Abstract
Congenital dislocation or subluxation of the hip (congenital acetabular dysplasia) is a complete or partial displacement of the femoral head out of the acetabulum. The physical signs essential for diagnosis are age related. In newborns the tests for instability are the most sensitive. After the neonatal period, and until the age of walking, tightness of the adductor muscles is the most reliable sign. Early diagnosis is vital for successful treatment of this partially genetically determined condition. Various therapeutic measures, ranging from abduction splinting to open reduction and osteotomy, may be required. Following diagnosis in the first month of life, the average treatment time in one recent series was only 2.3 months from initiation of therapy to attainment of a normal hip. When the diagnosis was not made until 3 to 6 months of age, ten months of treatment was required to achieve the same outcome. When the diagnosis is not made, or the treatment is not begun until after the age of 6, a normal hip will probably not develop in any patient.
Full text
PDF










Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ANDREN L., VON ROSEN S. The diagnosis of dislocation of the hip in newborns and the primary results of immediate treatment. Acta radiol. 1958 Feb;49(2):89–95. doi: 10.3109/00016925809171489. [DOI] [PubMed] [Google Scholar]
- Ashley R. K., Larsen L. J., James P. M. Reduction of dislocation of the hip in older children: a preliminary report. J Bone Joint Surg Am. 1972 Apr;54(3):545–550. [PubMed] [Google Scholar]
- BOTTING T. D., SCRASE W. H. PREMATURE EPIPHYSIAL FUSION AT THE KNEE COMPLICATING PROLONGED IMMOBILISATION FOR CONGENITAL DISLOCATION OF THE HIP. J Bone Joint Surg Br. 1965 May;47:280–282. [PubMed] [Google Scholar]
- CAFFEY J., AMES R., SILVERMAN W. A., RYDER C. T., HOUGH G. Contradiction of the congenital dysplasia-predislocation hypothesis of congenital dislocation of the hip through a study of the normal variation in acetabular angles at successive periods in infancy. Pediatrics. 1956 May;17(5):632–641. [PubMed] [Google Scholar]
- COLEMAN S. S. Diagnosis of congenital dysplasia of the hip in the newborn infant. J Am Med Assoc. 1956 Oct 6;162(6):548–554. doi: 10.1001/jama.1956.02970230020007. [DOI] [PubMed] [Google Scholar]
- COLEMAN S. S. TREATMENT OF CONGENITAL DISLOCATION OF THE HIP IN THE INFANT. J Bone Joint Surg Am. 1965 Apr;47:590–601. [PubMed] [Google Scholar]
- COLONNA P. C. CAPSULAR ARTHROPLASTY FOR CONGENITAL DISLOCATION OF THE HIP: INDICATIONS AND TECHNIQUE; SOME LONG-TERM RESULTS. J Bone Joint Surg Am. 1965 Apr;47:437–449. [PubMed] [Google Scholar]
- Chiari K. Medial displacement osteotomy of the pelvis. Clin Orthop Relat Res. 1974 Jan-Feb;(98):55–71. doi: 10.1097/00003086-197401000-00008. [DOI] [PubMed] [Google Scholar]
- Christensen I. Anteversion deformity and derotation osteotomy in congenital dislocation of the hip. Acta Orthop Scand. 1969;40(1):62–71. doi: 10.3109/17453676908989485. [DOI] [PubMed] [Google Scholar]
- Ferguson A. B., Jr Primary open reduction of congenital dislocation of the hip using a median adductor approach. J Bone Joint Surg Am. 1973 Jun;55(4):671–689. [PubMed] [Google Scholar]
- Gage J. R., Winter R. B. Avascular necrosis of the capital femoral epiphysis as a complication of closed reduction of congenital dislocation of the hip. A critical review of twenty years' experience at Gillette Children's Hospital. J Bone Joint Surg Am. 1972 Mar;54(2):373–388. [PubMed] [Google Scholar]
