" => "24"
                        "paginaInicial" => "565"
                        "paginaFinal" => "567"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15308908"
                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Agenesis of the corpus callosum and skeletal deformities in two unrelated patients&#58; analysis via MRI and radiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Al Kaissi"
                            1 => "H&#46; Kurz"
                            2 => "W&#46; Bock"
                            3 => "G&#46; P&#228;rtan"
                            4 => "K&#46; Klaushofer"
                            5 => "R&#46; Ganger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2014/186973"
                      "Revista" => array:5 [
                        "tituloSerie" => "Case Rep Orthop"
                        "fecha" => "2014"
                        "volumen" => "2014"
                        "paginaInicial" => "186973"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24592343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Occult spinal dysraphism in stablished congenital dislocation of the hip"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;A&#46; Wilkinson"
                            1 => "E&#46;M&#46; Sedgwick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "1988"
                        "volumen" => "70-B"
                        "paginaInicial" => "744"
                        "paginaFinal" => "749"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0170"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desarrollo locomotor en pacientes con displasia del desarrollo de cadera y pie equinovaro cong&#233;nito que recibieron tratamiento ortop&#233;dico antes del a&#241;o de vida&#46; Estudio prospectivo comparativo"
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                            2 => "A&#46; Torres-G&#243;mez"
                            3 => "V&#46; Allende"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr"
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                        "paginaFinal" => "240"
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Original Article
Developmental dysplasia of the hip in children with a psychomotor disorder. A risk factor for a poor outcome?
Displasia del desarrollo de la cadera en niños con trastorno psicomotor. ¿Factor de riesgo para un mal resultado?
Iván Pipa-Muñiza,
Corresponding author
ivanpipa85@gmail.com

Corresponding author.
, Ma de los Llanos Rodríguez-Rodríguezb, Ma Blanca Felgueroso-Julianac, Manuela Riera-Campilloa, Pedro González-Herranzb
a Servicio de COT, Hospital de Cabueñes, Gijón, Asturias, Spain
b Unidad COT Infantil Hospital Teresa Herrera, La Coruña, Spain
c Unidad Neurología Infantil Hospital Teresa Herrera, La Coruña, Spain
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Ombredanne quadrants&#46; The arrow points at the location of the centre of ossification of the femoral head in quadrant 3&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The treatment of developmental dysplasia of the hip &#40;DDH&#41; has been highly standardised for many years&#44; but its failure can lead to the development of major sequelae&#46; At present&#44; the routine performance of neonatal examinations combined with the knowledge of risk factors and the use of ultrasonography allow its early diagnosis&#44; which is crucial for the early initiation of treatment in order to achieve the best possible outcomes&#46; Outcomes are satisfactory in a high percentage of patients &#40;between 80&#37; and 92&#37; of cases&#41; irrespective of the method chosen for its treatment &#40;Pavlik harness&#44; abduction brace&#44; etc&#46;&#41;&#44; and depending on the degree of hip stability&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Avascular necrosis is possibly a complication that develops most frequently during treatment of hip dysplasia&#44; although its incidence has decreased significantly &#40;2&#46;38&#37; of cases treated with conservative approaches&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> The developed complications are usually related to the type of treatment used or the difficulty of hip stabilisation&#46; Many studies in the literature have found factors that influence the prognosis of conservative treatment and the development of complications&#44; such as delayed diagnosis&#44; bilaterality&#44; hip luxation versus preluxation&#44; teratologic dislocations&#44; adduction contracture of the hip or the initial position of the femoral head&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#8211;7</span></a> However&#44; few studies in the literature have analysed the impact of comorbidities such as psychomotor delays&#44; behavioural disorders or cerebral palsy on DDH&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to analyse the cases of DDH that did not respond well to conservative treatment and the possible influence of psychomotor disorders&#44; which could be risk factors contributing to these poor outcomes&#46; To do so&#44; we conducted a retrospective study of patients that received a diagnosis of psychomotor disorder when treatment for DDH had already started&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a retrospective observational study of the cases of DDH treated in our hospital between January 2002 and December 2012 &#40;325 cases of DDH in 293 patients&#41;&#46; Orthopaedic treatment failed in 