Hip dysplasia in babies

Hip dysplasia is one of the most common lower limb abnormalities in newborns. It appears in 3 of every 1,000 children , it is more common in girls than in boys and it occurs more frequently in the left que hip than in the right . Causes of hip dysplasia in babies Hip dysplasia occurs when the head o

Hip dysplasia is one of the most common lower limb abnormalities in newborns. It appears in 3 of every 1,000 children, it is more common in girls than in boys and it occurs more frequently in the left que hip than in the right .Causes of hip dysplasia in babies

Hip dysplasia occurs when the head of the femur bone and the pelvic cavity where it lodges do not fit properly. The anomaly consists of an outward displacement of the head of the femur, the upper bone of the leg that tends to come out of the hip intermittently. In the most severe cases, the bone is placed outside of its natural position permanently. It is what is known as

dislocated hip.The causes of hip dysplasia in the baby are unclear. Predisposing factors are considered to be high baby weight, breech position, first child, multiple pregnancy, maternal high blood pressure and baby's macrosomia. Some authors argue that it is due to the poor posture of the fetus in the maternal womb, to a low level of amniotic fluid, to family history, to a post-term pregnancy, to caesarean section or to a dislocation during childbirth.

Diagnosis of hip dysplasia in babies

The neonatologist is the one who becomes aware of this anomaly when exploring the newborn at birth, when he practices the

maneuvers of Ortolani and Barlow . These maneuvers consist of a series of movements that, with the child lying on his back and as relaxed as possible, flex and gently open the legs of the newborn to check if the joint is correct. It is done first on one hip and then on the other. The Ortolani maneuver allows to check if there is dislocation by performing rotations of the joint, while the Barlow maneuver allows to check if there is a possibility that a dislocation may occur. Half of the cases of hip dysplasia are detected in the neonatal period thanks to these maneuvers.The pediatrician can also observe that the shape of the folds of the baby's leg is asymmetrical. It is a less precise sign, but one that may suggest a hip dysplasia. After three months of the baby, the maneuvers are practically negative in all cases, so we resort to observing the asymmetry of folds or the shortening of one of the limbs to determine it.

The early diagnosis of hip dysplasia is very important and even more so if there are possible family antecedents. For this reason, when the result of the maneuvers is not clear, an ultrasound of the hips is performed for greater safety. It is important that it can be identified and resolved after the child's birth and before it begins to take its first steps. Hip dysplasia prevents the body from being perfectly sustained, resulting in an asymmetry between the two legs.

Treatment of hip dysplasia in newborn babies

However, correct this simple anomaly especially when it is detected early after the birth of the baby. The treatments vary depending on the severity of the case and the age of the child. To keep the femur inside the hip bone cavity, a double diaper is usually placed across the baby to keep the legs open, when the dysplasia is mild. A postural treatment is also recommended, such as carrying the baby astride and sleeping on his back with his legs open to try to get the bone back in place naturally.

If the dysplasia is medium or severe, soft or rigid prostheses or other treatments are often used, such as the Pavlik harness, which consists of straps that keep the hips in a hundred degrees flexion to reduce the dislocation. Before six months, it is not necessary to treat all cases orthopedically. Newborns can recover with positive maneuvers. If orthopedic treatments do not correct the dislocation, surgery may be the last solution.

Early diagnosis is essential to begin treatment before the baby begins to crawl and stand up. If hip dysplasia is not treated before the child begins to walk, it can lead to more serious problems such as irreversible lameness, bone injuries, asymmetry of the legs or early hip osteoarthritis.

In some cases, until the child begins to walk, no symptoms of hip dysplasia are detected despite having been negative in pediatric check-ups. A delay in the start of walking, lameness in walking or an unsteady gait (more unstable than normal in a baby that starts to walk) may indicate a dislocation.

Marisol Nuevo.

Copywriter