Developmental Dysplasia of The Hip Joint

This is a continuum of disorders and includes the term congenital dislocation of the hip which is not an accurate term because the dislocation tends to occur after birth. Developmental dysplasia of the hip joint results in an abnormal relationship between the proximal femur and the acetabulum (of the pelvis). The incidence is 1 per 1.000 live births. It is important to recognize the condition because if the hip is dislocated and not treated there may be permanent deformity. Ortolani described the maneuver of flexion of the hip to 90 derajat and then abduction, with the middle finger over the hipjoint and the thumb applying pressure to the medical aspect of the thigh. If the head of the femur slips out of the acetabulum it can be felt.
Dislocation or dysplasia can be treated by splinting the legs in a position of flexion and abduction. Treatment is indicated for months and when initiated early is very succesful. If dislocation is not recognized until the child starts to walk, a limp and lurching to the affected side will suggest the diagnosis.