6 Things to Know About Developmental Hip Dysplasia in Babies and Young Children
Every parent knows that special attention should be paid to the development of hips in newborns because this is the period when hip joint disorders occur. With early diagnosis of developmental hip dysplasia and timely initiation therapy, the disorder is corrected without consequences.
For this reason, it is necessary to perform an examination of the hips on the recommendation of a pediatrician.
Developmental hip dysplasia can manifest as a shallow cup of the hip joint or dislocation. It occurs before birth or after birth, and if left untreated at a later age can lead to lameness and shortening of the leg, and in adulthood due to cartilage damage to the deterioration of the hip joint or disability. If this incorrect position remains, the function of the hip is disturbed, and over time, the joint head deteriorates due to the disturbed blood supply. Correction, ie. insert-ion of the particular head into the cup is possible with special prostheses, and if done in time, the development of the joint is completely normal.
So, although this type of disease is present as much as humanity exists, there are some basic things that many do not know.
1. Dysplasia is most often congenital
At birth, the baby’s femoral head has not yet ossified (it consists of soft cartilage), and the cup that will accept it is not always equally well-shaped. If the head and cup do not fit well into each other, dysplasia will occur.
During the last month before birth, the space inside the uterus can become overcrowded and thus the hip joint can move out of its proper position. That is exactly the reason for the next step.
2. Hip ultrasound
Hip dysplasia or immaturity in babies is important to notice in time and therefore it is extremely important to examine the hips of a newborn at an early age, no later than 3 months of age, in order to start treatment on time if necessary. In the case of non-treatment, permanent problems with the hips can occur. It is important to know that hips develop up to 18 months of age, so most children born with “immature” hips are corrected by exercise or simply, with growth, and are not needed. no major interventions.
It is a developmental deformity that develops and changes, and there can be no spontaneous healing or deformity. There are believed to be several causes of developmental hip dislocation. One of the causes is the action of maternal hormones in pregnancy that enter the baby’s bloodstream, and under the influence of hormones, the connective tissues and joints become loose, which can result in the developmental disorder of the hips. Female children are especially susceptible to the action of maternal hormones. Of course, there are other external influences, such as the position of the baby during pregnancy.
4. It is curable
The good news is that this deformity will not have any consequences if the treatment is started on time, which means as soon as possible. Orthopedic treatment should be started after 3 weeks of age in a child who has been diagnosed with complete or partial hip dislocation by clinical and/or ultrasound examination. It is performed with a special orthopedic device, the so-called Pavlik’s straps (although there are other types of similar prostheses, Pavlik’s straps are the most widely accepted due to their practicality). The hips are fixed in the extended position of the legs, worn without interruption for 6-8 weeks in case of partial dislocation, or 10-12 weeks in case of complete dislocation. There are also many exercises that contribute to improving the condition of the child. What is important to note is that the longer you wait, the weaker the effect. For example, if the therapy is started after the child is one year old, there is little chance that the joint will return to a completely correct position.
However, even then, one should not lose hope because there are many treatments that can improve the condition, whether it is a combination of exercises or surgery. Developmental dysplasia of the hip is a deformity that can be lived with and that can be alleviated even in the elderly.
5. How to recognize a deformity?
The first and most obvious sign of recognizing this deformity is crooked legs, ie the position of the legs where' the feet are turned inwards. In babies, it is easy to recognize by the asymmetrical fold on the buttocks. This phenomenon may indicate a dislocation of the hip due to a difference in leg length. However, it is necessary to have an examination by an orthopedic specialist and diagnostic treatment that includes an ultrasound of the hips and, if necessary, X-rays. Also, one of the indicators is the limited movement of the baby/child, which is especially noticeable when changing diapers. When we talk about pain, it is present in the elderly with dysplasia, but not in babies and young children.
6. What happens if a developmental disorder of the hip is not recognized in time or is treated improperly?
If the developmental disorder of the hip is not recognized in time or is improperly treated, a deformity in the hip is left behind which can manifest as leg shortening, limping, and pain. In milder cases, these disorders may appear only years after the start of walking.
As we can see, prevention is the best cure. It is important to do everything that’s in your power to avoid it. So, ultrasound between- the 4th and 6th week of the baby is more than recommendable, but even if you skipped it, do not worry, because this is a problem that definitely has a solution.