Problems in Early Treatment of Congenital Dislocation of the Hip

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It is reported that by the functional treatment with Pavlik-bandage in C. H. D osteochondritis detormities are decreasing.But, actually, in our out-patient clinic, these osteo-chondritis deformities in femoral head due to manual reduction and retention by plaster cast are seen frequently.Moreover, often, reduction failures by Pavlik-bandage in our and another clinic are observed too. This may mean that functional treatment is not still popular and is not used exactly.We started functional treatment from this year generally for dislocated hip below 1 year to study effective reduction technic and to achieve best results, 19 dislocated hips have been treated by September in 1970. All cases are below 7 monthes. Reduction failures were seen in 3 hips.As for reduction failure in these 3 hips, we had obvious reason why we failed to reduce.The point of Pavlik-bandage treatment is to flex the suffered hip fully. This portion changes dislocation-promoting vector in extended hip, to dislocation-reducing vector by full flexion In this position, femoral head slips down to hinter accetabulum rand, and according to hip abduction comes to below accefabulum, and is reduced by extending movement.In our failure-cases, hips had been holded rather a little extended position. So upper posterior accetabular rand had been pressed inwardly by femoral head and in one case interposition had deen formed by application of Pavlik-bandage, in bad position. Band was not effective and not strong enough to hold full flexed position.Every time, we must take care to check bandage and condition of suffered hip exactly.
西日本整形・災害外科学会の論文

Problems in Early Treatment of Congenital Dislocation of the Hip

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