What is Hip Dysplasia?
Developmental Dysplasia of the Hip (DDH), or more commonly known as Hip Dysplasia, is a disorder that affects the hip joint in babies and young children. Hip Dysplasia isn't always present at birth and can develop over time, hence the name Developmental Dysplasia of the Hip (DDH).
DDH is a condition in which the femoral head (or hip ball) has an abnormal relationship to the socket of the hip and ranges from partial to complete hip dislocation to instability where the femoral head regularly moves in and out of the hip socket.
The term also includes an array of abnormalities that may only show up on ultrasound or x-ray that reflect the inadequate formation of the hip socket. Early detection of Hip Dysplasia is vital as its the most common cause of hip arthritis in adults.
What are the statistics?
Hip Dysplasia affects many more girls than boys. In fact, nearly 80% of cases of Hip Dysplasia are found in girls. 1 in 6 full-term newborn babies have some hip instability In 2003-2004, Hip Dysplasia was the fourth most common birth defect in Victoria, with a prevalence rate of 29.6 per 10,000 births.
What are the risk factors?
Hip Dysplasia, more often than not, affects girls. It is thought that the maternal hormones in female babies predispose baby girls to loose joints. Babies are significantly more likely to be affected if they have a family history of Hip Dysplasia (in a first-degree relative).
Breech presentation of a baby in utero results in extreme flexion and/or limitation of hip motion and increases the incidence of Hip Dysplasia. Intrauterine packaging problems - which is a relative reduction in the size of the womb - may result in several so-called packaging disorders like Hip Dysplasia.
There is now clear evidence that the practice of comfort wrapping where an infants legs are tightly swaddled is extremely detrimental to the hips and directly associated with the development of hip dysplasia and dislocation.
How will parents know if their child has Hip Dysplasia?
Screening by your Child Health service is a vital tool for detecting whether your child has Hip Dysplasia. Early diagnosis and treatment of Hip Dysplasia are so important as its the best way to prevent osteoarthritis in adulthood.
If your child has a risk factor or an abnormal finding at their regular screening, they will be referred to a specialist who will arrange further testing or x-rays required and implement an appropriate management plan.
How can parents manage, or even avoid, Hip Dysplasia?
Early detection of Hip Dysplasia is vital as if left untreated, can lead to chronic pain, limping and degenerative arthritis. On the positive side, early management of Hip Dysplasia allows the hip joint to develop normally, minimizing the need for surgical intervention and reduce the risk of long term disability. Therefore, every parent must ensure their child's hips are screened at each of their early child health visits.
Avoid swaddling techniques where a baby's legs are tightly wrapped by either learning the correct technique or using a pouch that avoids restriction of hip movement.
Author: Assoc Prof Leo Donnan Orthopaedic Surgeon VicOrtho donnan.office@vicortho.com.au
REFERENCES:
*Healthy Hips Australia, Healthy Hips Week Fact Sheet 2017 The ergoPouch range has been acknowledged as "hip-healthy" from the International Hip Dysplasia Institute as our ergonomic designed bell-shaped bottom allows babies to move their legs comfortably and adopt the optimum 'frog-leg' position.