44 of the cases under study &#40;13&#46;5&#37;&#41;&#44; with failure defined as not achieving concentric reduction of the hip or the persistence of a residual hip dysplasia with an acetabular index &#40;AI&#41; greater than 30&#176; that did not resolve after the patient began walking&#46; Psychomotor delays were detected in 10 of these patients &#40;16 hips&#41;&#44; months after treatment of DDH had been initiated&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Of the total cases of DDH that we found&#44; 309 &#40;283 patients&#41; were free of psychomotor comorbidity&#44; and the initial orthopaedic treatment failed in 34 cases &#40;10&#37;&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Of the 16 cases &#40;10 patients&#41; with a psychomotor comorbidity&#44; 75&#37; &#40;12 cases&#41; were refractory to treatment&#44; while the outcome of conservative treatment of DDH was successful in the remaining 25&#37; &#40;4 cases&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We collected data for the following variables for the 10 patients included in the analysis&#58; sex&#44; side involved&#44; gestational age at birth&#44; type of delivery &#40;caesarean or vaginal&#41;&#44; birth weight&#44; age at diagnosis of DDH&#44; type of treatment received&#44; and complications&#46; These patients were evaluated on the basis of clinical features and&#47;or magnetic resonance imaging by the Paediatric Neurology Unit to confirm the presence of brain lesions or behavioural disorders&#46; We collected data on the age at diagnosis&#44; neurologic disease&#44; ability to walk&#44; and age at which patients began walking&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The radiologic followup consisted of anteroposterior pelvis radiographs and axial hip radiographs&#46; In cases treated with spica casts or with a high degree of hip instability&#44; the followup also included a computed axial tomography scan in the early postoperative period to confirm the correct reduction of the dislocated hip&#46; The radiographic parameters that were documented were the location of the ossification centre in the femoral head based on the Ombredanne quadrants &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; and the AI before and after orthopaedic treatment&#46; These values were measured in digital radiographs using the Centricity application developed by General Electrics&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">We analysed the data using SPSS version 18&#46; We conducted a descriptive study&#44; expressing quantitative variables as medians and qualitative variables as absolute frequencies and percentages &#40;&#37;&#41;&#46; We determined the statistical significance of qualitative variables by means of the chi square test&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Of the 325 cases treated conservatively in our hospital&#44; 44 had poor outcomes &#40;failure to achieve concentric reduction of the hip or evidence of residual dysplasia with an AI greater than 30&#176;&#41; on follow-up imaging tests that did not resolve fully after the patient began walking&#41;&#46; Psychomotor disorders were diagnosed in 16 cases of DDH &#40;36&#37;&#41; that corresponded to 10 patients&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Sixty percent of the patients &#40;6 cases&#41; were female&#44; and 40&#37; male&#46; As for laterality&#44; six patients had bilateral involvement &#40;60&#37; of patients&#41;&#44; three had unilateral involvement of the right hip &#40;30&#37; of patients&#41; and one had unilateral involvement of the left hip &#40;10&#37; of patients&#41;&#46; Four patients &#40;40&#37;&#41; were delivered by caesarean section&#44; three due to breech presentation and one due to foetal distress&#46; Three patients &#40;30&#37;&#41; were born preterm &#40;before 38 weeks&#8217; gestation&#41;&#46; The mean birth weight for the 10 patients was 2967<span class="elsevierStyleHsp" style=""></span>g &#40;range&#44; 2250&#8211;4410&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Developmental dysplasia of the hip was detected during the physical examination of the newborn in five patients&#44; and late in the other five &#40;at ages 6&#8211;10 months&#41;&#44; although it was detected before the diagnosis of psychomotor disorder in all&#46; The mean age at diagnosis of DDH was 3&#46;3 months &#40;range&#44; 0&#8211;10 months&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the treatments received by each patient with their duration and outcomes&#46; Conservative treatment was only successful in four cases&#44; while in the remaining cases&#44; the persistence of luxation or subluxation or an elevated AI called for surgical intervention &#40;surgery has already been performed in eight of these cases&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The changes in the documented radiologic parameters showed improvement after treatment&#44; with the average AI changing 38&#46;2&#8211;30&#46;6&#176; &#40;IAs were greater than 30&#176; in seven cases&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">As for the position of the centres of ossification before treatment&#44; they were located in the lower inner quadrant in four cases&#44; in the lower outer quadrant in eight cases&#44; and in the upper outer quadrant in four cases&#46; After conservative treatment&#44; the position of the centres had shifted&#44; with ten of them located in the lower