Page 1 of 1: Ortho - Plan of action in Congenital dislocation of hip in

decembermist · Credits: 41191 My Scrapbook

Plan of action in Congenital dislocation of hip in ADULTS

a) Surgery
b) splinting
c) leave it alone
d) casts

vimoj · Credits: 27331 My Scrapbook My Reading List 85 Books

ANSWER IS SURGERY

TREATMENT PLAN OF CDH
AT BIRTH TILL 6 MONTHS- DO CLOSED REDUCTION AND SPLINT
6 MONTHS TO 6 YEARS-(after 2 years closed reduction is difficult as the head is out of acetabulum and the soft tissues around it is tight.. so a forced reduciton may coz avascular necrosis) sO AN OPEN REDUCTION HAS TO BE DONE AND ADDITIONAL FEMORAL SHORTENING REQUIRED.
OLDER CHILDREN REQUIRE ACETABULAR RECONSTRUCTION
6-10 YRS- HERE MOST OF THE TIME .. NO TREATMENT IS REQUIRED AS IN B/L DISLOCATIONS LIMP IS LESS NOTICABLE, NORMAL LIVES POSSIBLE TLL 40-50YRS, SURGERY RESULTS UNPREDICTABLE
IN U/L ASES - an attempt to open reduction + acetabular reconstruciotn+ derotation osteotomy done

11YRS ONWARDS- the indication for treatment is pain
--IF ONE HIP AFFECTED- TOTAL HIP REPLACEMENT IN ADULT HOOD OR ARTHRODESIS

TREATMENT PLAN IN A CHILD
AT BIRTH- DO CLOSEED REDUCTION
IF SUCCEESS FUL . MAINTAIN CAST IN 3 MONTHS ,AND THEN BRACE
IF ACETABULUM DEVELOPS REMOVE THE BRACE AND PHYSIOTHERAPY ONLYIS NEEDED
IF ACETABULUM NOT DEVELOPS- DO ACETABULAR RECONSTRUCTION AND PHYSIOTHERAPY

IF CLOSED REDUCTION UNSUCCESS FUL - GIVE TRACTION AND CLOSED REDCUTION- IF SUCCESS FUL .. CAST AND PLAN FURTHER AS ABOVE
IF UNSUCCESS FUL AFTER ALL THIS OR IF THE PATIENT PRESENTS LATER DO " OPEN REDUCTION +ACETABULAR RECONSTRUCTION+DEROTATION OSTEOTOMY"

decembermist · Credits: 41191 My Scrapbook

I also thot the ans is surgery only.Ans given is c)

thts why I posted thequestion !

sea_corel · Credits: 11991 My Scrapbook My Reading List 7 Books

operative technique of total hip arthroplasty is effective for the treatment of the difficult condition of high dislocation of the hip.

osteotomy is done but is rather avided coz it cause lateral rotation of hip and genu velgum and failure at union at osteotomy site and sometimes persistant knee painis present....so in adults its left alone.
i think this is the valid explanation for it...

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