Traction in developmental dislocation of the hip. Is its use justified?
Traction has been used for decades in the treatment of developmental dislocation of the hip. Traction is advocated to facilitate closed reduction and to decrease the need for open reduction. The use of prereduction traction also is advocated to decrease the incidence of proximal femoral growth disturbance (aseptic necrosis). Recently, several studies have called into question this widely accepted adjunct in the treatment of developmental dislocation of the hip. A critical look was taken at the use of traction in the treatment of developmental dislocation of the hip and whether its use can be justified by the existing medical literature was ascertained. Although there are several impressive reports of the positive effects of traction in developmental dislocation of the hip, there are no clinical or experimental studies on the direct effect of traction. There are also no well controlled studies to analyze the effect of traction as a single variable. Thus, it cannot be proven that traction alters the outcome of developmental dislocation of the hip treatment, and hence, there is only anecdotal basis for its use in the treatment of developmental dislocation of the hip.
Weinstein
S L
SL
Department of Orthopaedic Surgery, University of Iowa, Iowa City 52242, USA.
D005271:Femur Head Necrosis / Q000209:etiology; D006618:Hip Dislocation, Congenital / Q000601:surgery*; D006801:Humans; D014143:Traction / Q000009:adverse effects; D016896:Treatment Outcome