inner quadrant and the remaining six in the lower outer quadrant&#46; The hips that were positioned normally at the outset were treated due to the presence of marked acetabular dysplasia&#44; with a mean AI of 38&#176;&#44; as they were not likely to correct spontaneously when the patient started walking&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The complications that developed during treatment included a femoral head fracture and three cases of avascular necrosis of the femoral head &#40;18&#37;&#41;&#44; two of which were partial &#40;of which one resulted in a residual coxa magna deformity&#41; and one of which involved the entire epiphysis&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The mean age at which these patients started ambulating was 2&#8211;3 years&#44; and eight of them succeeded in achieving independent walking &#40;four patients are unable to walk unassisted&#41;&#46; The patient with hypoplasia of the corpus callosum has achieved an assisted gait with double support&#44; as has one of the patients with a pervasive developmental disorder&#44; which in this case was secondary to hydrocephalus&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The evaluation in the Unit of Paediatric Neurology took place at a mean age of 2&#46;5 years &#40;range&#44; 0&#46;7&#8211;7 years&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the aetiological diagnoses of the patients&#46; Pervasive developmental disorders were diagnosed in 80&#37;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In our series&#44; poor outcomes occurred in 75&#37; of patients with DDH and psychomotor comorbidities&#44; compared to 10&#37; of patients in whom such a comorbidity was not detected&#46; The relative risk of a poor outcome was 7&#46;2 times higher in patients with psychomotor disorders&#44; and the difference was statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">Appropriate and early treatment of DDH succeeds in resolving 85&#37; of cases with conservative approaches&#44;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1&#44;2</span></a> but certain circumstances may be associated with poor outcomes&#46; There are articles in the literature that refer to factors that may contribute to poor outcomes&#44; such as hip luxation compared to subluxation&#44; a delay in diagnosis or initiation of treatment&#44; and others&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#8211;7</span></a> However&#44; few studies have mentioned psychomotor disorders as potential risk factors for poor outcomes of orthopaedic treatment&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">As we mentioned above&#44; 16 &#40;36&#37;&#41; of the total hips that were refractory to conservative orthopaedic treatment corresponded to patients with psychomotor disorders that had been detected after treatment initiation&#46; In 75&#37; of these cases &#40;12 hips&#41;&#44; there was residual dysplasia or hip migration after completion of conservative treatment that was an indication for surgery &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; In our series&#44; this amounted to a probability of poor outcome in patients with DDH and a psychomotor disorder of 75&#37; compared to 10&#37; in patients that did not have this comorbidity&#44; with a relative risk that was 7&#46;2 times greater&#44; a difference that was statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; Despite the small number of cases&#44; these findings seem to support the hypothesis that the psychomotor disorders observed in our study&#44; which did not involve significant abnormalities in muscle tone that would hinder the restoration of the optimal biomechanical conditions to achieve adequate joint stability &#40;as observed in patients with cerebral palsy or flaccid paralysis&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">8&#44;9</span></a> contribute to the poor prognosis for treatment of DDH&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">It is important to differentiate between DDH and neuromuscular dislocation of the hip&#44; as explained by Luther and Clarke&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> Developmental dysplasia of the hip has been thoroughly investigated and documented&#44; and it characteristically presents with hip instability affecting both acetabular and femoral development&#46; It is detected in the neonatal period&#44; and usually responds well to early conservative treatment&#46; Neuromuscular dislocation results from an imbalance in muscular forces across the hip joint&#44; which gradually affects the position of the femoral head and subsequently impairs acetabular development in the growth period&#46; This type of dislocation generally presents later and requires primary surgical treatment&#46; Although the two are separate entities&#44; DDH may also occur in patients with underlying neurologic disease&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Of the ten patients studied in our series&#44; seven had a pervasive developmental disorder&#46; This type of disorder is not usually accompanied by significant abnormalities in muscle tone that would predispose the individual to late-onset neuromuscular dislocations&#44; although it is frequently associated with mild degrees of hypotonia and abnormalities in motor coordination that are detected in early childhood&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">11&#8211;13</span></a> Of