hip dysplasia in children

Hip dysplasia in babies: is it serious?

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine

Your baby has trouble spreading one of his legs ? Or, his legs are not symmetrical? What if it was hip dysplasia ? In fact, some babies are born with a hip problem which sometimes leads to dislocation of the hip bones. The hip dysplasia affects infants at birth, especially girls.

What does the hip dysplasia in babies ? What are its causes ? How to make the diagnosis? Are there treatments? We will discover the essentials to know about this pathology in this popularized article.

Definition of Hip Dysplasia

La hip dysplasia is a term used to describe a congenital anomaly of the hip. It corresponds to an abnormal development of the hip joint, in particular a lack of maturation of the acetabulum (or acetabulum) which fails to encompass the femoral head.

The acetabulum (or acetabulum) is the articular cavity of the iliac bone. It is the acetabulum and the femoral head that mainly constitute the hip joint.

Initially, the structure of the acetabulum consists only of a bony part and a cartilaginous part. With age, they evolve and form bone tissue to give the definitive acetabulum. This ossification largely depends on the interaction of the acetabulum with the femoral head.

La hip dysplasia can present with or without dislocation of the joint.

When it is without dislocation, the femoral head is well integrated into the acetabulum. But, there are risks of dislocation, especially with pressure on the femur. This causes stress for the cartilaginous bone part of the acetabulum and hinders its maturation. In this case, the dysplasia is likely to degenerate.

In the case where the femoral head has moved outside the acetabulum (dislocation of the femoral head), there is not the slightest contact between the femoral head and the acetabulum. Thus, the treatment is more complex.

Causes of hip dysplasia in babies: Is it related to childbirth?

Several causes can be at theorigin of hip dysplasia in babies. The seat position of the baby in the mother's belly is one of them. In this position, the baby's head remains up. At the time of childbirth, it is his feet that come out first and are in extension. This can lead to joint dislocation and hip dysplasia in the baby.

La hip dysplasia can also be of hereditary origin. A baby in which one of the two parents or certain members of the family has already presented with dysplasia or hip dislocation has a greater risk of suffering from it.

There are also other factors that can cause hip dysplasia in babies, as :

  • a baby weighing more than 4 kilos;
  • twins with hips bent in flexion;
  • low volume of amniotic fluid;
  • too high blood pressure of the mother during pregnancy;
  • the fetal reaction to maternal estrogen.

How is the diagnosis made?

For any hospital birth, the screening for hip dysplasia in newborns is done systematically. This takes place during the clinical examination carried out by the midwife or the pediatrician in the first 24 to 48 hours after birth.

In the event that one of the parents, the brother or the sister of the baby presents this disorder, the infant automatically benefits from screening in the first weeks of life.

Diagnosis is essential even if hip exam at birth appears normal. It is also essential if the risk factors for the disease are present.

Le diagnosis of hip dysplasia in children mainly based on clinical examination. He understands :

  • assessment of the degree of abduction of the infant's hip: it must be greater than 60°;
  • the Barlow manoeuvre: it allows to discover the instability of the hip by the presence of a jump;
  • observation of buttock folds, leg length and hip mobility.

If hip dysplasia is suspected on physical examination, further examination should be performed to confirm the diagnosis of the disease. This is an ultrasound that will highlight a hip dislocation of the baby.

The delay in diagnosis may evoke a congenital dislocation of the hip in the baby. The latter will generate lameness from the start of the child's walk as well as chronic pain and early degenerative damage.

here are some characteristic signs of hip dysplasia that you can try to look for in your child:

  • the position of her thighs is asymmetrical;
  • the skin folds of his thighs (around the groin and the buttocks) are not the same;
  • his legs are not the same length;
  • you can't spread both thighs symmetrically.

The prognosis of hip dysplasia in babies

Regardless chosen treatment for hip dysplasia in babies, the prematurity of the intervention is one of the factors determining the success of the treatment.

The success rate for the treatment of this anomaly is more than 90%. In the majority of patients, the result is satisfactory.

In children aged between 12 and 18 months, the treatment is more complex and requires several interventions. Thus, the success rate is inconsistent.

In young adults, dysplasia can cause hip osteoarthritis early (before age 30). Only hip joint surgery can cure it.

Treatments indicated for hip dysplasia in babies

La hip dysplasia is an anatomical deformity. Thus, the processing is then based on a orthopedic treatment which follows several steps.

The intervention usually consists of reduce the dislocation by keeping the femoral head in the acetabulum. To achieve this, it requires “accessories” or processing tools.

The abduction cushion

Le abduction cushion is also called abduction pants. It has the shape of overalls with suspenders. It has a small semi-rigid cushion between the legs. This cushion is used to hold the baby's little legs apart, in the position where the femoral head is well in its joint. This tool should be worn night and day.

The cuddly diaper

Le cuddly diaper is based on the same principle as the abduction cushion. However, it does not have straps. Thanks to its H shape, it keeps the baby in the "frog" position. It is thus less bulky. Parents prefer it more than the abduction cushion. But, we must not forget that it is up to the doctor to choose the device best suited to the child.

Pavlick's Harness

Also called the pavlick-bandage, Pavlick's harness is a heavy treatment. It has a strap system to keep the baby's legs apart. With this device, the gain of the spacing of the hip is done in a progressive way. This tool is preferred when the diagnosis of the disease is late.

The choice of tool treatment of hip dysplasia in babies is done according to the degree of involvement of the hip. However, these devices have limitations. If the diagnosis is too late and the dislocation is too large, these devices will no longer be effective. Indeed, the stresses on the head of the femur will become more critical, possibly even leading to a hip necrosis. In this case, consider inpatient treatment.






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