Congenital dislocation of the hip (CDH): liability for failure to diagnose early

摘要

‘Failure to detect CDH beyond the first 6 months isndifficult to defend. Failure to diagnose until the childnis walking with a grossly abnormal gait is not onlynindefensible but expensive as by this time treatment isnmore complicated and the results less satisfactory. ’n1nThe hip is a ball and socket joint. It consists of thenrounded head of the upper end of the thigh bonen(femur) and a cup in the pelvic bones called thenacetabulum. At birth most of the depth of this cup isnformed of fibrous tissue and cartilage that graduallynossifies during infancy . The integrity of the hip jointnat birth depends on the stability of the rim of thenacetabular cup, called the labrum, and also of the cap-nsule and ligaments connecting the two bones. Innfemale infants these may become lax around the timenof birth because of the influence of maternal hor-nmones whose prime function is to relax the mother’ snbirth canal in order to make delivery easier. Hencenthe predilection of girls to be born with unstable hips.nAfter birth the maternal hormone effect wears off andnthese tissues become firm.n2