- See:
DDH:
- Clinical Presentation:
- widened perineum, shortened lower extremity, & hyperlordosis of lower spine;
- Treatment Considerations:
- after 2 years of age, there is increased risk of
AVN & closed reduction is more likely to fail;
-
open reduction:
- in patients > 2 years of age, consider anterolateral approach to avoid AVN;
- innominate osteotomy can be performed thru anterolateral approach;
-
medial approach is advocated by some;
- is of more value in the child younger than 18 months;
- acetabular dyplasia:
- consider pelvic redirectional
Salter osteotomy;
- femoral & acetabular dysplasia:
- consider need for both
femoral varus derotational osteotomy &
pelvic osteotomy;
- choice for either osteotomy or both procedure depends on which side of joint is more abnormal;
- typically half of pts require both procedures to achieve congruence;
Surgical therapy for congenital dislocation of the hip in patients who are twelve to thirty-six months old.
Treatment of congenital dislocation of the hip in children between the ages of one and three years.
One-stage treatment of congenital dislocation of the hip in older children, including femoral shortening.
