Is your baby having a hip problem? Let's talk about Hip Dysplasia!

Have you ever noticed when bathing or changing your little one's clothes that the skin folds on one leg are different, maybe a little more, than the other? Or have you noticed that your baby limps a little when he walks, or that there is a slight difference in the length of his legs? These may seem like normal things that we don't pay much attention to. But these could also be signs of a condition called Hip Dysplasia, a problem with the hip joint that is especially common in babies. Don't worry, we'll talk about everything in simple terms.

Simply put, what is Hip Dysplasia?

Hip Dysplasia is when our hip joint is not formed properly. To understand this more simply, think of our hip joint as a ball and a cup that fits into it. The ball-like part at the top of our thigh bone (femur) (femoral head) must fit snugly into the round, cup-like part (acetabulum) in the pelvis.

In the case of Hip Dysplasia , either the cup-like part is not deep enough, so the ball-like part does not fit properly. Or, due to a change in the shape of the ball-like part, this fit does not happen properly. This causes the hip joint to become unstable and loose.

This condition is most common in newborns and young children. It is sometimes called congenital hip dysplasia or developmental dysplasia of the hip (DDH). However, sometimes milder cases of this condition only present in adulthood.

What are the symptoms of this condition?

The symptoms of Hip Dysplasia can vary with the age of the child. Let's break this down clearly.

Why is this happening? Who is most at risk?

It is difficult to pinpoint a single cause for hip dysplasia, but there are several factors that can contribute.

• Genetics: If someone in the family has had this condition, the risk of the child also developing it is higher.
• Womb position: The position the baby is in during the final stages of pregnancy, especially the breech position, can put pressure on the hip joint and lead to this condition.
• Having a first child: Since the mother's uterus is not as stretched during the first pregnancy, there may be some impact due to the lack of space for the baby.
• Gender: Girls are more likely to develop this condition than boys. This is because girls have more hormones in their bodies that loosen joints.

This condition often affects the left hip more.

What complications can occur if this is ignored?

Hip Dysplasia, especially if not diagnosed and treated at an early age, can cause various complications in the future.

• Hip Dislocation: Because the joint is not properly fixed, the risk of hip dislocation is higher than normal.
• Hip Labral Tears: The cartilage, a cushion-like part of the joint, can be damaged when the bones do not fit together properly.
• Osteoarthritis: This is the most serious long-term complication. As the joint does not function properly, over time it can wear down, causing severe pain and difficulty moving.

How do you find this, Doctor?

Your doctor will follow several steps to diagnose this condition.

1. Physical examination: There are special ways to examine the baby's hips. The doctor will gently bend and rotate the baby's legs to check for any abnormalities, "clicking" sounds, or looseness in the hip joint. In an adult, they will check for areas of pain and range of motion.

2. Imaging Tests: If there is any doubt, scans are performed to confirm the diagnosis.

• Ultrasound: This is the best way to see the hip joint in babies under 6 months of age, because at that age the bones are not yet fully developed.
• X-rays: An X-ray is done to clearly see the position of the bones in children over 6 months of age and adults.
• CT Scan: In some complex cases or when planning surgery, this test is used to obtain a three-dimensional (3D) image of the joint.

What are the treatments for this?

Early diagnosis is very important when treating Hip Dysplasia, because the sooner it is diagnosed, the simpler and more successful the treatment.

Treatment for babies

Babies under 6 months old usually do not need surgery.

• Bracing/Harness: The baby is fitted with a specially designed harness (e.g. Pavlik harness). This helps to keep the baby's hip joint in the correct position, exactly as the ball of the cup is, and to help it develop. The harness is worn continuously (around the clock) for several months. During this time, the hip joint stabilizes and develops properly. This is a very effective treatment.

Treatment for older children and adults

• Physical Therapy: Exercises and stretches are provided to strengthen the muscles around the hip and increase the movement and flexibility of the joint.
• Surgery: If other treatments are not successful, or if the disease is diagnosed in adulthood, surgery may be necessary.
• Hip Osteotomy: This involves cutting and reshaping the bone to bring the hip joint into the correct position.
• Hip Arthroscopy: This involves inserting a camera and instruments through a small incision to repair damage to the cartilage inside the joint.
• Hip Replacement (Arthroplasty): If the joint is very worn out and the arthritis is severe, surgery may be required to replace the entire hip joint with an artificial joint.

When should I see a doctor?

If you have any of the following, see your doctor immediately.

• If your baby is showing any of the symptoms we discussed earlier (such as uneven leg creases, limping).
• If you have hip pain that doesn't go away after a few days.
• If your hips feel unstable and jumpy when you walk.

When do you want to go to ETU?

It's normal to be scared when you find out that your baby has something like this. But remember, Hip Dysplasia is a very treatable condition, especially if it's detected early. After treatment, your baby can live a normal life without any long-term effects. So don't be scared, and if you have any doubts, talk to your doctor.

Hip, Hip Dysplasia, Pediatrics, Baby's Leg, DDH, Hip Pain, Congenital Hip Dysplasia, Hip Jump, Child Health