Hip Problems in Children

The most common hip problem in children is developmental dysplasia of the hip or DDH. It affects babies and young children. According to Lucille Packard Children's Hospital, DDH occurs once in every 1,000 births. The condition develops in utero or during the child's first year of life. It's a much more common conditions in girls than boys. The relationship between the femur and the hip socket is affected in one or both hips. DDH can be mild or severe depending on the child and situation. If it's mild, the child's hip is in the joint but may become dislocated rather easily. That's called unstable hip dysplasia. If DDH is severe, the hip may be partially or completely dislocated, which is called subluxation.

Cause

• Doctors cannot explain why hip problems occur in children. Sometimes, the ligaments around the joints are loose, which may be hereditary. Other times, the baby's position in the uterus or after birth may affect the formation of the hip joint. Stress is put on the hips if the baby is breech during birth, which counteracts normal development.

Symptoms

• You may not notice any symptoms because some children may not experience any pain. However, the child's legs and buttocks may look different. This may not be noticeable until he begins walking. Your child may have a slight limp if one hip is affected by DDH. He may sway or waddle when he walks if the condition affects both hips. However, it can be hard to detect an abnormality during movement if both hips are completely dislocated.

Diagnosis

• Early diagnosis of hip problems in children is essential to avoiding major problems. The pediatrician's early checkups are the most important tool in diagnosing DDH. Have your baby screened as early as possible, especially if she was breech or if you have a family history of hip problems. The doctor will use tests such as Barlow's test or Ortolani's maneuver to detect if the baby's hip is moving inappropriately.

Treatment

• Treatment of hip problems in children varies depending on the severity and age of the child. You may need to put two or three diapers on your baby at all times. If this doesn't work, there's a special harness called a Pavlik harness that can be used for several months. This keeps her hips in place. If your child is older, the doctor will use X-rays to see if the hip is stable. The doctor may recommend a standing program to help the hip develop correctly.

Surgery

• Older children can undergo surgery to treat hip problems. It's done under general anesthesia. The surgeon moves the hip gently and determines if it can be put back into the socket. They use Fluoroscopy, which is an X-ray system, to watch the pelvic and hip bones as they line up. The child has to wear a cast from his waist to toe to hold the hip joint in place until the tissues tighten.