Hip dislocation
From Holoprosencephaly
Hip Dislocation
| Please click on the Hip_dislocationDiscussion tab on the top left to read practical advice and information from other parents. |
Hip disorders are common in patients with cerebral palsy and cover a wide clinical spectrum, from subluxation (partial or incomplete hip dislocation) to dislocation with degeneration and pain.
Although the hip is normal at birth, a combination of muscle imbalance and bony deformity leads to progressive displacement. The spasticity or contracture usually involves the adductor and iliopsoas muscles; thus, the majority of hips subluxate in a posterosuperior (backward and upward) direction.
Symptoms
Reduced movement in the affected side(s) Restricted abduction of hip on affected side(s) Unequal gluteal folds The leg may seem shorter on the affected side Back may be swayed May appear to have a “pot belly” If unilateral, pelvis on the unaffected side droops when the heel of the affected side strikes the floor
Other problems that may be associated with dislocated hips inlcudes: decreased sitting tolerance, skin breakdown, difficulty with nursing care and problems with perineal hygiene.
Diagnosis
Because physical examination alone is unreliable, an anteroposterior (front to back) radiograph of the pelvis is required for diagnosis.
Treatment
It is generally believed that early prevention or relocation of hip dislocation/subluxation is the treatment of choice in most patients with CP. Prevention may include medication for spasticity. Early treatment may include closed reduction and casting, soft tissue releases, adductor release surgery, open reduction with femoral and/ or pelvic osteotomies and osteotomies with open reduction. These procedures may be helpful for younger children but may not be appropriate for older children with long-standing dislocations or severe contractures. Hip reconstruction in these children usually requires some type of salvage procedure, like hip fusion or arthroplasty.
Complications
Skin irritation from reduction devices Untreated, will lead to arthritis and deterioration of the hip which can be severely debilitating Limb length discrepancies may persist despite appropriate treatment
For helpful information about diagnosis and treatment of hip dislocations, visit: Children's Ortho Links
Sources:
If you have any concerns, please don't hesitate to discuss your concerns with your child's doctor(s).
For information about dealing with other potential health problems, treatments and medications, please visit our Miscellaneous Health Information category.
Click here to read what specialists have to say about caring for children with Holoprosencephaly: Doctor Q&A
