Patient's question:
Girl, 20 monthsDetailed medical history and purpose of consultation: I noticed that my daughter's right leg seems shorter when she walks, and she walks with a limp. Additionally, she always uses her left leg as the primary support leg when standing. However, there are no obvious creases in her buttocks, and her right leg is very flexible.
Previous diagnoses, treatments, and outcomes: I took her to the hospital for a checkup, but they said everything was fine. Then I went to another hospital, had X-rays taken, and they also said nothing was wrong. But I'm still worried. Could the X-ray results be used as evidence to rule out congenital hip dysplasia in children? How can I be certain whether she has it or not?
Doctor's answer:
?Hello: Congenital hip dislocation, in the context of China, is more prevalent in the northern regions than in the southern regions. The general incidence rate in the north is around 0.3%, with girls being more affected than boys and the left side being more common than the right. The earlier this condition is treated, the better the outcome. Infants under 2 months old can be treated most simply and effectively, with a high likelihood of complete recovery. Children between 3 months and 1 year old can also achieve ideal results through reduction and fixation.Children aged 1 to 3 years, due to prolonged dislocation, have varying degrees of soft tissue contracture around the hip joint. Therefore, traction must be performed before reduction to achieve a relatively ideal outcome. Children aged 3 to 8 years have even longer dislocation periods, more severe soft tissue contracture, and poorer acetabular development, making manual reduction extremely difficult. As a result, most require surgery to correct the hip joint. The treatment outcomes for this age group are not as good as those for younger children, but many can still recover.
Children over 8 years old face more challenging treatment and poorer outcomes. Some may be difficult to reduce, potentially leading to lifelong disability.
From the above description, we can conclude:
1. The earlier congenital hip dislocation in children is treated, the better the recovery.
2. If congenital hip dislocation is not treated in time, it can lead to disability.
So, how can it be detected early? We recommend performing a simple "frog test" on infants shortly after birth. This involves flexing the child's knees and hips and then spreading the hips outward. If the movement is smooth, it is normal; otherwise, further examination is needed.
Additionally, observe whether the child's gluteal and femoral creases are symmetrical. If they are not, it is advisable to have the child examined by an orthopedic doctor at the hospital.
Furthermore, when changing diapers, pay attention to whether there is any popping or abnormal movement in the child's hip joints. If so, seek further examination by an orthopedic doctor at the hospital.