Hip dislocation

Clinical features include neonatal hypotonia, a tendency toward congenital hip dislocation and diffuse muscle weakness. Later on children are frequently of short stature and low body weight and often have long thin faces and high-arched palates. Respiratory difficulties, where present, occur early on and tend to improve with time. In others a virtually static clinical picture is seen. 

Epileptics have low blood Mn A link between mseleni disease and Mn deficiency Low tissue Mn in MSUD and PKU Mn deficiency and hip dislocation in Down s syndrome Low hair Mn in infants with congenital malformations and their mothers Low blood Mn in non-head injury epileptics Low blood Mn in osteoporosis Experimental Mn deficiency in male subjects ... 

Ehlers-Danlos VII Amino terminal Hyperextensible easily bruised skin hip dislocations... 

Traumatic hip dislocation is uncommon in children and is the result of high energy force therefore, it is often associated with other significant injuries (Craig 1980 Salisbury and Eastwood 2000). Typically, it is the result of an axial force directed along the length of the femur, such as that which occurs when the hip is flexed and the knee impacted against the dashboard in a road traffic accident. The direction of dislocation will depend on the position of the hip at the moment of impact. If the hip is flexed and adducted, this will result in posterior dislocation. If the hip is abducted and externally rotated, this will result in anterior dislocation. Posterior dislocation is the commonest type and more frequently associated with fractures, particularly those of the posterior acetabulum. 

Treatment of hip dislocation is immediate closed reduction, and should preferably be performed within 6 h of injury. This is important to lower the risk of osteonecrosis. 

Complications of hip dislocation indude osteonecrosis and early degenerative osteoarthritis. MR imaging is used in the identification of early osteonecrosis by visualising early fatty marrow conversion in the intratrochanteric portion of the proximal femur. Osteonecrosis develops in less than 5% of patients whose dislocation was reduced within 6 h compared with over 50% if the reduction occurred after 6 h of injury. 

J Bone Joint Surg Am 53 1165-1179 Laorr A, Greenspan A, Anderson M, Moehring HD, McKinley T (1995) Traumatic hip dislocation early MRl findings. Skeletal Radiol 24 239-245... 

Hernias 114, 377, 384-392, 403, 642 Hips, dislocation 114 Hirschsprung disease 583 Hirsutism 438, 560561 Hoarseness 441, 443 Holoprosencephaly 583 Homeostasis, disturbed energy 332 Humeri, disproportionately affecting 495... 

Congenital hip dislocation. Congenital dislocation of the hip creates a waddling gait... 

Craniofacial malformation are common features of FAS, which impairs the normal development of the skull, jaws, teeth, nose, eyes, and facial skin. Sometimes variable anomalies of limbs and joints are present, including congenital hip dislocations, abnormalities of the toes, and inability to extend completely the elbows or metacarpal phalangeal joints. Cardiac malformations syndrome encompasses an atrial septal defect, a patent ductus arteriosis, and cardiac murmurs representing ventricular septal defects. Anomalies of external genitalia have also been noted. 

An AP radiograph of the entire abdomen is taken unless one has been obtained recently for any reason and there was no breakthrough event. An additional film in upright position is unnecessary. Abnormal calcification, nephrocalcinosis, spinal deformation, bony abnormality, spinal surgery, pubic symphysis abnormality, and the position of prosthesis (VP shunt, JJ tube, bladder catheter, nephrostomy tube or other) all can easily be shown prior to administration of contrast medium. Attention should be paid to extra urinary anatomy (think of congenital hip dislocation). 

Anda S, Svenn ingen S, Slordhal J et al (1986) Voluntary hip dislocation examined by computed tomography. Acta Orthop Scand 57 94-95... 

Lamer S, Sebag GH (2000) MRl and ultrasound in children with juvenile chronic arthritis. Eur J Radiol 33 85-93 Langer R (1987) Ultrasonic investigation of the hip in newborns in the diagnosis of congenital hip dislocation classification and results of a screening program. Skeletal Radiol 16 275-279... 

---