WhenParentsIf you notice that your little one’s legs are not the same length, it could be because your baby has hip dysplasia. What causes hip dysplasia and can a baby’s legs return to being the same length as other normal children’s legs?
The following is an explanation of this, plus an explanation of carrying and swaddling positions to prevent babies from hip dysplasia.
What is Hip Dysplasia?
Hip dysplasia caused by swaddling that is too tight. Source: hipdysplasia.org
Developmental dysplasia of the hip (DDH) or hip dysplasia is the medical term for a bone socket that does not completely cover the ball of the thigh bone at the top of the hip of a baby or child.
Simply put, it is a condition where the femur (thigh bone) does not fuse with the pelvis as it should. This condition is also often referred to as congenital hip dislocation.
The hip joint’s job is to attach the thigh bone (femur) to the pelvis. At the top of the thigh bone (femoral head) is something round like a ball that sits in a cup-shaped hip socket.
In DDH, the hip socket is too shallow and the femoral head is not held firmly in place, causing the hip joint to loosen. In very severe cases, the femur may even come out of the socket (dislocate)—partially or completely.
Mild cases of hip dysplasia may not cause symptoms until a person is a teenager or young adult. But in severe cases, hip dysplasia can damage the cartilage lining the joint, and can also injure the soft cartilage (labrum) lining the socket of the hip joint—this is called a hip labral tear .
Hip dysplasia can be detected shortly after birth, during a physical examination of the baby . If hip dysplasia is diagnosed early in infancy, treatment can be started right away – the baby is given a soft brace to correct the hip problem.
Frequency of Occurrence
Quoting the pageCleveland Clinic, at least about 1 in every 1,000 babies are born with hip dysplasia. Generally, sufferers are more experienced by girls and firstborns .
Hip dysplasia can occur in both hips, but is more common on the left side.
Causes of Hip Dysplasia
There are several causes of hip dysplasia. Among them are:
1. Dense Uterine Space
The hip joint is initially soft cartilage that gradually hardens into bone. Well, during the last month before birth, the space in the womb can become so crowded that the ball of the hip joint moves out of its proper position, and the socket is not deep enough to hold the femoral head in place.
Other factors that can reduce the amount of space in the uterus include first pregnancy, large baby, and buttocks size.
2. Congenital Conditions
Most people who have hip dysplasia are born with the condition. The term is developmental dysplasia of the hip (DDH) or congenital hip dislocation .
3. Genetics
Genetics or being passed down through the family could also be the cause.
4. Uterus Pressing on Hips
Hip dysplasia can develop if the baby’s position in the womb puts pressure on the hips.
5. Lack of Estrogen Hormone
Babies develop in the womb with estrogen produced by the mother. Estrogen is thought to promote relaxation of ligaments near the time of delivery, which can help with the birthing process. A lack of this hormone can potentially cause the baby’s hip ligaments to become somewhat looser and increase the risk of unstable joints.
Signs and Symptoms of Hip Dysplasia
Hip dysplasia can damage the cartilage, the tissue that supports these bones in the joint. It can also cause pain and problems ranging from an unstable joint to a dislocation (a bone moving out of place in the joint).
Signs and symptoms of hip dysplasia vary by age group. In infants, you may notice that one leg is longer than the other – usually the left hip is longer than the right.
When Parentschanging his diaper, you will notice one hip may be less flexible than the other. Once your little one starts walking, a limp may develop.
In addition, there are skin folds on the thighs, and there is a difference in movement between the right and left hips.
In adolescents and young adults, hip dysplasia can cause painful complications such as osteoarthritis or hip labral tears, activity-related groin pain, and in some cases the child may experience a sensation of instability in the hip. The child may experience a “clicking” or “popping” sound in the joint.
Hip Dysplasia Risk Factors
Not all hip dysplasia can be traced to a cause. Babies who are at risk of developing hip dysplasia are in the following positions:
- The baby is large or there is oligohydramnios , a condition in which there is too little amniotic fluid in the sac where the baby lives during pregnancy, which restricts the baby’s movement – the baby is cramped in the uterus.
- Reduced uterine fluid allows the fetus to move freely in the womb.
- Breech pregnancy position at 28 weeks of pregnancy.
