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    Congenital Hips Dislocation

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    Mar Ordanza
    Congenital hip dislocation, also known as developmental dysplasia of the hip, is a birth defect where the ball and socket of the hip joint do not properly form. It can cause the thigh bone to come out of the hip socket. Risk factors include breech birth position and family history. Symptoms include limping, leg length discrepancy, and limited hip movement on the affected side. Treatment depends on the child's age, ranging from use of a harness or brace in infants to help guide hip development, to surgical reduction of older children. The goal is early diagnosis and treatment to prevent long-term complications like premature arthritis.

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    Congenital Hips Dislocation

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    Mar Ordanza
    84 views6 pages
    Congenital hip dislocation, also known as developmental dysplasia of the hip, is a birth defect where the ball and socket of the hip joint do not properly form. It can cause the thigh bone to come out of the hip socket. Risk factors include breech birth position and family history. Symptoms include limping, leg length discrepancy, and limited hip movement on the affected side. Treatment depends on the child's age, ranging from use of a harness or brace in infants to help guide hip development, to surgical reduction of older children. The goal is early diagnosis and treatment to prevent long-term complications like premature arthritis.

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    Congenital hip dislocation, also known as developmental dysplasia of the hip, is a birth defect where the ball and socket of the hip joint do not properly form. It can cause the thigh bone to come out of the hip socket. Risk factors include breech birth position and family history. Symptoms include limping, leg length discrepancy, and limited hip movement on the affected side. Treatment depends on the child's age, ranging from use of a harness or brace in infants to help guide hip development, to surgical reduction of older children. The goal is early diagnosis and treatment to prevent long-term complications like premature arthritis.

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    Download as docx, pdf, or txt
    84 views6 pages

    Congenital Hips Dislocation

    Uploaded by

    Mar Ordanza
    Congenital hip dislocation, also known as developmental dysplasia of the hip, is a birth defect where the ball and socket of the hip joint do not properly form. It can cause the thigh bone to come out of the hip socket. Risk factors include breech birth position and family history. Symptoms include limping, leg length discrepancy, and limited hip movement on the affected side. Treatment depends on the child's age, ranging from use of a harness or brace in infants to help guide hip development, to surgical reduction of older children. The goal is early diagnosis and treatment to prevent long-term complications like premature arthritis.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 6

    CONGINITAL HIPS DISLOCATION (DYSPLASIA)

    A malformation of the hip joint that is present at birth. Genetic factors likely play a role in this
    disorder. Features include hip dislocation, asymmetry of leg positions, asymmetric fat folds, and
    diminished movement on the affected side. Some children will exhibit little or no features and
    must be diagnosed by physical examination of the hip joints.

    It is abnormality of the hip joint present from birth, is the most common disorder affecting hip
    joint of children. Younger than 3 yrs. Old it can unilateral or bilateral.

    Is an imperfect development of the hip that can affect the femoral head, acetabulum, or both.

    Occur when the ball of the hip of the joint come out of its socket.

    3 Types
    1. Hip dyaplasia
    2. Subluxation
    3. Complete or true congenital dislocation



    Cause
    Breech presentation
    Oligohydramios


    Sign and symptom
    Congenital dislocation
    Waddle like duck
    Shortening of the limb
    Lordosis
    Leg with hip problem may appear to turn out more
    Reduced movement on the side of the body with the dislocation
    Shorter leg on the side with the hip dislocation
    Uneven skin folds of thigh or buttocks
    Diagnostic test
    X-ray
    CT-Scan
    MRI
    Ultrasounds



    Risk factor

    First child in the family
    Being female
    Breech position
    Family history of disorder

    Complications
    Premature arthritis of the hip as early as late teen
    Joint malformation
    Crippling osteoarthritis
    Degenerative hip changes
    Treatment
    Pavlik Harness
    2 maneuvers
    > Ortolani test
    > Barlow test

    Nursing management
    Assist in teaching parents the important of exercise
    Double diapering
    Care of patient with cast and braces
    Provide adequate stimuli to promote growth and development
    Feed the child carefully to avoid aspiration and choking

    Medical management
    New born to 6 months
    Application of external device to maintain proximal femur centered in the acetabuulum
    6-18 months
    Traction followed by reduction and plaster cast immobilization
    Order child
    Surgical reduction

    Intevention
    Teach parents how to correctly splint or braces the hip as ordered.
    Instruct parents to remove braces and splint while bathing the infant but to replace them
    immediately after word.
    When transferring a child immediately after casting, use palm to avoid marking.
    Turn the child every 2 hours.
    Provide adequate nutrition and maintain adequate fluid intake.