- HARRIS L. E., LIPSCOMB P. R., HODGSON J. R. Early diagnosis of congenital dysplasia and congenital dislocation of the hip. Value of the abduction test. J Am Med Assoc. 1960 May 21;173:229–233. doi: 10.1001/jama.1960.03020210009003. [DOI] [PubMed] [Google Scholar]
- HEYMAN C. H. LONG-TERM RESULTS FOLLOWING A BONE-SHELF OPERATION FOR CONGENITAL AND OTHER DISLOCATIONS OF THE HIP IN CHILDREN. J Bone Joint Surg Am. 1963 Sep;45:1113–1146. [PubMed] [Google Scholar]
- Hummer C. D., MacEwen G. D. The coexistence of torticollis and congenital dysplasia of the hip. J Bone Joint Surg Am. 1972 Sep;54(6):1255–1256. [PubMed] [Google Scholar]
- LLOYD-ROBERTS G. C. Osteoarthritis of the hip; a study of the clinical pathology. J Bone Joint Surg Br. 1955 Feb;37-B(1):8–47. doi: 10.1302/0301-620X.37B1.8. [DOI] [PubMed] [Google Scholar]
- Lloyd-Roberts G. C., Swann M. Pitfalls in the management of congenital dislocation of the hip. J Bone Joint Surg Br. 1966 Nov;48(4):666–681. [PubMed] [Google Scholar]
- MCCARROLL H. R. RECONSTRUCTION OF THE ADULT HIP IN CONGENITAL DYSPLASIA AND CONGENITAL DISLOCATION. Pac Med Surg. 1965 Mar-Apr;73:116–118. [PubMed] [Google Scholar]
- MacKenzie I. G. Congenital dislocation of the hip. The development of a regional service. J Bone Joint Surg Br. 1972 Feb;54(1):18–39. [PubMed] [Google Scholar]
- Mitchell G. P. Problems in the early diagnosis and management of congenital dislocation of the hip. J Bone Joint Surg Br. 1972 Feb;54(1):4–12. [PubMed] [Google Scholar]
- Owen R. Early diagnosis of the congenitally unstable hip. J Bone Joint Surg Br. 1968 Aug;50(3):453–454. [PubMed] [Google Scholar]
- PEMBERTON P. A. PERICAPSULAR OSTEOTOMY OF THE ILIUM FOR TREATMENT OF CONGENITAL SUBLUXATION AND DISLOCATION OF THE HIP. J Bone Joint Surg Am. 1965 Jan;47:65–86. [PubMed] [Google Scholar]
- PLATOU E. Rotation osteotomy in the treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1953 Jan;35-A(1):48–54. [PubMed] [Google Scholar]
- PONSETI I. V., FRIGERIO E. R. Results of treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1959 Jul;41-A(5):823–passim. [PubMed] [Google Scholar]
- Pemberton P. A. Pericapsular osteotomy of the ilium for the treatment of congenitally dislocated hips. Clin Orthop Relat Res. 1974 Jan-Feb;(98):41–54. doi: 10.1097/00003086-197401000-00007. [DOI] [PubMed] [Google Scholar]
- Ponseti I. V. Non-surgical treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1966 Oct;48(7):1392–1403. [PubMed] [Google Scholar]
- RECORD R. G., EDWARDS J. H. Environmental influences related to the aetiology of congenital dislocation of the hip. Br J Prev Soc Med. 1958 Jan;12(1):8–22. doi: 10.1136/jech.12.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- RYDER C. T., MELLIN G. W., CAFFEY J. The infant's hipnormal or dysplastic? Clin Orthop. 1962;22:7–15. [PubMed] [Google Scholar]
- Ritter M. A. Congenital dislocation of the hip in the newborn. Am J Dis Child. 1973 Jan;125(1):30–32. doi: 10.1001/archpedi.1973.04160010018004. [DOI] [PubMed] [Google Scholar]
- SCHWARTZ D. R. ACETABULAR DEVELOPMENT AFTER REDUCTION OF CONGENITAL DISLOCATION OF THE HIP: A FOLLOW-UP STUDY OF FIFTY HIPS. J Bone Joint Surg Am. 1965 Jun;47:705–714. [PubMed] [Google Scholar]
