MOULDED BABY SYNDROME AND CONGENITAL DYSPLASIA OF THE HIP

Key words: Moulded baby syndrome, Congenital pelvic obliquity, Congenital postural deformities, Congenital dislocation of the hip

Congenital postural deformities, collectively referred to as moulded baby syndrome to underline the importance of intrauterine “moulding” in their origin, mainly include plagiocephaly, torticollis, scoliosis, pelvic obliquity, torsional abnormalities of the femura and tibiae, genu recurvatum and foot deformities. In the first 6 to 7 months after birth these newborn infants have a strong tendency to assume a lateral oblique lie, which worsen some of the neonatal deformities. The adducted hip, i.e. the hip opposite to the decubitus, usually shows limitation of abduction and must be considered at risk for mechanical inhibition of osteochondral growth and plastic deformation of the articular soft tissues. These changes are promptly reversible when posture is corrected. In a number of cases, evolution towards dysplastic- like changes can be expected, radiologically indistinguishable from CDH (Congenital Dysplasia of the Hip) of common type. The Ortolani’s maneuvre is usually negative and this explains the late or missed diagnoses. In the Author’s series of 187 moulded babies, 44,6% showed on ultrasound and X-ray examination a delayed development (hypoplasia) of the adducted hip and 10,2% definite dysplastic changes. The lateral oblique lie should therefore be considered among the signs suggesting CDH.