the three remaining patients&#44; one received a diagnosis of Prader-Willi syndrome&#44; which is characterised by obesity&#44; hypogonadism&#44; cognitive delay and hypotonia&#44; and in which DDH occurs up to 10 times more than in the general population&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> a fact that may be related to the reduced muscle tone&#46; No studies have been published on the specific subject of the treatment and outcomes of hip dysplasia in these patients&#46; In our study&#44; despite early diagnosis and treatment&#44; the poor outcome of orthopaedic treatment led to the surgical correction by osteotomy of both hips&#46; Another of our patients received a diagnosis of spastic diplegia after the neonatal diagnosis of DDH&#46; This patient is scheduled to undergo bilateral periacetabular osteotomy because the AIs and femoral head coverage have improved very little since the beginning of treatment&#46; The patient in our series that had hypoplasia of the corpus callosum&#44; which was diagnosed late &#40;at age 11 months&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a> had mild axial hypotonia with normal muscle tone in the extremities&#46; Despite treatment with a series of spica body casts&#44; there has been little improvement and the patient is currently awaiting surgery for bilateral hip subluxation&#46; The purpose in delaying surgical treatment in the last two patients is to allow them to develop a stable unassisted gait before the procedure&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The diagnosis of DDH was made in the neonatal period in six of the patients in our study&#46; The delay in the diagnosis of the remaining patients &#40;after age 6 months&#41; could be associated with a poorer prognosis of orthopaedic treatment&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#44;6</span></a> but in our series we did not observe any differences between patients with a delayed diagnosis compared to those with an early diagnosis&#46; Of the 16 hips in our series&#44; 12 required invasive intervention for complete resolution&#46; As for the degree of coverage of the femoral head&#44; six of the hips continued to show some degree of migration&#44; although the position of the femoral head improved in all&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Wilkinson and Sedgwick reviewed a series of 130 hips with DDH in which primary surgical treatment had failed&#44; and found that 11&#37; of these patients had occult spinal dysraphism or mild joint laxity&#46; These authors suggested that weakness of the internal rotators of the hip might have been the cause of the observed residual subluxation that was refractory to treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a> It may be possible to extrapolate these findings to our case series&#44; although we would need to obtain electromyographic data to confirm it&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The complications that developed during conservative treatment in our patients included avascular necrosis of the femoral head in three cases&#8212;a patchy necrosis in two cases that progressed to coxa magna in one&#44; and total avascular necrosis in one case&#8212;with the incidence of this complication reaching 18&#37;&#44; substantially exceeding the rates reported in other published studies&#44; which are of approximately 2&#46;4&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> Another patient had a femur fracture during treatment with the Pavlik harness&#44; which caused a significant deformity that hindered the reduction of the dislocation and the subsequent outcome&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Patients with DDH that receive conservative treatment tend to have mild delays in achieving unassisted walking compared to the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> However&#44; our cases reached this milestone with a considerable delay&#44; at a mean age of 2&#46;4 years&#44; although earlier than the mean age in patients with cerebral palsy&#44; many of whom reach it past age 5 years&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">17</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Psychomotor disorders were diagnosed after initiation of treatment for DDH in all patients in our series at a mean age of 2&#46;5 years&#46; The main challenge in this type of disorders is the difficulty in making an early diagnosis&#46; With the exception of those affected by Prader-Willi syndrome&#44; these patients do not have distinctive features to guide the diagnosis&#44; and exhibit normal psychomotor development at early ages in most cases&#44; with the disorder manifesting gradually as they grow&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In our series of 325 cases treated for DDH we only found 16 hips &#40;5&#37;&#41; in 10 patients that had a psychomotor disorder&#46; While it would not be counterproductive to keep in mind this possibility in the early weeks of life of a patient with DDH&#44; we do not think that families should be informed of it&#44; as the presence or absence of neurologic disease in these patients is not known at the outset and it would create unnecessary alarm in most of the families&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Conversely&#44; being aware of it may be useful if conservative orthopaedic treatment is completed and the outcome is not satisfactory&#44; with the patient