Congenital Hip Dislocation In Infants

Congenital hip dislocation affects one in 1,000 babies and one in three children has a slight instability in this joint. Also, girls are more likely than boys to develop this abnormality.

Congenital hip dislocation in infants

Congenital hip dislocation is an abnormality of the hip joint. It is also known as developmental hip dysplasia. Some babies are born with this malformation, where the tip of the thigh bone does not fit properly into the joint. This can lead to limping and pain later on.

In the most severe cases, this condition can also lead to a disability for the person concerned.

Congenital hip dislocation affects 1 in 1,000 babies and 1 in 3 children has mild hip instability. Girls are more likely to develop this abnormality.

The causes of a congenital hip dislocation

Hip dislocation

Experts consider congenital hip dislocation to be a “multifactorial inheritance”. In other words, many factors can cause this birth defect and these are usually genetic and environmental.

One of the environmental factors that experts believe may contribute to hip dysplasia is the baby’s response to mother’s hormones during pregnancy. A tight uterus that does not allow fetal movement or a breech birth can also cause chronic hip dislocation.

Most of the time, the right hip is more likely to be affected due to the position of the fetus in the uterus.

At the same time, firstborn babies are at higher risk of dislocating this joint. This is because the uterus is smaller when the baby is born for the first time and the baby’s freedom of movement is restricted, which in turn affects hip development.

Other risk factors can include:

  • The occurrence of developmental dysplasia of the hip or very flexible ligaments within the family.
  • The baby’s position in the womb, especially in the case of premature birth.
  • Connections with other orthopedic problems  such as sickle foot, clubfoot or the like.

What symptoms can a chronic hip displacement trigger?

In newborns, the signs of congenital hip dislocation are very subtle and parents may not notice them. Still, hip screening is part of the usual routine medical examination that pediatricians perform on newborns.

Some of the most distinctive symptoms of hip dysplasia in babies are as follows:

  • Perception of a clicking or hollowing noise while examining the hip
  • Greater difficulty moving one leg in relation to the other
  • Lower limb asymmetry: one leg is shorter than the other
  • Asymmetry in the folds usually found in the groin of a leg
  • Limping while walking is a late sign. However, this is usually noticed in the baby’s first months of life, before it starts walking
  • Scoliosis: This is the formation of an abnormal curvature in the spine when the body tries to compensate for the uneven distribution of weight between the legs.

Diagnosing chronic hip displacement

Hip dislocation

Doctors can usually anticipate this disease at birth through a physical examination of the infant. The so-called Ortolani test is carried out. If the result of this test is positive, the diagnosis will be confirmed by an ultrasound or an x-ray of the hip.

In some cases, a consultation with a specialist in pediatric orthopedics can also be carried out.

Treatment of congenital hip dislocation

It is not necessary to treat all cases orthopedically until the age of 6 months. Treatments vary depending on the severity of the case and the age of the child.

In the mildest cases, doctors recommend postural treatment, such as bringing the baby into a straddle position. It also helps to let the child sleep on their back with their legs open to bring the bone back into its natural position.

When the disease gets worse, certain prostheses or other treatment methods such as the Pavlik bandage are often used. The latter is made up of straps that hold the hips in a 100-degree flexion to reduce dislocation.

If the misalignment cannot be corrected even with orthopedic treatments, surgery is the last resort.

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