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The treatment of congenital hip dysplasia
L Valdiserri1, O Donzelli, G L Di Gennaro
1Divisione di Ortopedia e Traumatologia Pediatrica, Istituto Ortopedico Rizzoli, Bologna.
Insights
Treatment for congenital hip dysplasia (CHD) varies by age, focusing on hip reduction, retention, and maturation in infants. Older children may require reconstructive surgery, while severe cases in pre-teens benefit from early intervention for pain relief.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Developmental Biology
Background:
- Congenital hip dysplasia (CHD) presents a complex challenge in pediatric orthopedic care.
- Age-dependent anatomical and developmental changes significantly influence treatment strategies for CHD.
Purpose of the Study:
- To outline age-specific treatment objectives for congenital hip dysplasia.
- To emphasize the dynamic nature of hip development and the need for tailored interventions.
Main Methods:
- Review of treatment phases for congenital hip dysplasia based on patient age.
- Analysis of surgical interventions including acetabuloplasty and femoral osteotomy.
- Consideration of biological reconstruction for severe dysplasia.
Main Results:
- Infants (<1 year) require focus on epiphysis reduction, retention, immobilization, and hip maturation.
- Children (>3 years) needing surgery benefit from procedures like acetabuloplasty and femoral osteotomy post-reduction.
- Adolescents (>10 years) with severe dysplasia and pain may require early surgical intervention, potentially with acetabular reconstruction.
Conclusions:
- Treatment for congenital hip dysplasia must be adapted to the specific developmental phase of the hip.
- A dynamic approach considering age and disease progression is crucial for optimal outcomes in CHD management.
Abstract:
The authors take into consideration the different phases of the treatment of congenital hip dysplasia (CHD) as it is related to age and natural development. Within the first year of age three objectives must be aimed at: reduction of the epiphysis, its retention and immobilization, maturation of the hip. After three years of age, once the epiphysis has been reduced, reconstructive and stabilizing surgery must be performed (acetabuloplasty and femoral osteotomy) in order to correct the modified joint parameters. After ten years of age and until the end of growth the degree of dysplasia influences treatment, as intervention is justified (preferably with biological reconstruction of the acetabulum) in forms of severe dysplasia caused by the definite occurrence of pain at an early age. We emphasize the importance of adapting treatment to the specific phase of evolution of the hip understood to be dynamic reality.