Dislocation of the hip joint occurs in 5% of cases of dislocation; most often the cause of the disorder is injury to the joint. Dislocation can be congenital or acquired. The precursor to a dislocation in an adult is a subluxation, which has smoothed symptoms. The cause of subluxation of the hip joint in an adult can be instability of the joint, morphological changes in the tissues of the joint, trauma, or congenital predisposition.
In the Yusupov Hospital, innovative diagnostic equipment from leading manufacturers in the world is used to diagnose diseases of the musculoskeletal system. This allows for effective, accurate diagnosis and avoids errors in diagnosing diseases.
Etiology
There are several theories about the formation of congenital dislocation.
- Primary defect. Disorders occur during the embryonic stage of the hip joint. It manifests itself as aplasia (underdevelopment) of a part or an entire joint.
- Pre-dislocation of the hip. It occurs as a result of stretching of the capsule and slipping of the head from the socket due to the anatomical features of the hip joint or incorrect position of the fetus in the womb, for example, with breech presentation.
- Hip dysplasia. The most common cause of congenital hip dislocation. Occurs as a result of a hereditary disorder of joint formation.
Clinic
Congenital dislocation of the hip appears from the first days of a child’s life. Main symptoms:
- Asymmetry of skin folds in the lower extremities.
- The symptom of a “click” when flexing and abducting the hips, caused by the head of the femur jumping over the posteroinferior edge of the acetabulum. Appears at the age of 2-3 months.
- Limitation of range of motion in the area of the affected joint under the age of 1 year.
- Shortening of the lower limb on the affected side, gait disturbance. It appears at a later stage, when the child begins to stand and walk,
In the absence of diagnostic examinations of the child and untimely treatment, dysplastic coxarthrosis may develop in adulthood, which leads to complete dysfunction of the hip joint and disability of the patient.
Publications in the media
A huge number (hundreds!) of nosological units with the generic word “Dysplasia” are known. This article lists in alphabetical order those nosological units that could not be placed in other articles in the reference book characterizing dysplasia (Craniofacial dysplasia, Ectodermal dysplasia, Epiphyseal dysplasia, Dental development disorders, Chondrodysplasia, Achondrogenesis). Many dysplasias, like the vast majority of genetic diseases and phenotypes, are also difficult to identify using the ICD-10 system.
Acromicric dysplasia (102370, В), congenital acromicria. Clinically: moderate facial anomalies, shortening of the hands and feet, severe growth retardation, short metacarpal and phalangeal bones. Laboratory findings: disorganized cartilage growth. ICD-10. Q87.1 Syndromes of congenital anomalies manifesting predominantly as dwarfism
Arterial fibromuscular dysplasia, see Fibromuscular dysplasia.
Diastrophic dysplasia - skeletal dysplasia with severe curvature of bones • Diastrophic dysplasia (222600, 5q31–5q34 5q32–5q33.1, mutations of the transmembrane sulfate transporter gene DTD, r). Clinically: congenital dwarfism with short limbs, impaired ossification and congenital epiphyseal cysts, hypertrophy of ear cartilage, cleft hard palate, kyphosis, scoliosis, abducted thumb, fusion of proximal interphalangeal joints, brachydactyly, bilateral clubfoot, calcification of rib cartilage • Pseudodiastrophic dysplasia ical (264180 ). Clinically: rhizomelic shortening of the limbs, interphalangeal and metacarpophalangeal dislocations, elbow dislocations, severe clubfoot, increased distance between the coronal sutures of the skull, hypoplasia of the middle third of the face, hyperthermia, platyspondyly, tongue-like deformities of the lumbar vertebrae, scoliosis, hypoplasia of the 2nd vertebra, pronounced lumbar lordosis • Congenital bone dysplasia de la Chapelle (#256050, r). Clinically: Lethal at birth, severe micromelia, kyphosis of the cervical spine, clubfoot equinovarus, abducted hallux, abducted toes, duplication of the middle phalanges, cleft palate, patent foramen ovale, respiratory failure, laryngeal stenosis, softening of the cartilages of the larynx and trachea, hypoplasia lungs, shortness of breath, small chest, congenital bone dysplasia, triangular fibula and ulna, platyspondyly, pathological metaphyses and epiphyses, sacral anomalies, additional pelvic ossification points. Laboratory: lacunar halos around chondrocytes in skeletal cartilage. ICD-10. Q77.5 Diastrophic dysplasia.
