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DEPARTMENT OF PEDIATRIC SURGERY AND
ORTHOPEDICS
TOPIC OF THE LECTURE:
Congenital dislocation of the hip.
Lecturer: Assistant of the Department of
Pediatric Surgery and Orthopedics
Alikenov K.K.
 Definition
 Pathogenesis
 Classification
 Symptoms
 Сlinical picture of hip dislocation in children over a 1 year old.
 X-ray diagnostics
 Treatment
Congenital hip dislocation is a malformation of the tissues of the hip joint,
in which the head of the femur can be observed to protrude from the
acetabulum. This malformation encompasses all elements of the joint:
acetabulum, head, proximal end of the femur, tendon-ligamentous
apparatus, surrounding muscles.
The incidence of congenital hip
dislocation is not the same in
different countries, depending on
a number of conditions: social,
climatic, national.
It should be noted that joint dysplasia is more common: in 16 out of 1000
newborns, and severe hip dislocation is 5-7 cases per 1000 newborns.
Unilateral dislocation predominates over bilateral. Left-sided dislocation
occurs 2 times more often than right-sided. The female sex is affected 5
times more often than the male.
The pathogenesis of congenital hip
dislocation is associated with anterior
subluxation, hip instability (or
dysplasia). The last is characterized by
hypoplasia of the acetabulum of the
fetus, the femur by its flattening, the
development of the femoral head slows
down, the upper end of the femur is
turned anteriorly (anetorsia).
Pathogenesis
At the same time, the development of the neuromuscular and
bagulo-ligamentous apparatus slows down. If, after birth, the
child has a dysplasia of the femur and its subluxation, then the
growth of the child and in the absence of early non-operative
treatment by the time of the beginning of walking develops a
congenital dislocation of the hip.
Classification
1.Preluxation. 2. Subluxation. 3. Dislocation
Click symptom or Ortolani-Marx
symptom.
Restriction of hip abduction.
Ortolani-Marx
symptom.
Restriction of hip abduction.
Shortening of the limb.
The asymmetry of the skin fold
External rotation.
• Start to walk late
• Gait disorder
• Chasseignac symptom
• Trendelenburg symptom
• Dupuytren's symptom
In older children
age (scheme
Reinberg)
a - line
Hilgenreiner;
б - Ombredan's line;
в - Shenton line,
г - Calve arc;
alpha acetabular
angle (index);
betta - Wiberg angle
Scheme of X-ray diagnostics of
CDH on the right
Acetabular angle
Height h
Distance d
Shenton Line
Ombredon's line
 Wide swaddling.
 Application of orthopedic splints
• Exercise therapy.
• Massage.
• Physiotherapy.
Conservative treatment
Methods of treatment of dysplasia
Stirrups Wide
swaddling
Surgical treatment of congenital
dislocated hip
1. Open reduction of dislocation of the hip of the femoral head (over
1-2 years old)
2. Open reduction of the hip dislocation of the femoral head with
arthroplasty according to the Colon method (over 3 years old)
3. Osteotomy of the hip
4. Pelvic osteotomy
5. Acetabuloplasty
Thanks for your attention!

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на английском вывих бедра лекция.ppt

  • 1. DEPARTMENT OF PEDIATRIC SURGERY AND ORTHOPEDICS TOPIC OF THE LECTURE: Congenital dislocation of the hip. Lecturer: Assistant of the Department of Pediatric Surgery and Orthopedics Alikenov K.K.
  • 2.  Definition  Pathogenesis  Classification  Symptoms  Сlinical picture of hip dislocation in children over a 1 year old.  X-ray diagnostics  Treatment
  • 3. Congenital hip dislocation is a malformation of the tissues of the hip joint, in which the head of the femur can be observed to protrude from the acetabulum. This malformation encompasses all elements of the joint: acetabulum, head, proximal end of the femur, tendon-ligamentous apparatus, surrounding muscles.
  • 4. The incidence of congenital hip dislocation is not the same in different countries, depending on a number of conditions: social, climatic, national. It should be noted that joint dysplasia is more common: in 16 out of 1000 newborns, and severe hip dislocation is 5-7 cases per 1000 newborns. Unilateral dislocation predominates over bilateral. Left-sided dislocation occurs 2 times more often than right-sided. The female sex is affected 5 times more often than the male.
  • 5. The pathogenesis of congenital hip dislocation is associated with anterior subluxation, hip instability (or dysplasia). The last is characterized by hypoplasia of the acetabulum of the fetus, the femur by its flattening, the development of the femoral head slows down, the upper end of the femur is turned anteriorly (anetorsia). Pathogenesis
  • 6. At the same time, the development of the neuromuscular and bagulo-ligamentous apparatus slows down. If, after birth, the child has a dysplasia of the femur and its subluxation, then the growth of the child and in the absence of early non-operative treatment by the time of the beginning of walking develops a congenital dislocation of the hip.
  • 8. Click symptom or Ortolani-Marx symptom. Restriction of hip abduction. Ortolani-Marx symptom. Restriction of hip abduction.
  • 9. Shortening of the limb. The asymmetry of the skin fold External rotation.
  • 10. • Start to walk late • Gait disorder • Chasseignac symptom • Trendelenburg symptom • Dupuytren's symptom
  • 11. In older children age (scheme Reinberg) a - line Hilgenreiner; б - Ombredan's line; в - Shenton line, г - Calve arc; alpha acetabular angle (index); betta - Wiberg angle Scheme of X-ray diagnostics of CDH on the right
  • 12. Acetabular angle Height h Distance d Shenton Line Ombredon's line
  • 13.  Wide swaddling.  Application of orthopedic splints • Exercise therapy. • Massage. • Physiotherapy. Conservative treatment Methods of treatment of dysplasia Stirrups Wide swaddling
  • 14. Surgical treatment of congenital dislocated hip 1. Open reduction of dislocation of the hip of the femoral head (over 1-2 years old) 2. Open reduction of the hip dislocation of the femoral head with arthroplasty according to the Colon method (over 3 years old) 3. Osteotomy of the hip 4. Pelvic osteotomy 5. Acetabuloplasty
  • 15. Thanks for your attention!