CONGENITAL

DISLOCATION OF
HIP
Physiotherapy Management
-During immobilization:- Active movements to be encouraged whenever possible eg:-when immobilization is done with
pelvic harness,even hip movements within the available range should be encouraged .If possible isometrics to gluteal
muscles and quadriceps should be taught.
-Mobilization:-As the limbs are immobilized in abduction for a prolonged period ,the maximum limitation is present in
the movement of adduction.
-Mechanically malaligned gluteal muscles are weak .Therefore all the measures for gradual mobilization of the hip
especially adduction are taken.Relaxes passive adduction in a very small range should be initiated and progressed.Care is
to be taken to stabilize the pelvis to avoid tilting during adduction.
-Other movements of the hip should also be given to improve range of motion.Hip rolling can be started with
stabilization of the pelvis.Strengthening exercises should be well planned and progressed to the glutes.Ideally it should
be started quadruped knee standing and progress to knee standing(kneeling).
-Walking should be initiated with enough support so that proper weight bearing and weight transfers without dropping of
the pelvis are achieved.It may be necessary to initiate ambulation with a wide base.
-Assisted ambulation should be made independent as the muscle power,stability and ROM improve.
Reference Books
-Maheshwari
-Jayant Joshi
-John Ebnezar