Oculomaxilloosseous dysplasia (*164900, Â). Corneal opacity and multiple anomalies of the lower jaw and limbs. Synonym: OMM syndrome (from: o phthalmo m andibulo m elic). ICD-10. Q78.8 Other specified osteochondrodysplasias.
Greenberg dysplasia (215140, r) is congenital lethal dwarfism. Clinical picture: dwarfism with short limbs, prenatal death, severe fetal hydrops, noticeably shortened, “moth-eaten” long tubular bones, unusual ectopic ossification points, pronounced platyspondyly, pronounced extramedullary hematopoiesis. Synonym: hydropic chondrodystrophy. ICD-10. Q77.1 Small stature incompatible with life.
de Morsier dysplasia (septo-optic dysplasia, 182230, Â?). Hypoplastic optic discs with a double edge, absence of the septum pellucidum, GH deficiency, pathology of the corpus callosum and cerebellum. ICD-10. Q04.4 Septooptic dysplasia.
Diaphyseal dysplasia (Engelmann's disease) is a progressive symmetrical hyperostosis of the diaphysis of long tubular bones from the periosteum and endosteum with sclerosis of the newly formed bone tissue. Clinically: asthenic physique, severe pain in the bones of the legs, fusiform swelling of the lower leg, multiple subungual hemorrhages, myopathy, waddling gait, compression of cranial nerves, weakness, muscle fatigue, scoliosis, lumbar hyperlordosis, hypogonadism, anemia, leukopenia, increased ESR, hepatosplenomegaly, onset aged 10 to 30 years, sensitivity to GC, dysplasia, osteosclerosis and hyperostosis of the diaphysis. Synonyms •• Camurati-Engelmann disease •• Ribbing's disease •• generalized hyperostosis •• systemic diaphyseal congenital hyperostosis •• progressive diaphyseal dysplasia •• systemic hereditary osteosclerosis with myopathy. ICD-10. Q78.3 Progressive diaphyseal dysplasia.
Dissegmental dysplasia is a group of hereditary skeletal dysplasias manifested by dwarfism, damage to the brain and internal organs. At least 2 forms, differing in clinical, radiological and morphological signs • Handmaker-Silvermann dissegmental dysplasia (224410, r) - lethal form. Clinically: vertebral bodies of various sizes and shapes, early death, the clinical picture resembles Kniest syndrome • Dissegmental Rolland–Debuquois dysplasia (224400, r) is a milder form. Clinically: congenital chondrodystrophy, dwarfism, abnormal segmentation of the vertebrae, limited joint mobility, micromelia, curvature of the limbs, high palate, cleft hard palate, hydrocephalus, hydronephrosis, hypertrichosis. Synonyms: dissegmental dwarfism •• anisospondylic campomicromelic dwarfism •• Rolland-Debuquois syndrome • Dissegmental dysplasia with glaucoma (601561) - the phenotype resembles Kniest dysplasia (156550), and dissegmental dysplasia (224400, 224410), combined with severe glaucoma oh. ICD-10 • Q77.1 Small stature, incompatible with life • Q77.3 Point chondrodysplasia • Q77.5 Diastrophic dysplasia.
