Watching your precious child suffer from scratch can be a painful experience as new parents. However, it can be even more distressing to find out that your infant has a developmental disorder and needs to undergo several rounds of tests and treatments. While nothing can prepare parents for the stress that is experienced witnessing a tiny human go through so much, it helps a lot when you know why these things happen and what to expect. To help you prepare better, today we are going to address hip dysplasia and all the things you need to know as a parent. From the cause and effect to the methods of treating dysplasia of the hip, you will find a balanced viewpoint to deal with it better.
What Is Developmental Hip Dysplasia?
Developmental hip dysplasia or DDH refers to development issues in the way the hip joint is formed in a baby. At times, this condition can begin in the fetal stage, much prior to the birth of the baby. Other times, it occurs post their birth, during the growth stages. Hip dysplasia can impact one side of the hip or both.
Most babies that get proper treatment for hip dysplasia have active, healthy development and show no hip issues after they grow.
What are the Effects of Hip Dysplasia?
The hip joint is formed with a ball and socket. The upper region of the femur bone which comprises the hip ball joint meets a socket of the pelvic bone. The ball is ideally supposed to move in different directions, but stay connected inside this pelvic socket. This helps humans move their hips in various directions comfortably. These also fold the body weight so that we can walk and run freely. When there is developmental dysplasia of the hip or DDH, the joint formation is less than ideal, which will cause a problem in the movement of a child if left untreated.
Symptoms of DDH
Hip dysplasia does not hurt the babies, which makes it hard to diagnose as parents. Doctors assess the hips of all newborns and infants at regular intervals to detect signs of hip dysplasia.
As parents, you can keep an eye out for signs like:
- Popping or clicking sounds from the hip joints can either be heard or felt.
- The length of your child’s legs is unequal.
- One hip or leg has mobility issues as compared to the other.
- The skin under their buttocks or thighs has folds that don’t align evenly with the other side.
- Your baby shows a limp when beginning to walk.
Infants showing any of these symptoms need an immediate visit to the doctor and have their hips examined with a few test methods. The Barlow test is one such physical assessment of infants to search for developmental hip dysplasia. Barlow’s test detects posterior dislocations or sublimations. Diagnosing and treating developmental dysplasia of the hip in the early stages means you have a better chance for full recovery of your child.
How is Hip Laxity Different from DDH?
Many infants are born with loose hips known as neonatal hip laxity. It occurs when the bands of tissue connecting one bone to the other (ligaments) are extra flexible. Neonatal hip laxity generally gets better by itself at four to six weeks of age and is not categorized as true hip dysplasia. However, if a baby experiences hip laxity after 6 weeks, they might require treatment.
Who can Experience Hip Dysplasia?
Any infant can experience DDH. Alternatively, there is a higher probability of being born with DDH if the baby is:
- A girl (birth-assigned sex)
- First-born child
- Were breech babies in the womb with their buttocks down instead of having their head down. This counts especially if the breech occurred in the third trimester.
- Have a family history of hip dysplasia.
It is rare to see a baby not born with DDH developing after birth. To prevent this from happening, refrain from swaddling a newborn baby’s hips and legs too tightly. Always make sure that their legs have plenty of room to wiggle around.
You will need to consult with a pediatric orthopedic surgeon (specialist in conditions affecting children’s bones). The goal of their consultancy and treatment is to move the ball of the hip into the pelvic socket and keep it that way for the joint to grow naturally.
The surgeon picks their treatment course depending on the age of the child, which can be:
- Closed reduction and casting
- Open reduction surgery and casting
The path of treatment used for infants younger than 6 months is usually a brace. The Pavlik harness is the most commonly used brace. It comes with a shoulder harness to be attached to foot stirrups. This puts the infant’s legs into a position guiding the ball of the hip joint and the socket together.
This course of treatment lasts 6-12 weeks and is highly effective. Most children don’t need other courses of treatment.
On occasion, if the harness can’t keep the hip ball in the pelvic socket, the doctors might resort to:
- Closed reduction where they manually move back the ball into the socket and cast it
- Open reduction surgery and casting
Closed Reduction and Casting
A baby might need this procedure if:
- The harness did not do a good job at keeping the ball of the hip and socket aligned.
- A baby starts treatment post 6 months of age.
At times, the orthopedic surgeon may be required to loosen the tight muscle in the groin area during a closed reduction procedure.
Open Reduction Surgery and Casting
A baby might need open reduction surgery if:
- The closed reduction did not help to keep the ball of the hip inside the socket.
- The baby crosses 18 months of age while beginning their treatment.
As you can see, there are many ways to treat dysplasia of the hip or DDH. It is inevitable to worry as a parent, but if the doctor detects the dysplasia on time (and you have plenty). There is a high success rate that a brace will work. We hope that we could put your mind at ease with this information and give you some insight into what to expect.