requiring surgery&#46; We believe that it is when failure of treatment for DDH is accompanied by a delay in achieving motor or cognitive milestones &#40;speech&#44; crawling&#44; walking&#8230;&#41; that the child should be referred for evaluation by a paediatric neurologist and the family informed of this possibility&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The limitations of our study are those inherent in its retrospective design&#44; the small number of patients that met the inclusion criteria&#44; having different periods of followup&#44; and lack of a standard protocol for imaging tests&#46; However&#44; it seems evident that the outcomes of conservative treatment in these patients are poor&#44; which opens up a new line of research on the impact of psychomotor disorders as risk factors for a poor prognosis in DDH that could be subject to further study&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interests</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "xres721442"
          "titulo" => "Abstract"
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          "titulo" => "Resumen"
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          "titulo" => "Introduction"
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          "titulo" => "Materials and methods"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-05-13"
    "fechaAceptado" => "2015-07-24"
    "PalabrasClave" => array:2 [
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec726529"
          "palabras" => array:3 [
            0 => "Developmental dysplasia of the hip"
            1 => "Cerebral palsy"
            2 => "Cerebral impairment"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
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          "palabras" => array:3 [
            0 => "Displasia del desarrollo de la cadera"
            1 => "Par&#225;lisis cerebral infantil"
            2 => "Trastorno psicomotor"
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Orthopaedic treatment of developmental dysplasia of the hip &#40;DDH&#41; has a high success rate in cases that are diagnosed early&#46; However&#44; the outcomes of these patients are not really known when they are subsequently diagnosed with some type of cerebral impairment&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective observational study was conducted on cases of DDH with a poor outcome after orthopaedic treatment&#44; being unknown if they had any type of psychomotor disorder&#46; The patients were clinically and radiologically assessed&#44; and afterwards received neurological valuation by the Child Neurology Unit&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 325 cases of DDH diagnosed in 293 patients&#44; 10 patients &#40;3&#37;&#41; with 16 hips with DDH were diagnosed of any cerebral impairment&#46; All of them were initially treated orthopedically&#46; Clinical and radiologically evolution was succesful only in 4 cases &#40;25&#37;&#41; being necessary any surgical procedure in the remaining 12 cases&#46; After surgical treatment we got an improvement in the Acetabular Index &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41; and Reimers Extrusion Index &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;042&#41;&#46; Neck-shaft angle and Wiberg CE angle also improved but this difference was not statically significant&#46; Cerebral impairment was diagnosed at 2&#46;5 years of age and the begining of walking was delayed at 2&#46;4 years of age&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cerebral impairment can lead to an unfavourable outcome in the treatment of DDH&#44; with the relative risk of a poor outcome being 7&#46;2 times higher in these patients&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">An unfavourable outcome with conventional treatment of DDH must make us suspect the presence of some type of neurological disorder&#44; particularly if there is a delay in walking&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El tratamiento ortop&#233;dico de la displasia del desarrollo de la cadera &#40;DDC&#41; presenta un alto porcentaje de &#233;xito en casos diagnosticados precozmente o en los primeros meses de vida&#46; Sin embargo&#44; se desconoce qu&#233; resultados presentan estos pacientes cuando posteriormente son diagnosticados de un trastorno psicomotor&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se realiza un estudio observacional retrospectivo de los casos de DDC con mala evoluci&#243;n tras tratamiento ortop&#233;dico&#44; desconoci&#233;ndose si presentaban alg&#250;n tipo de trastorno psicomotor&#46; Los pacientes fueron valorados cl&#237;nica y radiol&#243;gicamente&#44; y por la Unidad de Neurolog&#237;a Infantil&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">De los 325 casos de DDC diagnosticados en 293 pacientes&#44; 10 pacientes &#40;3&#37;&#41; con 16 caderas con DDC fueron diagnosticados de alg&#250;n tipo de trastorno psicomotor&#46; Todos los casos inicialmente fueron tratados ortop&#233;dicamente&#46; La evoluci&#243;n tanto cl&#237;nica como radiol&#243;gica en estos casos fue favorable sOlo en 4 &#40;25&#37;&#41;&#46; En los 12 restantes se indic&#243; quir&#250;rgica para su resoluci&#243;n &#40;75&#37;&#41;&#46; Hubo mejor&#237;a tras tratamiento quir&#250;rgico en el &#237;ndice acetabular &#40;p &#61; 0&#44;005&#41; y en el &#237;ndice de extrusi&#243;n de Reimers &#40;p &#61; 0&#44;042&#41;&#46; El &#225;ngulo c&#201;rvico-diafisario y el &#225;ngulo CE de Wiberg tambi&#233;n mejoraron&#44; pero su diferencia no fue estad&#237;sticamente significativa&#46; El diagn&#243;stico del trastorno psicomotor se realiz&#243; a los 2&#44;5 a&#241;os de edad&#46; El inicio de la deambulaci&#243;n de estos pacientes estaba retrasado&#44; inici&#225;ndose a los 2&#44;4 a&#241;os&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">El trastorno psicomotor puede condicionar una t&#243;rpida evoluci&#243;n en el tratamiento conservador de la DDC&#59; el riesgo relativo de presentar un mal resultado es 7&#46;2 veces mayor en estos pacientes&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Ante una mala respuesta al tratamiento convencional de una DDC&#44; debe sospecharse la existencia de un posible trastorno neurol&#243;gico de base&#44; especialmente si hay un retraso en la deambulaci&#243;n&#46;</p></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Pipa-Mu&#241;iz I&#44; Rodr&#237;guez-Rodr&#237;guez ML&#44; Felgueroso-Juliana MB&#44; Riera-Campillo M&#44; Gonz&#225;lez-Herranz P&#46; Displasia del desarrollo de la cadera en ni&#241;os con trastorno psicomotor&#46; &#191;Factor de riesgo para un mal resultado&#63;&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;85&#58;142&#8211;148&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Ombredanne quadrants&#46; The arrow points at the location of the centre of ossification of the femoral head in quadrant 3&#46;</p>"
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Clinical case number 12&#46; &#40;A&#41; Diagnosis of DDH at age 8 months treated conservatively with a series of spica casts&#46; &#40;B&#41; Outcome of conservative orthopaedic treatment at age 6 years&#44; with acetabular dysplasia&#44; a coxa valga deformity&#44; and a disrupted Shenton&#39;s line&#46; &#40;C&#41; Surgical treatment with a Salter osteotomy&#44; combining transplantation of an allograft from a tissue bank with a femoral varus derotation osteotomy&#46; &#40;D&#41; Final outcome at age 8 years&#46;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">DDH&#44; developmental hip dysplasia&#59; Dx&#44; diagnosis&#59; F&#44; female&#59; FVDO&#44; femoral varus derotation osteotomy&#59; HAB&#44; hip abduction brace&#59; HCC&#44; hypoplasia of the corpus callosum&#59; L&#44; left&#59; LB&#44; left bilateral&#59; M&#44; male&#59; m&#44; months&#59; OR&#44; open reduction&#59; PDD&#44; pervasive developmental disorder&#59; R&#44; right&#59; RB&#44; right bilateral&#59; SBC&#44; spica body cast&#59; SD&#44; spastic diplegia&#59; Tx&#44; treatment&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Side&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Weeks of gestation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Delivery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Weight &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at Dx of DDH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type and duration of orthopaedic Tx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome of conservative treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Surgical treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Neurologic Dx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at neurologic Dx &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at beginning of walking &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2340&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2340&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2540&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2540&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-3<span class="elsevierStyleHsp" style=""></span>m<br>SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Luxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD &#40;hydrocephalus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-3<span class="elsevierStyleHsp" style=""></span>m<br>SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Luxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD &#40;hydrocephalus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4290&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-1<span class="elsevierStyleHsp" style=""></span>m<br>SBC-3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4290&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-1<span class="elsevierStyleHsp" style=""></span>m<br>SBC-3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Luxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OR<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span> FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HAB-9<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dega&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HAB-9<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pending FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Dega&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-1<span class="elsevierStyleHsp" style=""></span>m<br>SBC-3<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FVDO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2550&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBCs-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Subluxation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FVDO <span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBCs-6<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>occult spinal