Diagnosis and treatment of hip dysplasia

Diagnosis and treatment of hip dysplasia

Many novice parents will encounter the following problems:

After the baby was born, he went to the community nursery for a physical examination. The doctor said that the baby's hip lines were uneven and the hip lines were asymmetrical . He asked for further examination to see if it was DDH .

The appearance of uneven hip lines

Parents who have taken the baby for a physical examination know that the doctor will observe whether the baby's legs are the same length, whether the thighs can be opened symmetrically to the sides, whether the skin folds on the buttocks or thighs are obviously asymmetry, and so on. The number or position of the folds of the two legs are not consistent, that is, the leg lines are asymmetric.

● Position asymmetry

Let the baby lie on his stomach, with his legs straight, the lines of the left and right legs are asymmetrical.

● Asymmetry in quantity

One leg has three leg lines, and the other may have only one leg line.

The legs are not of equal length after straightening ;

During the inspection of hip flexion and abduction activities, the baby within 3 months heard the joint "click" ;

After 3 months, the hip joint movement is asymmetrical (for example, one leg can be opened 80 degrees, but the other side is only 60 degrees);

The child has learned to walk and then a big point may also curvature of the spine, lameness, duck swinging gait, or a sense of feel pain.

You see, there are many manifestations of hip dysplasia. Just because the leg lines are asymmetrical, it does not necessarily mean that there is a problem with the hip joint . Parents should not be overly alarmed. Some babies have normal hip joints, but because they are too fat, the fat on both sides of the legs is unevenly distributed, and leg lines will appear asymmetry.

What is hip dysplasia?

A general term describing infants and children with congenital or developmental anatomical abnormalities of the hip joint. Generally divided into simple type and malformed type.

Simple type: acetabular dysplasia, hip subluxation, hip dislocation.

Deformity: dislocation of both hips, often combined with upper and lower limb deformities.

At birth, hip instability is 0.5%-1%, but the typical incidence of dysplasia is 0.1%.

Hip dysplasia can cause a high incidence of degenerative arthritis in adulthood; severe dislocation can cause claudication and disability in gait.

Principles of diagnosis and treatment of hip dysplasia

After 42 days, every newborn needs to be screened when the physical examination finds tight hips, asymmetry of hip lines, and different lengths of lower limbs. Among them, B-ultrasound diagnosis is the most accurate without any radiation. 

Also provide parents with some self-test methods at home: Listen to the sound: If you find that the baby's legs are moving, there are hip sounds (sharp, slightly longer, rattling) and asymmetry of thigh skin patterns should be paid attention to.

Look at the gait: If older children are not swaying, unstable or walking late with their hands, they need to be checked by a specialist in time.

Positive abduction test: 70 degrees -80 degrees is normal; <50 degrees is abnormal.

Hip ultrasound examination for babies ≤6 months is an effective screening method, which can detect hip dysplasia early. It is recommended that ultrasound examination is routinely recommended 42 days after birth.

You can do it twice a day for your baby, about 20 minutes is enough. Talk to your baby while doing it, this is also a good parent-child interaction!

● Hold your baby and open his legs

When parents usually hold the baby upright, be sure to open the baby's legs to both sides, do not force the baby together, the baby in that posture is not comfortable at all.

Also when using a baby carrier, keep the child's legs apart as much as possible like a frog, instead of hanging down directly.

> 6 months is recommended for children of primary hip X-ray examination , to understand acetabular index (acetabular angle), Perkin's box, Shenton's line is abnormal.

Treatment of hip dysplasia

● Do exercises for the baby

Let the baby lie flat on the bed, come with soothing music, and the baby's hip abduction exercises will begin!

Step 1: Hold the baby under the knee joint, lift the leg upwards, bend the hip and the knee joint to 90 degrees;

Step 2: Slowly open the legs, abduct the hip joints, try to make the baby's outer knee joints close to or touch the bed surface, and be careful not to break. After maintaining for a few seconds, return to the original path and repeat.

You can do it twice a day for your baby, about 20 minutes is enough. Talk to your baby while doing it, this is also a good parent-child interaction!

● Hold your baby and open his legs

When parents usually hold the baby upright, be sure to open the baby's legs to both sides, do not force the baby together, the baby in that posture is not comfortable at all.

Also when using a baby carrier, keep the child's legs apart as much as possible like a frog, instead of hanging down directly.

Prognosis of hip dysplasia

If the baby's leg lines are asymmetrical and hip joint development problems are found, parents must take the baby to the hospital for review every 1 month or so to see if there is any improvement.

If necessary, the doctor will propose treatment measures, such as: using a special wide diaper for the baby, wearing a special corrective brace or brace, a small number of serious cases will be treated with surgery. Hip development problems can be cured early, so don’t delay.