The Journal of Bone and Joint Surgery, Vol 63, Issue 1 140-146, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Management strategy for prevention of avascular necrosis during treatment of congenital dislocation of the hip
JR Buchanan, RB Greer and JM Cotler
We retrospectively analyzed the cases of fifty children with unilateral
congenital dislocation of the hip in an attempt to determine what factors
in treatment were associated with the prevention of avascular necrosis of
the femoral head. All children were less than thirty-six months old at the
initiation of treatment, had no other anomalies, had their entire treatment
rendered at the same institution, and were followed for at least one year
after reduction. Avascular necrosis occurred in 36% of the patients; in all
cases definite roentgenographic signs were apparent within twelve months of
reduction. No patient whose hip had grown normally during the first twelve
months after reduction later had avascular necrosis. The management
strategy for congenital dislocation of the hip in the child who is less
than thirty-six months old should include a minimum two-week period of
traction until achievement of the +2 traction station and immobilization in
the so-called human position following reduction. Skeletal traction,
gradually increased over several weeks to an average of 39% of body weight,
usually was required to attain the +2 station. Observation of these
principles should decrease the incidence of avascular necrosis and increase
the probability of obtaining a normal hip.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
