Surgical management of the congenital dislocation of the knee and hip in children presented after six months of age

Abstract Purpose Congenital dislocation of the knee and hip is a rare congenital disorder. The specific aim of the study was to evaluate the clinical and radiological outcomes of the children with congenital dislocation of the knee and hip who presented after six months of age. Methods All the consecutive children with congenital dislocation of the knee and hip joints were retrospectively reviewed. We included cases that were treated after six months of age and followed up for a minimum of two years. Twenty-four children with congenital dislocation of the knee and hip (thirteen with ligamentous laxity, eleven children with stiff joints) were included. The knee was dislocated in 45 limbs; the hip was dislocated in 40 instances. The knee joint dislocation was treated with quadricepsplasty in all twenty-four children (45 knees). The hip dislocation (n = 32) was addressed with either closed reduction (n = 8) or open reduction of the hip (n = 24). Eight hip dislocations were not addressed. The outcome of the hip and knee was evaluated. Results The clinical and radiological outcomes were better in children with ligamentous laxity than without laxity. Twenty-two children were community walkers. An orthosis was needed in eight children. The frequency of spontaneous reduction of unreduced dislocation of the hip was noted in three children (5/8 hips). Conclusion Outcome in combined dislocation of knee and hip is good in most cases with surgical interventions. The outcome is better in children with ligamentous laxity. Spontaneous reduction of the dislocated hips might be achieved after gaining knee flexion following knee surgery for congenital the knee in a few cases.

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Congenital Hip Dislocation with a Genu Recurvatum in Togo: A Case Report

Asploro Journal of Biomedical and Clinical Case Reports ◽

10.36502/2021/asjbccr.6232 ◽

2021 ◽

Vol 4 (1) ◽

pp. 72-76

Author(s):

Agbeko FY ◽

Fiawoo M ◽

Djomaleu RA ◽

NZonou M ◽

Talboussouma S ◽

...

Keyword(s):

Hip Dislocation ◽

Black Population ◽

Lower Limbs ◽

Sub Saharan Africa ◽

Congenital Dislocation ◽

Congenital Hip Dislocation ◽

Genu Recurvatum ◽

Ultrasound Of The Hip ◽

The Right ◽

Dislocation Of The Hip

Introduction: CHD is a condition, which is frequent in pediatrics in the Caucasian population, remains rare in the Black population, and exceptional in sub-Saharan Africa. The Patient: We report this first Togolese case of bilateral congenital dislocation of the hip associated with genu recurvatum observed in a newborn received on the second day of life. The Primary Diagnoses, Interventions, and Outcomes: The pediatric examination had noted extension of lower limbs. The thighs were in adduction with a stiff bilateral genu recurvatum. The abduction of the thighs on the pelvis was considerably limited. The Barlow and Ortolani maneuvers showed a protrusion. There was also a camptodactyly of the thumbs and a cleft palate. The rest of the examination was normal. Ultrasound of the hip showed a bilateral congenital dislocation of the hip with an estimated acetabular fundus of 7 mm on both the right and left sides. Ultrasound and radiography of the knees were normal. Conclusion: Clinical examination at birth is the key step in diagnosis of congenital hip dislocation. In situations where diagnosis is difficult, ultrasound is of capital importance. Treatment is in the majority of cases orthopedic.

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Congenital Dislocation of Hip

PEDIATRICS ◽

10.1542/peds.10.4.512a ◽

1952 ◽

Vol 10 (4) ◽

pp. 512-512

Keyword(s):

Hip Dysplasia ◽

Weight Bearing ◽

Hip Dislocation ◽

Congenital Dislocation ◽

Congenital Hip Dislocation ◽

Orthopedic Surgeon ◽

Dislocation Of The Hip ◽

Comprehensive Discussion

This monograph presents a comprehensive discussion of all aspects of congenital hip dislocation, and constitutes valuable reading for both pediatrician and orthopedic surgeon. The author is well qualified to write such a book; he was associated with Lorenz for many years in Vienna, and was his successor at the Orthopedic University Clinic there. Hass classifies congenital dislocation of the hip in 3 categories: (1) Typical, in which hip dysplasia is present at or before birth and is followed in some cases by dislocation after weight-bearing begins.

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CONGENITAL DISLOCATION OF THE HIP

PEDIATRICS ◽

10.1542/peds.9.1.94 ◽

1952 ◽

Vol 9 (1) ◽

pp. 94-100

Author(s):

L. G. PRAY

Keyword(s):

Hip Dysplasia ◽

Effective Means ◽

Clinical Signs ◽

Hip Dislocation ◽

Signs And Symptoms ◽

Congenital Dislocation ◽

Congenital Hip Dysplasia ◽

Hip Abduction ◽

Treat All ◽

Dislocation Of The Hip

Limited hip abduction, when present, is a valuable early sign of congenital hip dysplasia. Other signs and symptoms should be looked for. Confirmation by roentgenographic studies should be sought in all patients. Roentgen changes may be equivocal or lacking during the first three months of life in patients with hip dysplasia. The Frejka pillow splint is a convenient and effective means of treating hip dysplasia or subluxation in early infancy. It is as effective as a cast during this period, and is cleaner and more comfortable. It would seem that a high percentage of cases of congenital hip dysplasia recover spontaneously. However, in view of the seriousness of hip dislocation and the value of early treatment of hip dysplasia, it seems best to treat all infants with clinical signs of this disease.

