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[Abnormal joint laxity in hip dislocation during the first year of life. Arthrographic findings and prognosis]
1Unité d'Orthopédie Infantile, Service de Chirurgie Orthopédique et Réparatrice, C.H. René Dubos, Pontoise.
Insights
Congenital dislocation of the hip (C.D.H.) is often caused by hip socket deformity, leading to abnormal articular mobility (A.A.M.). The snapping sign and Barlow sign help identify this condition in infants.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Developmental Biology
Background:
- Congenital dislocation of the hip (C.D.H.) affects infant hip joint mobility.
- Abnormal articular mobility (A.A.M.) is a key indicator in C.D.H. diagnosis.
- Understanding the biomechanics of hip instability is crucial for early intervention.
Purpose of the Study:
- To analyze abnormal articular mobility (A.A.M.) in infants with congenital dislocation of the hip (C.D.H.).
- To investigate the mechanisms behind the snapping sign and Barlow sign in C.D.H.
- To identify prognostic factors for C.D.H. in patients over one year of age.
Main Methods:
- Review of 247 C.D.H. cases.
- Analysis of A.A.M. in 64 infants using Le Damany and Barlow maneuvers under arthrographic control.
- Examination of prognostic factors in 161 patients older than one year.
Main Results:
- A.A.M. in C.D.H. is attributed to hip socket deformity.
- The snapping sign results from the femoral capital epiphysis rising over the acetabular rim.
- The Barlow sign indicates abnormal femoral head displacement within a distorted hip socket.
Conclusions:
- Hip socket deformity is the primary cause of A.A.M. in C.D.H.
- Specific clinical signs (snapping sign, Barlow sign) are linked to distinct pathomechanics.
- Prognostic factors require further analysis in older pediatric populations.
Abstract:
247 cases of congenital dislocation of the hip (C.D.H.) with abnormal mobility of the hip joint were reviewed. Abnormal articular mobility (A.A.M.) was analyzed in 64 infants in whom the maneuvers described by Le Damany and Barlow were executed under arthrographic control. A.A.M. was caused by the deformity of the hip socket. The snapping sign was produced by the rise of the femoral capital epiphysis over the cartilaginous rim, in front of the limit separating the central, underformed part of the osseous acetabulum from its outer dysplastic portion. In eleven cases the "limbus" was located within the acetabular cavity, centrally with respect of the labrum. The Barlow sign was produced by the abnormal displacement of the femoral head within the incontinent and distorted hip socket. Prognostic factors were analysed in 161 patients reviewed older than one year.