about hip dysplasia
Hip dysplasia in babies is used to describe a problem in the formation of the hip joint. For more information, read the below articles compiled from leading health websites.
What is the treatment for DDH?
Specific treatment for DDH will be determined by your baby's doctor based on:
- Your baby's gestational age, overall health, and medical history
- The extent of the condition
- Your baby's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
The goal of treatment is to put the femoral head back into the socket of the hip so that the hip can develop normally.
Treatment options vary for babies and may include:
Nonsurgical positioning device or placement of a Pavlik harness.
The Pavlik harness is used on babies up to 6 months of age to hold the hip in place, while allowing the legs to move a little. The harness is put on by your baby's doctor and is usually worn one to two months. Your baby is seen frequently during this time so that the harness may be checked for proper fit and to examine the hip. At the end of this treatment, X-rays (or an ultrasound) are used to check hip placement. The hip may be successfully treated with the Pavlik harness, but sometimes, it may continue to be partially or completely dislocated.
Casting. If the hip continues to be partially or completely dislocated, casting, or surgery may be required.
Surgery. If the other methods are not successful, or if DDH is diagnosed at age 6 months to 2 years, surgery may be required to put the hip back into place manually, also known as a "closed reduction." Children older than 2 years may require an "open surgery" to realign the hip, followed by spica cast. If successful, a special cast (called a spica cast) is put on the baby to hold the hip in place. The spica cast is worn for approximately three to six months. The cast is changed from time to time to accommodate the baby's growth and to ensure the cast's rigidity, as it may soften with daily wear. The cast remains on the hip until the hip returns to normal placement. Following casting, a special brace and/or physical therapy exercises may be necessary to make the muscles around the hip and in the legs stronger.
What is a short leg hip spica cast?
A short leg hip spica cast is applied from the chest to the thighs or knees. This type of cast is used to hold the hip in place after surgery to allow healing.
Cast care instructions:
- Keep the cast clean and dry.
- Check for cracks or breaks in the cast.
- Rough edges can be padded to protect the skin from scratches.
- Do not scratch the skin under the cast by inserting objects inside the cast.
- Use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. Never blow warm or hot air into the cast.
- Do not put powders or lotion inside the cast.
- Cover the cast during feedings to prevent spills from entering the cast.
- Prevent small toys or objects from being put inside the cast.
- Elevate the cast above the level of the heart to decrease swelling.
- Do not use the abduction bar on the cast to lift or carry the baby.
When to call your baby's doctor
Contact your baby's doctor or other health care provider if your baby develops one or more of the following symptoms:
- Increased pain
- Increased swelling above or below the cast
- Drainage or foul odor from the cast
- Cool or cold toes
Long-term outlook for a baby with DDH
While newborn screening for DDH allows for early detection of this hip condition, starting treatment immediately after birth may be successful. Many babies respond to the Pavlik harness, and/or casting. Additional surgeries may be necessary since the hip dislocation can reoccur as the child grows and develops. If left untreated, differences in leg length or a duck-like gait, and a decrease in agility may occur. In children 2 years or older with DDH, deformity of the hip and osteoarthritis may develop later in life. DDH can also lead to pain and osteoarthritis by early adulthood.
A Healthy Me. Orthopedic Conditions and Children. Available at: http://www.ahealthyme.com/conditions/orthopedics/children/90,P02755. Accessibility verified July 16, 2012.