The analysis of the unfavorable outcome causes for the functional treatment of congenital hip dislocation in infants

Relevance. The problem of conservative treatment of congenital hip dislocation in children has been the subject of numerous studies. Today the functional treatment that suggests gradual centering of the femoral head in the acetabulum and fixation of the lower limbs with a splint while maintaining movement in the hip and knee joints is definitely considered efficient. However, the unfavorable outcomes featured with post-repositional avascular necrosis of the femoral head and joint instability are frequent with this patient cohort. These complications lead to severe irreversible changes in the hip joints, early dysplastic coxarthrosis and patient disability. The analysis of the factors that cause the development of complications can contribute to understanding the causes of failures leading to unfavorable outcomes of functional conservative treatment for dysplastic hip dislocation.

The aim of this study is to identify and analyze the main causes of unfavorable outcomes of the functional treatment for dysplastic hip dislocation in infants.

Materials and methods. The research is based on the analysis of the results of a survey that involved 26 children aged 1 to 3 years with unfavorable outcomes of conservative treatment for congenital hip dislocation using a functional method.

Results. The analysis of the findings of the questionnaire survey conducted for parents of this patient cohort revealed that the main reasons for failures at the outpatient stage of orthopedic care were the violation of the orthopedic product use regime by parents, child's anxiety for a long time during treatment, failure to fully comply with recommendations and untimely arrival for a scheduled examination by an orthopedist.

Conclusion. Our research showed that the social aspect of this problem plays an important role in the treatment of children with congenital hip dislocation using the functional method. Taking into account the results of this study by outpatient orthopedists in their routine will reduce the number of complications for this patient cohort and in most cases prevent surgical interventions.