What to do with congenital hip dislocation

The hip joint clinically refers to the area around the buttocks. Congenital dislocation of the hip joint is actually quite serious. If not treated, it will have a great impact on the child's future growth. Congenital hip dislocation must be treated promptly, and surgical treatment is also an option.

(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 acetabuloplasty is a procedure that involves osteotomy 1 to 1.5 cm above the superior rim of the acetabulum parallel to the acetabular roof slope, prying the acetabular end upward and changing the inclination of the acetabular roof, allowing the acetabulum to fully encompass the femoral head and allowing the acetabulum to achieve 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 more 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.