Treatment of congenital dislocation of the hip after neonatal diagnosis

Abstract

During 1966-1975, 920 infants with a congenital dislocation of the hip diagnosed neonatally were born in Uusimaa county in southern Finland. The first examination of the hips was made by a pediatrician, but the diagnosis was generally confirmed by a pediatric surgeon before treatment was started. The mean age of beginning treatment was 7 days. An abduction pillow was the only treatment in 852 cases, six of whom later developed complications, notably two with avascular necrosis. The duration of the pillow treatment shortened noticeably during the time under review but this caused no increase in the number of failures. In 64 cases the routine pillow treatment could not be carried through, mostly because the hip dislocated on the pillow. The most apparent reason for this was inappropriate control of the pillow by the parents. In this group bilateral dislocations and associated calcaneovalgus feet were found more often than in the rest of the neonatal group. Non-operative treatment was successful in 96 per cent of the 920 cases.

Abduction treatment in late diagnosed congenital dislocation of the hip

“…Also Heikkila and Ryoppy (1984) reported on treatment started between the age of 5 and 8 days with the proportion of failures very similar to ours, but the radiographic state of the hips at the end of treatment was not presented.…”

“…Smith's ( 1968) long-term observations were limited to 53 cases. On the other hand, the general characteristics of our patients are similar to those presented by PalmCn (1984) and Heikkila (1984).…”

“…By comparison, Shamotov et al (1982) described 2,032 cases, but their cases were treated with different methods. Heikkila and Ryoppy (1984) presented the results from 920 children treated by a single method, but their conclusions were based only on short-term results and were not c o n f i i e d by radiographic examination. Smith's ( 1968) long-term observations were limited to 53 cases.…”

Ultrasound in the diagnosis of developmental dysplasia of the hip in newborns. The European approach. A review of methods, accuracy and clinical validity

“…Moreover, we searched the reference lists of other relevant published systematic reviews [11,13,14]. In accordance with others, we have used the term late, or established DDH for diagnosis after 1 month of age [15][16][17][18][19].…”