CONGENITAL HIP DISLOCATION ( CHD)

The cause of CHD is unknown in many cases.

• Girl
• low levels of amniotic fluid in the womb
• First born children
• breech presentation (when your baby is born hips first)
• family history of the condition. 

• legs that turn outward
• Legs of different lengths
• Uneven skin folds on the thigh
• limited range of motion less flexibility
• folds on their legs and buttocks that are uneven when their legs extend 
• Limping, toe walking, or a waddling gait
• delayed gross motor development, which affects how your child sits, crawls, and walks

• When CHD is detected at birth, it can usually be corrected with the use of a harness or brace.
• If the hip is not dislocated at birth, the condition may not be noticed until the child begins walking. At this time, treatment is more complicated, with less predictable results.

NON SURGICAL TREATMENT

NEWBORN

• The baby is placed in a soft positioning device, called a Pavlik harness.
• For 1 to 2 months to keep the thighbone in the socket.
• This special brace is designed to hold the hip in the proper position
• 1-6 MONTHS
• A hip abduction braceis typically worn all the time for the first six weeks
  • then for half of each day for an additional six weeks
  • This brace is made of a non-flexible material that will keep the femur in correct alignment.
  • 6 MONTHS -2YEAR OLDER
  • The babies are also treated with closed reduction and spica casting. In most cases
  • skin traction may be used for a few weeks prior to repositioning the thighbone.
  • Skin traction prepares the soft tissues around the hip for the change in bone positioning.

6 MONTHS -2YEAR OLDER

• The babies are also treated with closed reduction and spica casting. In most cases
• skin traction may be used for a few weeks prior to repositioning the thighbone.
• • Therapy is important to correct poor posture
  • muscle weakness
  • poor joint awareness
  • PT needs to be kept in a certain position to give their hip a mechanical advantage. associated tendon inflammation.Skin traction prepares the soft tissues around the hip for the change in bone positioning.
  • 6 Month older
  • the physiotherapist takes advantage of their current milestones and trains the hip muscles on a number of surfaces keeping the hip position in mind and challenge the hip muscles. 
  • Therapy is important to correct poor posture
  • muscle weakness
  • poor joint awareness
  • associated tendon inflammation.

  • POST SURGICAL TREATMENT

  • as gait training where patients are taught

     how to use a walker and/or crutches.

     After approximately six to eight weeks the muscles will have reattached and the bone will be healed 

    • Therapy can improve all these factors including the
    • strength of hip extensors
    • external rotators
    • gait re-education
    • improving body awareness.
    • Strong muscles will act like shock absorbers and provide greater support for the hip.