What is the Primary pathology in Congenital displacement of hip :
Pathological changes observed in CDH : 1.Bone- *acetabulum shows primary acetabular dysplasia and acetabulum is shallow.In addition there could be a gap or groove at posterosuperior aspect,triangular outer surface of ilium and acetabulum are in same line ,above acetabulum there is a depression containing the head of femur. Head of femur: head of femur normal initially ,later head is flat on its posterior and medial aspect,femoral head in the ilium is buffer or conical shaped. *Neck of femur:shoening and ante version *pelvis: tilted forwards,small and atrophied ,lordosis present &is more veical than normal. *Capsule: show hourglass constriction, one containing head and other containing acetabulum,constriction is produced by iliopsoas,ligamentum trees passes through this constriction,& it is hyperophied. 2.muscles : * pelvifemoral group -adductors ,saorius,gracious,rectus femoris,hamstrings,tensor fascia lata muscles.these muscles are shoened and they prevent reduction of head. *pelvitrochanteric group (obturators,quadratus femoris,iliopsoas) These are elongated & psoas forms an obstacle to reduction. *glutei muscles -show little organic change but power is diminished. REF:Textbook of ohopedics,John Ebenezer,4th edition pg no.494
Large head of femur
Shallow acetabulum
Excessive retroversion
Eveed limbus
Pediatric orthopedics