Hip dysplasia and congenital dislocation of the femoral head

Pemberton’s Osteotomy It is indicated in paralytic dislocation and in postacetabular deficiency between 1 and 10 years. Here, the osteotomy is done through the acetabular roof using triradiate cartilage as the hinge.
Steel’s Osteotomy
This is useful in older children when symphysis pubis and the tri-radiate cartilage are fused. This is a triple innominate osteotomy.
Shelf Operation
It is indicated in CDH with recurrence. Here, the acetabulum is extended laterally and anteriorly by bone graft.
Signs and symptoms
:
Hip dysplasia can range from barely detectable to severely malformed or dislocated. The congenital form, teratologic or non-reducible dislocation occurs as part of more complex conditions.
The condition can be bilateral or unilateral:

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  If both hip joints are affected, one speaks of "bilateral" dysplasia. In this case, some diagnostic indicators like asymmetric folds and leg-length inequality do not apply.
  
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  In unilateral dysplasia only one joint shows deformity, the opposite side may show resulting effects In the majority of unilateral cases, the left hip has the dysplasia.
  

If the joint is fully dislocated a false acetabulum often forms (often higher up on the pelvis) opposite the dislocated femoral head position.
In acetabular dysplasia, the acetabulum (socket) is too shallow or deformed. The center-edge angle is measured as described by Wiberg Two forms of femoral dysplasia are coxa vara, in which the femur head grows at too narrow an angle to the shaft, and coxa valga, in which the angle is too wide.
A rare type, the "Beukes familial hip dysplasia" is found among Afrikaners that are members of the Beukes family. The femur head is flat and irregular. People develop osteoarthritis at an early age


Cause :
Hip dysplasia is considered to be a multifactorial condition. That means that several factors are involved in causing the condition to manifest
The cause of the condition is unknown; however, some factors of congenital hip dislocation are through heredity and racial background. It is also thought that the higher rates in some ethnic groups (such as some Native American groups) is due to the practice of swaddling of infants, which is known to be a potential risk factor for developing dysplasia. It also has a low risk in African Americans and southern Chinese.