Hip dysplasia – diagnosis and treatment

Proven content

Hip dysplasia is an inborn, defective hip. It is one of the most common birth defects among white people.

What is hip dysplasia?

Hip dysplasia is the most common birth defect involving deformation of the hip. It is most often found in the female sex and may coexist with other birth defects. This defect was also found in the family.

Dysplasia can occur in two forms: as pure dysplasia, characterized only by defective hip shape, and dysplasia with the displacement of the femoral head beyond the acetabulum (congenital dislocation of the hip joint).

In a typical form of dysplasia, the newborn is born with the defect without dislocation of the hip. The fetal development of the hip is specific as it develops in flexion, so that the hip joint of each newborn has a weakened compactness. The hip extension is particularly detrimental to the compactness of this joint. The newborn defends against this movement by keeping its hips physiologically bent. For this reason, sudden or prolonged extension of the hip joints should be avoided in the postpartum period. That is why the most physiological position of the limbs is that of the children of the peoples, where mothers straddle their torso.

Early detection of hip dysplasia and early treatment give the opportunity to manage the development of dysplastic hip until it is fully healed.

Hip dysplasia – causes

Problems related to hip dysplasia may occur in utero. However, at the perinatal stage, these changes may intensify. While the specific causes of a child’s illness are not known, there are certain factors that increase the risk of dysplasia:

1. genetic disposition – hip dysplasia is more common in children whose parents or siblings were born with dysplasia;
2. baby’s pelvic position during pregnancy – very common in twin / multiple pregnancies because there is little space in the uterus;
3. bad leg curling by a child in the womb (at the end of pregnancy) – it is related to a small amount of space in the woman’s uterine cavity; abnormal leg curl may cause the femoral head to fall out of the acetabulum;
4. straightening of a newborn’s legs due to improper care; Straightening the naturally contracted legs forcibly may dislocate the femur of the joint;
5. relaxin hormone – this is a hormone that appears in the woman’s body in the last trimester of pregnancy and is designed to relax the pelvic joint. In a child, it can loosen the articular ligaments, which contributes to the development of dysplasia.

Hip dysplasia – symptoms

In the course of hip dysplasia, the following occurs:

1. shifting the femur beyond the joint, i.e. hip instability – in the first weeks of a child’s life, jumping is felt in the hip joint during abduction and adduction of the legs;
2. limitation of abduction of the legs in the hips – after the neonatal period, tilting the legs to the sides is much more difficult.

When should you see a doctor?

You should see your doctor if your child:

1. places the legs in an unnatural and uneven way,
2. gives the impression that it could not open the legs to the sides,
3. the folds between the child’s buttocks and thighs are arranged unevenly on both sides (however, this does not always indicate hip dysplasia; sometimes it can be simple asymmetry),
4. the baby starts crying when you touch his feet or move them,
5. one leg appears longer than the other.

Hip dysplasia – diagnosis

Diagnosis of dysplasia in a newborn baby it is very simple, it only requires checking the hip for two symptoms: jumping and limiting abduction. These examinations may be extended with ultrasound examination of the hip joints. Ultrasonography, as a non-invasive method, enables early diagnosis of hip joint hypoplasia and control of treatment progress. That is why it is worth having an ultrasound of the hips in every child. However, it should be remembered that the referral is issued by an orthopedist or family doctor. This examination is safe and painless, there is no need to specially prepare the toddler. It is worth for the doctor performing the examination to be certified by the Polish Ultrasound Society. The symptom of the unevenness of the folds is not characteristic of dysplasia. Nevertheless, it is important, as it causes anxiety in mothers who seek advice from an orthopedist.

Hip dysplasia – treatment

Treatment of dysplasia It is extremely simple and consists in slowly, gradually overcoming the resistance of the shortened muscles, thus limiting the Abduction until the Abduction is complete. The essence of treatment is the centering of the femoral head to the bottom of the acetabulum. Such a centering of the head relieves the underdeveloped upper edge of the acetabulum. To maintain this position of the hip, various types of stays are used, e.g. Frejka cushion, Pawlik harness, Koszla rail. Untreated dysplasia does not limit the child’s activity to develop healthy and normal, which is why it has been overlooked. Symptoms are more pronounced when dysplasia is joined by a subluxation or sprain of the femoral head, accompanied by shortening of the leg and walking limp. They require surgery.

If ignored or overlooked, hip dysplasia manifests itself in the pubertal period, then fatigue appears, pain in the knee, and then in the hip. Women often experience pain after giving birth to their first child. It is the result of early degenerative changes in the hip against the background of persistent dysplasia.