Symptom >> Surgical >> Orthopedics

Hip dysplasia

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Congenital hip dysplasia includes the following three levels of typical lesions: (1) hip dysplasia, (2) hip subluxation, and (3) total hip dislocation. Hip dysplasia refers to the baby's or child's hip joints not caused by injuries, complications of infection, various muscle paralysis or other neuropathy.

Cause

Cause

It occurs in baby girls, combined with breech production, less amniotic fluid, more on the left side.

So it may be due to congenital causes determined by genetic factors, plus some external mechanical factors. Typical hip dislocations occur at a rate of about one in a thousand to one-five. If hip subluxation and dysplasia are added, it is estimated to be around 20/1000.

Examine

an examination

Related inspection

Children's orthopedic examination of bone and joint soft tissue CT examination of serum osteocalcin (BGP)

How to detect or diagnose early in the baby stage

Clinical observation of the following abnormalities, parents or caring for the baby can be aware of unilateral complete dislocation or semi-dislocation:

(1) The length of the two lower limbs is different, and the lower limbs have poor mobility.

(2) The hip joint on one side (affected limb) is less likely to expand outward.

(3) The skin folds on the inner side of the thigh, the groin, the perineum or the buttocks are asymmetrical.

(4) The thigh of one side (affected side) is raised upwards and outwards.

Medical staff can use the following science check items to assess the diagnosis:

(1) The hip joint is unstable or displaceable (Barlow & Ortolani Sign).

(2) The affected hip joint does not move with the pelvis (Telescoping Sign).

(3) When the legs are flexed 90o, the affected side is lower (Allis Sign or Galeazzi Sign).

X-rays are not helpful for babies within 3 to 4 months and are generally used to analyze and determine skeletal dysplasia. If there is only a stunted condition, the above tests are not easy to detect.

Recently, the ultrasonic inspection evaluation can make up for the blind spots of the above inspection.

Diagnosis

Differential diagnosis

Differential diagnosis of hip dysplasia:

1, simple congenital dislocation of the hip

(1) Hip dysplasia: also known as hip instability, X-ray films are often characterized by an increase in the acetabular index, most of which use the hip joint outreach and then self-heal, about 1/10 in the future to develop congenital Hip dislocation, and a few cases of persistent acetabular dysplasia, symptoms appear after the elderly.

(2) Hip subluxation: X-ray films have an increased acetabular index, and the acetabulum covers part of the femoral head. This is an independent type that can exist for a long time without being converted into a full dislocation.

(3) total dislocation of the hip joint: the femoral head completely detached from the acetabulum, according to the level of dislocation of the femoral head can be divided into four degrees:

I degree: the femoral head is only displaced to the outside, at the same level as the acetabulum;

II degree: the femoral head is displaced outwards and upwards, which is equivalent to the level above the acetabulum;

The femoral head with III is located at the site of the humeral wing;

The femoral head that IV dislodged moves to the level of the ankle joint.

2, deformed congenital dislocation of the hip

The typical one is dislocation of the two hips. The knee joints are stiff in the straight position and can not be flexed. The two feet are in an external rotation position, and often combined with upper limb malformation.