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Phát triển của loạn sản xương hông

Phát triển của loạn sản xương hông (DDH) biểu thị một phổ rộng các điều kiện bệnh lý khác nhau, từ loạn sản acetabular tinh tế đến trật khớp hông tối giản. Khi DDH được công nhận trong 6 tháng đầu tiên của cuộc sống, điều trị với một khai thác Pavlik thường xuyên kết quả trong một kết quả tuyệt vời. | Developmental Dysplasia of the Hip From Six Months to Four Years of Age Michael G. Vitale MD MPH and David L. Skaggs MD Abstract Developmental dysplasia of the hip DDH denotes a wide spectrum of pathologic conditions ranging from subtle acetabular dysplasia to irreducible hip dislocation. When DDH is recognized in the first 6 months of life treatment with a Pavlik harness frequently results in an excellent outcome. In children older than 6 months achieving a concentrically reduced hip while minimizing complications is more challenging. Bracing traction closed reduction open reduction and femoral or pelvic osteotomies are frequently used treatment modalities for children aged 6 months to 4 years. In the past treatment recommendations have often been based on the patient s age. However recent practice has placed more emphasis on addressing the specific disorder and avoiding iatrogenic osteonecrosis. The incidence of osteonecrosis of the femoral head has been reduced by avoiding immobilization of the hip in extreme abduction and by using femur-shortening osteotomies when appropriate. Pelvic osteotomy continues to gain favor for the treatment of selected patients over 18 months of age. J Am Acad Orthop Surg 2001 9 401-411 Despite efforts to identify and treat all cases of developmental dysplasia of the hip DDH soon after birth in some children the diagnosis is delayed and they are 6 months of age or older when they finally present to the orthopaedic surgeon. The timing of diagnosis is important because the treatment of DDH initially diagnosed between 6 months and 4 years of age differs considerably from that of DDH diagnosed in the immediately postnatal period. These older children may present for treatment of DDH for any of the following reasons a delay in diagnosis failure of Pavlik harness treatment and late development of the pathologic changes of DDH with maturation. Normal physical examination findings during the immediate postnatal period do not preclude a .