Interstate medical journal . d patients, the more I am convincedthat we should make special effort to impress on the nurse andmothers that early recognition is probably the greatest factortoward obtaining a perfect joint in these cases. Late Walking. Children with congenital dislocation of the hipwalk late, not until 14, 15 months or two years. When the childis backward about walking the reason should be found and thedoctor should be given a chance to make a diagnosis. Thomas: Congenital Dislocation of the Hip 729 The Limp. The same may be said regarding a limp or waddlein a childs gait. The n
Interstate medical journal . d patients, the more I am convincedthat we should make special effort to impress on the nurse andmothers that early recognition is probably the greatest factortoward obtaining a perfect joint in these cases. Late Walking. Children with congenital dislocation of the hipwalk late, not until 14, 15 months or two years. When the childis backward about walking the reason should be found and thedoctor should be given a chance to make a diagnosis. Thomas: Congenital Dislocation of the Hip 729 The Limp. The same may be said regarding a limp or waddlein a childs gait. The nurse, the parents and the doctor shouldlearn its cause. They should appreciate this danger signal. Diagnosis. The diagnosis of congenital hip is not difficult. Thechild tvalks late but continues to walk after it begins. There is nopain. If only one hip is dislocated the leg is shorter on that sideand the gluteal folds are asymmetrical. The trochanter on the af-fected side is higher, and will slip up when the weight is put on. Fig. 1.—Back view of patient, 6 years Fig. 2.—Side view of patient shown inold, with double congenital disloca- Fig. 1. Pelvis thrown forward, backtion unreduced. The hips are broad, shows lordosis,and the legs are unduly separated atgluteal folds. See Fig. 5. the dislocated limb and slide down when the weight is shifted tothe other leg. In a case of double congenital dislocation, the legs are near thesame length, the gluteal folds are symmetrical. The trochantersare both high, high above Nelatons line. They both slip up anddown as the weight is shifted from one leg to the other. The backis lordosed; the abdomen protrudes. The hips are prominent. Thewalk is characterized by a waddle. Congenital hip may be confusedwith coxa vara, fracture of the femur, tuberculous hip, traumaticdislocation, infantile paralysis, etc., but is usually easily differen-tiated by the history of the case. 730 INTERSTATE MEDICAL JOURNAL Treatment. Now, there is no chance for th
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