Teratologic Dislocation of the Hip
Objectives- Define teratologic dislocation of the hip
- Describe associated conditions accompanying teratologic dislocation of the hip
- Describe treatment of teratologic dislocation of the hip, and complications of treatment
Discussion
Teratologic dislocation of the hip is a term used to imply that the hip joint did not develop normally in utero, thus the hip is in a fixed dislocated position at birth. This condition always accompanies other congenital anomalies or neuromuscular conditions; the two most common generalized conditions are arthrogryposis and myelomeningocele. Obviously, treatment of such hips is more difficult than those with DDH, and a high complication rate has been reported. Decision making for infants with teratologic dislocation can be difficult. For children with arthrogryposis, some authors have recommended treatment of the unilateral hip dislocation, but not the bilateral. Staheli has been the most persistent advocate of treatment of the bilateral hip dislocation and has reported reasonable outcomes. For children with high level myelomeningocele and congenital dislocations, most authors would presently defer treatment. In general, motion is the most desirable end product of treatment, but it may be difficult to achieve that goal without reduction of the hip.
References
- Aaro S, Gottfries B, Kraepelien T, Troell S. Teratologic congenital dislocation of the hip. Report of two cases. Acta Orthopaedica Scandinavica 1983; 54( 2): 178-81.
- Akazawa H, Oda K, Mitani S, Yoshitaka T, Asaumi K, Inoue H. Surgical management of hip dislocation in children with arthrogryposis multiplex congenita. Journal of Bone & Joint Surgery -British Volume 1998; 80( 4): 636-40.
- Gruel CR, Birch JG, Roach JW, Herring JA. Teratologic dislocation of the hip. Journal of Pediatric Orthopedics 1986; 6( 6): 693-702.
- Huurman WW, Jacobsen ST. The hip in arthrogryposis multiplex congenita. Clinical Orthopaedics & Related Research 1985( 194): 81-6.
- Milgram JW, Tachdjian MO. Pathology of the limbus in untreated teratologic congenital dislocation of the hip. A case report of a ten-month-old-infant. Clinical Orthopaedics & Related Research 1976( 119): 107-11.
- Staheli LT, Chew DE, Elliott JS, Mosca VS. Management of hip dislocations in children with arthrogryposis. Journal of Pediatric Orthopedics 1987; 7( 6): 681-5.
May 16-19, 2012 in Denver, CO
