An evaluation of conservative and operative methods in the treatment of congenital hip dislocation.
An evaluation of different methods of closed reduction of dislocated hips during different periods of time shows that manual reduction and fixation in Lorenz position account for a high rate of avascular necrosis. Even with functional and slow reduction by Pavlik harness and overhead extension, there is still a certain percentage of femoral capital necrosis. The fetal position recommended by Fettweis and Salter seems to reduce the incidence of necrosis. Acetabuloplasty combined with detorsion-varus-ostcotomy provides the means of normalizing a hip joint with a greater degree of success than most other methods.
D000077:Acetabulum / Q000601:surgery; D002370:Casts, Surgical; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005269:Femur / Q000601:surgery; D005271:Femur Head Necrosis / Q000209:etiology; D006618:Hip Dislocation, Congenital / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D008349:Manipulation, Orthopedic / Q000009:adverse effects / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D013165:Splints