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    Surgery: Hip Dysplasia

    Hip dysplasia reduction surgery: techniques, spica cast and detailed postoperative course for infants. Dr. Priano, Milan.

    Surgical treatment when bracing is insufficient

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    Surgical Techniques

    Closed Reduction + Spica Cast

    Hip reduction maneuver performed under general anesthesia, followed by immobilization in a spica cast to maintain the hip in correct position.

    When it is used

    Dysplasia with dislocation not resolved by bracing or diagnosed late. Age is not a rigid threshold: the choice depends on age, reducibility, hip stability and imaging.

    Recovery

    Period in a spica cast with periodic changes; duration and number of changes are orientative and are adapted to age, stability of the reduction and imaging checks.

    Open Reduction + Pelvic/Femoral Osteotomy

    Direct surgical intervention to reduce the hip and reshape the acetabulum or femur to ensure adequate coverage of the femoral head.

    When it is used

    Irreducible dislocation, very late diagnosis, residual dysplasia.

    Recovery

    Prolonged postoperative immobilization, with timing depending on the procedure performed. Results evaluable after years.

    Postoperative Overview

    Hip dysplasia treatment requires an individualised approach and prolonged follow-up until skeletal maturity. Each case is unique: age, cast duration, number of changes and follow-up intervals are decided according to stability, quality of the reduction and the procedure performed. In Dr. Priano's practice, physical therapy after cast removal is not an automatic step: in most young children movement recovers spontaneously and rehabilitation is proposed only when needed.

    Recovery Pathway (indicative)

    Note: This is an indicative pathway, personalised after surgery. Some elements are relatively stable (goal of the procedure, approximate hospital stay, presence of a cast or brace); others depend on the individual case (weight bearing, range of motion, imaging, sport, hardware removal, follow-up intervals) and on the surgical technique chosen.

    1. Hospital stay

      Hospital stay of a few days, shorter for closed reduction and longer for procedures involving osteotomy.

    2. First weeks

      Immobilization in a spica cast. The child learns to adapt. Hygiene and cast care are essential.

    3. Second month

      Possible cast changes to accommodate growth, with intervals decided case by case. Imaging checks to verify maintained reduction.

    4. Third month

      Cast removal once the reduction is stable. Movement usually recovers spontaneously in most children; in selected cases an abduction brace or a short rehabilitation course may be indicated.

    5. Return to sport

      Indicative pathway: young children generally recover spontaneously and resume activities gradually. In older children sport may be resumed in a possible window of roughly 6 to 12 months after cast removal, depending on recovery and on the type of procedure.

    6. Follow-up

      Close follow-ups in the initial phase, then progressively spaced out until the end of growth, with periodic imaging to monitor acetabular development. Intervals are personalised.

    Possible Complications

    Possible: temporary stiffness (usually transient), avascular necrosis of the femoral head (rare but serious), residual dysplasia (may require further surgery).

    For parents

    Hip Dysplasia: condition information page

    Causes, diagnosis, conservative options and when surgery is considered.

    Questions about this surgery?

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