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“A hip dislocation is when thethe head of the femur, the thigh bone, does not articulate in a good position in contact with the pelvic bone », Explains Professor Raphaël Vialle, head of the orthopedic and reconstructive surgery department at the Armand Trousseau hospital in Paris. “In the very smallest baby, the head of the femur is no bigger than a quail egg and can come out of its normal location. Then the joint grows badly, becomes deformed, and the more time passes the more difficult it is to treat ”.
Congenital dislocation of the hip: the diagram to better understand
Hip dislocation: early examinations and treatment
When the pediatrician who has just examined your baby immediately after birth announces that you have a congenital hip dislocation, don’t worry! The term sounds barbaric but the problem is frequent (6 babies in 1000) and is treated very well … especially if it is treated from birthTo ensure early detection, the hips of all babies are examined at the maternity ward. “In the event of a dislocation, the child is in abduction, that is, the legs kept apart and in the correct position, to prevent the hip from remaining in the dislocated position. For this, we use a ” cuddly swaddle ” : a big very thick layer that we put between the thighs in addition to the layer ”. Duration of treatment ? “Ideally four months, to be sure that stabilization is as complete as possible, ”said the Professor. “Babies of this age are almost always lying down, so they are not bothered by the treatment.” Around a month and a half, an ultrasound of the hip will confirm that it is stabilized and has normal growth. The infant will be seen again at four months with an x-ray when stopping the cuddly swaddle, then at walking age with a final x-ray.
Congenital dislocation: babies “at risk” are more followed
Certain children at risk require careful screening: in addition to the clinical examination of the hips at birth, an ultrasound is done at a month and a half. “The risk factors are very well identified: there is the family history when a brother, a sister or one of the parents has already been treated for a congenital dislocation of the hip; babies over 4 kilograms, who may have gotten stuck in awkward positions in late pregnancy, twins, and babies born in breech. Normally, with these measurements, almost all dislocations are detected in the first few weeks. And in the majority of cases, placing the hips in abduction stabilizes them and subsequently guarantees harmonious growth without sequelae. “
Congenital dislocation: in case of late screening …
“If the dislocation is detected late, after several months, the hip will often be stiffer and difficult to put back in place. The child can then be put on traction (a device with weights that pulls on the leg) for several days in the hospital before being immobilized by a cast and sometimes operated. Whatever the delay, it is always possible to offer a treatment, but it will be much more cumbersome and restrictive ”.
Author: Hélène Bry