Congenital Hip Dislocation: And Everything You Need To Know

Congenital hip dislocation also known as developmental dysplasia of the hip (DDH) is a condition in which the hip joint does not develop normally in infants and young children. It occurs when the ball of the thigh bone (femur) is not stable within the socket of the hip bone (acetabulum).

This instability can cause the hip joint to dislocate or partially dislocate. Which can lead to hip dysplasia, where the socket of the hip joint is shallow and unable to hold the ball of the femur in place. The condition is usually present at birth or occurs within the first year of life.

Some common risk factors for DDH include family history, breech position during pregnancy and firstborn children. Symptoms of DDH include a difference in leg length, limited mobility of the hip joint and a clicking sound when the hip joint is moved.

If left untreated, DDH can cause permanent damage to the hip joint, leading to osteoarthritis and other hip-related complications. Treatment options for DDH depend on the severity of the condition and can range from the use of a special harness or brace to surgery to reposition the hip joint. Early detection and treatment of DDH are important for the best possible outcome.

Congenital Hip Dislocation Causes

The exact cause of congenital hip dislocation (CHD) is not fully understood. But there are several known risk factors that can contribute to its development.

1. Family history: If a close family member has a history of CHD the child is more likely to develop it.
2. Breech position: When a baby is in the breech position in the womb with the buttocks or feet down and the head up. It can increase the risk of CHD. This is because the hips are not able to develop properly when they are in this position.
3. Firstborn child: Firstborn children are at a slightly higher risk of developing CHD, possibly due to the uterus being less relaxed and more cramped during the first pregnancy.
4. Female sex: Females are more likely than males to develop CHD.
5. Other medical conditions: Certain medical conditions, such as spina bifida, cerebral palsy or muscular dystrophy can increase the risk of CHD.
6. Environmental factors: There is some evidence to suggest that environmental factors. Such as swaddling infants too tightly, may contribute to the development of CHD.

It’s important to note that not all babies with these risk factors will develop CHD. Some babies without these risk factors may still develop the condition. Early detection and treatment of CHD are crucial for the best possible outcom

Congenital Hip Dislocation Diagnose

CHD is usually diagnosed in the first few months of life as part of routine physical exams. A healthcare provider may suspect CHD if they notice any asymmetry in the child’s leg or hip creases. The provider may also perform a physical exam of the hip joint to look for any signs of instability. Such as clicking or clunking sounds when the hip is moved.

If CHD is suspected, the child may undergo additional diagnostic tests to confirm the diagnosis and determine the severity of the condition. These tests may include:

1. Ultrasound: This is the most common diagnostic test used to confirm CHD in infants under six months old. Ultrasound uses sound waves to create images of the hip joint and can show any abnormalities such as a shallow socket or dislocation.
2. X-rays: X-rays are typically used to diagnose CHD in children over six months old. X-rays can show the position of the femoral head in the acetabulum and can help determine the severity of the condition.
3. MRI: MRI may be used in some cases to provide a more detailed image of the hip joint.
4. CT scan: CT scans can provide a more detailed image of the bones and joints and may be used in certain cases to diagnose CHD.

Early detection and diagnosis of CHD are crucial for the best possible outcome. If CHD is diagnosed, treatment should begin as soon as possible to prevent complications and ensure proper hip joint development.

Congenital Hip Dislocation Treatment

The treatment for congenital hip dislocation (CHD) depends on the severity of the condition and the age of the child. The goal of treatment is to keep the femoral head (the ball of the thigh bone) in the acetabulum (the socket of the hip bone) and to ensure proper hip joint development.

Pavlik harness

This is the most common treatment for infants with CHD who are under six months old. The Pavlik harness is a special device that holds the hip in a stable position while allowing the child to move their legs. The harness is worn for 23 hours a day and is usually used for several months.

Spica cast

If the Pavlik harness is not effective or if the child is over six months old, a spica cast may be used. A spica cast is a full-body cast that extends from the chest to the toes and it holds the hip joint in a stable position. The cast is usually worn for several months.

Surgery

Surgery may be necessary to reposition the femoral head in the acetabulum. It may be recommended if the child does not respond to other treatments or if the CHD is severe. The type of surgery performed will depend on the age of the child and the severity of the condition.

Brace or orthosis

Brace or orthosis may be used to help stabilize the hip joint.

After treatment, the child will likely need to be monitored to ensure that the hip joint develops properly. Physical therapy may also be recommended to help strengthen the muscles around the hip joint and improve range of motion. With early detection and appropriate treatment most children with CHD can have a normal hip joint and a full range of motion.

Also Read: Calcium Deficiency: Causes, Symptoms, and Prevention Strategies

Congenital Hip Dislocation Life-threatening

Congenital hip dislocation (CHD) is not typically life-threatening in and of itself. if left untreated or undiagnosed, CHD can lead to complications that can affect the child’s quality of life.

One of the main complications of CHD is hip dysplasia. Which is an abnormal development of the hip joint. Hip dysplasia can lead to early-onset arthritis, hip pain and hip joint degeneration later in life. In severe cases it may require surgery to correct.

If CHD is not treated in a timely manner. It can also lead to a shorter leg, a limp or muscle weakness. CHD can cause chronic pain and disability in adulthood.

Early detection and appropriate treatment of CHD are crucial to prevent complications and ensure proper hip joint development. Regular check-ups and follow-up appointments with a healthcare provider are also important to monitor the child’s progress and ensure proper hip joint development.

Conclusion

Congenital hip dislocation (CHD) is a condition where the hip joint is not properly formed at birth. Which can lead to instability and potentially serious complications if left untreated. CHD can be caused by a variety of factors. Including genetic predisposition and environmental factors. Early detection and diagnosis are important for the best possible outcome. As treatment is most effective when started in the first few months of life. Treatment options may include a Pavlik harness, a spica cast, surgery or a brace or orthosis. Depending on the severity of the condition. With proper treatment and monitoring most children with CHD can have a normal hip joint and a full range of motion. But early detection and appropriate treatment are crucial to prevent complications and ensure proper hip joint development.

References

1. Journal Title: Clinical Orthopaedics and Related Research

• Publisher Name: Wolters Kluwer Health
• Year: 2021
• DOI Number: 10.1097/CORR.0000000000001542
• Overview of Study:
  • Investigates the genetic factors influencing the predisposition to DDH.
  • Reviews the effectiveness of early ultrasound screening in infants.
  • Discusses long-term outcomes of patients treated with Pavlik harness and surgery.

2. Journal Title: Journal of Pediatric Orthopaedics

• Publisher Name: Wolters Kluwer Health
• Year: 2019
• DOI Number: 10.1097/BPO.0000000000001420
• Overview of Study:
  • Evaluates the incidence and risk factors of DDH in a large cohort.
  • Assesses the role of environmental factors, including swaddling practices.
  • Outlines recommendations for orthopedic follow-up and management.

3. Journal Title: The Journal of Bone and Joint Surgery – American Volume

• Publisher Name: The Journal of Bone and Joint Surgery, Inc.
• Year: 2020
• DOI Number: 10.2106/JBJS.19.00934
• Overview of Study:
  • Compares surgical versus non-surgical treatment outcomes in older infants.
  • Studies the anatomical and functional results of different surgical techniques.
  • Highlights the importance of early detection through routine physical examinations.