Pediatric Hip Dislocation
The hip dislocation is also called as development dislocation of hip(DDH). The hip is a combination of ball and socket joint. In normal hip, the ball which is at the upper thigh bone fit exactly into the socket, which is the part of large pelvis bone. In babies and small children, the development of hip joint is not formed normally. The ball is loose and it can easily dislocate.
It mostly present at birth. It can also develop during child’s first year. Latest research shows that new-borns whose legs are wrapped firmly with hip and knee straight, have more chances of developing DDH after birth.
There are various types of DDH:
- Dislocated: In this the head of femur is completely out of the socket.
- Dislocatable: The head of the femur is within the socket, it can be easily pushed out of socket during physical examination.
- Subluxatable: It is a mild case of DDH, head of femur is loose in socket.
- Firstborn child.
- Low level of amniotic fluid.
- Different length of legs.
- Toe walking.
- Less mobility.
- Flexible on one side.
When DDH is detected at birth, it can be treated with use of braces. If it is not dislocated at birth, the condition is not noticed until the child starts walking.
The treatment depend on the age of child. Non surgical treatment will include harness and/or brace/casting. However, Surgery could be suggested based on the case.
Hip Dislocation Surgery is usually an open surgery, if the closed reduction process does not work. In open surgery, an incision is made at hip which allows the surgeon to see the bones and soft tissue clearly. In some cases, thighbone will be shortened so that it will fit the bone in socket. An X-ray is taken during operation to confirm the bones are positioned correctly. Post operation, the baby or child may be placed in spica cast to maintain the proper hip position.
In children with DDH, the body cast or braces is required to required to keep the hip bone in joint in healing. The cast may be changed for 2-3 months. X-rays is followed up for monitoring during the treatment until the child’s growth is complete.