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Diagnosis of congenital hip dislocation
Last reviewed: 04.07.2025
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Diagnosis of hip dysplasia or dislocation in the maternity hospital is the standard of diagnosis. Anamnestic or objective signs of pathology require careful instrumental (ultrasonography or radiography) examination with the simultaneous adoption of preventive measures in the form of prescribing abduction devices, corresponding to the principles of functionality of splints, pillows, stirrups. It is extremely important to examine the child by a specialist competent in neonatal orthopedics and experienced in interpreting ultrasonography and radiography data. Timely functional treatment leads to anatomical recovery in 95% of children. Unfortunately, it is not always possible to carry out a timely consultation with an orthopedic specialist.
Recommended course of action even if hip dysplasia is suspected:
- ensure the position of the limbs in maximum abduction; perform wide swaddling with 10-12 layers of flannel diaper; before each feeding, gently bend and spread the lower limbs;
- At the first opportunity, without removing the wide swaddling, provide a consultation with an orthopedic traumatologist or pediatric surgeon.
Unfortunately, the final diagnosis is made at the age of about 3-4 months in approximately 60% of children. Clinical data, analysis of X-ray characteristics of joint components, and classical schemes (Hilgvenreiner, Putti V.) are of great importance.
For diagnostics, it is important to evaluate the orientation of the mechanical axis of the femoral neck, with mandatory allowance for corrections for errors in hip positioning. The longitudinal axis of the femoral neck is a line passing through a point located in the middle of a line passing between the lateral and medial edges of the femoral neck and perpendicular to it. A radiographic sign of decentration is the direction of the femoral neck axis within the range from the border of the medial and next quarter of the roof to the border of the third and last quarters, subluxation - to the lateral quarter of the roof. Orientation of the neck axis to the lateral edge of the supraacetabular part of the ilium corresponds to dislocation.
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