Campomelic dysplasia (114290, Â, more often *211970, 17q24.3–q25.1, SOX9 gene [CMD1, SRA1, SRY], r) - congenital lethal dwarfism with short limbs, small cartilaginous skull size, platybasia, hypertelorism, depressed nasal bridge , micrognathia, cleft palate, recessed tongue, pulmonary hypoplasia, tracheal hypoplasia, narrow pelvis, hip abnormalities, platyspondyly, kyphoscoliosis, hypotonia, absence of olfactory nerves, small hypoplastic scapulae, 11 pairs of ribs, short phalanges of the hands and feet, moderate curvature of the femoral and tibial bones, leg equinovarus deformity • Grant family syndrome (138930, Â) is one of the forms of skeletal dysplasias of the campomelic type. Clinically: blue sclera, hypoplasia of the jaws, campomelia, curvature of the clavicles, femurs and tibias, sloping shoulders, additional bones in the sutures of the skull. ICD-10. • Q77.1 Small stature incompatible with life.
Bone dysplasia with medullary fibrosarcoma (112250, BDMF gene, 9p22–p21, r). Clinically: skeletal dysplasia, malignant fibrous histiocytoma, bone fractures with minimal trauma, multiple necrosis of the bone diaphysis, compaction of the cortical layer of the diaphysis. ICD-10. C41 Malignant neoplasm of bones and articular cartilage of other and unspecified locations; C41.8 Damage to bones and articular cartilage, extending beyond one or more of the above locations.
Craniocarpotarsal dysplasia (*193700, Freeman–Sheldon syndrome, Â, r). Clinically: hypoplasia of the nose, mouth, deep-set eyes, ocular hypertelorism, camptodactyly; scoliosis. ICD-10. Q78.8 Other specified osteochondrodysplasias.
Cranio-metaphyseal dysplasia - dysplasia of the metaphyses of long bones in combination with severe sclerosis and thickening of the skull bones (leontiasis ossea), hypertelorism. ICD-10. Q78.8 Other specified osteochondrodysplasias.
Mesomelic Nivergelt dysplasia (*163400, Nivergelt syndrome). Clinically: short limb, dwarfism recognized at birth, radioulnar synostosis, rhomboid tibia and fibula, synostosis of the tarsal and metatarsal bones. ICD-10. Q77.8 Other osteochondrodysplasia with growth defects of long bones and spinal column.
Mesomelic Reinhardt-Pfeiffer dysplasia (191400, Â). Congenital dwarfism, hypoplasia of the bones of the forearm and lower leg. ICD-10. Q78.8 Other specified osteochondrodysplasias.
Metatropic dysplasia (dysplasia) - congenital dwarfism with damage to the metaphyseal cartilages • Non-lethal form (156530, Â) • Lethal form (*250600, r): death in utero or shortly after birth. Clinically: intrauterine growth retardation, relatively short spine, severe scoliosis, kyphosis, anisospondyly, pelvic anomalies, hyperplasia of the femoral epicondyles, abnormal shape of the metaphyses, respiratory failure. Laboratory examination: violation of the formation of cartilage of the trachea and bronchi, absence of spongy substance of the metaphyses. ICD-10. Q78.5 Metaphyseal dysplasia.
Metatropic Knistic dysplasia is a group of hereditary skeletal diseases manifested by rhizomelic dwarfism, probably due to collagen defects (#156550, collagen gene COL2A1 [120140], Â): metatropic dwarfism, macrocephaly, flat face, myopia, retinal detachment, cataract, hearing loss, cleft palate, platyspondyly, inability to clench the hand into a fist. Laboratory examination: pathological collagen of cartilage under electron microscopy, excretion of keratan sulfate in the urine. ICD-10. Q78.5. Metaphyseal dysplasia. OMIM. Metatropic dysplasia: •• type I (*250600) •• type 2 Cnista (#156550) •• with protruding lips and ectopic lens (245160) •• lethal (245190).
Metaphyseal dysplasia. Impaired transformation of the metaphyses of long bones into a normal tubular structure; at the same time, the ends of the long tubular bones become thickened and porous, the cortical layer becomes thinner. ICD-10. Q78.5 Metaphyseal dysplasia.
Metaphyseal multiple dysplasia is a congenital disease characterized by thickening of long tubular bones, valgus deformation of the knee joints, flexion ankylosis of the elbow joints, enlargement and deformation of the skull cranial metaphyseal dysplasia. ICD-10. Q78.5 Metaphyseal dysplasia.
