Every infant should be referred to an orthopedist after the age of 6 weeks for hip joints evaluation. Some children are born with not fully developed joints, on average one in 20 has hip dysplasia. Although the baby will lie down for several months, it is already possible to detect and effectively treat any abnormalities that may hinder proper movement in the future.

To make it easier to understand what iship dysplasia in a child , imagine how they are built. Clench one hand into a fist, and embrace it with the other. Then move your fist around it all the time. The fist is the end of the femur, the so-called the head, and the hand is the acetabulum, that is, a depression in the bones of the pelvis. Although the head moves in different directions, its surface is still in contact with the surface of the acetabulum. Hip dysplasia occurs when the acetabulum is too shallow or too steep, and the femoral head is poorly fitted to it. The defect may affect one or both joints. The joint cannot develop properly, in addition, it is at risk of dislocation, i.e. loss of connection between the acetabulum and the head of the bone.

Hip dysplasia: causes

Hip dysplasia more often affects girls, children with multiple pregnancies and buttock births. Children with this defect are more often born in families where it has already occurred, e.g. with parents or siblings. The reason may also be incorrect positioning of the baby in the mother's abdomen, e.g. due to oligohydramnios, lateral position or high weight. It is important to detect abnormalities in the structure of the hip joints as early as possible. As a result, the treatment will be shorter and less painful.

You must do it

Visit the doctor when your child:

  • gives the impression that it cannot open the legs to the sides
  • arranges legs unnaturally or unevenly
  • you feel resistance and your baby cries when you touch or move his feet
  • one leg seems longer than the other
  • the folds between the buttocks and thighs are uneven on both sides

Remember! Uneven buttock folds, i.e. the grooves that form between the thighs and buttocks, do not necessarily indicate a defect in the baby's hip joints. They just happensometimes asymmetric also in he althy children. However, if you notice such an inequality, consult a doctor just in case.

Baby's first joint examination

While still in the hospital, after the delivery, a neonatologist (a specialist dealing with newborns) should examine the baby's joints. This is the first time a child has had a joint examination (ask the doctor if it has been done before discharge from hospital). You have to take care of the next ones yourself. It should take place after the baby is 6 weeks old, not later than 12 weeks (but better late than never, of course). To go to a pre-luxation clinic (which deals with the diagnosis of congenital and developmental joint defects) or simply to a pediatric orthopedist, a referral from a general practitioner is necessary.

Examination of hip joints at an orthopedist

Due to the waiting period for an appointment with an orthopedist, it is worthwhile to apply for a referral in the first month of the child's life (not necessarily with the child) and make an appointment with the orthopedist in advance. For examination by an orthopedist, the child must be completely undressed, also with a diaper. After all, the doctor has to assess the child's motor system. First, he will examine the baby's legs, compare the length of the thighs and the symmetry of the buttocks. He will also check the abduction of both legs to the sides (it is a bit like arranging the legs "on a frog"). The examination is not unpleasant for the child, it does not hurt him. If a baby cries during the examination, it is for another reason, e.g. because he is hungry or because he is cold.

Ultrasound examination of the hip joints

The doctor will order an ultrasound of the hip joints. It should be done in every child, as it enables the detection of abnormalities that are not revealed by an ordinary medical examination. A referral for examination may be issued by an orthopedist (family doctor and pediatrician at the clinic do not have such authorization). The ultrasound is completely safe for the baby. It is also not painful. The child does not need to be prepared for this examination. The baby must lie on his side, and the doctor moves the small head of the apparatus over the skin around the hips. The examination takes several or several minutes. In most clinics, it is performed as part of an orthopedic visit, free of charge. If the doctor does not order your baby to have an ultrasound, ask him why. If for some reason it cannot be done, it is better to invest and do it at your own expense. When making an appointment for an ultrasound, ask if the doctor performing it has a valid certificate of the Polish Ultrasound Society, and the device has undergone quality control in the last 5 years. Do not be afraid or ashamed to ask about it. Meeting these requirements guarantees good quality of the examination, and the he alth of the child depends on it.

Hip examinations uchildren

Slight abnormalities in the structure of the hip joints

Then the doctor may only recommend putting the baby on its tummy frequently and diapers. Flannel diapers are great, as they do not curl between the baby's legs (flannel diapers are available in stores with baby goods, you can also buy a flannel at a fabric store and then cut it). Since such a diaper warms up quite well (it is a solid insulation layer), it is better not to put on additional layers of clothing, e.g. double rompers, to prevent chafing and overheating of boys' testicles. It is very important that the bodysuits or rompers put on the diaper are not too loose (the diaper will slide out) or too tight (it can be harmful and lead to abrasions and chafing). If for some reason you have to use the tetras for wide diapers, put two in a rectangle and the third in a triangle.

Treatment of hip dysplasia

If the orthopedist finds dysplasia, he will recommend the child to put on a special device, the so-called orthoses (e.g. Frejka's pillow, Koszli stay, Pavlik's harness or splint). The apparatus keeps the infant's legs abducted and flexed, thanks to which the femoral head is centrally located in the acetabulum and the joint is properly shaped. The doctor should issue an application for such a device. Unfortunately, it is only partially reimbursed. First you have to put in your own money, and the National He alth Fund will reimburse some of the costs later. Caring for a baby with a camera is a bit more difficult. Usually, it can only be removed for beauty treatments, e.g. bathing or changing. The baby cannot move freely in it. The brace slightly restricts the child's freedom of movement and exploring the world. However, it is worth gritting your teeth, following the doctor's instructions consistently and not wearing the braces "just for a little while". Surviving this difficult period will be rewarded: usually 2-3 months after dysplasia there is no trace and you can say goodbye to the apparatus. If the defect is detected quickly and the parents follow the recommendations, the child will start to sit down and walk no later than his peers. If you disregard your doctor's recommendations and avoid treatment, you may need to be treated in a hospital with a special extractor hood.

Hip Dysplasia

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Child's he alth