    Nonsurgical Hip Dysplasia

    Many nonsurgical treatments for adults with hip dysplasia focus on reducing inflammation or
    supporting joint health. Glucosamine and chondroitin sulfate, often sold as a single dietary
    supplement, can be taken for joint health. Oral glucosamine comes from shellfish (although
    vegetarian options exist) and may help rebuild cartilage. Chondroitin sulfate is also a major
    component of cartilage. While both may reduce joint pain, there are conflicting reports about their
    effectiveness in treating osteoarthritis.

    A doctor can also give steroid shots to reduce inflammation. The decrease in inflammation
    reduces the level of pain. The most common side effect is a condition called cortisone flare -- the
    injected cortisone crystallizes and becomes painful for a day or two. Some studies have shown that
    repeated use of cortisone can weaken tendons and soften cartilage, so a doctor may limit the
    number of injections.
    2
    nd
    . TREATMENT
    When the problem is found during the first 6 months of life, a device or harness is used
    to keep the legs apart and turned outward (frog-leg position). This device will usually
    hold the hip joint in place while the child grows.
    This harness works for most infants when it is started before age 6 months, but it is less
    likely to work for older children.

    PATHOPHYSIOLOGY

    Newborn ( Girl) _____________Malformation of the hips


    Breech presentation


    Oligohydramios


    Lordosis


    Subluxation


    Dislocation

    Prevention

    Prevention includes proper prenatal care to determine the position of the baby in the womb.
    This may be helpful in preparing for possible breech births associated with hip problems.
    Avoiding excessive and prolonged infant hip adduction may help prevent
    strain on the hip joints.
    Early diagnosis remains an important part of prevention of congenital
    Congenital hip dysplasia.

    Anatomy of Femur









    PHYSIOLOGY


    The Head (caput femoris).The head which is globular and forms rather more than a
    hemisphere, is directed upward, medialward, and a little forward, the greater part of its
    convexity being above and in front.

    The Neck (collum femoris).The neck is a flattened pyramidal process of bone,
    connecting the head with the body, and forming with the latter a wide angle opening
    medialward.

    The Trochanters.The trochanters are prominent processes which afford leverage to
    the muscles that rotate the thigh on its axis.

    The Greater Trochanter (trochanter major; great trochanter) is a large, irregular,
    quadrilateral eminence, situated at the junction of the neck with the upper part of the
    body

    The medial surface, of much less extent than the lateral, presents at its base a deep
    depression, thetrochanteric fossa

    The Lesser Trochanter (trochanter minor; small trochanter) is a conical eminence,
    which varies in size in different subjects; it projects from the lower and back part of the
    base of the neck

    The Body or Shaft (corpus femoris).The body, almost cylindrical in form, is a little
    broader above than in the center, broadest and somewhat flattened from before
    backward below

    The articular surface of the lower end of the femur occupies the anterior, inferior, and
    posterior surfaces of the condyles. Its front part is named the patellar surface and
    articulates with the patella;

    The Architecture of the Femur.Koch
    62
    by mathematical analysis has shown that in
    every part of the femur there is a remarkable adaptation of the inner structure of the
    bone to the machanical requirements due to the load on the femur-head.

    The Inner Architecture of the Upper Femur.The spongy bone of the upper femur
    (to the lower limit of the lesser trochanter) is composed of two distinct systems of
    trabecul arranged in curved paths: one, which has its origin in the medial (inner) side
    of the shaft and curving upward in a fan-like radiation to the opposite side of the bone

    References
    Professional guide to disease by: Wolter kluwer
    Medical and surgical book by: Wolter kluwer


    MARK JOSEPH ORDANZA

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