109.
Treatment of Congenital hip dysplasia in newborns
Roland Knudsen, Vilhelm Engell, Niels Wisbech Pedersen
Ortopedic Kolding Hospital; Ortopedic, Odense University Hospital;
Ortopedic, Odense University Hospital
Background:
It is controversial whether congenital hip dysplasia (CHD) in a
stable hip should receive treatment. New studies indicate that treating CHD in
a non- dislocated/dislocatable hip without an abduction brace is the best
treatment. For many years the standard treatment has been an abduction brace.
Nevertheless, this treatment might even be harmful causing avascular necrosis
of the caput.
Purpose / Aim of Study:
The purpose is to document what the outcome was
in newborn patients’ stable hips who suffered from CHD when treated with
”
watchful waiting” alone. Our Hypothesis is that CHD in stable newborn hips
will normalize despite no treatment.
Materials and Methods:
Prospective cohort study of newborn patients
referred to Kolding or Odense paediatric orthopaedic department having the
tentative diagnosis “Dysplasia of the hip” since January 2010 until August
2011.
We have documented the outcome of our treatment and also registered
certain risk factors. We exclude all instable hips and children having secondary
CHD (eg. cerebral paralysis)
Findings / Results:
181
children did not have CHD. 11 were excluded because
of instability. 27 children (40 hips) were included. All hips became normal
despite no treatment after 3-20 weeks (median 6 weeks). 39/40 hips were
“
immature” (acetabular angle of 50-59°) and one hip was dysplastic (43°).
Conclusions:
Using our treatment protocol, all stable hips diagnosed with
CDH became normal despite no active treatment. None of the children referred
with “asymmetrical skinfold” had any CDH or signs of other diseases around
the hips. This was true for both immature hips and dysplasia of any degree.
Hips with a “dry click” were associated with CHD, even when the hip was
stable: (16% had CDH). This study is among other resent studies, which
concludes that stable immature hips will normalize without treatment.