Mondini dysplasia is a congenital anomaly of the bones and membranous ear labyrinth, characterized by aplasia of the cochlea of the inner ear and deformation of the vestibule and semicircular canals with partial or complete loss of auditory and vestibular functions. ICD-10. Q16.5 Congenital anomaly of the inner ear.
Oculoauriculovertebral dysplasia (*257700) is a syndrome characterized by epibulbar dermoid, anomaly of the auricle, micrognathia, vertebral and other anomalies “Goldenhar syndrome. Q18.8 Other specified malformations of the face and neck.
Oculovertebral dysplasia - microphthalmia, coloboma or anophthalmia with a small orbit, unilateral dysplasia of the upper jaw, macrostomia with underdeveloped teeth and malocclusion, malformations of the spine, cleft and underdeveloped ribs. ICD-10. Q87.8 Other specified congenital anomaly syndromes not elsewhere classified.
Otodental dysplasia (*166750, Â) - sensorineural hearing loss, dental anomalies (ball-shaped teeth, absence of small molars, molars with two pulp chambers, taurodontia, pulp stones). ICD-10. Q87.8 Other specified congenital anomaly syndromes not elsewhere classified.
Spondylometaphyseal dysplasia is a heterogeneous group of skeletal diseases with impaired growth and formation of the spine and long tubular bones; it differs from spondyloepimetaphyseal and spondyloepiphyseal dysplasias by involving only the metaphyses of the tubular bones. All three groups of dysplasia have spinal abnormalities. Spondylometaphyseal dysplasias are often observed as isolated cases, but various inherited forms with dominant, X-linked and recessive modes of inheritance have been described. ICD-10. Q77.8 Other osteochondrodysplasia with growth defects of long bones and spinal column. OMIM: Spondylometaphyseal dysplasia: • Goldblatt (184260) •• with angular fractures (184255) •• Algerian type (184253) •• with enchondromatosis (271550) •• Richmond type (313420).
Spondyloepimetaphyseal dysplasia (SEMD) is a heterogeneous group of skeletal diseases with impaired growth and formation of the spine and long bones. SEMD differs from spondylometaphyseal dysplasia (SMD) and spondyloepiphyseal dysplasia (SED) by involving both the metaphyses and the epiphyses. In all three groups of dysplasias (SEMD, EDS and SMD), there are spinal anomalies. SEMD is often observed as isolated cases, but various inherited forms with dominant, X-linked and recessive modes of inheritance have been described • Kozlovsky spondyloepimetaphyseal dysplasia (*184252, Â): short stature, usually manifests between 1 and 4 years of age, short trunk, pathological femoral necks and their trochanter, general platyspondyly • Spondyloepimetaphyseal dysplasia with White's hypotrichosis (183849, Â): congenital hypotrichosis, rhizomelic short stature, limited abduction of the hips, enlarged metaphyses, delayed ossification of the epiphyses, areas of decay in the metaphyses, vertebral bodies in the thoracic and lumbar regions pear-shaped spine • Strudwick spondyloepimetaphyseal dysplasia (#184250, 12q13.11–q13.2, type II collagen a1 chain gene COL2A1 [120140], Â, the eponym “Strudwick” comes from the surname of one of the patients): severe dwarfism, “chicken” chest", scoliosis, cleft hard palate, retinal detachment, facial hemangioma, inguinal hernia, clubfoot, disproportionately short limbs, normal mental development, sclerotic changes in the metaphyses of long bones, the lesion is greater in the ulna than in the radius and in the fibula more than tibia, delayed maturation of the epiphyses • Spondyloepimetaphyseal dysplasia with joint laxity (*271640, r) • Spondyloepimetaphyseal dysplasia with short limbs (271665, r). ICD-10. Q77.8 Other osteochondrodysplasia with growth defects of long bones and spinal column. OMIM: Spondyloepimetaphyseal dysplasia • Kozlovsky (184252) • White (183849) • Strudwick (184250) • with joint laxity (271640) • with short limbs (271665) • X-linked (300106) • with abnormal dentin development (601668) • type Missouri (*602111) • micromelic (601096).
