Congenital hip dysplasia Treatment

Congenital hip dysplasia

    * Introduction
    * Pathogenesis
    * Signs and symptoms
    * Diagnosis
    * Treatment 
 
Treatment
Multiple observational studies show increased rates of spontaneous healing of hip dysplasia in the newborn period. They are due to bone growth and development of the femur and the acetabular cartilage. Indications for surgery depend on the severity of the disease, and the formation bilateralitate or not a false acetabulum. Indications for treatment depend on patient age and the success of previous techniques. Children under 6 months examination instability are treated with a form of limb tijare and harnesses. If this method has no benefit to trying to reduce the traction before closed reduction.
Pavlik harness therapy: Treatment for hip dysplasia begins with a careful examination of the newborn. If there is instability indicate a Pavlik harness. Ultrasound is an excellent way to reduce thigh as technical documentation Pavlik and should be performed during therapy. If the balance is subluxated posterior then Pavlik therapy should be discontinued. Pavlik duration of therapy is not established. If the patient has more than 6 months of therapy success is less than 50%, so should be used for patients under 6 months.
Reduction therapy: When the patient has more than 6 months or if therapy is not successful Pavlik try a closed reduction. Traction is performed frequently for 2-3 weeks before the discount. Traction can be performed at home or hospital. Should be monitored closely to ensure the integrity of the skin. General benefit of traction is still controversial. The reduction is performed using artrografiei inhisa to determine the reduction. To define a cone of stability of balance, which includes: flexion, abduction and internal and external rotation. If the cone is over 30 degrees is considered satisfactory technique. After performing a CT reduction is to determine posterior subluxation. When the child is over two years or failure to consider other methods attempted open reduction. If the patient has more than three years trying to shorten a member. One patient with residual acetabular dysplasia over four years should be treated with an acetabular procedure. Treatment for a patient diagnosed in adult age is considered for residual hip dysplasia.
Open reduction: The treatment of choice for children over 2 years at diagnosis or who failed closed reduction attempts. In children with short teratology dischiza reduction can be effected by medial approach. More common in older children are using the standard-anterolateral. If your child is over 3 years is made shorter limb. Pelvic osteotomy is required for residual hip dysplasia.
Complications of treatment: There may be numerous complications, including redeployment phases, stiffness balance, ineffective, and most devastating hemorrhage, necrosis of femoral head. Necrosis rate varies significantly. Studies show that extreme abduction combined with extension and internal rotation have a higher rate of avascular necrosis.
Prognosis: Early diagnosis is crucial issue of treatment of children with hip dysplasia. Evolution of children treated for hip dysplasia is very good, especially if dysplasia is controlled by closed treatment. If successful techniques have not closed and open reduction is required, the prognosis is less favorable, although short-term prognosis seems favorable. If secondary procedures are needed to achieve reduction worsens prognosis.