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Bilateral pathological hip dislocation in children

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors5121-27 ◽

2017 ◽

Vol 5 (1) ◽

pp. 21-27 ◽

Cited By ~ 1

Author(s):

Yuriy E. Garkavenko

Keyword(s):

Functional State ◽

Hip Joint ◽

Hip Dislocation ◽

Well Being ◽

Hip Joints ◽

Hematogenous Osteomyelitis ◽

Number Of Patients ◽

Hip Reduction ◽

Dislocation Of The Hip ◽

Open Hip Reduction

Introduction. Pathological dislocation of the hip is one of the most severe complications of acute hematogenous osteomyelitis. The program of treatment for children with pathological hip dislocation is complex, but it has been sufficiently developed and implemented very successfully. At the same time, the available literature provides no cases of treating children with bilateral pathological hip dislocations after hematogenous osteomyelitis. There is no information on the incidence of such cases or in regards to remote functional results. Materials and methods. The results of the treatment of 18 children with bilateral pathological dislocation of the hip after hematogenous osteomyelitis are presented, which constituted 23.1% of the total number of patients (78) who underwent surgery in 2000–2016 for the diagnosis of pathological hip dislocation. Both hip joints were surgically operated on in 12 patients, while one hip joint was operated on in 6 patients. To assess the anatomical and functional state of hip joints, the clinical and roentgenological diagnostic techniques were used. Results and discussion. To stabilize and restore the function of the hip joints, 18 children underwent 30 surgical interventions: simple open hip reduction (19) and open hip reduction with hip arthroplasty with one (6) or two (5) demineralized osteochondral allogeneic grafts. The decision regarding the possibility of performing surgical intervention on the second hip joint was made only after a child's check-up examination was complete and after positive information about the anatomical and functional state of the operated hip joint was obtained. According to these criteria, 14 (77.8%) children underwent surgical treatment of the second hip joint 1–1.5 years after the course of conservative measures to restore the range of motion in the previously operated hip joint. Over a period of 1–12 years, 17 patients were examined, 10 of which underwent an operation on both sides (27 joints). The preservation of up to 80º or more of motion amplitude was noted in 17 (62.9%) of 27 operated hip joints. When assisting patients with pathological hip dislocation, it is necessary to understand that it is practically impossible to restore the affected joint to the anatomical state of the opposite unaffected joint. As for the bilateral lesion, this is most certainly impossible, and the development of arthrosis is inevitable. Therefore, the most important factor reflecting the degree of well-being and stability of the affected joint is the amplitude of active movements. Preserving this amplitude in the affected joints with a careful and attentive attitude is a fundamental and feasible task.

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Treatment of congenital dislocation of the hip in young children Jaeger (Surg. Gyn. A. Obst. V. 50, No. 4)

Kazan medical journal ◽

10.17816/kazmj81511 ◽

2021 ◽

Vol 32 (8-9) ◽

pp. 786-786

Author(s):

I. Tsimkhes

Keyword(s):

Young Children ◽

Successful Treatment ◽

Hip Dislocation ◽

Congenital Dislocation ◽

Glenoid Cavity ◽

Congenital Hip Dislocation ◽

Dislocation Of The Hip

Jaeger (Surg. Gyn. A. Obst. V. 50, No. 4) gives 2 cases of successful treatment of congenital hip dislocation in young children. In contrast to the generally accepted late reduction, when the deformation of the glenoid cavity has already gone far, the author proposes to set it early.

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Features rehabilitation of infants with congenital hip dislocation on the stages of conservative treatment

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors3266-70 ◽

2015 ◽

Vol 3 (2) ◽

pp. 66-70

Author(s):

Sergei Yurievich Voloshin ◽

Ekaterina Anatolevna Belousova

Keyword(s):

Conservative Treatment ◽

Hip Dislocation ◽

Late Complications ◽

First Year ◽

Congenital Dislocation ◽

Anatomical Structures ◽

Complete Restoration ◽

Orthopedic Diseases ◽

First Year Of Life ◽

Dislocation Of The Hip

Congenital dislocation of the hip is one of the most common diseases in children leading to disability, which is difficult to diagnose in the first days of life. In the structure of congenital orthopedic diseases congenital dislocation of the hip holds one of the first places. This determines the importance and urgency of the problem, as the most complete restoration of anatomical structures and functions of the hip joint in children occurs in the early diagnosis and comprehensive, timely begun treatment. Rehabilitation of children in the first year of life should be early, systematic, comprehensive and differentiated. Technique of rehabilitation stages conservative treatment includes: wearing functional tires, gymnastics, massage, physiotherapy, therapeutic swimming. This prevents the progression of the disease, the development of early and late complications, does not violate the static-dynamic functions without delay verticalization.

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