Congenital Dislocation Of The Hip CDH and treatment
Congenital Dislocation Of The Hip CDH:
Refers to malposition of the femur in the acetabulum. the head of the femur is usually dislocated posterosuperior. dislocation may be either partial or complete and may be either unilateral or bilateral.
Etiology of Congenital Dislocation Of The Hip CDH:
- Possible causes :
- abnormal development of the joint caused by fatal position or genetic factors.
- Hormonal factors.
- Environmental factors such as breech delivery.
Incidence: more common in females than in males.
Clinical manifestations :
- May not be observed until 1-2 month of age.
- Asymmetry of gluteal folds with deeper creases apparent on the affected side.
- Limited ability to abduct the hip when the infant is lying on his back with his knee and hips flexed to 90 degrees.
- Trendelenburg’s sign: pelvis drops on the normal side if the child stands on his abnormal leg.
- Leg length inequality with unilateral complete dislocation.
- Delayed walking.
- Limp, waddling gait with bilateral dislocation.
Treatment of Congenital Dislocation Of The Hip CDH :
- Varies with age and extent of the defect.
- Early stages: reduction with gentle manipulation, splinting the hip in abduction by means of double or triple diapers.
- Later stages: preliminary traction, closed or open reduction with immobilization in a hip Spica cast.
Care of child in spica cast :
- Prepare the child for application of the cast.
- Observe for complications resulting from the pressure of the cast, discoloration or cyanosis, impaired movement, loss of sensation, edema, temperature changes or absent pedal pulses.
- Provide good skin care, inspect skin for a sign of irritation, bathing if possible and good skin massaging.
- Prevent the skin around the edges of the cast from being excoriated.
- Prevent urine and feces from soiling the cast.
- Plans for short periods of muscle exercise every day.
- Have the child breath deeply at intervals.
- Turn the child every 2 hours.