We can put the hip casts only when we are sure that the head is freely in the acetabulum
and we can check the blood supply by ultrasound doppler:
if in the acetabulum there is an obstacle, the most often hypertrophied ligament of femur head,
placing the spica cast does not make sense and only causes total ischemia.
If the hip is unstable and the head does not stick in the acetabulum,we put it on either ;after
an over head truction or rehabilitation and check the blood flow by the ultrasound in spica cast;
(for a maximum of 4 weeks) and do ultrasound doppler and x-ray
. Blood supply disorders are the main reason for the lack of rebilding of the
acetabulum;therefore, it is necessary to make a very precisely matched spica cast,
with a maximum abduction of 45 degrees and check with ultrasound whether there are any
blood circulation disorders;
if there is no improvement after the spica cast, we have disturbed the blood supply in the Hip
and should be put under ultrasound control again.
Without ultrasound doppler control , we should not give spica cast.
arteria cicumflexa medialis
