For successful treatment of the CDH it is mandatory to understand the natural history of the disease. For abnormal neonatal hips , following are the possible outcomes:
1. May normalize
2. Dysplasia – may stabilize with abnormal development of acetabulam or femoral head
The treatment goals for CDH is
· To produce normal development of acetabulum and femoral head
· To achieve the concentric reduction of hip
· To reduce or avoid the associated complications due to treatment like infection, stiffness and Avascular necrosis of Femoral head
· To minimize and avoid the hardship to parents and the patient either, physical/emotional/financial.
1. Frejka Pillow
· Used for abduction and flexion of the femurs
· Can be wear like diapers and harness by the straps and velcors
· Easy to use
· The out wared rotated postion keep the head of femur in acetabulum.
2. Pavlik harness
· It’s a light weight soft fabric harness
· Can be put on under the babys vest next to skin
· Consists of chest strap, two shoulder straps and four leg straps
· This can be attached to the shoes of baby
· Used from birth to six month age
3. Von Rosen Orthosis
· passive restraining/positioning device.
· It is a malleableframe which was originally made with metal but now available in plastic with straps around the shoulders, waist, and thighs.
4. Ilfled Orthosis
· A passive positioning device that holds the hips in abduction but does not create significant hip flexion.
· More effective as postoperative abduction device than DDH Brace
· Two thigh cuffs attached to an adjustable cross bar.
· A waist strp to maintain positioning
5. Plastazote Hip Abduction Orthosis
· Made up of plastazote
· Light weight and easy to use