Diagnosis and treatment of congenital dislocation of the hip.
Up to 10 percent of infants in the United States are born with congenital dislocation of the hip. The disorder is readily diagnosed using the Ortolani and Barlow maneuvers. If congenital hip dislocation is recognized and treated within the first six to 12 months of life, affected joints develop normally in the vast majority of infants. Prolonged dislocation makes it difficult to return the femoral head to the acetabulum and is associated with a higher incidence of osteoarthritis and poor hip function in adulthood. Infants diagnosed with congenital hip dislocation before six months of age may be managed with a simple positioning device or a Pavlik harness. Older children may require traction, casting or surgery. Radiographs, ultrasound scanning, hip arthrography, computed tomography and magnetic resonance imaging can be helpful in making the diagnosis. Avascular necrosis of the femoral head is the most serious complication of treatment. Family physicians can play a major role in reducing the morbidity associated with improper treatment.
Churgay
C A
CA
University of Michigan Medical School, Ann Arbor.
Caruthers
B S
BS
D002648:Child; D005269:Femur / Q000601:surgery; D005271:Femur Head Necrosis / Q000209:etiology; D006618:Hip Dislocation, Congenital / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D014143:Traction