Congenital hip dislocation (dysplasia)
Dysplasia is a term that defines a broad spectrum of hip formation irregularities.
Present from birth, it can be mild or involve complete dislocation of the hip. Some factors can increase the risk of developing hip dysplasia, such as family history, female gender, pregnancy history, associated malformations, etc. It is recommended that all newborns undergo exploratory tests to check for the presence of dysplasia or hip dislocation.
Unstable hip, decrease in the normal opening of the hips, difference between the skinfolds of the lower limbs and apparent shortening of one of the limbs. Untreated dysplasia results in premature wear (arthrosis) of the joint, pain and lameness. Asymmetry is evident and may require treatment.
Treatment of newborns with dysplasia consists of keeping the hips in abduction and maximum flexion, ensuring that the femoral head stays within the acetabulum for a period of time that depends on the infant’s age and severity of the dysplasiadislocation.
Although all orthotic devices seek equal positioning of the hips as a common denominator, their designs vary depending on the infant’s age, severity and the prescriber’s own judgement.
Frejka, Von Rosen and Ponseti nappy-type devices keeps the hips immobilised in abduction and flexion, and enable the angles to be varied and adjusted. The Pavlik harness, which features chest, shoulder and leg straps, and booties for the feet, enables abduction and flexion to be adjusted, according to medical
judgement, and a varying range of mobility for the hip joints. The Pavlik device is indicated for infants between 0 and 6 months of age, but can continue to be used for a month or so more. All CHD orthoses require special training for the parents to ensure proper fitting and complete success of this orthotic treatment.