Abstract
Our institution has used echo examination to diagnose congenital dislocation of the hip since 1985. Echo diagnosis, in particular Graf's method, the most typical echo examination for CDH, has taken the place of X-ray, arthrography and CT examination. We present a practical examination and treatment based on Graf't method. A periodic observation is applied to Graf classification type I and IIa+. A continuous echo examination is applied to type IIa- and IIb. Riemenbugel harness (Rb) is applied to type IIc or worse. Although type IV commonly requires operative treatment, we apply Rb for cases that respond and shift to type III by traction treatment. Rb is also applied to non-responding cases after additional period of traction. The operative treatment is enforced only against completely non-responding cases. Nearly 10% of type IV can acquire reduction by the use of Rb. After Rb treatment, sonographic observation is performed with an anterior approach. We have established and put into practice protocol for the diagnosis and treatment of CDH.
