Mr Phillip Thomas is based at the Children’s Unit, University Hospital of Wales, Cardiff. Mr Thomas’ practise has it’s own unique challenges, and surgical intervention in children “should be planned with a view of the future and possible need for arthroplasty”.

“We still unfortunately do not screen for DDH in babies and as a consequence, 10-15 cases per year present at our unit with late hip dislocation, I am therefore working hard with both colleagues and the Welsh Government to get a universal screening programme in place”.

Hip replacement in these DDH patients does then come with its challenges, including lack of bone stock compromising cup coverage, high femoral neck shaft angle, increased femoral anteversion and femoral canal stenosis. Mr Thomas then goes on to discuss the enigma that is ‘Perthes’, a catastrophic consequence of femoral head necrosis in the 4- 8 year old patient, SUFE, AVN, Skeletal dysplasia and the treatment options in some of the most challenging orthopaedic procedures, including the role of custom implants.


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