AN INTEGRATED APPROACH TO THE TREATMENT OF CONGENITAL HIP DISLOCATION

Abstract

The article presents almost forty years of experience in the treatment and follow-up of congenital hip dislocation in 839 children at Tver Children's Regional Clinical Hospital (Russia). An analysis of conservative and surgical treatment methods was carried out taking into account concomitant pathology. The children were aged from 3 months to 13 years, girls predominated (78%). Bilateral damage to the hip joints was observed in 278 children (33%), unilateral - in 561 children (67%). Surgical treatment was performed in 312 patients (37.2%).The majority of patients admitted with a diagnosis of congenital hip dislocation were treated conservatively (527 - 62.8%). Long-term results of treatment (12-27 years from the start of treatment) were monitored in 174 patients. 123 of them (70.7%) obtained good anatomical and functional treatment results (no complaints or functional limitations, anatomically correct formation of the hip joints according to radiation diagnostics), 45 (25.8%) - the treatment results were assessed by us as satisfactory (patients considered themselves healthy, but X-rays revealed subluxation of the femoral head without degenerative-dystrophic changes). In 6 surgically treated patients (3.4%), deforming coxarthrosis occurred, which required endoprosthetics at the age of 27-33 years. Dysplastic changes in the musculoskeletal system require an integrated approach involving specialists of various profiles at all stages of the child’s treatment.