Can hip dislocation be completely cured?

Hip dislocation is a common bone disease with a relatively high incidence rate in infants and young children. However, if such a problem occurs, parents or patients do not need to worry too much, because hip dislocation can be completely cured through certain methods, but the correct treatment method needs to be adopted. Below, we will introduce the treatment methods for hip dislocation.

1. Treatment principles

The treatment principle of this disease is early diagnosis and timely treatment. Once the diagnosis of congenital dislocation of the hip is established after birth, treatment should be started immediately, and it is expected that a hip joint with close to normal function will be obtained. The older the age when treatment is started, the less effective it is.

2. Conservative treatment

The theoretical basis of conservative treatment is Harris's law, which states that head and acetabulum concentricity is the basic condition for hip joint development. In order to achieve stability of the hip joint after reduction, the following conditions must be met: ① Choose a posture that maintains hip joint stability. The traditional frog position is the most ideal posture, but it is not conducive to blood supply to the femoral head. ② Choose a brace, splint or plaster fixation according to the different ages of the patients. It should be stable, comfortable, convenient, and easy to manage urine and stool. It is best to keep the hip joint properly active. ③ Choose the most suitable age for hip joint development. The younger the better, generally under 3 years old. ④ The head and acetabulum should be proportional. If the proportion is unbalanced, the stability of the hip joint cannot be maintained, and even treatment failure may occur. ⑤ Maintain reduction for a certain period of time to allow the joint capsule to shrink back to nearly normal and prevent dislocation after the fixation is removed. It usually takes 3 to 6 months. The younger the patient is, the shorter the fixation time will be.

3. Surgical treatment

1. Salter pelvic osteotomy

In addition to repositioning the femoral head, the Salter operation mainly changes the abnormal acetabulum direction to a normal physiological direction, relatively increases the acetabulum depth, and makes the femoral head and acetabulum concentric. This surgery can be used for patients aged 1 to 6 years with hip dislocation, including those who have failed manual reduction.

2. Pemberton Acetabular Plasty

The osteotomy is performed 1 to 1.5 cm above the upper edge of the acetabulum and parallel to the acetabular roof slope. The acetabular end is pried up and downward to change the inclination of the acetabular roof, so that the acetabulum can fully accommodate the femoral head and the acetabulum can reach a normal shape. This procedure can be used for patients over 7 years old or under 6 years old with an acetabular index greater than 46°.

3. Femoral rotation osteotomy and femoral shortening osteotomy

Femoral rotation osteotomy is suitable for patients with an anteversion angle of 45° to 60° or above and should be performed at the same time as the above-mentioned surgery. Generally, osteotomy is performed below the lesser trochanter, usually with a wire saw. After osteotomy, the proximal osteotomy end is internally rotated or the distal osteotomy end is externally rotated and fixed with a 4-hole steel plate, but care should be taken not to over-correct. Femoral shortening osteotomy is suitable for older patients with grade III dislocation, especially those with inadequate traction before surgery. Osteotomy is also performed under the lesser trochanter, shortening the femur by about 2 cm. It can also correct excessive anteversion at the same time, and then fix it with a 4-hole steel plate.