Congenital dislocation of the hip

Causes and Risks:
A congenital hip dislocation varies in the degree of malformation. The cause is unknown but genetic factors may play a role. Problems resulting from congenital dislocation of the hip may not become apparent until the person is in their 30's or 40's. One or both hips may be involved. Risk factors include being female, being born as a breech delivery, and a family history of the disorder. It occurs in about 1 out of 1,000 births.

Prevention:
None; however, routine screening to detect the disorder is routinely done during the newborn's first examination as well as other well-baby checkups.

Symptoms:
  • diminished movement in the affected side
  • asymmetry in leg positions
  • asymmetry of the thigh fat folds
  • after 3 months of age, marked asymmetry of the angles of the leg, rotation of the leg, and shortening of the affected leg may become apparent

Note: There may be no symptoms.

Signs and Tests:
Physical examination and hip maneuvers (rotating the hip through various positions) may make it obvious to the health care provide that the hip is dislocated.

A hip X-ray ( joint X-ray ) is helpful in older infants and children.

Treatment:
In early infancy, positioning with a device to keep the legs apart and turned outward (frog-leg position) will stabilize the joint. If there is difficulty in maintaining proper position a plaster cast may be applied and changed periodically to accommodate growth. Operative management may be necessary if early measures to stabilize the joint are unsuccessful, or if the defect is detected in an older child.

Prognosis:
The outcome is usually good with treatment.

Complications:

  • delay in walking may occur for a child in a cast
  • skin irritation from reduction devices
  • untreated, may lead to arthritis and deterioration of the hip later in life
  • limb length discrepancies may persist



Call Your Healthcare Provider:
Call for an appointment with your health care provider if you suspect that your child's hip is not properly positioned.


This is a view of the right side of the hip bone. The socket, visible in the center, is where the femur (large bone of the leg) joins with the hip.