Congenital hip dislocation symptoms are not be easily seen in a newborn child. However, a pediatrician will typically check for the presence of this disorder using a simple procedure that involves pushing the infant’s legs apart.
Congenital hip dislocation is a disorder in which the hip bone (head of the femur) does not fit properly into its socket or is partially or completely outside of its socket. The condition is present at birth and is more common in girls.
This article shares how this condition is diagnosed in both infants and older children and explains how the dislocation is treated.
Congenital Hip Dislocation Symptoms and Causes
Due to the fact that symptoms are not easily noticed in a newborn, most infants are routinely checked for congenital hip dislocation by their obstetrician or pediatrician. If the test is positive, the medical doctor will hear a clicking sound when flexing and spreading the infant’s legs apart.
In older infants or toddlers, one leg may appear shorter than the other or the toddler may walk with a limp, on his or her tip-toes, or with a waddling gait.
The cause of congenital hip dislocation is not fully understood. There may be a link to a hormonal imbalance in the mother during pregnancy or injury during the birth process which may be due in part to the position of the fetus (i.e. breech position).
Congenital Hip Dislocation Diagnosis and Treatment
Diagnosis is typically made by an obstetrician or pediatrician who may identify the problem during a routine examination. During a routine physical examination, the doctor will flex and spread the infant’s legs, if a clicking sound is heard, the condition may be present.
For toddlers or older children, the doctor will monitor the child’s gait to detect a limp or other unusual walking characteristics such as walking on his or her toes, or waddling like a duck. Other signs of this condition in toddlers and older children may include the appearance that one leg is shorter than the other, skin folds in the thighs that appear uneven and less flexibility on the side affected by the dislocation.
In older infants and children, the diagnosis may be confirmed by additional tests such as ultrasound and/or x-rays of the hip.
Congenital hip dislocation is usually correctable if discovered early and treatment will depend on the age of the child. In newborns and young infants, a soft device called a Pavlik harness can be used to maintain proper positioning of the hip bone in its socket. This allows the hip to develop normally.
For older infants and toddlers a procedure called closed reduction may be performed in which the hip bone is pushed back into the socket. This procedure may be performed under anesthesia. If this procedure fails, open surgery may be recommended.
Treatment typically involves immobilizing the hip joint until it heals. Immobilization can involve using a splint, brace or cast, which may need to be worn for many months. If a cast is needed for a very young child, the child may experience a delay before walking.
Mild cases may be immobilized by placing 2 or 3 layers of diapers on the infant at one time.
Early and proper treatment will often lead to normal hip joint function and should not hinder the child from leading an active lifestyle. However, one leg may remain short.