Spondyloepiphyseal dysplasia is a group of hereditary skeletal diseases that differs from spondyloepiphyseal dysplasias in the absence of damage to the metaphyses of long tubular bones • Congenital spondyloepiphyseal dysplasia (#183900, collagen gene COL2A1 [120140], Â). Клинически: врождённая карликовость с коротким туловищем, нормоцефалия, плоское лицо, миопия, отслойка сетчатки, расщелина твёрдого нёба, платиспондилия, короткая шея, подвывих шейных позвонков, гипоплазия зубовидного отростка, кифоз, сколиоз, поясничный лордоз, цервикальная миелопатия, гипотония, умственная отсталость, barrel-shaped chest, sensorineural hearing loss, hypoplasia of the abdominal muscles, abdominal and inguinal hernias, insufficient ossification of the pubic bones, distal epiphyses of the femur and proximal tibia, talus and calcaneus, flattening of the vertebral bodies • Dysplasia spondyloepiphyseal Maroto (184095, Â): platyspondyly, normal nal intelligence, shortening of the extremities, x-shaped legs deformation, abnormal shape of the input opening of the pelvis • Spondyloepyphysular dystrophy with retinal dystrophy (183850, â) • Spondyloepyphysular dysplasia, myopia and neurosenory hearing loss (184000, â), possibly allel with sticker syndrome • Display of spondyloepyphyphyphyphyphypically Shimke (*242900, r) • Spondyloepiphyseal dysplasia, Irapa type (*271650, r), common among the Irapa Indians in Venezuela and Mexico. Clinically: shortening of the spine, platyspondyly, short bones of the metacarpus and metatarsus, pathological proximal femoral epiphyses and distal humerus • Spondyloepiphyseal dysplasia with atlantoaxial instability (600561, Â) • Spondyloepiphyseal dysplasia pseudoachondroplastic (3 types: 177150, Â; 2641 50, r; #177170 [19p13.1, gene for oligomeric cartilage matrix protein COMP, Â]) is one of the most common skeletal dysplasias. Patients appear normal at birth, and growth retardation is rarely recognized until the second year of life or later. Unlike achondroplasia, the head and face are normal. The fingers are short but do not have the trident shape typical of achondroplasia. There are various deformities of the lower extremities, and ligament weakness is noted. Clinically: short-limb dwarfism, recognized in childhood; lumbar lordosis, kyphosis, scoliosis, dislocations in the atlantoaxial joint, brachydactyly, ulnar deviation of the wrists, limited straightening in the elbow and hip joints, ligament weakness, X-shaped deformity of the legs, chronic myelopathy of the cervical spinal cord, platyspondyly, deformation of the vertebral bodies, shortening of the tubular bones, expansion of metaphyses, abnormal epiphyses • Late dominant spondyloepiphyseal dysplasia (*184100, Â): dwarfism with shortening of the trunk, recognized in childhood, wide face, platyspondyly, short neck, subluxation of the cervical vertebrae, hypoplasia of the odontoid process, kyphoscoliosis, lumbar lordosis, barrel-shaped chest, pathology of the femoral heads with degenerative changes • Late spondyloepiphyseal dysplasia with a characteristic face (600093, r): microcephaly, developmental delay, wide root and tip of the nose, short wide filter (philtrum), thick lips, progressive narrowing of the intervertebral distances, smoothed knee epiphyses • Late spondyloepiphyseal dysplasia with progressive arthropathy (*208230, 6q, PPAC gene, r). Synonym: progressive pseudorheumatoid arthropathy. Clinically: arthropathy, progressive morning stiffness, swelling of the finger joints; histologically: normal synovial membrane, age of onset - about 3 years, reduced mobility of the cervical spine, smoothed vertebral bodies, ossification defects, widened proximal and middle phalanges of the fingers. Laboratory: normal ESR, negative rheumatoid tests, bone dysplasia, pathological acetabulum, short stature in adults (140–150 cm) • Late spondyloepiphyseal dysplasia (*313400, À): congenital dwarfism with short limbs, normal skull shape, flat face, short neck, platyspondyly, subluxation of the cervical vertebrae, hypoplasia of the odontoid process, kyphoscoliosis, lumbar lordosis, barrel chest, degenerative arthritis of the hip joints, diagnosis cannot be made before 4–6 years of age • Late recessive spondyloepiphyseal dysplasia (*271600, r) • Late spondyloepiphyseal dysplasia with mental retardation (271620, r). Clinically: mild or moderate mental retardation, tongue-like shape of the lumbar vertebral bodies, platyspondyly, expansion of the iliac bones, deformity of the acetabulum with hip subluxation and varus deformity in the joint, thin femoral necks. ICD-10. Q77.7 Spondyloepiphyseal dysplasia.
