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Diagnostics of the congenital hip dislocation
Last reviewed: 23.04.2024
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Diagnosis of dysplasia or hip dislocation in the maternity hospital is the standard of diagnosis. Anamnestic or objective signs of pathology require careful instrumental (ultrasonography or roentgenography) studies with simultaneous adoption of preventive measures in the form of assignments that correspond to the principles of functionality of tires, pillows, stirrups. The examination of the child by a specialist competent in neonatal orthopedics and having experience in interpreting ultrasonography and radiography data is extremely important. Timely begun functional treatment leads to the achievement of anatomical recovery in 95% of children. Unfortunately, it is not always possible to carry out a timely consultation of an orthopedic specialist.
The recommended algorithm of action even with suspicion of hip dysplasia:
- ensure the position of the extremities in the maximum lead; to carry out a wide swaddling with 10-12 layers of flannel diaper; before each feeding, non-violently bend and dilute the lower limbs;
- at the first opportunity, without removing wide swaddling, provide advice to an orthopedic trauma specialist or a pediatric surgeon.
The final diagnosis at the age of 3-4 months of life is established, unfortunately, in about 60% of children. Of great importance are the clinical data, analysis of the radiometric characteristics of the components of the joint, classical schemes (Hilgvenreiner, Putti V.).
For diagnosis, it is important to assess the orientation of the mechanical axis of the femoral neck with the necessary consideration of corrections for the error of the hip placement. The longitudinal axis of the femoral neck is a line passing through the point located in the middle of the line passing between the lateral and medial edge of the femoral neck and perpendicular to it. The radiological sign of the decentralization is the orientation of the axis of the femoral neck from the border of the medial and the next quarter of the roof to the boundary of the third and last quarters, the subluxation to the lateral quarter of the roof. Orientation of the cervical axis on the lateral edge of the nadacetabular portion of the ilium corresponds to dislocation.
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