Closed reduction guided by dynamic ultrasound in late-diagnosed hip dislocation

The potential for dynamic ultrasound in the primary treatment of late-diagnosed congenital hip dislocation was assessed in 21 patients. The study showed that dynamic ultrasound was a useful technique in guiding closed reduction and for assessing the effects of positioning on the stability of children less than 2 years of age. In older children, however, this assessment was less reliable. Although dynamic ultrasound evaluation can be done without sedation, general anesthesia provides optimal conditions for such evaluation. The benefits of ultrasound are that it does not involve exposure to radiation, that the need for elaborate radiographic methods like arthrography and computed tomography is reduced, and that closed reduction is more reliably achieved when guided by direct visualization. Because a thorough knowledge of the dynamics of hip dislocation is essential, the ultrasound evaluation should be performed by orthopedic surgeons.