General treatment principles are to maintain movement in the hip and to keep the femoral head contained in the acetabulum (the socket of the hip). Depending on the patient’s age, this may be achieved with activity modification, physical therapy, casting or bracing, and/or surgery to redirect the femoral head and/or acetabulum.
If the child is young, 2–6 years of age, and there are minimal changes of the hip, the child will only need to be observed, while older children will need more intervention to preserve motion of the hip.
Medication, such as Ibuprofen is used to decrease inflammation of hip joint. It may be used for several months. If the child is already presenting with a limp and stiffness of the hip, the child may require crutches and partake in physical therapy to improve the motion of the affected hip. If the motion of the hip becomes limited or radiographs show progressive deformity, a special cast may be used to keep the head of the femur in the proper position in the hip joint.
Surgery may be needed in severe cases to realign and place the hip back in the proper position. This is done with screws and plates which will be removed at a later time. Other surgeries may include a procedure to redirect or contain the upper part of the thigh bone (femur) in the socket to help maintain the roundness of the upper end of the femur. The patient again will be placed into a cast from chest to toes for 6–8 weeks. After the cast is removed, the child will participate in physical therapy to regain motion of the hip.