Non-operative Management of DDH - Sally Tennant 31/10/2000
Aim of treatment - congruent reduction, and maintenance of, until stability restored
0-6 months - Clinically unstable at 10/7 abduction brace whatever US shows Stable clinically and Graf 2 - follow and observe, dx at 4/12 if US and XR normal If still dislocated after 4/52, continued abduction unlikely to reduce, risks of AVN:EUA Find safe zone of reduction between 40 and 60 degrees abduction (if >3/12 may need adductor tenotomy).If no safe zone- open reduction Some use prelim. Traction then hip spica then abduction device for those >3/12 6/18 months - ?No benefit from preliminary traction. Gentle EUA, adductor tenotomy, hip spica, arthrogram, +/- abduction device after short period in spica. If can't reduce closed - open reduction 18/12 - 3 years - Sometimes closed reduction with psoas and adductor tenotomies, spica, then abduction device - discard when acetabulum developed but dysplasia common. More often, open reduction needed +/- surgery to femur/acetabulum >3 years - Never closed reduction Please log in to view the content of this page. If you are having problems logging in, please refer to the login help page. |
|||
|
|||
|
