Follow-up and early treatment of developmental dysplasia of the hip

Problem: The reliability of ultrasound of the hip is examined by the courses of mature and physiologically immature hips. The results of sonographically controlled therapy of the congenital dysplasia of the hip are investigated. Method: 470 children out of a hip-screening program could be controlled at least one more time clinically and by ultrasound. X-rays were taken at the end of treatment in children who were treated by an abduction device. The sonographical and radiological results were compared and grafically presented. Results: None of 570 matured hips deteriorated. 88% of the physiologically immature hips matured spontaneously while 12% got a cast because of unsatisfactory development. 68 pathological hips improved soon under therapy in an abduction device applied a few days after birth; they reached the borderline of 60 degrees at the maximum age of 80 days. X-ray examinations at the end of therapy showed normal acetabular indices in all cases. Six of 22 girls showed deterioration of the acetabular indices in further x-ray controls at the age of one year. Conclusion: Even in successful therapy of the congenital dysplasia in the newborn hip x-ray examinations are highly recommended to recognize deteriorations and to initiate another therapy if neccessary.