What is Hip Dysplasia?
Hip dysplasia, also called as developmental dysplasia of the hip (DDH), is the term used to identify the condition which results in the hip socket not covering the ball portion in the upper part of the thigh bone in a child after birth. It is most of the times a congenital (birth) disorder and needs prompt detection and treatment.
The hip joint is a ‘ball-and-socket’ type of joint. The upper end of the femur (thigh bone) is round like a ball while the hip has a hollow and half-spherical socket in which the ball end of the femur fits. This hip joint is additionally supported by various ligaments and tissues.
Dysplasia of the hip increases the risk of sudden dislocation of the hip joint, due to a minor injury or even shock to the hip.
What are the symptoms of Hip Dysplasia?
The various signs and symptoms of hip dysplasia include:
- Uneven length of legs – The leg on the affected side seems to be non proportionate with the other side.
- Abnormal skin folds on the thigh – The affected side might exhibit extra skin folds as the loose joint causes the femur to shift.
- Limping, waddling or abnormal gait – The child shows an abnormal way of walking due to unevenness in the length of the leg or because of the loose hip joint.
- One leg is less flexible or mobile – The affected leg seems to be stiff and lacks normal movement.
What are the types of Hip Dysplasia?
Hip dysplasia is a term used to identify a number of similar disorders of the hip bone in a person. It is further divided to identify the exact disorder according to the severity of the dislocation.
- Subluxatable –It is a mild form of hip dysplasia. In this type the socket in the hip bone is larger than the ball end of the femur. This causes a slight gap between the ball and socket. In Subluxatable type of hip dysplasia the thigh bone can be moved inside the hip joint but some instability can be felt.
- Dislocatable – In this kind of hip dysplasia, the ball end of the femur is loosely fitted in the socket of the hip. It is in a weak position and faces the risk of total dislocation due to stretching extremely.
- Dislocated – This is the most severe form of hip dysplasia which causes the upper end of the femur to be completely disjointed from the socket in the hip bone.
What are the causes for Hip Dysplasia?
- Hereditary -The main cause of most cases of hip dysplasia is found to be genetics. There are more chances of a child to have hip dysplasia if the same disorder is seen in the parents or the siblings.
- Ante natal – Another common cause for hip dysplasia is found to be the position of the baby in the mother’s womb. In cases of breech positioning of the child in the womb their hips face excess amounts of pressure which affects the natural and normal development of the hip joint in the baby.
- Mishandling – The baby’s bones at the time of birth are soft and pliable as they are formed mostly of cartilage as compared to the hard bone of an adult. Hence, an injury or mishandling of the baby is more likely to cause hip dysplasia.
- Other causes – Babies with feet deformity like fixed foot or stiffness in the neck (torticollis) are at a larger risk of hip dysplasia.
How is Hip Dysplasia diagnosed?
A doctor may use the following types of tests to identify hip dysplasia:
- Visual symptoms – An experienced doctor can identify the signs of hip dysplasia by a thorough physical examination. In some cases the doctor may check for undue friction in the hip joint when the leg is moved in different positions.
- Imaging tests – In some cases the doctor would recommend a few imaging tests like an ultrasound test or an x-ray test to confirm his diagnosis and the type of hip dysplasia.
The treatment of hip dysplasia falls into two categories: Non-surgical and Surgical. The type of treatment basically depends on the age and the severity of the symptoms and disability.
Non – Surgical Treatment:
- Newborns – Newborns need a special harness called a ‘Pavlik harness’ to be worn for a period of 1-2 months. This harness is specially designed to keep the hip joint in a fixed position without hindering the normal movement of the leg. This harness is also useful in strengthening and supporting the ligaments and muscle tissues around the hip joint and ensures its normal development.
- 1-6 months – Children belonging to this age group also need a harness (or another similar device) that helps to strengthen the hip joint. In a few cases the doctors may use an abduction brace to hold the joint firmly in place till it becomes normal. Certain other cases might require the use of ‘Spica cast’ (body cast) which can be used to hold the hip joint in place. This procedure is done under general anaesthesia to avoid discomfort to the baby.
- 6 months-2 years – In older children doctors normally suggest the use of Spica cast (or an abduction brace as well). Skin traction technique is also used in some cases. In this procedure the traction provides the necessary strength to the softer tissues around the hip joint and keeps it in a natural and normal position.
- 6 months-2 years – When the Spica cast treatment is unsuccessful in aligning the hip joint into a normal position the doctor may then suggest an ‘open-type surgery’. This requires the surgeon to make a large incision on the hip to get a better diagnosis of the problem. If needed, the surgeon can shorten the ball end of the femur in a way which would make the ball end to fit snugly in the hip socket. Post surgery the baby will be required to wear a Spica cast to keep the joint in place.
- 2 years and above – Due to increased activity in a child at this age the instability in the joint gets more pronounced. Hence, an open surgery is performed to place the thigh bone in the hip joint properly. The child is required to wear a body cast to keep the joint firmly in place.
Why choose Travcure for Hip Dysplasia treatment in India?
India has the largest and most comprehensive healthcare network in the world. This network consists of the best and most advanced hospitals and clinics that are spread across all major Indian cities such as Mumbai, Chennai, Kolkata, Bangalore, etc. Travcure offers every patient with the best and most affordable hip dysplasia treatment in India at the hands of the country’s most experienced and renowned paediatric orthopaedics and bone specialists.