Notes

Hiring conjecture pertaining to multicenter numerous studies using a hierarchical Poisson-gamma model: Asymptotic investigation as well as improved intervals.
Traditional infant swaddling or binding with hips and knees extended is a known risk factor for Developmental Dysplasia of the Hip (DDH), while 'hip-safe swaddling' with hips and knees flexed is believed to eliminate this risk. We conducted a survey to determine the prevalent practices for infant swaddling in India; why mothers practice swaddling and who teaches them; and whether Paediatricians, nurses and caregivers are aware of hip-safe swaddling.

Anonymous one-time surveys were conducted in three groups-Paediatricians, Nurses and caregivers - at a tertiary-care, urban based, paediatric and maternity hospital.

Forty-five paediatricians, 219 nurses and 100 caregivers were surveyed. Ninety percent caregivers practiced traditional swaddling, for on average 10.2hours a day, starting soon after birth, up to 4.2months of life. Traditional swaddling was advocated by 99% nurses and 53% Paediatricians. Reasons for swaddling included sleep, warmth and the misbelief that the child's legs would remain bowed if not bound straight; contrarily few mothers (8%) avoided swaddling out of superstition. Mothers learntswaddling mainly from relatives (94%) and nurses (64%). Most nurses (70%) had learntthe practice during nursing training. Only 6.6% Paediatricians, 4% caregivers and 0% nurses were aware of 'hip-safe swaddling'.

Traditional swaddling of infants is a practice deeply rooted in India, born out of misbeliefs, and propagated by lack of awareness. Training in hip-safe swaddling targeted at nurses and Paediatricians would be an effective initial step in creating awareness among mothers and changing their practices.
Traditional swaddling of infants is a practice deeply rooted in India, born out of misbeliefs, and propagated by lack of awareness. Training in hip-safe swaddling targeted at nurses and Paediatricians would be an effective initial step in creating awareness among mothers and changing their practices.
Acetabular morphology has always been an area of interest in patients with slipped capital femoral epiphysis (SCFE). Acetabular retroversion in SCFE is proposed as a pre-disposing factor and also can predispose the hip to pincer impingement. But there is controversial data in literature regarding the acetabular morphology. All available data are from the West and we present the first study on acetabular morphology in Indian children with SCFE.

CT scans of 29 patients with SCFE were collected from our database and anteversion was measured as described by Dandachli et al. Lateral central edge angle (LCEA) was measured in the standard AP radiographs of the pelvis. There were 20 boys and 9 girls with a mean age of 13.5. Seven patients had right side SCFE, eighteen had left side SCFE, and four had bilateral involvement. Measurements were done in 33 affected hips and compared with 25 normal hips.

The mean AVsup and AVcen of affected hips were 6.59° and 13.51°, respectively, and that in normal hips were 8.36° and 14.04° (
 > 0.05). The mean LCEA was 23.05° on the affected hips and 25.45° on the normal hips (
 > 0.05). The AVsup showed retroversion in 24.24% (8/33) of the affected hips and 20% (5/25) of the normal hips. Though the mean version was less in SCFE hips, it was not statistically significant.

Our study documents that 25% of hips with SCFE had acetabular retroversion. However, this was not significantly high compared to the contralateral hips.
Our study documents that 25% of hips with SCFE had acetabular retroversion. However, this was not significantly high compared to the contralateral hips.
The literature is scanty on reports directly comparingthe outcomes of anterior open reduction (AOR) and medial open reduction (MOR) in the management of developmental dysplasia of the hip (DDH).

To compare clinical and radiographic outcomes of surgical treatment using either AOR or MOR in children with DDH aged < 24months and to evaluate the procedure-inherent risks of avascular necrosis of the femoral head (AVN) and need for further corrective surgery (FCS).

61 children who underwent surgical treatment for DDH were categorized into two groups AOR (31 hips of 28 patients) and MOR (39 hips of 33 patients). NX-5948 cell line The mean age was 17 ± 5.85 (range 7-24) months in group AOR and 13 ± 5.31 (range 6-24) months in group MOR. The mean follow-up was 118 ± 41.2 (range 24-192) months and 132 ± 36.7 (range 24-209) months in group AOR and MOR. At the final follow-up, mid- to long-term clinical and radiographic outcomes were assessed. FCS was recorded.

Regarding McKay's clinical criteria, both groups exhibited similar results (
 = 0.761). No significant differences were observed between the groups in both the center-edge-angle (
 = 0.112) and the Severin score (
 = 0.275). The AVN rate was 32% in the AOR group and 20% in the MOR group (
 = 0.264). The FCS rate was 22% in the AOR group and 12% in the MOR group (
 = 0.464).

This study showed similar clinical and radiological outcomes with AOR and MOR with no significant relation to AVN and FCS.

Level III.
Level III.
Paediatric elbow fractures constitute 10% of all paediatric fractures. Radiological interpretation of the immature elbow is difficult due to its cartilaginous structure. We aimed to describe an X-ray technique in paediatric patients to obtain true lateral elbow X-rays and to prevent the repeat X-ray shots.

Radiographs of 39 children, with a mean age of 48.17months (range; 7-84months), with elbow trauma were included. All elbow lateral radiographs were taken in the 90º flexion position. In the first group, radiographs were taken using the standard technique(lateral radiographs in shoulder internal rotation). In the second group, lateral radiographs of the elbow were taken while the patient was standing and the forearm was elevated passively with 90° shoulder abduction and 90° elbow flexion (standing salute position). Three criteria were examined from the graphs to determine the true lateral elbow graphy.

In group 1 (
 = 20) and group 2 (
 = 19), lateral elbow radiographs were evaluated. No statistically significant differences were found between the groups, in terms of mean age and distal humeral fractures.
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