Hip dysplasia or developmental dysplasia of the hip (DDH) are the medical terms that cover a wide range of hip instabilities that most commonly affect new born babies, with a particular prevalence in girl babies where 1 in 600 girls are affected versus 1 in every 3000 boys.  Briefly, hip dysplasia is the abnormal development of the structures that support the hips.  This could mean loose hip joints, poor hip stability due to shallow socket joints or other ligament weaknesses that leave the hip joint more prone to dislocation.   The symptoms of hip dysplasia vary greatly, with some babies even being born with their hip joint already dislocated.  If you’ve ever wondered what the doctor is checking for when they assess your newborn’s hips and legs, this is exactly what they are looking for; and early detection is key.

CAUSES OF HIP DYSPLASIA

  • Higher prevalence of hip dysplasia has been found amongst breech birth babies who had more limited room for kicking in the womb.
  • Family history – one third of babies born with hip dysplasia will have a blood relative who has also had the condition.
  • Swaddling – too tight a swaddle, or poor swaddling techniques can lead to hip dysplasia due to pushing the legs (and therefore the hips) into an unnaturally straight position that can cause hip issues to develop.
  • There is a higher instance of hip dysplasia in babies with congenital disorders such as cerebral palsy and spina bifida.
  • Multiple babies – overcrowding in the womb can impact the freedom of movement of a baby 

SYMPTOMS TO LOOK OUT FOR

Babies are checked at birth to make sure that their hip joints are properly positioned and formed, however, mild cases of hip dysplasia can be missed so parents should stay cognisant of the following symptoms:

  • ‘Clicky’ hips.  When you rotate your baby’s leg you might hear a low clunky sound.  This is often termed as ‘clicky’ hips and refers to the sound that the femur is making inside the hip socket
  • Reduced mobility in your baby – you might notice the one hip does not ‘open’ as much as the other when changing your baby’s nappy
  • Knee joints are not aligned – one may appear higher than the other
  • One leg looking shorter than the other
  • Extra skin creases on one thigh or one buttock
  • In older babies/children look out for limps when they start to walk

If you notice any of these symptoms or have any concerns regarding the hip health of your child, you should seek assistance from your GP or Health Visitor.  The earlier the hip problem is diagnosed the more effective and easier the course of treatment will be.

TREATMENT AND CARE

Treatment varies, but in cases where early diagnosis was possible (baby is under 6 months of age), efforts are concentrated in keeping a baby’s hips in a better position for healthy hip development.  This will often include the use of splints or special hip harnesses for periods of around 3 months that act to hold the hip in the socket of the hip joint by keeping a baby’s thighs apart.  The aim here is to influence the natural growth process to develop more stable hip joints.  These simple and straightforward techniques to correct hip dysplasia are not known to cause the baby harm, and is often all that is needed to fix the issue.

In cases of late diagnosis, the treatment options are invariably more complex and unfortunately will often include surgery and lengthy (6-9 months) post-surgical cast wearing.  With later diagnosis, also comes less certainty that the final result will be a complete solution.  However, over time new procedures and treatment options are being developed.

At any stage of your child’s development, if you have concerns about their hip health, you should see your GP as soon as possible.