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Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot – A rare Packaging disorder


[box type=”bio”] What to Learn from this Article?[/box]

1. Management of multiple congenital joint dislocation, sequence and principles?

2.Differentials of multiple congenital joint dislocations?

Case Report |  Volume 3 | Issue 2 | JOCR April – June  2013 | Page 21-24 | Tiwari M, Sharma N

Authors: Mukesh Tiwari[1], Nishith Sharma[1]

[1] NIMS Medical College, Jaipur. Rajasthan, India

Address of Correspondence:

Dr Mukesh Tiwari: NIMS Medical College, Jaipur. Rajasthan, India E-mail-


Introduction: Reduced intrauterine space gives rise to ‘packaging disorder’ which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK), bilateral congenital hip dislocation (CDH) and congenital talipes equino varus  (CTEV)deformities.

 Case Report: A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper) with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well  with baby able to stand with support.

 Conclusion: Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good.

 Keywords: Congenital genu recurvatum, Develpmental dysplasia hip, CTEV, Clubfoot, serial manipulation, packaging disorders.


How to Cite This Article: Tiwari M, Sharma N. Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot – A rare Packaging disorder. Journal of Orthopaedic Case Reports 2013 April-June;3(2): 21-24. Available  from:

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