Congenital hip dislocation (DCH) is an abnormal development of the hip joint and is defined as the protrusion of the femoral ball out of the hip joint socket. Hip joint ligaments are loose in patients. The degree of DKK varies from child to child. In some cases, the knob is inside the socket but loose. In some children, the knob is completely out of the socket and there is a complete dislocation.
A newborn baby should be checked for TCM during routine examinations. . If this condition is detected at birth, it can usually be corrected. Hip dislocation may not be detected until the child starts walking. The treatment of hip dislocations, which cannot be detected until this stage, is more complex and uncertain.
When hip dislocation is not treated, we encounter a difference in the length of the legs and a "duck-like" gait. It results in arthritis and disability in the joints in later ages. Especially with successful treatment before the age of 1.5, the hip joint can regain its normal functions. However, in cases of delayed treatment after the age of 2, calcification may occur in the hip joint.
Causes
- Familial or genetic factors may be prominent in DCH. Although it is usually seen unilaterally and on the left side, it can also be bilateral;
- Girl
- Breech birth
- Swaddling
- First babies are at risk.
Clinical Findings
Babies with hip dislocation do not show any external symptoms until they walk. For this reason, every parent should routinely take their children to the doctor and have them checked. Apart from this;
- Leg length difference
- Irregular skin folds
- Less movement in the hip on one side
- Hip dislocation when walking with a limp
Physician Examination
In addition to the visual clues above, your doctor will perform special hip tests. In hip examination, it is important to listen and feel and to obtain a clunk sound from the hip (it is the sound made when the hip settles into place and comes out again). X-rays are useful for babies and children, and ultrasound for newborns.
Treatment
Non-surgical treatment
According to the age of the child. treatment planning changes;
Newborn
Pavlik Bandage, a special hip orthosis, is used in this age group. This bandage allows the hip joint to develop within the socket. The duration of treatment is 1 or 2 months.
Infants between 1 and 6 months of age
In this age group, treatment is started with a Pavlik bandage. However, if the child is compliant or the treatment is unsuccessful, a hip-torso cast can be applied under general anesthesia.
Pavlik Bandage
Surgical Treatment
Babies between 6 months and 2 years old
Torso-hip cast is performed under general anesthesia and sometimes open surgery It may be necessary to put the hip joint into place.
Children aged 2 and above
To put the hip joint into place. Open surgery is necessary and then a trunk-hip cast is applied to keep the hip in place.
The treatment and follow-up process in these children continues until the child continues to grow. X-rays are taken at regular intervals.
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