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Congenital dislocation of the hip. Recent advances and current problems
1Department of Orthopaedic Surgery, Tulane University Medical Center, New Orleans, Louisiana.
Clinical Orthopaedics and Related Research
|October 1, 1989
Summary
Congenital dislocation of the hip (CDH) is now understood as a spectrum of conditions requiring tailored treatments. Early diagnosis through newborn screening and ultrasonography improves outcomes, while gentle reduction methods are preferred over surgery.
Area of Science:
- Orthopedics
- Pediatric Medicine
- Developmental Biology
Background:
- Congenital dislocation of the hip (CDH) is a complex condition with varied causes and outcomes.
- Historically, treatment approaches for CDH have evolved significantly.
- Understanding CDH as a spectrum is crucial for effective management.
Purpose of the Study:
- To review advancements in the understanding and treatment of congenital dislocation of the hip (CDH).
- To highlight the shift towards earlier diagnosis and less invasive treatment modalities.
- To discuss the spectrum of CDH, its etiology, and natural history.
Main Methods:
- Literature review of changes in CDH understanding and treatment.
- Analysis of diagnostic advancements, including ultrasonography.
- Evaluation of evolving treatment strategies, from closed reduction to surgical interventions.
Main Results:
- CDH is recognized as a spectrum of diseases requiring individualized treatment.
- Early diagnosis is facilitated by newborn screening and ultrasonography.
- Gentle closed reduction, often with Pavlik harness or traction, is successful in most cases, reducing the need for open reduction.
Conclusions:
- Modern understanding emphasizes the spectrum of CDH, necessitating tailored treatment plans.
- Ultrasonography is a key diagnostic tool for early detection in newborns.
- Conservative treatment methods are increasingly successful, minimizing complications like avascular necrosis.