Developmental dysplasia of the hip, or with its former name congenital hip dysplasia is caused by the deformed development of hip joint in babies. Under normal condition, the round part of the femur where it joints with the hip is placed in the round hole in the hip bone. However, in case of dysplasia of the hip, the socket part and head of the femur do not place in the hole correctly. The hip joint gets loose and hip dysplasia occurs. This condition starts when the baby is in the womb in early development stage. If the hip is not stable, it advances during development. Due to the structure of round and socket joint, head of the femur may slip or be dislocate during this process. Congenital hip dysplasia is seen in 1 out of 1000 babies.
In hip dysplasia cases, deformation may occur in hip development as the head of the femur is dislocated. When it is diagnosed early and therefore treated early, many children can continue their life without any problem. If the treatment is applied late, hip problems and hip joint osteoarthritis can be experienced at an early age.
Causes of Developmental Dysplasia of the Hip
First of all, it should be noted that the cause of hip dysplasia is not revealed completely. However, some conditions may increase risk of hip dysplasia. These conditions include decrease of amnion fluid in the womb, girl baby, breech birth, difficult birth or genetic factors. Hip dysplasia risk is higher in the first child because the womb is not relieved enough and therefore it causes pressure on the baby. These factors are as follows:
- First delivery,
- Multiple deliveries,
- Breech birth,
- Genetic factors (If there is a hip dysplasia history in the family, the child is likely to have dis deformation.)
- Low amount of amnion fluid,
Symptoms of Hip Dysplasia in Babies
- One leg is longer than the other.
- Restricted movement occurs. Legs do not open outward.
- Babies have nodes in the hip and legs. In the babies having hip dysplasia, the number of nodes in one leg is different than the other. Also, shape is different.
- During infancy, babies can have tension during crawling and sitting.
- Babies in the walking period may walk lamely.
- When the hip is moved, a voice can be heard from the joint.
It should be noted that symptoms may not be observed in some babies. Therefore, the baby should be examined by the physician regularly.
- Walking lame.
- Hip pain during adolescence.
- Osteoarthritis at an early age.
- Permanently restricted movement.
Diagnosis of Developmental Dysplasia of the Hip
For early diagnosis,scanning should be done during delivery.In routine control done within the first 3 days after delivery, the hip should be examined.Afterward, when the baby is 6-week-old, hip ultrasonography and another examination are carried out. Physical examination is essential for diagnosis. Imaging methods are carried out for final diagnosis. Therefore, hip ultrasound is performed for babies younger than 6 months, and hip graphs are performed for older babies (or children).
Treatment of Developmental Dysplasia of the Hip
Early diagnosis is very important for the treatment. If it is determined in the early stages, it is treated with non-surgical methods. For the first 6 months, treatment is completed with splint and some simple measures. For babies older than 6 months, surgical intervention may be required. The protruding head of the femur is placed with surgery. Then plaster is applied. In interventions performed within the first 6 months, recovery rate is close to 100%. While it is impossible to provide recovery with non-surgical methods after the age of 1, after age of 6-7, it is very difficult to place the hip even with surgery. Even if it is placed, restricted movement may occur. Therefore, hip dysplasia should be diagnosed early and treated as soon as possible.