The dislocation of the baby's hip

At birth, the pediatrician performs your child a series of tests among which is the revision of the hips to detect a possible dislocation. In some hospitals they do a hip ultrasound to all newborns, very useful until the second or third month. From the fourth or fifth month an X-ray is done, since the head of the femur is already formed. It's about avoiding a limp in the future.

The hip dislocation, or evolutionary hip dysplasias, are produced when the bone of the femur is not inserted into the hip bone. This pathology, detected in time, does not have more importance than the inconveniences of the treatment, but it is of vital importance to stop it; otherwise, it may cause a limp in the future.

How can the pediatrician detect a baby's hip dislocation?

Your child's pediatrician will perform a series of tests in which he can detect "clicks" on his hips, or directly notice how his head comes out of the femur of one or both hips.

1. First, the child will lie on his back to explore it, Holding him by the knees with his index finger and thumb, bringing his legs together and flexed at the hips. From this position he will make rotating movements with them several times, opening his legs like a frog. It is at this time, when the doctor can detect the click on your hips.

2. Next, you will have another test by pressing the child's thigh with your thumb, being able to notice that it leaves the head of the femur; or, if you already had it outside, you will appreciate that it is put back in its place when performing the rotation.

3. Third, the pediatrician will check if the child has asymmetric folds of the buttocks, if you have an oblique pelvis, if your lower limbs at rest acquire a different posture or, if you are a girl, if you present a deviation from the midline of the vulva. All of them are obvious signs of dislocation, at least in one of the hips. In any case, the diagnosis will be confirmed with a hip ultrasound.

Steps to follow to detect a dislocation of the baby's hip

This characteristic click may have its origin in the ligaments, rigidity of the tendons, etc. The truth is that you do not know, today, what is owed. Statistics indicate that girls, premature babies, and low-birthweight babies are more likely.

If the parents suspect or the pediatrician detects it, the next step will be the ultrasound (two or three months old babies) or the hip radiograph (after four or five months). After the confirmation of the dislocation, the pediatrician will refer you to the child traumatologist and possibly you will have to put harnesses on the child, for a minimum period of two months, depending on the grade.

The important thing is not to forget to do the tests to your child, because the sequels are important, such as lameness.

Treatment for dislocation of the baby's hip

The treatment of the click of the hips consisted until recently in put a double diaper on the child to keep the little legs separated, while the pelvis was strengthening. Currently, there are other methods of greater effectiveness, such as harnesses that securely fix the thighs of the child and ensure the success of the treatment. The system consists of straps that keep the baby's legs separated, even while changing. Logically, orthopedic treatment produces better results the sooner you start.

With the harnesses it is intended to correct in a shorter period of time the anomaly of your child and to ensure that the child can learn to walk without difficulties.

What do we do if the baby cries?

According to Dr. Molinari, this is the most common question of the parents, worried about how uncomfortable their son will be with the harnesses. Normally, orthopedic treatment begins in the baby before six months, so their ability to adapt is very high and get used quickly, without showing any type of discomfort. The average is two days to get used to, after which the child no longer shows any rejection.

We can think that he will start to sleep badly, or that his skin will be irritated, but none of this happens so, with a little patience, when we want to give an account, they will have to take it away. In this sense, it is good to remember that the harnesses are four straps that are placed on top of the child's clothes, which at the most will give a little more heat in summer.

It can be pointed out as the only consequence its delay to crawl and walk, due to the logical physical impediment that the harnesses carry; although it is counteracted with the assurance that by walking, you can do it correctly and you will not have the consequence of lameness.

Tips for acting on a baby's hip dislocation

one. When changing your baby, see if you can put your little legs together and stretched, both in front and behind, and see if their skin folds are asymmetrical. If so, you should not be alarmed, but let him know his pediatrician.

2. Being a problem that leaves important sequels, the sooner the specialist detects it the better for the child. On the other hand, the harnesses are uncomfortable and if you wear them when the child is older, he will suffer more than baby.

3. Ask at the hospital or the pediatrician's office if you have been tested. If yes, when they send you an X-ray, do not delay this appointment for the good of the child.

4. When you have occasion, it is very good that you take the child astridethat is, on one of your hips, so the baby can put one leg on each side (in jar). This position greatly favors the good formation of the baby's hips.

5. The pediatrician will check if the child has asymmetric folds of the buttocks, the oblique pelvis and if their lower limbs at rest acquire a different posture

Ana Aznar
Adviser: Pedro de León Molinari. Pediatrician from the University of Navarra. Comprehensive Pediatric Assistance Clinic, Seville.

Video: Developmental Hip Dysplasia and the Pavlik Harness

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