dega

Dislocated Hip

Issue

Hip has been out for some time

- degree of acetabular dysplasia evident

- less time for remodelling

- increased instability if not addressed

Management

Open reduction + FDRO / Pelvic Osteotomy 

- usually perform pelvic osteotomy to correct acetabular dysplasia

- reserve FDRO for > 3 years / or if difficult reducing hip

Benefit most from Treatment

Problems

1. Tight psoas / Adductors / Hamstrings / T Achilles

2. Increased Femoral Anteversion

3. External Tibial Torsion

4. Valgus Foot

Principles

Surgery once walking but before school (3-4)

SEML surgery

Gait analysis lab

Gait

True equinus

Apparent equinus (FFD knee and hip)

Jump

Crouch