Hip joint dysplasia
Hip dysplasia is a birth or acquired defect in the neonatal or infancy period.
Hip dysplasia is a congenital or developmental (acquired in the neonatal period or infancy) deformation or misalignment of the hip joint. This term refers to the defects of all elements forming the hip joint, both the bone components, such as acetabular, and the ligaments. The most common image of this condition is the abnormally developed acetabulum of the hip, which covers femoral head insufficiently, which is accompanied by incorrectly shaped proximal end of the femur. Hip dysplasia is the most common birth defect, much more common in girls ( about 80 % of cases) than in boys.
What cause Hip joint dysplasia
The causes of its formation and development are not known. It is believed that the emergence of hip dysplasia can be triggered by:
- genetic factors
- hormonal factors (which affect the tension of the ligaments and joint capsule)
- the position of the fetus in the uterus
- the position of legs in flexion, adduction
- the external rotation
Also the probability of occurrence of dysplacia may be affected by other factors such as:
- sex - the majority of dysplasia cases of the hip occurs in girls)
- genetics - if your parents had dysplasia of the joint, the probability of occurrence in the child is increased
- conditions of pregnancy - positioning of the fetus in the uterus (arrangement of feet as flexed, adducting and external rotation, or a small amount of amniotic fluid)
- rapid straightening of the legs of the child during birth
- hormonal - affecting the tension of ligaments and joint capsule
- other anomalies- cerebral palsy, spinal cord diseases or other disorders of the nervous or muscular system
Hip dysplasia is diagnosed by performing the clinical screening on each child in the first month of life. This screening includes the:
- relocation syndrome followed by a distinctive ‘clunk" ( Ortolani maneuver),
- balancing syndrome ( Barlow’s syndrome, performed by adducting the hip while applying light pressure on the knee)
- the degree of joint abduction
- the stability of the joint
- the length of the legs
- the position of thigh, groin and buttock folds.
This study is complemented by the ultrasound examination, on the basis of which one of the several types of hips is determined according to Graf’s classification:
- a healthy, properly-shaped hip joint
- the immature joint, abnormal joint
- the dysplastic hip
- the dislocated hip
Hip dysplasia - what next?
In the case of hip dysplasia, the most commonly used are medical treatments, consisting of the correct orientation of the femoral head of the child by:
- appropriate, broad diaper use (so that the child's legs are arranged in a 'frog' position)
- using Frejka pillows
- Pavlik harness - this is often used as a first treatment in children less than 6 months of age. In the course of carrying harness, ultrasound is made, which illustrates progressive changes. The harness is adjustable, it 'grows' with the child, even though it restricts its movements. It does not allow straightening of the legs at the knees and rotating the hip inwards (the main complication of wearing a Pavlik harness can be avascular bone necrosis, a rare bone disease)
- Koszla splint
It is also indicated to arrange the child in a lying position on its stomach. It is also possible to manually set the femoral head.
A non-treated dysplastic hip can cause:
- the feeling of overlapping
- difficulty in walking, and consequently it can lead to rapid wear of the joint covered by the defect and the adjacent joints, mainly the sacroiliac and knee joints.
The prevention of hip dysplasia is not unambiguous due to reasons for the lack of a precise cause of the disease. It would therefore be advised to follow basic rules of hygiene and a healthy lifestyle, especially for pregnant women. Regular ultrasound and contact with your leading doctor are important in the prevention of complications.