Congenital dislocation of the hip – Hip dysplasia

Developmental Dysplasia of the Hip (DDH; Congenital Dysplasia/Dislocation of the Hip [CDH]; Congenital Dysplasia of the Hip; Congenital Dislocation of the Hip; Congenital Subluxability of the Hip; Congenital Hip Dysplasia; Congenital Hip Dislocation; Congenital Hip Subluxability; Dysplasia of the Hip, Developmental)

Description of congenital hip dislocation

Hip – the junction of the femur to the pelvis. The femur has a spherical end (femoral head), which is a cup-shaped recess on the pelvis (acetabulum). When DDH these bones are in the wrong position,. Type of dislocation may vary in different children, but basically it involves:

• The head of the femur hangs freely in the acetabulum, causing instability of the joint;
• The head easily comes out of the acetabulum, causing dislocation of the hip;
• The head is out of the acetabulum;
• Acetabulum has an irregular shape.

Causes of congenital hip dislocation

The exact cause of hip dysplasia is not known. Some factors, which may play a role:

• Location of the child in the womb;
• The maternal hormones;
• Genetics.

Some methods of swaddling the baby or to wear can also affect the development of the hip.

Risk factors for congenital hip dislocation

Factors, which may increase the risk of congenital hip dislocation include:

• A family history of hip dysplasia;
• Gluteal birth (feet first), particularly for girls;
• Paul: more common in women, than men;
• Low levels of amniotic fluid during pregnancy;
• Late delivery – after childbirth 42 weeks of pregnancy;
• Birth weight more than 4 kg.

Symptoms of congenital hip dislocation

Hip dysplasia can cause instability of the hip. Symptoms depend on the age of the child and may include:

• Irregular pleats at the hip – They can be seen in newborn;
• Poor mobility and flexibility, when the child starts to crawl – about 9 months;
• One leg shorter than the other when the child begins to stand – in 10-11 months;
• Claudication, wiggle, walking on toes, or other problems with walking – about 1 year.

Hip dysplasia usually affects the left hip. Sometimes suffer from both the hip joint. The disease can be detected, when a child is born.

Diagnosis of congenital hip dislocation

Your child's doctor will look for signs of hip dysplasia during a medical examination of the child. If the gentle movement of the hip will be heard a dull crackling creaking, this may indicate a dislocation of the hip.

Assess the condition of the hip may also be using the following methods:

• Inspection of child, putting him on his back and straighten his legs to check for symmetry of placing the knees;
• Search uneven pleats at the hip;
• Difficulty rating hips move out.

Detailed images of the hip joint can help confirm the diagnosis or to determine the method of treatment. To take pictures used:

• Ultrasound – in children less than 4 or months in children with risk factors, but normal values ​​for external inspection;
• Roentgen – in children older than 3 months.

Treatment of congenital dislocation of the hip

Depending on the child's age and severity of disease, treatment options include:

• For newborns: Pavlik stirrups, to maintain to keep the hips. They can be worn for 1-2 months;
• For children 1-6 months:
  • A special device, allowing you to change the position of the hips;
  • Manual reposition – doctor sets the bone in the correct position, and then puts the child cast on the lower part of the body;
• For children aged from six months to two years:
  • Manual reposition;
  • Hip surgery, then the imposition of gypsum;
• For children older than two years: hip surgery, then the imposition of gypsum.

If your child has been diagnosed with hip dysplasia at birth, the doctor will not be able to start treatment, until the child is two weeks. Early hip dysplasia can pass itself.

The doctor will monitor the condition of the hip during subsequent inspections, studying X-rays, until the child grows.

Prevention of congenital hip dislocation

Because the exact cause of congenital dislocation of the hip is unknown, it is difficult to prevent. If you are pregnant and have a family history of hip dysplasia, tell your doctor.

Avoidance of certain positions in the swaddling can also help reduce the likelihood of certain types of hip dislocation.