Developmental hip dysplasia in children

　　The cause of developmental hip dysplasia in children is not yet fully clear. Genetic factors play an important role in the pathogenesis, transmitted through dominant genes. The main cause of this disease is the abnormal morphology of the bony structure of the hip joint and the developmental defect of the surrounding soft tissues of the joint.

　　Developmental hip dysplasia in children can lead to osteonecrosis of the femoral head, fractures, nerve palsy, limited or rigid joint movement after surgery, and other diseases, so it should be highly emphasized by clinical doctors and parents.

　　Due to the age of the child, the degree of dislocation, and the difference between unilateral or bilateral lesions, the clinical manifestations of developmental hip dysplasia in children can vary. However, the main signs are as follows:

　　1. Limping gait

　　Limping gait is often the only complaint for consultation. Unilateral cases have body sway towards the affected side, and bilateral cases have obvious 'duck walk' symptoms with side-to-side swaying. At the same time, lumbar anterior prominence and buttock posterior prominence can be seen.

　　2. Unequal length of the lower limbs

　　Unequal length of the lower limbs is seen in unilateral dislocation cases. Unilateral cases have asymmetric thigh and buttock lines. Bilateral cases have a widened perineum.

　　3. Changes in the greater trochanter

　　The greater trochanter rises and protrudes, located above the Nelaton line (the line connecting the anterior superior iliac spine to the ischial tuberosity).

　　Developmental hip dysplasia in children belongs to congenital malformation. The prevention of congenital malformation is divided into the following aspects:

　　1. During the early stages of pregnancy, pregnant women should avoid fever and colds. High fever causing fetal malformation is also related to the sensitivity of pregnant women to high fever and other factors.

　　2. Pregnant women should avoid being close to cats and dogs. Infected cats are also a significant source of infectious diseases that can cause fetal malformation.

　　3. Pregnant women should avoid wearing heavy makeup every day. Toxic substances such as arsenic, lead, and mercury in cosmetics can affect the normal development of the fetus.

　　4. Pregnant women should avoid mental stress during pregnancy. When pregnant women are mentally stressed, adrenal cortical hormones may hinder the integration of embryonic tissue. If it occurs in the first three months of pregnancy, it may cause fetal malformation.

　　Pregnant women should avoid drinking alcohol. Alcohol can pass through the placenta to harm the developing embryo. It can cause serious damage to the fetus.

　　In diagnosing developmental hip dysplasia in children, in addition to relying on clinical manifestations, chemical tests are also needed. The main methods of examination include the following:

　　1. X-ray examination

　　X-ray examination can confirm whether there is dislocation, unilateral or bilateral, subluxation or complete dislocation, and can also see developmental defects in the ipsilateral acetabulum.

　　2. Ultrasound examination

　　Most studies show that in checking for abnormal hip development in infants, ultrasound is more sensitive than X-ray. Ultrasound screening can detect hip dysplasia that cannot be diagnosed clinically, and will not increase the misdiagnosis rate for mild hip dysplasia that can self-improve.

　　Children with developmental hip dysplasia should maintain regular and reasonable diets, mainly high-protein and high-vitamin foods. Choose high-nutritious plant or animal proteins such as milk, eggs, fish, lean meat, and various bean products. In addition, patients should also pay attention to avoid spicy and刺激性 foods.

　　The earlier the treatment for developmental hip dysplasia in children, the better the effect. The methods of treatment vary according to the age of the child and the pathological changes, as follows.

　　1. For infants under 6 months old:Treatment for infants under 6 months old is relatively simple, maintaining a high abduction position of both lower limbs can gradually realign. Use trapezoidal urine pillow, frog position splint, or Pavlik harness to maintain for 3 to 4 months, and most can be cured.

　　2. For children under 3 years old:Children under 3 years old use conservative therapy, perform manual reduction under anesthesia, and use frog position plaster or brace for fixation for 2 to 4 months, and then switch to abduction position brace plaster or abduction brace for fixation for 4 months, with satisfactory efficacy.

　　3. For children over 3 years old:The failure rate of manual reduction in children over 3 years old increases. Children between 4 and 7 years old generally need to undergo surgical reduction. According to pathological changes, pelvic osteotomy, periacetabular osteotomy, pelvic osteotomy with internal displacement, acetabular deepening or acetabular roof formation, and other methods can be adopted.