dysraphism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">unknown&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-2<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Acetabular dysplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prader-Willi&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uncomplicated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neonatal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pavlik-2<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Acetabular dysplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Salter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prader-Willi&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4410&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SBC-4<span class="elsevierStyleHsp" style=""></span>m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PDD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:17 [
            0 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early failure of Pavlik harness treatment for developmental hip dysplasia&#58; clinical and ultrasound predictors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Lerman"
                            1 => "J&#46;B&#46; Emans"
                            2 => "M&#46;B&#46; Millis"
                            3 => "J&#46; Share"
                            4 => "D&#46; Zurakowski"
                            5 => "J&#46;R&#46; Kasser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "2001"
                        "volumen" => "21"
                        "paginaInicial" => "348"
                        "paginaFinal" => "353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11371819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Pavlik harness in the treatment of congenital dislocating hip&#58; report on a multicenter study of the European Pediatric Orthopedic Society"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Grill"
                            1 => "H&#46; Bensahel"
                            2 => "J&#46; Canadell"
                            3 => "P&#46; Dungl"
                            4 => "T&#46; Matasovic"
                            5 => "T&#46; Vizkelety"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "1988"
                        "volumen" => "8"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3335614"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differences in risk factors between early and late diagnosed developmental dysplasia of the hip"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Sharpe"
                            1 => "K&#46; Mulpuri"
                            2 => "P&#46;J&#46; Cundy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "2006"
                        "volumen" => "91"
                        "paginaInicial" => "158"
                        "paginaFinal" => "162"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictive factors for unsuccessful treatment of developmental dysplasia of the hip by the Pavlik harness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Kitoh"
                            1 => "M&#46; Kawasumi"
                            2 => "N&#46; Ishiguro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/BPO.0b013e3181b2f200"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "2009"
                        "volumen" => "29"
                        "paginaInicial" => "552"
                        "paginaFinal" => "557"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19700982"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High failure rate of the Pavlik harness in dislocated hips&#58; is it bilaterality&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Palocaren"
                            1 => "K&#46; Rogers"
                            2 => "T&#46; Haumont"
                            3 => "L&#46; Grissom"
                            4 => "M&#46;M&#46; Thacker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/BPO.0b013e318287ffc6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Orthop"
                        "fecha" => "2013"
                        "volumen" => "33"
                        "paginaInicial" => "530"
                        "paginaFinal" => "535"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23752151"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful Pavlik treatment in late-diagnosed developmental dysplasia of the hip"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;A&#46; Van de Sande"
                            1 => "F&#46; Melisie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00264-012-1587-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Orthop"
                        "fecha" => "2012"
                        "volumen" => "36"
                        "paginaInicial" => "1661"
                        "paginaFinal" => "1668"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22684545"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasonographic findings in hips with a positive Ortolani sign and their relationship to Pavlik harness failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;K&#46; White"
                            1 => "D&#46;J&#46; Sucato"
                            2 => "S&#46; Agrawal"
                            3 => "R&#46; Browne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "2010"
                        "volumen" => "92-A"
                        "paginaInicial" => "113"
