Hip dysplasia affects 3 out of every 1,000 babies and is more common in girls than boys.
Hip dysplasia is one of the most common abnormalities in newborn babies. It appears in 3 out of every 1,000 children, is more common in women than in men, and appears more on the left hip than on the right.
Hip dysplasia occurs when the head of the femur bone and the cavity of the pelvis where it is housed not fit correctly. The abnormality involves an outward shift of the head of the femur, the upper leg bone that tends to come off the hip intermittently. In more severe cases, the bone is placed out of its natural position permanently. This is what is known as a dislocated hip.
Causes of hip dysplasia in babies
The causes of hip dysplasia in babies are still unclear. Factors such as a high weight of the baby, the position of the buttocks, the first child, a multiple pregnancies, maternal hypertension and the macrosomia of the baby are considered. Some authors argue that it is due to poor posture of the future baby in the womb, a low level of amniotic fluid, a family history, a post-term pregnancy, a cesarean section, or a dislocation that occurred during delivery.
Diagnosis of hip dysplasia in infants
The neonatologist is the one who notices this anomaly when examining the newborn at birth when he performs the Ortolani and Barlow maneuvers. These maneuvers consist of a series of movements that, carried out with the baby lying on the back and as relaxed as possible, gently flex and open the newborn’s legs to check if the joint is correct. It is done first on one hip and then on the other. The Ortolani maneuver allows checking for dislocation by performing joint rotations, while the Barlow maneuver allows checking for the possibility of dislocation. Half of hip dysplasia cases they are detected in the neonatal period thanks to these maneuvers.
The pediatrician may also see that the shape of the baby’s leg folds is asymmetric. It is a less accurate sign, but one that may lead to suspicion of hip dysplasia. From the three months of the baby, the maneuvers are practically negative in all cases, for which reason the observation of the asymmetry of folds or the shortening of one of the extremities is used to determine it.
Early diagnosis of hip dysplasia is vital, and even more so if there is a possible family history. 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 baby is born and before it begins to take its first steps. Hip dysplasia prevents the body from being perfectly supported resulting in an asymmetry between the two legs.
Treatment of hip dysplasia
Correcting this anomaly is easy, especially when it is detected early after the baby is born. Treatments vary depending on the severity of the case and the age of the child. To keep the femur inside the cavity of the hip bone, a double diaper is usually put across the baby to keep the legs open, when the dysplasia is mild. A postural treatment is also recommended, such as straddling the baby and sleeping on his back with his legs open to try to get the bone back to its natural place. In more serious cases, soft or rigid prostheses are usually used.