Name of the Procedure:

Treatment of Spontaneous Hip Dislocation (Developmental, including Congenital or Pathological), by Abduction, Splint or Traction; without Anesthesia, without Manipulation

Summary

This procedure involves repositioning the hip joint of a patient who has a developmental, congenital, or pathological hip dislocation. It is achieved by using abduction, splints, or traction. The procedure does not require anesthesia or physical manipulation.

Purpose

The main purpose of this procedure is to correct a dislocated hip that has occurred due to developmental issues, congenital abnormalities, or pathological conditions. The goal is to re-align the hip joint properly, alleviate pain, and prevent further complications associated with hip dislocation.

Indications

• Developmental dysplasia of the hip (DDH)
• Congenital hip dislocation
• Pathological hip dislocation resulting from underlying diseases
• Symptoms include pain, limping, and restricted range of motion in the hip.

Preparation

• Patients may need to undergo diagnostic imaging such as X-rays or MRI to assess the hip dislocation.
• No specific preparation such as fasting or medication adjustments is typically required as the procedure does not involve anesthesia.

Procedure Description

1. Positioning: The patient is placed in a comfortable position suitable for applying abduction, splinting, or traction.
2. Abduction: The legs are gently positioned and maintained in an abducted (spread apart) position to encourage the hip joint to return to its proper place.
3. Splinting: A splint may be applied to keep the hip and leg in the correct position.
4. Traction: Special traction devices may be used to apply a controlled pulling force that helps in realigning the hip joint.
5. Observation: The healthcare team monitors the patient to ensure the hip remains in the correct position.

Duration

The procedure typically takes a few minutes to an hour, depending on the complexity and the method used.

Setting

This procedure is usually performed in a hospital or outpatient clinic.

Personnel

• Orthopedic surgeon or pediatric orthopedic specialist
• Nursing staff for patient care and assistance
• Radiologist for initial diagnostic imaging, if needed

Risks and Complications

• Rarely, nerve injury or pressure sores from splints or traction
• Mild discomfort or pain from the application of devices
• Potential for the hip to dislocate again, requiring further intervention

Benefits

• Re-alignment of the dislocated hip
• Relief from pain
• Improved mobility and function of the hip joint
• Prevention of long-term complications related to hip dislocation

Recovery

• Patients are often advised to limit physical activity for a certain period
• Follow-up appointments to monitor the hip position and healing
• Physical therapy may be recommended to strengthen the hip muscles
• Full recovery time varies but can range from several weeks to months

Alternatives

• Closed reduction with anesthesia and manipulation
• Surgical intervention in cases where non-surgical methods are ineffective
• Pros and cons: Non-surgical methods have fewer risks and a quicker recovery, while surgical methods may be more definitive but come with more risks and longer recovery.

Patient Experience

• Patients may experience mild discomfort during the application of splints or traction.
• Pain management is generally conservative, focusing on comfort and alleviating discomfort through positioning and mild analgesics if needed.
• The patient often experiences a significant improvement in symptoms shortly after the hip is successfully repositioned.