Hip Dysplasia in Infants

What is Hip Dysplasia in Infants?

Hip Dysplasia, also known as the Developmental Dysplasia of the Hip (DDH), is a hip joint deformation which is usually present at birth in patients. This congenital disorder can lead to various developmental problems and physical deformities as a child grows up.

Hip Dysplasia in Infants Incidence

According to statistics, 1 in every 4 babies in breech position develops symptoms of DDH.  About 1 out of every 8 babies having a parent suffering from the disorder is affected by it. Girls are more likely to have this Dysplasia as compared to boys.

Causes of Hip Dysplasia in Infants

The exact factors responsible for the development of DDH are not known. However, various risk factors of the condition have been identified. An abnormal position of the baby in the womb (breech position) can lead to this deformity. Family history is another important risk factor as it is a genetic condition. An infant may have the disorder at birth if one or both the parents are carriers of the defective gene responsible for it. Some other risk factors are mentioned below:

• First-born girls
• Mother aged over 35 years
• Hip click at the time of birth
• Birth weight over 4 Kg (8 lbs, 13 oz)

Signs and Symptoms of Hip Dysplasia in Infants

DDH does not cause any pain in affected infants. However, the condition results in partial or complete dislocation of the hip, leading to the development of various symptoms.

• The affected hip joint seems loose and comes out of place with movement
• One leg may be shorter compared to the other
• Uneven folds of skin may be noticed on the insides of the thighs and buttocks
• The dislocated hip joint moves in a different way than the other one
• There may be a wider than normal space between the two legs of the baby
• The affected side may have less flexibility and mobility

Prevention for Hip Dysplasia in Infants

It is not possible to prevent this congenital condition as it results from many unknown factors. In some cases, however, its advancement can be prevented by taking a few measures such as swaddling the baby in a manner that does not harm his or her hips as well as choosing the right carriers and slings for the infant. But such measures are not useful if the newborns are severely affected by the dysplasia.

Diagnosis of Hip Dysplasia in Infants

Sometimes, DDH is detected at birth by the abnormalities in the physical appearance of the child. In most cases, however, it is diagnosed with ultrasound. Some gentle manipulations are performed by a neonatologist (newborn specialist) or pediatrician for screening a newborn for DDH. However, it is not detectable at this stage in many cases.

Since this form of Dysplasia often goes undetected at birth, it is generally noticed by an evaluation in infancy. A thorough physical examination can help the pediatrician detect any instability in the infant’s hip joint. A doctor also studies the family history of the child to see if there is any family history of the disorder. The diagnostic tests used for the purpose include:

Ultrasound (Sonography)

It is the most preferred diagnostic method used for infants aged less than 6 months. It is useful for detecting a dysplastic hip (faulty development of the hip socket) or dislocated hip (femur is not in the socket).

X-ray

This diagnostic radiology is necessary for diagnosing DDH in babies aged over 6 months.

Hip Dysplasia in Infants Treatment and Management

The treatment for this condition may vary from one patient to another depending on one or more of the following factors:

• The gestational age, medical history and overall health of the baby
• The infant’s tolerance for certain medications, therapies and procedures
• The severity of the condition
• Expectations for the disorder’s course

The main object of the treatment is to restore the normal position of the dislocated femoral head to allow the hip to develop normally.

Non-surgical Treatment

The non-surgical treatment comprises of placing different restorative devices like the Pavlik harness for correcting the abnormality. This device is used in babies younger than 6 months. The baby needs to wear the harness all day for the first 6 to 8 weeks and then for 12 hours a day for the next 6 weeks. It is important to take the child to his or her pediatrician for regular checkups during this time. Once the treatment ends, the doctor performs x-rays and/or ultrasound to check the hip placement of the patients. It is possible to cure DDH with Pavlik harness. But in some cases, the hip continues to be dislocated even after the treatment.

Casting

Casting is a surgical procedure which can be used to treat a partial or complete hip dislocation.

Physical Therapy

In some instances, the patient may need proper physical therapy following a corrective surgery to maintain the normal mobility of the hip joint.

Surgery

Surgery may be necessary for treating the disorder if all the other treatment options fail and if the condition is diagnosed in babies more than 6 months old. The hip is manually restored in its normal position during the surgery. This procedure is commonly known as “closed reduction”.

Hip Dysplasia in Infants Prognosis

Early diagnosis of DDH makes it possible to begin the treatment as early as possible. This generally has a positive prognosis, allowing the child to achieve complete recovery. Many patients respond well to Pavlik harness and casting. The baby may need some additional surgeries in case of any recurrence of the condition. Long term effects may include change in gait and a decreased agility.

Hip Dysplasia in Infants Pictures

Here are some pictures to help you find out how the dislocation of the hip affects the appearance of a newborn.

Picture 1 – Hip Dysplasia in Infants

Picture 2 – Hip Dysplasia in Infants Image

Hip Dysplasia is a fairly rare genetic condition which is often present at birth of the patient. Infants suffering from this physical malformation can lead a long and normal life with early diagnosis and timely treatment.