- SLATER B. C., WATSON G. I., MCDONALD J. C. SEASONAL VARIATION IN CONGENITAL ABNORMALITIES. PRELIMINARY REPORT OF A SURVEY CONDUCTED BY THE RESEARCH COMMITTEE OF COUNCIL OF THE COLLEGE OF GENERAL PRACTITIONERS. Br J Prev Soc Med. 1964 Jan;18:1–7. doi: 10.1136/jech.18.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Salter R. B., Dubos J. P. The first fifteen year's personal experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. Clin Orthop Relat Res. 1974 Jan-Feb;(98):72–103. doi: 10.1097/00003086-197401000-00009. [DOI] [PubMed] [Google Scholar]
- Salter R. B. Etiology, pathogenesis and possible prevention of congenital dislocation of the hip. Can Med Assoc J. 1968 May 18;98(20):933–945. [PMC free article] [PubMed] [Google Scholar]
- Salter R. B. Role of innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip in the older child. J Bone Joint Surg Am. 1966 Oct;48(7):1413–1439. [PubMed] [Google Scholar]
- Samuelson K. M., Nixon G. W., Morrow R. E. Tomography for evaluation of congenital dislocation of the hip while in a spica cast. J Bone Joint Surg Am. 1974 Jun;56(4):844–845. [PubMed] [Google Scholar]
- Smaill G. B. Congenital dislocation of the hip in the newborn. J Bone Joint Surg Br. 1968 Aug;50(3):525–536. [PubMed] [Google Scholar]
- Steel H. H. Triple osteotomy of the innominate bone. J Bone Joint Surg Am. 1973 Mar;55(2):343–350. [PubMed] [Google Scholar]
- Thieme W. T., Wynne-Davies R. Clinical examination and urinary oestrogen assays in newborn children with congenital dislocation of the hip. J Bone Joint Surg Br. 1968 Aug;50(3):546–550. [PubMed] [Google Scholar]
- Trevor D. The place of the Hey Groves-Colonna operation in the treatment of congenital dislocation of the hip. Ann R Coll Surg Engl. 1968 Nov;43(5):241–258. [PMC free article] [PubMed] [Google Scholar]
- Utterback J. D., MacEwen G. D. Comparison of pelvic osteotomies for the surgical correction of the congenital hip. Clin Orthop Relat Res. 1974 Jan-Feb;(98):104–110. doi: 10.1097/00003086-197401000-00010. [DOI] [PubMed] [Google Scholar]
- Wedge J. H., Salter R. B. Innominate osteotomy: its role in the arrest of secondary degenerative arthritis of the hip in the adult. Clin Orthop Relat Res. 1974 Jan-Feb;(98):214–224. doi: 10.1097/00003086-197401000-00025. [DOI] [PubMed] [Google Scholar]
- Weissman S. L., Salama R. Treatment of congenital dislocation of the hip in the newborn infant. J Bone Joint Surg Am. 1966 Oct;48(7):1319–1327. [PubMed] [Google Scholar]
- Williamson J. Difficulties of early diagnosis and treatment of congenital dislocation of the hip in Northern Ireland. J Bone Joint Surg Br. 1972 Feb;54(1):13–17. [PubMed] [Google Scholar]
- Wilson J. C., Jr Surgical treatment of the dysplastic acetabulum in adolescence. Clin Orthop Relat Res. 1974 Jan-Feb;(98):137–145. doi: 10.1097/00003086-197401000-00015. [DOI] [PubMed] [Google Scholar]
- Wynne-Davies R. A family study of neonatal and late-diagnosis congenital dislocation of the hip. J Med Genet. 1970 Dec;7(4):315–333. doi: 10.1136/jmg.7.4.315. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wynne-Davies R. Acetabular dysplasia and familial joint laxity: two etiological factors in congenital dislocation of the hip. A review of 589 patients and their families. J Bone Joint Surg Br. 1970 Nov;52(4):704–716. [PubMed] [Google Scholar]
- von Rosen S. Further experience with congenital dislocation of the hip in the newborn. J Bone Joint Surg Br. 1968 Aug;50(3):538–541. [PubMed] [Google Scholar]









