Congenital Hip Dislocation: Diagnosis and treatment - Children Orthopaedic Care Institute Pravira Hospital - Orthopaedic Hospitals - Book Appointment Online - Orthopaedic Hospitals in Wardha Road, Nagpur

Congenital Hip Dislocation

The common etiology is excessive laxity of capsule, which fails to maintain the femoral head within the acetabulum. Syndrome in the newborn consists of instability of the hip, such that the femoral head can be displaced partially (subluxed) or fully (dislocated) from the acetabulum.

Recent research shows that babies whose legs are swaddled tightly with the hips and knees straight are at a notably higher risk for developing DDH after birth. As swaddling becomes increasingly popular, it is important for parents to learn how to swaddle their infants safely, and to understand that when done improperly, swaddling may lead to problems like Congenital Hip Dislocation.

Types of Dysplasia Hip / Congenital Dislocation of Hip

Developmental dysplasia of hip(DDH) is a spectrum of disorders of development of the hip that presents in different forms at different age.
The common etiology is excessive laxity of capsule, which fails to maintain the femoral head within the acetabulum.
Syndrome in the newborn consists of instability of the hip, such that the femoral head can be displaced partially(subluxed) or fully(dislocated) from the acetabulum.
The dislocation is complete displacement of a joint, with no contact between the original articular surfaces.
Subluxation is a displacement of the joint with some contact between the original articular surfaces.
Dyplasia refers to deficient development of the acetabulum.
Teratologic dislocation of the hip is distinct from hip dislocation that usually occurs with other disorders.
Teratologic dislocation of the hip is usually associated with neuromascular syndromes, especially those related to muscle paralysis, such as myelodysplasia and arthrogryposis.The association of DDH with torticollis is quite strong.
A relationship has also been noted between DDH & Metatarsus Adductus.

Treatment

Achievement

The pelvic harness is the preferred method of treating neonatal DDH. Use of the harness is most effective where there is strong support system to educate the parents and to closely monitor neonate’s progress.

If the hip remains dislocated after 3-4 weeks of harness wear, use of harness should be discontinued and the hip should be managed with either closed or open reduction.

The child who presents with dislocated hip between ages 6 months to 2 years & the child in whom initial splintage has failed are managed in same manner.The goals of the treatment are to obtain & maintain reduction of the hip without damaging the femoral head.

The two principles methods of treatment are closed reduction & open reduction.Treatment of children between 2 & 6 years of age with hip dislocation is more challenging.The femoral head is usually in more proximal location in the older child, and the muscles that cross the hip are more severely contracted.

Femoral shortening is an essential part of management of the older child, and with higher dislocation, greater shortening is necessary. The open reduction from anterior approach is suggested. The acetabular dysplastic part is corrected with acetabuloplasty.

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