Congenital Hip Dysplasia

Congenital Hip Dysplasia

Congenital hip dysplasia is a hip joint deformity that exists at birth. The femoral head is not secure in the acetabulum and the ligaments at the hip joint may be detached or stretched. This malformation may well be hereditary but some children will present little or no traits and must be determined by a physical examination of the hip joint. Visible signs in children include walking with a limp, walking on toes and waddling stride. Characteristics consist of uneven leg positions, inconsistent fat folds, hip dislocation and decreased movement on the affected hip.

There are a few methods to diagnose congenital hip dysplasia. X-ray films help discern abnormalities of the hip joint allowing correct positioning of the hip joint if a cast is needed. Ultrasound is even more helpful because it permits multiple positioning of the hip joint. The Barlow method is where the doctor places the infant's hips together with the knees totally bent then the doctor places their middle finger over the outside of the hipbone as the thumb is positioned on the medial side of the knee. The hip is pulled away from the body where the doctor can feel whether the hip is sliding in and out of the joint. The Ortolani test is where the doctors hands surround the infants knees, with the second and third fingers turn down toward the infants thigh. Moving the legs apart, the doctor will be able to notice a pronounced clicking noise with the movement.

Exercise programs can be used to strengthen hips and help with hip motion and relieve pain along with medication as nonsurgical treatments. Treatment is needed to return the head of the femur into the hip socket. Some infants are placed in a stiff shell cast to keep the hip in position and in older children surgery may be performed to reposition the hip and then a cast is applied to keep the hip in place. Later on in life, a total hip replacement surgery may be necessary.