Trichodental dysplasia (601453, Â) - hypodontia and abnormal hair growth. ICD-10. • Q84.2 Other congenital hair abnormalities • K00.8 Other disorders of dental development.
Fibrous bone dysplasia is a violation of the structure of the tubular bone in the form of replacement with fibrous tissue, which leads to its symmetrical curvature and thickening; the process may be limited to one bone or involve many bones (multiple fibrous osteodysplasia) “fibrous osteodysplasia” Lichtenstein–Braitz disease “fibrous osteoma” osteofibroma “local fibrous osteitis. ICD-10. • D48 Neoplasm of undetermined or unknown nature in other and unspecified localizations • D48.0 Bones and articular cartilage.
Frontofacial dysplasia (*229400, frontofacial dysostosis, r) - brachycephaly, cerebral hernia, hypoplasia of the frontal bone, blepharophimosis, ptosis, hare's eye, coloboma of the eyelid and iris, hypertelorism, cataracts, microphthalmos, microcornea, hypoplasia of nasal structures, cleft lip/ palate. ICD-10. Q87.0 Syndromes of congenital anomalies affecting primarily the appearance of the face.
Cranioclavical dysplasia (#119600, 6p21, defect in the CBFA1 transcription factor gene [600211, AML3], Â; 216330, r, severe form). Clinically: moderate growth retardation, brachycephaly, hypoplasia of the middle third of the face, delayed eruption of primary and permanent teeth, supernumerary teeth, spina bifida occulta, widened sacroiliac joints, hypoplasia or aplasia of the clavicles, abnormal position of the shoulder blades, narrow chest, shortened ribs, hypoplasia pubic bones, widening of the symphysis, hypoplasia of the hip joint with dislocation of the hip, brachydactyly, acroosteolysis, joint laxity, syringomyelia, permanently open sutures of the skull with protrusion of the fontanelles, shortening of the middle phalanx of the fifth finger, thin diaphyses of the phalanges and metacarpal bones of the fingers, cone-shaped epiphyses, moderate delay bone age in childhood • Younis-Varon syndrome (*216340, r): large skull with dehiscence, micrognathia, poorly defined lips, absence of clavicles, thumb, distal phalanges of the fingers, hypoplasia of the proximal phalanx of the big toes, pelvic dysplasia, bilateral hip subluxation. ICD-10. Q87.5 Other congenital anomaly syndromes with other skeletal changes.
Epithelial dysplasia of the mucous membranes (*158310, Â). Clinically: damage to the red border of the lips, photophobia, follicular keratosis, nystagmus, keratoconjunctivitis, cataracts, moderate baldness, chronic nail infections, repeated pneumonia, cystic fibrosis lung disease, cor pulmonale, candidiasis of the skin and mucous membranes, diarrhea in infancy, T disorders - and B cellular immunity. Laboratory: in smears from the vagina, oral cavity, urinary tract - large immature cells containing vacuoles and strip-like inclusions, histology of the mucous membranes - dyskeratosis and lack of keratinization, ultrastructure of epithelial cells - lack of keratohyalin, a decrease in the number of desmosomes. ICD-10: coded according to the clinically most significant syndrome for a given treatment.
