Baby hip development standards

Hip joint development begins in infancy. We have encountered many diseases of hip joint deficiency in our lives today, so we must have a correct understanding of the phenomenon of hip joint deficiency and know the standards of infant hip joint development. First of all, it is best to go to the hospital for professional testing, because this test can more clearly confirm whether the child’s current stage of physical development is within the normal range, and it can be confirmed through normal understanding and examination.

This disease is abbreviated as CDH (congenital dislocation of the hip), also known as developmental hip dislocation or developmental dysplasia of the hip (displasia dislocation of the hip, DDH) and hip dysplasia. It is a common congenital malformation. The femoral head loses its normal relationship with the acetabulum in the joint capsule, so that it cannot develop normally before and after birth.

Hipkocsates described this disease as early as BC, and many scholars have conducted extensive research on it since then, but the early diagnosis and treatment of this disease is still an unresolved issue.

Symptoms and signs

1. Clinical manifestations

(1) Symptoms in neonates and infants:

①Symptoms:

A. Joint movement disorder: The affected limb is often in flexion, with less movement than the healthy side, and the pedaling force is located on the other side. Restricted hip abduction.

B. Shortening of the affected limb: The femoral head on the affected side is dislocated posteriorly and superiorly, and corresponding shortening of the lower limb is common.

C. Changes in skin wrinkles and perineum: The skin wrinkles on the buttocks and inner thighs are asymmetrical, the skin wrinkles on the affected side are deeper than those on the healthy side, and the number of wrinkles increases. The labia majora of the baby girl are asymmetrical and the perineum is widened.

②Inspection:

A. Ortolani test and Barlow test: Applicable to congenital hip dislocation between birth and 3 months, first proposed by Ortolani in 1935 and improved by Barlow. Ortolani's method is to flex the child's knees and hips to 90°. The examiner places the thumb on the inner side of the child's thigh and the index and middle fingers on the greater trochanter, gradually abducting and externally rotating the thigh. If dislocation occurs, the femoral head may be felt embedded in the rim of the acetabulum, causing slight resistance to abduction. Then, lift the greater trochanter upwards with the index and middle fingers. The thumb can feel the bounce of the femoral head as it slides into the acetabulum, which indicates a positive Ortolani test. The Barlow test is the opposite of the Ortolani test. The examiner passively adducts and internally rotates the child's thigh and pushes the thumb outward and upward on the greater trochanter of the femur, and another bounce can be felt.

B. Allis sign (Galezzi sign): Make the newborn lie flat, bend the knees 85° to 90°, put the legs together, and align the heels. If this disease exists, the knees will be seen to be of different heights. This is caused by the upward displacement of the femur on the affected side.

C. Intussusception test: Have the child lie flat with the affected hip and knee flexed 90°. The examiner holds the distal femur and knee joint with one hand and presses the groin with the other hand. When lifting and pushing the knee of the affected limb, if the greater trochanter is felt to move up and down, the intussusception test is positive.

D. Hip and knee flexion and abduction test: Make the infant lie flat with the hip and knee flexed. The examiner holds the knees with both hands, with the thumb on the inside of the knee and the other four fingers on the outside of the knee. A normal infant can generally abduct about 80°. If it can only abduct 50° to 60°, it is positive, and if it can only abduct 40° to 50°, it is a strong positive.