Hip dysplasia

Overview

Hip dysplasia occurs when the hip joint isn't sufficiently developed before birth. Risk factors include being female, genetic predisposition and lack of space in the womb. Hip dysplasia can be symptom-free, but can also cause mobility restrictions and the shortening of one leg. Newborns should always be examined carefully after birth to ensure early diagnosis of this condition.

Symptoms

• Often symptom-free
• Mobility restrictions (e.g. limited range of movement of leg)
• Knee pain
• Limping/”waddling gait”
• Asymmetrical skin folds in the area of the buttocks and thighs
• When dislocated: possibly, shortening of the leg

This malformation frequently occurs together with club feet, torticollis and plagiocephaly

Complications

• If untreated, permanent (i.e. irreversible) damage to the skeleton leading to
  • Osteonecrosis of the femoral head (the bone in the head of the femur dies)
  • Early arthrosis
  • Difference in leg length
  • Limping
  • Mobility restrictions
  • Knock knees

Causes and treatment

Causes

• Malformation of the hip joint
  • Hip socket is too shallow
  • Ball of hip is therefore not completely covered

Risk factors

• Genetic predisposition
• Female gender (five times more often than males)
• Breech birth (breech position)
• Lack of space in the womb
  • Low amniotic fluid
  • Twins
  • Birth weight > 4,000 g

Further treatment by your doctor / in hospital

Possible tests

• Routine examination of all newborns
  • Physical examination (search for signs of instability)
  • Ultrasound (for all newborns, if possible)
• X-ray, if necessary (only after the age of 1)

Possible therapies

• Use double nappies ("wide wrapping")
• Hip abduction treatment (harness or bandage)
• Pelvic and leg plaster
• For luxation (dislocation): repositioning (resetting) with/without an operation
• Operation (to give hip joint better cover)

What can I do myself?

• Avoid early stretching of the hip joint (important for good development; hips are still developing after birth)
• Preventive measures
  • Carry the baby in a sling
  • Fold nappies so that hip joint is bent
  • Baby shouldn't sleep on its side

When to see a doctor?

• The earlier the diagnosis, the better the course of treatment
• Routine preventive examination
  • Hip ultrasound for babies during the first to sixth weeks of life
• Shortening of leg
• Restricted movement
• Limping/waddling gait
• Knee pain

Synonyms

hip dysplasia, hip joint luxation, congenital hip dysplasia, developmental dysplasia of the hip (DDH)