Congenital Dislocation of the Hip

Congenital hip dislocation (CHD) happens when a child is born with an unstable hip due to abnormal hip joint formation during the fetal stage. The term "developmental dysplasia of the hip" also applies to this condition. As your child grows, this instability worsens. Their hip's ball-and-socket joint can dislocate at any time. This means that when you move your hand, the ball will fall out of the socket. The joint may occasionally dislocate completely.

Causes:

In many cases, the cause of CHD is unknown. Low levels of amniotic fluid in your womb, breech presentation (when your baby is born hips first), and a family history of the condition are all risk factors. Constrictions in the uterus may also cause or contribute to CHD. This is why, if you're pregnant for the first time, your baby is more likely to have this condition. Your uterus has never been stretched before.

Risk factors:

CHD is more common in females than in males. However, the condition can affect any infant. This is why your child's doctor will check your newborn for signs of hip dislocation on a regular basis, and why they will continue to examine your child's hips at well-baby checkups throughout his or her first year of life.

Signs and symptoms:

• legs that bend outward or appear to be different lengths
• restricted range of motion
• when their legs are extended, they have uneven folds on their legs and buttocks
• delayed gross motor development, which affects your child's ability to sit, crawl, and walk

Diagnosis:

• A physical examination is used as a screening method.
• During the Ortolani test, your child's doctor will apply upward force while moving his or her hip away from the body. The term "movement away from the body" refers to movement away from the body.
• During the Barlow test, your child's doctor will apply downward pressure while moving your child's hip across his or her body. Adduction is a type of body movement.
• Limping, limited abduction and a difference in leg lengths in older babies and children are signs of CHD if they have a single affected hip.
• Imaging tests can be used to confirm a CHD diagnosis. Ultrasounds are examined by doctors for babies under the age of six months. X-rays are used to examine older babies and children.

Treatment:

There are numerous approaches that can be taken to address this condition. A Pavlik harness is a treatment that can be used on newborns or infants. The Pavlik harness is a soft harness-like device with straps that hold the legs apart and are bent at the knee to keep the femur (ball) in the acetabulum (socket) in the proper position. A closed reduction, in which the hip is positioned under anesthesia, is another treatment method that can be used to correct the condition. This procedure can be performed on children ranging in age from six months to two years. If the closed reduction treatment fails, open reduction (surgery) is another option. Following the closed or open surgery, the child may need to wear a cast or brace to keep the hip bone in place while it heals. The child's hip joint function can be restored by using one of these treatment methods.

Rehabilitation:

• A reduction is the first step in recovering from a hip dislocation. This refers to returning the bones to their original positions. Normally, this is done by a doctor while the patient is sedated. In some cases, a surgical procedure is required to restore the hip bones to their natural state.
• Rest, ice, and anti-inflammatory medication should then be used to reduce hip swelling.
• Weight-bearing is permitted for type one posterior dislocations but should be done only when pain allows and the patient is comfortable.
• Patients may perform passive range of motion exercises to increase flexibility within 5–7 days of the injury occurrence.
• Until the patient is comfortable with both weight-bearing and range of motion, a walking aid should be used.