Q: My baby is 3 months old, suffering from bilateral developmental dysplasia of the hip joints. She has been treated in spica cast for 2 months. After the 2nd plaster, on examination under general anaesthesia, the left hip was reduced stable in all dissection, the right hip was unstable (posteriorly dislocatable). It could be maintained in 110 flexion, 90 abduction & 30 external rotation and the doctor again advised to put the plaster. At this stage, will a pelvic harness or double diaper work for my baby? Will it be a problem for my baby to receive anaesthesia at this age?

A:Usually at this age, the closed reduction under GA is satisfactory in majority of cases but one needs to decide when this is not acceptable and some other treatment may perhaps be necessary. Here is when a hip arthrogramme is immensely useful. It tells us about our adequacy of reduction and if not adequate, then highlights on the obstacles responsible. One can clearly then, take a decision regarding the need for an open reduction (surgery). All decisions need to be taken when the child is under one GA.