The duration that children need to be in plaster varies. Great care needs to be taken in looking after them! Plasters such as this always need to be changed after six weeks or sometimes earlier, under a general anaesthetic. If, after traction, it is possible to put the hip back in joint in this way, the baby is placed in a plaster hip spica cast which extends from the waist down to the knees or feet. In this test a small amount of dye that shows up on X-ray is injected into the hip joint while the baby is asleep, and X-rays are taken to see if it is possible to put the ball back into the socket safely and completely. Often in association with this anaesthetic an arthrogram is performed. This means gently pulling on the leg to relax the muscles etc.Īfter a period of such traction it is usual to examine the baby's hips under a general anaesthetic. For children under the age of two years most surgeons arrange for admission into hospital for a period of preliminary traction. If the hip will not reduce, or if the Pavlic harness does not allow the hip to grow properly, other treatment is necessary. Under these circumstances it is entirely reasonable to see whether a period in a Pavlic harness (a harness that keeps the baby's hips and knees bent upwards and outwards) allows the hip to stabilise more safely in the joint and allows the socket to grow more satisfactorily around the ball of the hip joint. for the ball to go back into the socket - without any other additional treatment being necessary. It is sometimes possible in a child of four or five months for the hip to reduce - i.e. When a General Practitioner, Health Visitor or Paediatrician recognises these problems in an older child (after the age of 10-12 months) it is important to take an X-ray so that the degree of displacement can be seen and judged. Examination of the hip may show that the hip will not bend out as fully sideways or move as freely as the other hip. Typically when the hip displaces a little or completely, the baby's leg lies with thigh creases which do not line up perfectly and with the affected leg looking slightly shorter and rolled out sideways. The socket of the hip joint (acetabulum) is usually shallow and the ball (femoral head - top of the thigh bone) can be loose or completely dislocated instead of fitting snugly into the socket (the severity of the condition varies).Īlthough screening programmes allow us to detect most babies with unstable or abnormal hips, some children have an abnormality which simply cannot be detected with clinical examination and the hip may fail to develop normally. It can occur before birth or in the first months of life. What is Developmental Dysplasia of the Hip (DDH)?ĭDH is a condition where the ball and socket hip joint fails to develop normally.
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