Congenital hip dislocation

Congenital Hip Dislocation

Congenital hip dislocation (CHD), also known as Developmental Dysplasia of the Hip (DDH), is a condition present at birth that affects the hip joint. This condition can occur in one or both hips, and is more common in females and first-born children.

Etiology

The exact cause of CHD is unknown, but it is believed to be a combination of genetic and environmental factors. Some of these factors include breech presentation, family history of hip dysplasia, and conditions that limit the baby's movement in the womb such as Oligohydramnios.

Pathophysiology

In CHD, the hip socket (acetabulum) is shallow, causing the femoral head to be unstable within the socket. The ligaments of the hip joint may also be loose and stretched. This instability allows the femoral head to move or dislocate.

Clinical Presentation

The most common signs of CHD in infants include asymmetry of the thigh folds, limited range of motion in the hip, and a positive Ortolani Test or Barlow Test. In older children and adults, symptoms may include limping, hip pain, and osteoarthritis.

Diagnosis

Diagnosis of CHD is typically made through physical examination and imaging studies. Ultrasound is commonly used in infants, while X-ray and MRI may be used in older children and adults.

Treatment

Treatment for CHD depends on the age of the patient and the severity of the dislocation. Non-surgical treatments include the Pavlik Harness and the Spica Cast. Surgical treatments may include closed reduction, open reduction, and osteotomy.

Prognosis

With early diagnosis and treatment, most children with CHD are able to lead normal lives. However, if left untreated, CHD can lead to complications such as hip osteoarthritis and hip labral tear.

See Also

• Hip Dysplasia
• Hip Joint
• Pediatric Orthopedics

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