- Other conditions that affect the baby’s position in the womb (for example, those that occur in babies who have permanent leg defects).
- Baby girls are at greater risk.
- First pregnancy or first child.
- Genetically inherited.
All of the above can reduce the amount of space in the uterus which then results in the baby feeling cramped so that the ball or femoral head comes out of its proper position.
Swaddling a baby with straight hips and knees can also cause hip dysplasia, you know, Parents .
Wrong Carrying Method Can Cause Hip Dysplasia
The wrong way to carry a baby (left) and the recommended way to prevent hyp dysplasia (right). Source: hypdysplasia.org
Orthopedists also advise parents not to carry babies with their legs extended downward with their hips too wide apart. This position places the femoral head (ball) close to the acetabulum (socket), and encourages deepening of the socket.
Even though doctors say that there is not much that can be done Parentsdo if your baby has congenital hip dysplasia, but at least you can prevent it from happening to children with normal hips by carrying or swaddling your baby properly.
Hip Dysplasia Diagnosis
Dr. Rosendahl’s 1994 note in the Journal of Pediatrics stated that hip dysplasia problems can be detected in the first 6 weeks of a baby’s life through a physical examination.
Baby
Your doctor will check for hip dysplasia at the first appointment by gently moving your baby’s legs in different positions to see if the joints fit together. If your doctor suspects your baby may have dysplasia, an ultrasound will be performed during the first 3 months of life.
Teenagers and Adults
In older children, the doctor will perform a physical examination to look for:
- Pelvic tilt
- Leg length difference
- Muscle wasting
- Socket and ball adhesion
To check mobility in the hip, the doctor will do something called an impingement test, which is a method of flexing the hip by rotating the middle of the body. If a child has hip dysplasia, he will feel a pinched sensation.
To confirm the diagnosis, the doctor will recommend imaging tests, such as MRI to see how severe the child’s hip dysplasia is.
Required Care
Children with hip dysplasia require special care and equipment to align the legs and correct the baby’s hip posture. These treatments include:
1. Pavlik Harness
Pavlik harness is a device that is installed on babies under 6 months of age. This device will support the baby’s legs with the hips bent so that over time the hips will be able to return to their normal position.
The harness must be worn continuously for 6 to 12 weeks and should not be removed by anyone except a healthcare professional.
2. Spica Cast
Spica cast is a tool to balance the position of the waist, legs, and pelvis. The material used for this tool is plastic or fiber glass and can be used for 2-3 months.
This tool is used for babies over 6 months old. There are spaces on both legs to strengthen the child’s leg position.
3. Operation
Surgical procedures are needed to correct thigh or hip bone defects after the baby is 6 months old, or if the Pavlik seat belt does not help.
The most common operation is called reduction, which is a procedure where the femoral head is placed back into the hip socket.
After surgery, your child will need to wear a cast for at least 12 weeks. In the first 6 weeks, your doctor will check your baby’s hip to make sure it is stable and healing well. Then the cast will be reapplied for another 6 weeks.
4. Braces or Splints
Can be used as a replacement for a Pavlik harness or spica cast. Or they can be used after surgery.
5. Physical Therapy
A child who has had a spica cast may need to do exercises to regain movement and build muscle strength in the leg.
If your child has undergone the above treatment, it is likely that he will not have any more hip problems. Therefore, it is very important for Parentscheck the progress with the doctor.
Possible Complications
If hip dysplasia is left untreated, it can lead to painful, long-term problems. These include:
- Hip labral tear: Damage to the soft cartilage (labrum) that lines the socket of the hip joint.
- Osteoarthritis: Cartilage breakdown causing hip pain and stiffness due to higher contact pressures over a smaller socket surface.
- Joint dislocation: The bone slides out of place in the joint.
- Unstable joints: Looseness in the joints that causes pain and weakness.
In babies who wear casts for a long time, they may walk a little slower than expected. However, this delay in motor skills can be immediately followed by the child after the cast is removed.
Is There a Prevention for Hip Dysplasia?
Most cases of hip dysplasia cannot be prevented. To reduce the risk of hip dysplasia after birth, avoid wrapping or swaddling your baby too tightly.
Republished with permission from theAsianParent Indonesia