Diagnostics
Congenital hip dislocation should be diagnosed as early as possible. In addition to the clinical examination, ultrasound and radiography of the hip joints are performed.
Ultrasound is the standard for diagnosing hip dysplasia. Developmental disorders of both bone and cartilaginous structures of the hip joint are revealed.
X-rays are performed to clarify the diagnosis of congenital hip dislocation. A violation of the position of the femur in relation to the acetabulum is determined.
Hip dislocation in adults: symptoms
Dislocations and subluxations of the hip joint are formed as a result of heavy physical stress on the joint and traumatic effects. Dislocation is a serious pathology of the hip joint and can lead to a fracture of the femur. When the hip joint is dislocated, the symptoms manifest themselves in the form of impaired motor activity of the joint, discomfort when walking, and constant pain. With subluxation, which precedes dislocation of the hip joint, the symptoms are smoothed out. A dislocation of the hip joint is characterized by deformation of the joint, lameness, severe pain, swelling of the limb, and the difference in leg length is visually determined.
Treatment
With early diagnosis of congenital dislocation, at the stage of hip dysplasia, conservative treatment is carried out, the principle of which is to give the child’s legs an abducted position while maintaining movements in the joint.
Surgical treatment can be one-stage or two-stage.
Simultaneous surgical intervention is performed for children under 2 years of age. It consists of closed or open reduction of the dislocation. Closed reduction refers to a conservative type of treatment and consists of traction using the “over head” technique for 10-25 days, followed by fixation in a coxite plaster cast for 8 months, then fixation continues in an abduction splint for 2-4 months. Loading of the lower extremities is allowed no earlier than 1 year after reduction of the dislocation. Rehabilitation must be performed throughout the course of treatment.
Open reduction is performed when closed reduction is unsuccessful or impossible. During the operation, access to the hip joint is made, revision and removal of intra-articular obstructions. Then the head is repositioned into the socket, fixed with a knitting needle, and postoperatively fixed in a coxite plaster cast for up to 3 weeks. Next, the wire is removed, the patient is placed in a special plaster bed and begins to develop movements in the hip joint. Weight-bearing on the lower limbs is allowed 3 months after surgery.
Subluxation of the hip joint in adults: treatment in Moscow
Treatment of subluxation and dislocation in Moscow can be done in orthopedic and traumatology departments of clinics and hospitals, as well as in the Yusupov Hospital and other medical institutions. At the Yusupov Hospital, patients undergo rehabilitation after endoprosthetics. The hospital is equipped with high-tech equipment that is used in the treatment of the musculoskeletal system. The hospital includes a 24-hour hospital and a rehabilitation department.
Orthopedic rehabilitation helps correct deformities that preceded surgery, helps restore the functionality of the affected hip joint after surgery, and prevents the development of complications and relapse of the disease. In the hospital you can undergo diagnostic examination using MRI, CT. You can make an appointment with a doctor by calling the Yusupov Hospital.
Stages of surgical treatment of congenital hip dislocation
A two-stage method for the treatment of congenital hip dislocation was developed in the Department of Pediatric Orthopedics of the CITO named after. N.N. Priorova.
- The first stage consists of osteotomy of the femur with the application of a distraction device. In the postoperative period, the head is finally brought down to the level of the acetabulum within 14-18 days.
- The second stage involves dismantling the device, repositioning the femoral head and pelvic osteotomy according to Salter. In the postoperative period, the lower limbs are fixed in a coxite plaster cast for 6 weeks. After removing the bandage, a rehabilitation course is carried out, which is repeated every 3 months. Loading of the lower limbs is permitted 4-5 months after consolidation of the osteotomies.
After performing this type of surgical treatment, patients require constant follow-up.
For more detailed information about surgical treatment of congenital hip dislocation in our center for pediatric bone pathology and adolescent orthopedics, you can contact us by phone +7(499) 940-97-47.