Hip Dysplasia in Infants

Hip dysplasia in infants is often discovered when you take newborns to your physician for examinations, but it sometimes develops after this time in many children. So experts consider this condition to be developmental. It doesn't cause any pain in babies and often goes undetected – it is, therefore, referred to as a "silent" condition. It is important to learn a bit about this condition to help your little one deal with this problem.

What Is Hip Dysplasia in Infants?

Hip dysplasia or developmental dysplasia of the hip (DDH) is a problem that babies are usually born with – it sometimes shows up in the first year of their lives. It refers to a condition in which the top of the thighbone of your baby cannot fit securely in the hip socket. The problem can affect one or both of the hip joints.

Under normal circumstances, the thighbone will always fit tightly in a cup-shaped socket in the pelvic region of a baby. The combination of tendons, muscles and ligaments keeps this bone in its position. But in babies with DDH, the hip socket is often too shallow and the tissues around the joints may also be quite loose. Early diagnosis is important to correct this issue and to prevent long-term hip problems.

What Are the Symptoms of Hip Dysplasia in Infants?

As mentioned earlier, it is called a "silent" condition mainly because it often comes with no symptoms at all. Here are some symptoms that infants with hip dysplasia may experience.

  • Reduced movement on one side of the body;
  • Leg of your baby may appear to turn out more than normal;
  • Leg of your baby may look shorter on the side with the dislocation that makes your child to walk on their toes;
  • Uneven skin folds of buttocks or thigh;
  • The affected leg may turn outward after your baby is 3 months old. You will notice some specific signs of dislocation when your child begins walking. This may include limping or waddling while walking and lower back of your child rounded inward.

What Causes Hip Dysplasia in Infants?

Just like your shoulder, your hip has a ball and socket joint. The ball, also called the femoral head, forms the top part of your thighbone, also called femur, whereas the socket forms in your pelvic bone. In case of hip dysplasia occurring to infants, you will notice that the socket is a little too shallow that causes the ball to slip out of it.

The real cause of this condition is still not clear, but low levels of amniotic fluid in the womb may have something to do with this condition. Some other risk factors include:

  • Being female
  • Being the first child
  • Family history of the disorder
  • Breech position when you were pregnant
  • Large birth weight

How Is Hip Dysplasia in Infants Treated?

When detected at the time of birth, your doctor will try to correct it by using a brace or harness. This condition may go undetected and doesn't appear at birth. It means you may only notice it once your child begins walking. The treatment becomes more complicated if you don't detect this condition early.

Non-Surgical Treatments for Hip dysplasia in infants

A number of nonsurgical treatments are available for this condition; however, the effectiveness of these treatments usually depends on your child's age.

  • Newborns: The doctor will place your baby in a Pavlik harness, a soft positioning device that helps keep the thighbone in the socket. This special brace works really well to keep the hip in position while allowing free movement of the legs. It also helps tighten the ligaments around your baby's hip joint. This promotes normal hip socket placement. You will have to learn how to use the harness properly while performing daily care tasks, such as bathing, diapering, dressing and feeding.
  • 1 month – 6 months: The treatment is quite similar to the first one because the harness is used here to reposition your baby's hip. Your baby usually needs to wear the harness for at least 6 weeks. Once you notice improvement, you can use it occasionally for another six weeks.

In some cases, a harness won't prove effective. If that's the case, your doctor may use an abduction brace, which is made of firmer material. It helps keep the legs of your baby in position. Sometimes, your doctor may stick to a closed reduction procedure that involves moving your baby's thighbone into position and securing it with a body cast. You will have to follow specific instructions when your baby is in a body cast. Work with your doctor to learn how to take care of your baby while he or she is still in a Spica cast and what to do when you notice any problems.

  • 6 months – 2 years: Closed reduction is usually the only treatment option for older babies, but sometimes a healthcare provider may stick to skin traction for a few weeks before they reposition the thighbone. This procedure helps prepare the tissues around your baby's hip for the change.

Surgical Treatments for Hip dysplasia in infants

For older babies, you have no choice but to go for a surgical treatment.

  • 6 months – 2 years: You will have to opt for an open surgery when a closed reduction fails to put your baby's thighbone in position when he or she is about 6 months to 2 years old. The procedure involves making an incision at your baby's hip to reposition the thighbone. A surgeon may find it better to shorten the thighbone to place it properly into the socket. The child will have to use a body cast after the procedure.
  • Over than 2 years old: Open surgery is the only option when your child is older than 2 years old because the looseness worsens with time. Your doctor will perform a surgery to realign the hip and apply a Spica cast to keep it in position.

Most treatments for hip dysplasia in infants will fix the issue in 2-3 months, but regular checkups are essential after treatment.

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