Pediatric Hip Dysplasia: Any Mother’s Nightmare

Like most mothers- to- be, Daniela wanted nothing more than to give birth to a healthy baby.  As a child, she had endured months of surgery and treatment to correct her pelvic deformity, clinically known as Hip Dysplasia. Her medical professional told her since Hip Dysplasia was a genetic disorder, there was a very good chance that her baby girl would be susceptible to it.  Daniela earnestly hoped that her doctor was wrong and that her child would be spared such a diagnosis.

What is Pediatric Hip Dysplasia?

Hip Dysplasia, also known as Congenital Dysplasia of the Hip, or simply Dysplasia of the Hip, “is a condition of the hip joint that occurs once or twice in every 1,000 live births.” (The Boston Children’s Hospital)

In a healthy pelvis, the acetabulum (hip socket) is deep enough for the femur (thigh bone) to fit securely. In someone afflicted by hip dysplasia, either the acetabulum is too shallow, or the femoral head is too small or too large to fit properly into the socket.

Hip Dysplasia “occurs once or twice in every 1,000 live births.” (The Boston Children’s Hospital)

Hip Dysplasia Risk Factors

• Being born a girl
• Being a first born child increases the risk of Hip Dysplasia  “since the mother’s uterus provides limited toom for the baby to develop and move." (The Boston Children’s Hospital) This can adversely affect the normal development of the pelvis.
• If the infant comes from a family with a history of “developmental dysplasia, or very flexible ligaments,” (The Boston Children’s Hospital) it is highly probable that they will have Hip Dysplasia.
• The position of the baby when it comes out of the vagina is crucial. Babies are supposed to be born head first. If they emerge bottom first, this could cause Hip Dysplasia. 

What are the symptoms of Hip Dysplasia?

A child with hip dysplasia will usually display one or more of the following:

• Their leg is short on the side of the malformed hip
• Their leg on the side of the malformed hip turns outwards at an awkward angle
• The folds in the skin of their thigh or buttocks appears uneven
• The space between their legs appears wider than normal

(The Boston Children’s Hospital)

How is Hip Dysplasia diagnosed?

After a strenuous birth, Daniela delivered a baby girl. The child was taken into a separate room by the doctor for medical tests and screening.  Fortunately, all of the baby’s vital signs were good, but the odd formation of the baby’s waist and legs could not be overlooked.

Major physical deformities can be seen with the naked eye, but a medical professional (usually an on-site pediatrician or newborn specialist) will take the newborn baby into a special room for further analysis.  Some of the diagnostic procedures they might conduct include:

Magnetic Resonance Imaging (MRI)- This procedure utilizes a “combination of large magnets, radiofrequencies and a computer in order to produce detailed images of organs and structures within the body.” (The Boston Children’s Hospital)

X- Ray- This test uses “invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film.”  (The Boston Children’s Hospital)

Ultrasound- (alternate name, sonogram)-  This test involves the use of “high frequency sound waves and a computer to create images of blood vessels, tissues and organs.” They permit a medical professional to “view internal organs as they function, and to assess blood flow through various vessels.” (The Boston Children’s Hospital)

How is Hip Dysplasia Treated?

Fortunately, Hip Dysplasia is highly treatable, but if left untreated, it can leads to all kinds of complications including limping and arthritis, which may necessitate hip replacement surgery. Thus, medical professionals advise that immediate action be taken to rectify the problem, while it is still possible to do so.

A doctor will work with the baby’s parents to determine the best course of action, while keeping the following criteria in mind.

• The baby’s age
• The baby’s overall health
• Family medical history
• The extent of the condition
• The baby’s tolerance for specific medications, procedures or therapies

Possible types of treatment for babies with Hip Dysplasia include:

Palvik Harness:This device is most typically reserved for babies up to 4 months of age. It keeps the baby’s pelvis in place, without completely compromising leg movement. “It is worn full time for at least six weeks, then part- time (approximately 12 hours per day) for another six weeks.” (The Boston Children’s Hospital) During this period, the baby’s physician will monitor whether or not the harness has rectified the problem.

Traction: If the Palvik Harness is not effective, traction may be required. “Traction is the application of a force to stretch certain parts of the body in a specific direction.” (The Boston Children’s Hospital) It can be done through the use of pulleys, strings, weights and a metal frame attached over or on the bed where the baby is situated. A newborn’s body is highly flexible, so traction can “stretch the soft tissues around the hip to allow the femoral head to move back into the hip socket.” (The Boston Children’s Hospital) This procedure lasts up to two weeks.

Surgery and Casting:As explained, the longer the parents wait to treat their child’s hip dysplasia, the more complicated the treatment will be. The older a child gets, the less flexible their tissues are, which renders the first two treatment options ineffective. In the surgery and casting procedure, “a medical professional manually puts the hip back into place, then utilizes a spica cast to hold the pelvis together.” (The Boston Children’s Hospital) The spica cast stays on the hip till it returns to normal placement. After the procedure, physical therapy may be employed to strengthen the muscles and bones of the child’s waist and legs.

As part of our ongoing commitment to providing the public with important information pertaining to the Depuy implant recall and related areas, Weitz & Luxenberg updates these pages frequently with the latest available data. Should you have any questions, comments or concerns,  do not hesitate to contact us.

Acknowledgments:

The Boston Children’s Hospital: http://www.childrenshospital.org/az/Site706/mainpageS706P0.html

About.com: http://orthopedics.about.com/od/pediatrichipinjuries/a/dysplasia.htm

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