Hip joint is a ball & socket type joint. Sometimes the hip joints of an infant do not develop properly during early stages of foetal development. It results in to the unstable hip since birth. A careful examination can detect it early and can be treated early with good results. If left untreated can results in serious joint problem with gait abnormality.
Many theories have been given for possible cause of this problem like intrauterine position of baby, less amount of amniotic fluid in the mother’s womb.
Risk factors like first baby, female child, breech position of baby, family history of same disorder should be watch carefully.
One can easily find abnormal creases around hip, limb length discrepancy, abnormal posture of limb and abnormal mobility of lower limb.
Normally, an orthopaedic surgeon diagnoses congenital hip dislocation by examining the child’s hips and legs carefully. Barlow and Ortolani test are to be performed to diagnose the status of hip. These tests are screening test.
Recently Ultrasound of hip gives us accurate status of hip dysplagia. Ultrasound is a non-invasive and safe mode of investigation with high accuracy rate. X-rays can be done to diagnose the DDH if age of child is old.
Treatment is depending on age and status of hip. If child is younger than six months then closed reduction and pavlik harness is helpful or closed reduction and spica cast can be given for few weeks. If it fails then it require surgery by performing either open reduction or closed reduction followed by casting.
Q: – Why it happened in my child??
A: – There are many possible reasons for this but intrauterine position, space in mother womb are two most common reasons. Others like first female child with family history of same disease also in risk.
Q: – Can we diagnose it before delivery??
A: – Yes, with USG level 1 or 2
Q: – Will it affect future growth of hip and will it cause limp??
A: – If diagnosed early and treated appropriately then results are fairly good. If remained untreated or diagnosed late then results are not as good as it should be. Hence early the treatment better is result.
Child Ortho Care
Child Orthopedic Surgeon & Consultant, Delhi