Hip Dislocation in Children and Current Treatment Methods
Hip dislocation in children is commonly referred to in the medical literature as developmental dysplasia of the hip (DDH). It occurs when the hip joint does not develop normally or the femoral head does not properly fit into the acetabulum. While early diagnosis and appropriate treatment can lead to successful outcomes, delays can cause impaired hip function and serious complications such as osteoarthritis in later life.
The causes of hip dislocation are considered to result from a combination of genetic and environmental factors. It is seen more frequently in first-born girls, infants born in breech position, and those with a family history of the condition. Mechanical stress on the hip during birth, laxity in the ligaments surrounding the joint, and muscle imbalances also contribute to the development of the dislocation.
In early stages, hip dislocation in children may not present obvious symptoms. There may be limited hip movement, asymmetry in leg length, pain or a catching sensation when opening or closing the hips. However, orthopedic physical examination tests such as Ortolani and Barlow are effective in detecting hip dislocation. For definitive diagnosis, ultrasonography is preferred especially in infants younger than 4 weeks, while X-ray imaging is used in older children.
Currently, conservative treatment is the first-line option for early-stage hip dislocation. Dynamic orthopedic devices like the Pavlik harness are used for newborns and infants to properly position the femoral head inside the acetabulum. This method supports femoral head placement and promotes hip joint development. Regular physician supervision and ultrasound follow-up are critical during Pavlik harness treatment to monitor hip development.
Surgical intervention is considered if conservative methods fail or diagnosis is delayed. Surgical options include closed reduction, open reduction, and osteotomy procedures around the hip joint when necessary. Closed reduction involves muscle relaxation and careful manipulation to place the femoral head back into the acetabulum. If unsuccessful, open surgery is performed to directly access and correct the dislocation and restore joint structure. Osteotomies are important for correcting bone deformities, making the hip more stable and functional.
Early diagnosis is vital for successful hip dislocation treatment. Effective treatment initiated in infancy allows most children to achieve normal hip anatomy. Delayed treatment can lead to walking difficulties, pain, and permanent joint damage. Therefore, it is recommended that infants in risk groups be evaluated by an orthopedic specialist shortly after birth.
Technological advancements such as 3D imaging, surgical planning software, and minimally invasive techniques have improved treatment outcomes recently. Moreover, physical therapy and rehabilitation programs remain essential components of treatment protocols to maintain long-term hip joint health.
Hip dislocation in children is a condition where positive results can be achieved through a multidisciplinary approach and individualized treatment planning. Educating families, ensuring regular follow-ups, and providing early interventions significantly enhance children’s quality of life. Innovations in Orthopedics and Traumatology are bringing significant progress in managing hip dislocation and other pediatric orthopedic disorders.