Congenital Dislocation

Congenital Hip Dislocation

Congenital hip dislocation (CHD), also called developmental dysplasia of the hip, occurs when a child is born with an unstable hip due to abnormal formation of the hip joint during early stages of fetal development. This instability worsens as the child grows.


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The exact cause of congenital hip dislocation is not known. Some families have been reported to have a hereditary form of congenital hip dislocation (meaning multiple family members are affected). Congenital hip dislocation is more common in girls and babies born in the breech position (feet first); the left hip is also more often involved than the right hip.

Treatment

Shortly after birth, babies with congenital hip dislocation may be fitted with a device to help hold the hip in place. Surgery may be necessary if the dislocation is diagnosed at an older age or if earlier treatment options did not work. Left untreated, congenital hip dislocation may lead to problems with walking or activity, as well as pain and arthritis (inflammation of the hip joint) by early adulthood. Your child’s doctor(s) will discuss appropriate treatment options with you.

Congenital Knee Dislocation

Congenital knee hyperextension, which is also known as congenital knee dislocation, is a relatively rare birth condition where one or both of the baby’s knees are not in normal alignment. The knee is overextended and looks backward. The lower leg may face outward rather than being positioned in a straight line with the rest of the leg. The condition may be mild and only involve the knee being in the wrong position, which can be treated by splinting. Or, it may be severe, where the tibia (the main shin bone) is dislocated from the femur (the thigh bone).

Treatment

The treatment plan may depend on how old your child is and how severe the condition is. The best results come from early detection and treatment. Initial treatment for congenital knee dislocation involves placing the leg in a cast or splint and increasing the bend angle every 1-2 weeks. This “serial casting” is used to stretch the tight anterior structures and to allow the posterior structures to tighten up. Once the knee can be flexed past 90 degrees of flexion, additional casts are set to hold the knee in place for 2-4 weeks. Once stability is obtained, a brace can be fashioned and this is typically used for 4-6 weeks full time and then 4-6 at night time. In some instances, the knee cannot be flexed 90 degrees and surgery is needed at 4-6 months of age, usually before the child begins to crawl.

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