title: Chiropractic management of patients with bilateral congenital hip dislocation with chronic low back and leg pain.
abstract: OBJECTIVE
  To discuss conservative methods for treating patients with chronic low back and leg pain associated with the biomechanical and postural alterations related to bilateral congenital hip dislocation.
  
  
  METHODS
  This report describes the cases of 2 adult female subjects with bilateral congenital hip dislocation without acetabula formation who suffered from chronic low back and leg pain managed conservatively by chiropractic methods. The first subject is a 45-year-old woman with a 9-month history of right buttock pain and radiating right leg pain and paresthesia down to the first 2 toes, with a diagnosis of a herniated L4 intervertebral disk. The second subject is a 53-year-old woman who complained of chronic intermittent low back pain and constant unremitting pain on her right leg for the last 3 years.
  
  
  RESULTS
  Chiropractic manipulation utilizing Logan Basic apex and double notch contacts, as well as sacroiliac manipulation on a drop table with a sacrum contact and with a posterior to anterior and superior to inferior (PA-SI) rocking thrust, together with a spinal stabilization exercise program, were used on these 2 patients. Both patients had significant clinical improvement, with reduction on the Visual Analogue Scale (VAS) of 67% and 84%, Oswestry Disability Index improvement of 73% and 81%, and an improvement on the Harris hip score of 71% and 44%, respectively.
  
  
  CONCLUSIONS
  A conservative management approach, including specific chiropractic manipulation and a spinal stabilization exercise program, can help manage the treatment of adult patients with chronic low back and leg pain related to bilateral congenital dislocation of the hips.
authors.affiliation: Centro Biomédico Indiana, Indiana #188 Col. A, Napoles, Mexico D.F. 03818. fcodiez@prodigy.net.mx
authors.forename: Francisco
authors.initials: F
authors.lastname: Diez
mesh_terms: D002908:Chronic Disease; D005260:Female; D006618:Hip Dislocation, Congenital / Q000150:complications*; D006801:Humans; D007866:Leg / Q000503:physiopathology; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy*; D026882:Manipulation, Chiropractic / Q000379:methods; D008875:Middle Aged; D010147:Pain Measurement; D012307:Risk Factors; D012585:Sciatica / Q000209:etiology / Q000628:therapy*; D013997:Time Factors