Congenital hip abduction contracture and pelvic obliquity

　　Congenital hip abduction contracture and pelvic obliquity are caused by abnormal fetal position in the uterus, leading to contraction of the hip abduction muscles. Due to the abnormal fetal position in the uterus, the hip joint has been in an abducted position, and the middle gluteal muscle and the lateral part of the joint capsule are contracted. The gluteus maximus and the external rotator muscle group also have varying degrees of contraction.

　　Congenital hip abduction contracture and pelvic obliquity can lead to wound infection. The disease may also lead to avascular necrosis of the femoral head after surgery. After the treatment of石膏 fixation, skin pressure sores will appear in all patients. Once the pressure is relieved from the plaster, the pressure sores can be cured within one week through measures such as changing dressings and disinfection, without the need for special treatment.

　　Children with congenital hip abduction contracture and pelvic obliquity often present with a frog-like lying position. The affected lower limb is in an abducted position, with less movement. When the pelvis is fixed, the hip cannot be adducted or internally rotated. The anterior superior iliac spine and iliac crest on the affected side are lower than on the healthy side. The gluteal creases on both sides are asymmetrical. When the two lower limbs are brought together, the healthy side pelvis is upward, the affected side pelvis is downward, the lumbar spine bends to the healthy side, and bulges to the affected side. Only when the affected limb is abducted, can the pelvis be at a normal horizontal position, and the spine forms a straight line. As the age increases, the child walks awkwardly, with a circling gait, and has difficulty squatting.

　　Congenital hip abduction contracture and pelvic obliquity belong to congenital malformations. The prevention of congenital malformations is divided into the following aspects:

　　1. In the early stages of pregnancy, pregnant women should avoid fever and colds. High fever causing fetal malformation is also related to the sensitivity of pregnant women to high fever and other factors.

　　2. Pregnant women should avoid close contact with cats and dogs. Infected cats are also a significant source of infectious diseases that can threaten fetal malformation.

　　3. Pregnant women should avoid wearing heavy makeup every day. Toxic substances such as arsenic, lead, and mercury in cosmetics can affect the normal development of the fetus.

　　4. Pregnant women should avoid emotional stress during pregnancy. When pregnant women are emotionally stressed, adrenal cortical hormones may hinder the integration of embryonic tissues. If this occurs in the first three months of pregnancy, it can cause fetal malformation.

　　5. Pregnant women should avoid drinking alcohol. Alcohol can pass through the placenta to harm the developing embryo.

　　When taking an anteroposterior X-ray film of the hip joint in the abduction 45° position for congenital hip dislocation and pelvic obliquity, there is a delay in ossification of the acetabular roof, which is due to the internal adduction contracture of the healthy side after the affected hip is abductively deformed, and the femoral head on the adducted side exerts less central pressure on the acetabulum.

　　The diet of patients with congenital hip dislocation and pelvic obliquity should be light, with an emphasis on vegetables and fruits such as bananas, strawberries, and apples, and foods that enhance immunity. In addition, patients should avoid smoking and drinking, and avoid spicy, greasy, and cold foods.

　　Once the diagnosis of congenital hip dislocation and pelvic obliquity is confirmed, early treatment should be given. Conservative therapy involves placing the child in a prone position, flexing the knee joint of the affected limb, lifting the thigh, extending the hip, and then adducting and internally rotating the thigh, performing 10 to 20 repetitions each time, 10 to 20 times a day for correction. Mild cases can be basically corrected in 1 to 2 months. Severe cases may require hospitalization for 2 to 3 weeks of horizontal skin traction on the affected side, followed by positioning the affected hip in adduction, internal rotation, and extension. The healthy hip joint is flexed 90°, externally rotated 80°, and abducted 90°, and the scissors-type plaster cast is fixed. Generally, the cast is fixed for 4 to 6 weeks. If plaster treatment is ineffective, surgery can be performed to release the iliotibial band and contracted gluteal muscles, which generally achieves good results.