A newborn baby is evaluated by a pediatrician at birth for many congenital diseases. One of these conditions is Developmental Dysplasia of the Hip (DDH). Research on this condition, previously called congenital hip dislocation, has revealed that the actual cause is a delay in the baby’s hip development. For this reason, this condition is now called “DEVELOPMENTAL DYSPLASIA OF THE HIP” (DDH). As a result of this developmental delay, the baby’s hip may develop delayed development, subluxation, or complete dislocation.
Which babies are at risk for this condition?
The baby being the mother’s first child is considered a risk factor. Hip dysplasia occurs 6 times more frequently in female babies compared to male babies. A breech birth poses a risk for developmental hip dysplasia. A family history of congenital hip dislocation and oligohydramnios (low amniotic fluid) during pregnancy also constitute risk factors.
How is developmental dysplasia of the hip diagnosed?
Every newborn undergoes a physical examination. When findings suggestive of developmental hip dysplasia are detected during the examination and when the risk factors mentioned above are present, a hip ultrasound is performed on the baby. The baby’s hip development is evaluated through the ultrasound. Performing the hip ultrasound before 6 weeks is important for early diagnosis. A baby’s hip ultrasound can be performed up to 6 months of age. For babies older than 6 months, diagnosis is made by taking plain X-ray films.
Should I have my baby get a hip ultrasound after birth?
Hip ultrasound is the cheapest and harmless method for evaluating hip development in babies. Some orthopedics and traumatology specialists state that every newborn should be evaluated with a hip ultrasound within the first 6 weeks. The opinion of another group of physicians is that directing every child to hip ultrasound would place too much economic burden on the healthcare system, and therefore only babies considered at risk should undergo hip ultrasound. The criteria established by the Ministry of Health is to request hip ultrasound for babies with risk factors in their physical examination and history. Hip ultrasound poses no harm to the baby’s health.
How is a baby with delayed hip development treated?
Treatment of developmental hip dysplasia varies according to the baby’s age. If delayed hip development is detected in the baby within the first 6 months, only a Pavlik harness is applied. The baby’s hip development is monitored with the Pavlik harness. When diagnosed in babies between 6-18 months of age or in babies who do not benefit from the Pavlik harness, the hips are reduced in a closed manner and a spica cast is applied to the entire torso, allowing the hip to develop in place. Children older than 18 months are treated by surgically reducing the hip through open surgery and then applying a spica cast. The later the diagnosis is made, the greater the scope and risks of the required surgery. For children who remain untreated until 8 years of age, it becomes too late for treatment. These children undergo prosthetic surgery after their hips develop osteoarthritis (calcification) in adulthood. This means waiting until approximately after the age of 40.
As can be seen, a condition that can be treated with just a simple harness when diagnosed early in babies requires major and risky surgeries if neglected. Children who remain untreated until 8 years of age are forced to walk with a limp for a large portion of their lives. It is crucial that every newborn baby undergoes hip examination by a Pediatrician or Orthopedics and Traumatology specialist, and that hip ultrasound is performed on at-risk babies to save a baby from disability.
Assoc. Prof. Dr. Özgür Karakoyun
Medical Disclaimer: This information is provided for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.