Congenital hip dislocation is a condition in which the hip joint is abnormal. It is also known under the name of hip development dysplasia.
Some babies are born with this malformation. It is characterized because the head of the femur does not fit properly in the joint, which can cause lameness and pain later.
It can also happen that, in the most severe cases, this condition is disabling for the person who suffers.
Congenital hip dislocation affects 1 in every 1,000 babies and in 1 of every 3 children there is slight instability in this joint. In addition, girls are more likely to develop this anomaly.
Causes of congenital hip dislocation
Congenital hip dislocation is considered a condition of "multifactorial inheritance", which means that the congenital defect can be caused by many factors, which are, normally, genetic and environmental.
One of the influences of the environment that is thought to contribute to hip dysplasia is the baby's response to the mother's hormones during pregnancy. A narrow uterus that does not allow fetal movement or a breech birth can also cause hip dysplasia.
Usually, the left hip is usually more prone to be affected than the right, by the position of the fetus inside the uterus.
On the other hand, Firstborn babies are more at risk of suffering dislocation of this joint. This is because the uterus of the primiparous mother is smaller and the space for the baby to move is more limited, which affects the development of the hip.
Other risk factors can be:
- Family history of dysplasia of the development of the hip or very flexible ligaments.
- The position of the baby inside the uterus, especially with the presentation of breech.
- Associations with other orthopedic problems, As the metatarsus adductus, malformation of clubfoot, congenital pathologies and other syndromes.
What symptoms can it trigger?
In newborn babies, the signs of congenital hip dislocation are very subtle and they can go unnoticed by parents.
But nevertheless, the exploration of the hips is part of the routine routine of clinical exploration that pediatricians perform newborns.
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Some of the most characteristic symptoms of hip dysplasia in babies are:
- Detection of a click or hollow sound during the maneuver of the exploration of the hips.
- Difficulty moving one leg with respect to the other.
- Asymmetry of lower limbs, noticing one leg shorter than the other.
- Asymmetry in the folds that are normally observed in the groin of one leg with respect to the other.
- Lameness when walking: this would be a late sign. Typically, it is detected in the first months of the baby's life, before he starts walking.
- Scoliosis: is the formation of an abnormal curvature of the spine to try to compensate the unequal weight distribution between both legs.
How can it be diagnosed?
The diagnosis is suspected from the moment of birth when the baby is given his first physical examination. For this, a maneuver called Ortolani-Barlow is carried out. When this maneuver is positive, the diagnosis is confirmed with an ultrasound or hip radiograph.
In some cases, a consultation with a pediatric orthopedic surgeon is also carried out.
Treatment of congenital hip dislocation
Before 6 months, it is not necessary that all cases be treated orthopedically. The treatments vary depending on the severity of the case and the age of the child.
In the milder ones, a postural treatment is recommended For example, take the baby astride or sleep on his back with the legs open to try to get the bone back naturally in place.
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To the extent that the disease worsens, some types of soft or stiffer prostheses and other treatments are often used, such as the Pavlik harness. This apparatus consists of straps that keep the hips in flexion of 100 degrees to reduce the dislocation.
If still with orthopedic treatments it is not possible to correct the dislocation, the surgery would be the last solution.