II. Indication
-
Developmental Dysplasia of the Hip evaluation
- Evaluation for Congenital Hip Dislocation
III. Pathophysiology
- Femoral head displaced superiorly, posteriorly
IV. Mechanism
- Attempt to relocate hip into acetabulum
- Examine each hip individually
V. Preparation
- Infant supine with diaper off
- Hips flexed to 90 degrees
VI. Technique
- Infant's legs placed in frogleg position
- Place index and middle finger over greater trochanter
- Place thumb medially at inner thigh inguinal crease
- Attempt relocation of femoral head into acetabulum
- Gently abduct the hip while applying upward force
- Push upward with greater trochanter (away form bed)
- Push toward bed and laterally with thumb at knee
- Gently abduct the hip while applying upward force
- Also assess for reduced Hip Range of Motion in abduction
- Abduction less than 60 degrees OR
- Abduction more than 20 degrees difference between sides
VII. Findings: Signs of dislocation
- Hip Clunk felt on exam
- Occurs when femoral head relocates in acetabulum
- Suggests Congenital Hip Dislocation
- Distinguish from a hip click
- Benign finding