Current trends in the treatment of congenital dislocation of the hip.
The best results in CDH are after early diagnosis and treatment. More carefully taught examination techniques of the newborn are important. With the addition of ultrasound examination of the hip, the number of children with CDH diagnosed in the newborn period should increase. The Pavlik harness has had increased use in the child up to 6 months of age. It allows a simple reduction technique for approximately 90% of these children. If skillfully used, the risk of avascular necrosis can approach zero. The early gentle reduction will improve the results of treatment in avoiding avascular necrosis. Skin traction, the human position during the application of a cast, and femoral shortening at the time of open reduction in the child over 3 years of age also contribute to the decreased incidence of avascular necrosis. The early recognition of even the minor forms of subluxation and the treatment with proximal femoral or acetabular procedure is important. This program should increase the number of children reaching adulthood with a concentrically reduced painless hip.
MacEwen
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GD
Children's Hospital, Department of Pediatric Orthopedics, New Orleans, LA 70118.
Zembo
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MM
D000077:Acetabulum / Q000601:surgery; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000601:surgery; D005271:Femur Head Necrosis / Q000209:etiology / Q000517:prevention & control; D006618:Hip Dislocation, Congenital / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009989:Orthotic Devices; D010027:Osteotomy; D014143:Traction