Patient's question:
Detailed medical condition and consultation purpose: The thigh scar is asymmetrical but of the same thickness. It can be opened, but the right leg has an extra scar, and the child's strength is not as good as the left leg when kicking. The child's mother's cousin has congenital hip dysplasia as an infant. Is the child likely to have it too? Is this condition hereditary?Previous diagnosis and treatment history and effectiveness: The doctor said there is basically no problem and suggested an X-ray after 6 months. Is it necessary to do it?
Doctor's answer:
The prognosis of this disease hinges on early diagnosis. The earlier the treatment, the better the outcome. As age increases, the pathological changes become more severe, and the treatment effect becomes poorer.Treatment:
- For infants under 1 year old, the Pavlik harness method is used.
- If hip joint subluxation or dislocation is detected within 8–9 weeks after birth, the Pavlik harness can be worn for 6–9 months.
- This method restricts only the extension of the hip joint, while other activities remain unrestricted.
- Except for cases with obstacles to reduction in the hip joint, most children can achieve successful reduction, and there is no risk of avascular necrosis of the femoral head.
- For children aged 1–3 years:
- For some mild cases, the Pavlik harness method can still be used.
- If reduction is not achieved after 4–6 weeks of treatment, manual reduction with ( is a Chinese term for plaster immobilization) can be adopted.
- For children over 4 years old:
- At this stage, the degree of dislocation is more severe, and the secondary changes in bone and soft tissues are also more pronounced.
- Manual reduction is often unsuccessful, and surgical treatment should be performed.
- The Salter pelvic osteotomy is recommended.
- If the anteversion angle of the femoral neck is greater than 45°, additional femoral rotational osteotomy should be performed.