Will Treatment for Congenital Hip Dislocation Cause Limb Length Discrepancy?

Q: Will Treatment for Congenital Hip Dislocation Cause Limb Length Discrepancy?

Hello： In response to your question, based on your description, addressing each of your concerns individually may not fully satisfy you. <br>I have two suggestions. <br>First, since your child has already received treatment, if you have any doubts, please return to the original t

Will children with congenital hip dislocation still have leg length discrepancy after treatment?

Dr.
Li: Hello! During my child's health check at birth, a left hip dislocation was detected due to being in a breech position, which necessitated a cesarean section.
He is currently 19 months old.
From months 1 to 4, the doctor used a double diapering method for assessment, but the hip joint remained unreduced.
Therefore, from months 5 to 8, the doctor opted for treatment with a cast.
In months 9 to 10, the doctor used a brace to keep the legs apart.
Finally, by the 11th month, the treatment was completed, and he began to learn to crawl.
He is now walking well, but I recently observed from behind that his left shoulder is lower than the right.
Upon closer inspection, it seems to be due to a short left leg and a longer right leg.
When observing his standing posture, his right foot is more externally rotated than his left.
I would like to ask the doctor: 1.
Is the difference in shoulder height related to the leg length discrepancy, or could it be due to the previous casting treatment, where we held him with the cast, which had gaps, potentially causing spinal scoliosis? (The suggestion of scoliosis came from other parents.) 2.
After treatment for congenital hip dislocation, is it still possible to have leg length discrepancies? 3.
Is regular rehabilitation necessary after treatment for congenital hip dislocation? (As suggested by other parents.) 4.
Sometimes my child falls after walking or running; could this be due to a potential leg length discrepancy causing imbalance? 5.
My child has inherited flatfoot from his father, and currently, his weight is centered on the inner side of his feet while walking.
How can this be improved? I apologize for the many questions.

Lily, 30~39 year old female. Ask Date: 2004/10/04

Dr. Li Wenlin reply Orthopedics

Hello: In response to your question, based on your description, addressing each of your concerns individually may not fully satisfy you.
I have two suggestions.
First, since your child has already received treatment, if you have any doubts, please return to the original treating physician for consultation.
Second, if returning to the original physician is inconvenient or you cannot locate them, you can seek out an orthopedic surgeon who specializes in pediatric orthopedics nearby, or refer to the Pediatric Orthopedic Society.

Reply Date: 2004/10/04

More Info

When addressing the concerns regarding congenital hip dislocation and its treatment, particularly in relation to limb length discrepancies, it's essential to understand the implications of the treatment methods used and the potential outcomes for your child.

1. Shoulder Height Discrepancy and Limb Length: The observation of one shoulder being lower than the other can indeed be related to a limb length discrepancy. If one leg is shorter, it can lead to an uneven pelvis, which in turn may cause the shoulders to appear uneven. However, it is also possible that the use of a cast during treatment could have influenced the child's posture. If the cast was not fitted properly or if the child was held in a way that favored one side, it could contribute to postural imbalances, including scoliosis. A thorough examination by a pediatric orthopedic specialist would be beneficial to determine the exact cause of the shoulder height difference.

2. Limb Length Discrepancy Post-Treatment: It is not uncommon for children who have undergone treatment for congenital hip dislocation to experience some degree of limb length discrepancy. This can occur due to various factors, including the nature of the dislocation, the timing of the intervention, and the specific treatment methods employed. While some children may have a significant discrepancy, others may have only a minor difference that may not require intervention.

3. Need for Regular Rehabilitation: Regular follow-up and rehabilitation are crucial after treatment for congenital hip dislocation. Physical therapy can help improve strength, flexibility, and overall function of the hip joint. It is advisable to have periodic assessments by a healthcare professional to monitor the child's development and address any emerging issues, including gait abnormalities or further discrepancies in limb length.

4. Falls and Balance Issues: If your child is frequently falling while walking or running, it could be related to the limb length discrepancy, which may affect balance. Children with uneven leg lengths may have difficulty maintaining stability, especially during dynamic activities. A pediatric physical therapist can provide exercises and strategies to improve balance and coordination.

5. Flatfoot and Weight Distribution: The observation of your child having a flatfoot condition and a weight-bearing pattern that favors the inner side of the foot can be addressed through specific interventions. Orthotic devices, such as custom shoe inserts, can help support the arch and redistribute weight more evenly across the foot. Additionally, exercises that strengthen the foot and ankle muscles can improve stability and alignment.

In summary, while treatment for congenital hip dislocation can lead to some complications, including limb length discrepancies, regular monitoring and rehabilitation can significantly enhance outcomes. It is crucial to maintain open communication with your child's healthcare providers and seek their guidance on the best course of action for ongoing care and support. Early intervention and appropriate therapies can help mitigate potential issues and promote healthy development as your child grows.

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