DEVELOPMENTAL DYSPLASIA OF THE HIP - PATHOPHYSIOLOGY AND SURGICAL INDICATIONS IN THE 1ST 2 YEARS OF LIFE

The hip joint is fully developed at the eleventh gestational week. Thi s is the earliest time at which dislocation can occur because only a c oncentrically congruent femoral head in the acetabulum can lead to dev elopment of a normal hip joint. If normal development does not occur, treatment is required as soon as possible. In the first months of life , simple means of physiologic abduction should be used. If maintenance of reduction is impossible by these means, gentle closed reduction sh ould be performed. Open reduction of the hip joint is reserved for hip s in which obstacles to gentle closed reduction exist or hips that do not respond to conservative treatment. Open reduction is recommended f rom age 6 months; after age 18 months, subtrochanteric varus derotatio nal or Salter's innominate osteotomy should be performed, according to the bony changes on the femoral or pelvic side of the hip joint.