                        "paginaFinal" => "120"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation and treatment of hip dysplasia in cerebral palsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;A&#46; Speigel"
                            1 => "J&#46;M&#46; Flynn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ocl.2005.11.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Orthop Clin North Am"
                        "fecha" => "2006"
                        "volumen" => "37"
                        "paginaInicial" => "185"
                        "paginaFinal" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16638449"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The hip in cerebral palsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;S&#46; Cornell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Dev Med Child Neurol"
                        "fecha" => "1995"
                        "volumen" => "37"
                        "paginaInicial" => "3"
                        "paginaFinal" => "18"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7828785"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Developmental dysplasia of the hip and occult neurologic disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;Z&#46; Luther"
                            1 => "N&#46;M&#46; Clarke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11999-008-0118-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop Relat Res"
                        "fecha" => "2008"
                        "volumen" => "466"
                        "paginaInicial" => "871"
                        "paginaFinal" => "877"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18231844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Protocolos diagn&#243;stico terap&#233;uticos de la AEP&#58; Neurolog&#237;a Pedi&#225;trica&#46; &#91;Internet&#93;"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2008"
                        "editorial" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abnormalities on the neurological examination and EEG in young children with pervasive developmental disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Akshoomoff"
                            1 => "N&#46; Farid"
                            2 => "E&#46; Courchesne"
                            3 => "R&#46; Haas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10803-006-0216-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Autism Dev Disord"
                        "fecha" => "2007"
                        "volumen" => "37"
                        "paginaInicial" => "887"
                        "paginaFinal" => "893"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17048091"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of motor impairment in autism spectrum disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "X&#46; Ming"
                            1 => "M&#46; Brimacombe"
                            2 => "G&#46;C&#46; Wagner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.braindev.2007.03.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Brain Dev"
                        "fecha" => "2007"
                        "volumen" => "29"
                        "paginaInicial" => "565"
                        "paginaFinal" => "570"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17467940"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High incidence of hip dysplasia but not slipped capital femoral epiphysis in patients with Prader-Willi syndrome"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;A&#46; West"
                            1 => "R&#46;T&#46; Ballock"
                          ]
                        ]
                      ]
                    ]
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                        "paginaFinal" => "567"
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                        0 => array:2 [
                          "etal" => true
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24592343"
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                0 => array:2 [
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                    ]
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                    0 => array:1 [
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                        "tituloSerie" => "J Bone Joint Surg"
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                        "paginaInicial" => "744"
                        "paginaFinal" => "749"
                      ]
                    ]
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                    0 => array:2 [
                      "titulo" => "Desarrollo locomotor en pacientes con displasia del desarrollo de cadera y pie equinovaro cong&#233;nito que recibieron tratamiento ortop&#233;dico antes del a&#241;o de vida&#46; Estudio prospectivo comparativo"
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                          ]
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                    ]
                  ]
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                        "tituloSerie" => "An Pediatr"
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                    ]
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ISSN: 23412879
Original language: English
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Idiomas
Anales de Pediatría (English Edition)
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