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[Dysplasia and pseudodysplasia of the infantile hip joint (author's transl)]
Insights
Hip dysplasia in children diagnosed radiographically often resolves naturally without intervention. Stable hip dysplasia without clinical instability does not progress to dislocation and requires no treatment, avoiding potential harm from immobilization.
Area of Science:
- Pediatric Orthopedics
- Developmental Biology
Background:
- Hip dysplasia is a developmental condition affecting infants.
- Early diagnosis and management are crucial for preventing long-term complications.
Purpose of the Study:
- To investigate the natural course of hip dysplasia diagnosed in children aged 2-10 months.
- To determine the necessity of therapeutic interventions for stable hip dysplasia.
Main Methods:
- Followed the natural course of hip dysplasia in 47 children diagnosed via radiographs.
- Observed outcomes with and without therapeutic interventions, focusing on clinical instability and dislocation.
Main Results:
- Radiographic signs of hip dysplasia in stable hips without clinical instability consistently resolved after the child began walking.
- No dislocations occurred in children with radiographically diagnosed dysplasia but no clinical instability, even without treatment.
- Treatment of unstable hips between 3-12 months posed risks of epiphyseal damage due to immobilization.
Conclusions:
- Stable hip dysplasia diagnosed radiographically in infants does not necessitate treatment and typically resolves spontaneously.
- Intervention for stable hip dysplasia may be unnecessary and potentially harmful.
- Focus should be on managing unstable hips while avoiding risks associated with immobilizing stable conditions.
Abstract:
The natural course of "dysplasia" of the hip diagnosed between the age of two and ten months was followed in 47 children. If the dysplasia diagnosed by radiographs was not combined with a clinical instability of the hip dislocation never occurred although no therapy- except abduction exercise - was given. The radiological signs of dysplasia regularly disappear after the child has learned to walk. Three different kinds of dysplasia are described. Dysplasia may be a residual sign of neonatal instability which became stable with or without treatment. Pseudodysplasia is the effect of faulty X-ray technique or X-ray interpretation. In dysplasia with no known instability in the history it may be the residual sign of a neonatal instability which was not diagnosed or it may be a variation of development of the hip joint during the first year of life. Since dysplasia without clinical instability does not progress and will never end with a dislocation there is no indication for therapeutic measures in a stable hip with radiological signs of dysplasia during the first year of life. The treatment of unstable hips diagnosed between the third and the twelfth month of life may be dangerous due to epiphyseal damage by immobilisation.