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[Squatting cast for biomechanical treatment of decentred hip joints]
E Mühlbacher1, W Lick-Schiffer1, M Lojpur1
1Orthopädie, LKH Stolzalpe, Österreich.
Insights
Congenital hip dislocation, common in Central Europe, is detected early using ultrasound. Conservative treatment with a special cast and bracing promotes hip maturation, potentially preventing surgery.
Area of Science:
- Orthopedics
- Pediatric Medicine
- Diagnostic Imaging
Background:
- Congenital hip dislocation affects approximately 1% of newborns in Central Europe.
- Early detection and intervention are crucial for successful treatment outcomes.
- Current clinical practice in German-speaking countries utilizes routine ultrasonography for diagnosis.
Abstract:
The so-called "congenital" luxation of the hip joint is endemic in Central Europe and occurs in about 1% of all newborn infants. By the means of ultrasonographic diagnosis according to the Graf method an early detection instantly after birth has become a good clinical routine in the German-speaking countries. Sonography-based conservative treatment has become the gold standard. The cast in squatting ("human") position is a standard procedure in order to retain the originally decentred or unstable hip joints in the reduced position: 100° flexion and 50° abduction are necessary to fix the hip joint in the reduced position without the risk of avascular necrosis. After the fixation in a squatting-cast, a period of functional bracing in flexed position enhances bony maturation. This two-phase functional conservative treatment can avoid later osteotomies or even early total hip replacement.
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