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Treatment of CDH: Age 18 mo to 36 months



- 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.