Hip dysplasia, also known as congenital hip dislocation, is a condition that can appear right after a baby is born. This alteration completely impairs the stability of the joints due to the poor fit of the femur with the pelvis, giving the impression that the hip is “loose,” or as the medical term goes, dysplastic. Occurrences of hip dysplasia or DDH, which is the acronym for the disorder, are considered common and can happen in 1 out of every 60 babies born, with a higher incidence in female babies and those of white race. Suspicion of dysplasia in almost all cases arises already at the maternity hospital, identified by the neonatal pediatrician.
Diagnosis
Through routine newborn screening examinations at the maternity nursery, a “click” is noticed when examining the baby’s hip. In addition to the characteristic sound, there may also be a certain snap when moving the hip, both of which are strong indicators of dysplasia.
IMPORTANT: When discovered in the neonatal phase, treatment yields a much quicker response than at any other stage of life. Early diagnosis shortens the treatment period and offers more concrete results.
After suspicion, detailed investigation must proceed before confirming the diagnosis, which should be evaluated by a specialized pediatric orthopedic doctor. The diagnosis can only be confirmed after imaging tests, specifically ultrasound. Through ultrasonography, it is not only possible to confirm hip dysplasia but also to assess the type and severity of the issue. Dysplasia is categorized into two types, mild or severe.
Why Does Hip Dysplasia Occur?
After years of studies and research, it has been concluded that hip dysplasia may be caused by two factors. The first is considered a genetic or familial factor, meaning the baby is born with ligament issues in all joints, which are loose and completely unstable. The second factor is mechanical, generated by the baby’s position inside the uterus, where a breech position affects or favors the existence of dysplasia. This includes cases where there is reduced amniotic fluid, very large babies, or babies born breech. Through prenatal screening exams, it is already possible to detect the problem early and plan what to expect after birth.
How to Treat Hip Dysplasia?
As with most illnesses and health issues, the earlier it is diagnosed and treated, the better the results and the faster the recovery. As soon as signs of hip dysplasia are noticed, the baby should be evaluated by an orthopedic specialist, preferably within the first weeks of life. Depending on the severity of the hip dysplasia, treatment can be started with orthopedic devices that will keep the baby’s thighs flexed and apart. The most recommended device in these cases is similar to the well-known braces, which is why it is called a Pavlik harness. This position allows for greater hip stability, keeping the femoral head centered, and immobilization will help remodel the joints. When diagnosed late, treatment may be longer and yield slower results. Usually, babies older than 6 months who have hip dysplasia and do not receive the appropriate treatment after birth tend to have the problem worsen, resulting in the hip becoming dislocated. In these cases, intervention with anesthesia is required, in which traction of the limbs and release of the shortened muscles and tendons are performed. This procedure is called tenotomy, and after it is performed, a cast is applied to realign the hip.
Is There Treatment When Diagnosed Late?
In the case of babies who are not diagnosed before their first birthday and hip problems are only noticed when they start walking, the chances of treatment are almost nil, making surgical intervention for correction the only option. The procedure in these cases is called osteotomy, where the bone needs to be cut and fixed in the correct position. After the procedure, casting is necessary to complete the repositioning. The focus of all the treatments described is to place the head of the femur in the centralized and appropriate position in the pelvic cavity so that the baby’s own body can resume normal function. When not properly treated, hip dysplasia can cause movement limitations and the child may develop osteoarthritis and other conditions in adulthood, in addition to intense pain. Treatment is essential to provide a quality life and avoid the need for surgical interventions and medications to control pain in adulthood. Important Tip: Sometimes sexual intercourse during pregnancy becomes uncomfortable, both due to the belly and vaginal dryness, and for this reason, many women avoid their partners during this period. To give a little help, Famivita developed FamiGel, a water-based intimate gel with the same consistency as natural vaginal mucus! You can find FamiGel here. See also: Intestinal Intussusception – What is it and What is the Treatment? Photo: RGDJ
