Congenital Hip Dislocation or Developmental Dysplasia of the Hip: Causes, Symptoms, Tests

The meaning of congenital hip dislocation (CHD) or developmental dysplasia of the hip is that there is a dislocation in the hip joint of a new born baby or there is a possibility of dislocation.¹

Out of 600 girls, one is affected with congenital hip dislocation (CHD) or developmental dysplasia of the hip and out of 3,000 boys one is affected.
The determinant of the mode of treatment for congenital hip dislocation (CHD) or developmental dysplasia of the hip depends on the age of the child when they are diagnosed. It entails special harnesses or casts and operations.

Abnormality in the hip joint formation in the early growth stages of the fetus, results in a child having unstable hip on birth, which causes congenital hip dislocation (CHD). Developmental dysplasia of the hip is another name attributed to this condition.² With maturity of the child, the condition worsens. Dislocation of the ball-and-socket joint on the hip will occur sometimes. It means that the ball can slip from the socket when moved. Complete dislocation sometimes does occur. Out of every 1,000 newborns, one will have congenital hip dislocation (CHD) or developmental dysplasia of the hip according to the American Family Physician.

It is very common for some newborns to have congenital hip dislocation (CHD) or developmental dysplasia of the hip. Several factors including nationality, race, sex, and others affect the frequency of congenital hip dislocation (CHD) or developmental dysplasia of the hip requiring treatment.³ 2-3 children in every one thousand will have congenital hip dislocation (CHD) or developmental dysplasia of the hip needing treatment. Mild instability has been detected by some studies in 15% of infants. Majority of the mild instability resolve in a spontaneous manner. Girls are likely to be affected four times more than boys are.

No. there is no known reason of congenital hip dislocation (CHD) or developmental dysplasia of the hip during pregnancy or delivery. It entails the looseness of ligaments developing during the late stages of pregnancy.

No. Diagnostic tests are not available during pregnancy for the prediction of congenital hip dislocation (CHD) or developmental dysplasia of the hip nor can the detection be done on the ultrasound. This is unidentifiable birth defect. Despite, being able to develop after birth, congenital hip dislocation (CHD) or developmental dysplasia of the hip is more or less a birth condition.

Pediatric orthopedist is the most preferred to be consulted for a baby who is diagnosed with congenital hip dislocation (CHD) or developmental dysplasia of the hip. Regardless of the skills to treat muscle skeleton disorders that involve bones, general orthopedists may be lacking the experience to deal with congenital hip dislocation (CHD) or developmental dysplasia of the hip. Muscle-skeleton related disorders in children can be handling best by pediatric orthopedists.

If untreated for a span of two years, congenital hip dislocation (CHD) or developmental dysplasia of the hip can lead to waddling walking, painful hip and reduced strength will occur. Young adults can have osteoarthritis and other deformities of the hip if it is not treated altogether.

Discuss how you feel with the doctor. Ask any question that you have. Know that childcare is difficult even for parents whose children are born without congenital hip dislocation (CHD) or developmental dysplasia of the hip. It will be more difficult when a child is having congenital hip dislocation (CHD) or developmental dysplasia of the hip. Seek help if you need it. Involve the life of your child with other family members or grandparents. Get connected with a parent whose child has congenital hip dislocation (CHD) or developmental dysplasia of the hip through your child’s doctor. Enjoy the development and growth of your child.

In most cases, the cause of congenital hip dislocation (CHD) or developmental dysplasia of the hip is unknown. When the level of amniotic fluid is low in the womb congenital hip dislocation (CHD) or developmental dysplasia of the hip may occur.

Family history of this condition and breech presentation occurring when the hips comes first during birth are some of the contributing factors. Another cause or contribution can be uterus confinement. This is why congenital hip dislocation (CHD) or developmental dysplasia of the hip is likely to affect firstborns, lack of previous stretch of the uterus.

There is the tendency of congenital hip dislocation (CHD) or developmental dysplasia of the hip running in families. Any individual’s hip can be affected. The left hip is usually affected predominantly in:

• Firstborn children.
• Girls.
• Infants born in breech position (particularly with feet up the shoulder). It is now recommended that there be an ultrasound screening for congenital hip dislocation (CHD) or developmental dysplasia of the hip for female breech babies as per the American Academy of Pediatrics.
• Congenital hip dislocation (CHD) or developmental dysplasia of the hip family history (sibling or parents)
• Low amniotic levels (Oligohydramnios).

Initially there will not be any visible signs and symptoms of congenital hip dislocation (CHD) or developmental dysplasia of the hip. When the signs and symptoms for congenital hip dislocation (CHD) or developmental dysplasia of the hip develop, they may include:

• Turning outward of the legs and leg length discrepancy is seen in congenital hip dislocation (CHD) or developmental dysplasia of the hip.
• Motion range becomes limited in a child with congenital hip dislocation (CHD) or developmental dysplasia of the hip.
• When the legs are straightened, uneven folds will emanate from buttocks and legs.
• Gross motor development is delayed, affecting the style of sitting, crawling and walking in babies with congenital hip dislocation (CHD) or developmental dysplasia of the hip.

Congenital hip dislocation (CHD) or developmental dysplasia of the hip screening happens at birth and during the whole of following one-year after birth. Physical exam is the most common method for screening. The doctor will detect dislocation of the hip by maneuvering gently on the legs and hips of the child in order to listen for clunking and clicking sounds.

• In ortolani test for congenital hip dislocation (CHD) or developmental dysplasia of the hip, the doctor of your child will apply upward force while the hip of your child is moved away from the body. Abduction is the term given to the movement away from the body.
• In barlow test for congenital hip dislocation (CHD) or developmental dysplasia of the hip, the doctor of your child applies a force downward in the process he/ she moves the hips of the child across the body. The movement towards the body is known as adduction.

The accuracy of these above tests is certain when the child is below 3 months old. Legs will have varied lengths with one hip being affected, limited abduction, and limping are some of the finding indicating congenital hip dislocation (CHD) or developmental dysplasia of the hip in older children and babies.

The accuracy of this information is only when the child diagnosis can be confirmed through imaging tests. Babies below six months are examined by doctors through ultrasound. X-rays is used for older children and babies.

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Also Read:

• Congenital Hip Dislocation or Developmental Dysplasia of the Hip: Treatment, Surgery, Complications
• Congenital Hip Dislocation or Developmental Dysplasia of the Hip: Recovery, Prognosis, Splint, Prevention, Coping