Hesperian Health Guides

Hip Contractures

Hip ‘flexion’ contractures (in which the thighs stay bent forward at the hips) are often difficult to straighten and require special techniques.

Advanced hip contractures like this often require surgery.
DVC Ch8 Page 86-1.png

Less advanced hip contractures like this can sometimes be straightened using positioning and straps. The child lies face down with a wide strap pulling his butt down.
DVC Ch8 Page 86-2.png
child lies down with straps and a cushion
cushion under thighs (avoid pressure on knees)
The child should spend as many hours as possible each day in this position. And if possible, also at night. Knees should be checked for early signs of pressure sores every hour or so. (See Chapter 24.)

Life can be made more interesting for the child during the weeks or months of stretching by using a lying frame on which she can move about.

a child on a mobile lying frame
A rack or bookholder so she can play or read.
casts to straighten knees and ankles
A bar fastened between the 2 leg casts helps keep them in a stable position (and also helps prevent contractures that pull the legs together).
large bicycle wheels
‘caster’ rear wheels, for turns
See other designs in Wheelchair with Lying Board.
CAUTION! When stretching contractures this way, be careful to prevent pressure sores (bed sores), especially on the knees. If the child complains a lot, loosen the strap a little. For eating, bathing, toilet, and exercise she can be unfastened and moved into convenient positions. But it is best that she remain strapped down about 20 out of each 24 hours.

The child with more severe contractures at the hips may need to be strapped on an angled frame.

a child on an angled frame
wood frame
old tires or anything to lift body
frame and leg boards
plywood or wood
Leather or canvas strips work as hinges that support legs.
The angle of the leg boards is set to give gentle but continuous pressure against the thighs. As the contracture is gradually corrected, the angle is changed by raising the leg boards or by lowering the body board. For children with different angles of contracture in each hip, the 2 leg boards can be adjusted differently.

For methods to correct contractures, see Chapter 59.

This page was updated:27 May 2020