1, what is congenital hip dislocation in children Congenital hip dislocation in children is a relatively common hip deformity, characterized by infants at birth, part or all of the femoral head out of the acetabulum, lesions often involving the acetabulum, the femoral head, the joint capsule and the ligamentous muscles around the hip. Because children with this disease do not have obvious signs at birth, most hospitals have not established a newborn physical examination census and registration system, resulting in this disease is often underdiagnosed, there are a lot of children early also went to the hospital to seek medical treatment, the answer is often “children lack of calcium, chondromalacia,” or “grow up to be good! The answer is often “calcium deficiency, chondromalacia” or “it will get better when it grows up”, which makes the diagnosis that there is no abnormality in the hip. If this disease can be diagnosed and treated early, the clinical effect will be satisfactory; if the treatment is delayed, it will eventually lead to irreversible painful osteoarthritis and different degrees of disability. 2, why get hip dislocation, what people are prone to get the disease Hip dislocation causes are very complex, so far is not very clear, the following factors may lead to hip dislocation: 1. genetic factors: hip dislocation children, the incidence of its family as high as 20% ~ 30%, and in the girls are more common. 2 ligament laxity factors: mothers need to secrete a lot of hormones to promote the ligament laxity in the process of production. 2. Ligament laxity factor: During labor, mothers need to secrete a large amount of hormones to promote ligament laxity and facilitate delivery. Excessive hormones may be an important factor causing hip dislocation in infants. 3. Fetal position and mechanical factors: among the infants with hip dislocation, as many as 16-30% are born in breech position, and the incidence of congenital hip dislocation in breech births is 10 times higher than that in cephalic births. In China, every 500-1000 newborns have a congenital hip dislocation, the male to female ratio is about 1:6-8. 3, what are the symptoms of congenital hip dislocation? Infants do not begin to walk, it is difficult to attract the attention of parents and medical personnel, this time is easy to miss the diagnosis, but if you look carefully, there are still abnormal manifestations, for example, the appearance: thighs, calves, and the opposite side of the asymmetrical, which may be manifested as thickening, shortening, or thinning, external rotation (toes), and the other side of the leg, and the opposite side of the leg. For example, appearance: thighs and calves are asymmetrical with the opposite side, which may be thickened, shortened or thinned, externally rotated (toes pointing to the outside of the body, seen unilaterally); widening of the buttocks (seen bilaterally); skin tattoos: skin tattoos on the buttocks, groin and thighs increase in size, deepen, and become asymmetric; limb movements: the leg with the problem is most easily found to have less movement when changing diapers, and there is a restriction on separating the legs when changing the baby’s diaper. Gait abnormalities can be seen in toddlers and children, such as starting to walk late, or starting to walk with an unsteady gait, with a waddling, rocking or wobbling step (unilateral); bilateral dislocations are manifested as duck-walking steps, unequal limb lengths, lateral bending of the trunk or the presence of hip popping, and so on. 4.What examination is needed The examination of hip dislocation mainly relies on the doctor’s manual examination and X-ray to diagnose. There are many methods of manual examination, such as: Ortolani’s method; Barlow’s method; Galeazzi’s or Allis’s method; in addition, there are also double lower limb isometric examination, hip abduction or 4-word test. The type and degree of dislocation is also determined by the shape, interrelationship and angle of the bone fragments in the radiographs. Through the parents’ introduction, manual examination and analysis of the photographic results, the doctor can basically confirm the diagnosis and provide guidance for further treatment after excluding other diseases. 5, how to treat the first hip dislocation, what are the conservative treatment measures The principle is early diagnosis, early treatment. The principle is early diagnosis and early treatment. The earlier the reset, the better the acetabular development. Conservative treatment is suitable for children under 3 years old. The younger the age, the easier the reset, the shorter the fixation time, the more ideal the effect. under 1 year old: found in infancy, can be cured by using a dress brace to keep both hips flexed and abducted for 6~8 weeks after the reset; age older than 6 months, such as complete dislocation, after the reset, both hips flexed and abducted in a brace fixed in a safe range for 6 months, and regular checkups during the period of fixation. 1~3 years old: hip flexion and double lower extremity suspension traction for 2~3 weeks, after closed reset, make a modification of the hip flexion and abduction, and then fixation. After closed reset, modified frog cast external fixation for 6~9 months, replace the cast every 3 months, and review the X-ray photo to determine whether the reset is successful or not. Surgery is suitable for children over 3 years old, with long time of dislocation, difficult to reset and more serious deformity; failure of manipulation and plaster fixation; children who come to the doctor later after walking, older children, etc. Before surgery, bone traction is needed. Bone traction should be performed before operation, and the corresponding operation style should be chosen according to the specific condition. Salter pelvic osteotomy, Chiari pelvic osteotomy, peri-acetabular osteotomy, triple osteotomy and so on are commonly used operation styles, which aim at restoring the normal shape, providing the basis for further development of the hip joint, and avoiding the occurrence of deformity. 7.Special reminder The therapeutic effect of hip dislocation has a great relationship with the age, if the children can get the right treatment before the age of 6, most of them can be cured, if they are more than 8 years old, the arthropathy is already very serious, and the therapeutic effect will be less satisfactory. The care and functional exercise after conservative or surgical treatment is very important, which is related to the final therapeutic effect. The doctor’s treatment only tries his best to restore the shape of the hip joint, while the recovery of its function mainly depends on the parents’ exercise under the doctor’s guidance, which requires the parents’ patience to cooperate with the postoperative care and functional exercise in order to achieve the best therapeutic effect.