This is a common orthopedic issue in newborns
When there is a problem with the development of a baby’s hip joint, they may be diagnosed with hip dysplasia, or developmental dysplasia of the hip (DDH). It can affect one or both hips, and can be present in newborns but sometimes occurs after birth as a child grows. The orthopedic condition may be detected immediately at birth through physical examination, confirmed via ultrasound up until 6 months of age or diagnosed after 6 months with an X-ray.
“The three most common risk factors for hip dysplasia are being female, the first-born child and breech positioning in the womb, but it can occur in anyone,” explains Dr. Andrea Kramer, a pediatric orthopedic surgeon at Advocate Children’s Hospital. “When hip dysplasia is not detected at birth and instead develops later in childhood, parents may notice signs like popping or clicking in the hips, different length legs, one hip moving differently than the other, asymmetric thigh folds or a limp when a baby starts to walk.”
If you notice any of the above signs, orthopedic follow-up is recommended. Dr. Kramer describes hip dysplasia treatment options, which vary based on a child’s age:
Newborn to 3 months of age
If a child is less than 3 months of age, they are treated with a brace, either a Pavlik harness, which is similar to a soft splint, or a hip abduction brace. For those slightly older, 3-6 months of age, the hip abduction brace is used to keep the hips in a healthy position. Treatment among this age group typically lasts between 6-12 weeks.
6 months to 2 years old
For children between 6 months and 2 years of age or among whom the Pavlik harness was unsuccessful in treating hip dysplasia, we perform a closed reduction, adductor tenotomy (small incision over the tight tendon) and hip spica casting under general anesthesia. During a closed reduction, we manipulate the femur to properly place it into the hip socket. We then use the hip spica cast to immobilize the femur and pelvis as they heal. In children with severe hip dysplasia, we may perform an open reduction, which requires opening the hip joint and removing any soft tissue that is blocking reduction and align the hip into the socket. The children are placed in a hip spica cast post surgery.
Over 2 years old
Children over 2 years of age tend to require extensive open reduction surgery with possible femoral and pelvic osteotomies, which involves cutting and realigning the bones and is also followed by the hip spica cast.
After treatment for hip dysplasia is complete, follow-up care with a pediatric orthopedic surgeon continues annually until skeletal maturity to ensure the child is developing typically.
“If your child is diagnosed with hip dysplasia, know this is a common condition that we are able to treat and correct, and we will continue to monitor your child as they grow,” says Dr. Kramer.
About the Author
Holly Brenza, health enews contributor, is a public affairs coordinator on the content team at Advocate Health Care and Aurora Health Care. She is a graduate of the University of Illinois at Chicago. In her free time, Holly enjoys reading, watching the White Sox and Blackhawks, playing with her dog, Bear and running her cats' Instagram account, @strangefurthings.