Text Box: PHASED CLOSED REDUCTION FOR CONGENITAL DISLOCATION OF THE HIP IN INFANT YOUNGER THAN 6 MONTHS OLD
XU Ruijiang, LU Qiang, MA Chenxuan, HE Rongguo
Department of Pediatric Surgery, PLA General Hospital, Beijing, China 

Objective: To reduce the incidence of avascular necrosis of the capital femoral epiphysis following closed reduction of CDH in infant younger than 6 month old, a new method was adopted. 
Methods: Closed reduction was divided into two phases. In the first phase, to take the dislocated hip with a flexion in 90°and do a series exercise of the hip abduction and lateral rotation motion 4 times everyday and then the infant was fixed in the plexiglass abduction frame. When the contracted soft tissues about the hip became loosen, the second phase was then carried out by manual reduction. The infant was fixed in the plexiglass abduction frame. A series exercise of the hip was done until the dysplasia of the acetabulum got nearly normal. From 1992.1 to 2000.1, forty-five cases, 14 boys and 31 girls with 62 hips(17 left , 11 right and 17 bilateral hips),were treated. The mean age at the time of closed reduction was 5 month old (range, 30 days to 6 months).    Xay showed acetabular index was 34.4°±6o, the hip dislocated and ossific nucleus absent. 
Results: 62 dislocated hips was follow-uped with a mean length of 4 years ranged from 1 to 6 years, 58 hips (94%)got satisfactory reduction, 4 hips (6%)failed to reduction and 4 hips(6%) developed typeⅠavascular necrosis. Conclusion: A phased closed reduction is an effective method of reducing the incidence of avascular necrosis of the capital femoral epiphysis following closed reduction of CDH in infant younger than 6 month old.  
[Key Words] Congenital dislocation of the hip; Ossific nucleus; Closed reduction
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