Patient's question:
Congenital hip dislocationDoctor's answer:
Congenital hip dislocation includes pre-dislocation lesions. In the pre-dislocation stage, there is no dislocation of the hip joint, only developmental dysplasia of the acetabulum, femoral head, and joint capsule. Within the first year before the child stands and begins to walk, although the lesions already exist, the symptoms are not obvious or relatively mild. After the infant starts to stand and learn to walk, the hip joint gradually dislocates. Children who have already developed partial or complete dislocation show more obvious symptoms, but it is often difficult for parents to notice the abnormality because the child is just beginning to learn to walk.Children with this condition tend to start walking later, walk sideways like crabs or ducks, and have a noticeable anterior convexity of the waist when standing.
If congenital pediatric hip dislocation is detected early and treated early, the outcome is generally better with a high cure rate. If it is discovered late, the treatment process is prolonged, the child suffers greatly, and the results are not ideal. Therefore, it is essential for parents and medical personnel to pay attention. How can this condition be detected early?
1. Frog test: In some developed countries in the West, after every newborn is delivered, midwives are required to perform a frog test. The child is laid flat on a table or bed, and both hip and knee joints are flexed to 90 degrees. Then, the legs are abduction. If both knees can touch the table simultaneously, the result is negative. If the outer side of one knee cannot lie flat on the table, dislocation may be suspected. This is the simplest method for early detection of congenital hip dislocation.
2. Lying flat on a bed: Have the child lie flat with both legs bent, and place the heels on the same horizontal line. If one knee is higher than the other, the lower one may be dislocated. The affected leg is shorter than the healthy leg, reluctant to straighten, and shows weak kicking strength. When the affected foot is pulled straight, the child may cry.
3. When the child begins to walk: If the child's gait is slanted like a crab crawling or swaying side to side like a duck walking, but the child does not feel pain and continues to jump and play.
4. Compared to normal children, the affected child's buttocks may appear higher. From the front, the entire pelvis appears rhomboid-shaped, indicating that the femoral head is not inside the acetabulum but rather outside and above it. If any of these conditions are observed, it should be considered a possible case of congenital hip dislocation. The child should be taken to an orthopedic department for examination and X-ray to assess the development of the acetabulum and the position of the femoral head.
The treatment of congenital pediatric hip dislocation should, in principle, be as early as possible, and the treatment methods should vary with the child's age.