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All newborn babies have their hips checked within a few days of birth and, at 6 weeks, if a dislocation goes unnoticed, the child will grow up with a short leg on one side, a painful limp, and arthritis later in life. So, while is not a life threatening problem, (and as a baby, he is unlikely to experience any pain), it can have long term complications, especially if not treated early.

Hips are a ball and socket joint

The hip joint is a ball and socket joint - that is, the end of the leg bone forms a ball shape, which rolls around in a cup-shaped socket in the pelvic bones. The benefit of this sort of joint is that, the leg can move at the hip, through a large circle.

But the cup shape of the socket may be very shallow in new babies and, this allows the ball of the leg bone to slip in and out of the cup.

More than 1 in a 100 newborn babies have "unstable" hips, (i.e. hips which can be dislocated by the doctor during testing), but only 1 in 10 of these is a true dislocation that requires more intensive treatment.

Girls are affected 6 times more often than boys are, and, rather strangely, left hips are 4 times more likely to be affected than the right side. In a third of cases, both hips are affected, like your friend's baby.

Dislocated hips missed at birth cause symptoms later

Sometimes, a dislocation is missed when babies are tested, and x-rays aren't a lot of help because, at this age, so much of the hip joint is made of cartilage, not bone.

If tests in the newborn baby don't pick the problem up, it may cause symptoms when the baby starts to walk. These may include:

delayed walking
an abnormal waddling gait (the affected leg is shorter)
asymmetrical thigh creases (there is an extra crease on the affected side)
an inability to fully abduct the affected hip (i.e. to move the leg out, away from the body)
Double nappies is the first treatment

The treatment depends on the extent of the dislocation and the shape of the hip socket.

Initial treatment consists, very simply, of putting the baby in double nappies, which keep the leg in the right position to stop it dislocating, so allowing normal growth of the cartilage of the socket.

After three weeks, the baby is reassessed and, if there is still a problem, referral to a specialist orthopaedic surgeon will be needed. They will most likely recommend a splint or plaster cast to hold the legs slightly open. This is kept on for 3 months, to allow the socket of the joint to grow into the right shape.

After this, if the problem has not sorted itself out by about 6 months, then more complex traction and splinting may be needed, or sometimes, even an operation.

If your friend's baby needs splints, it does make carrying him around a bit more complicated, so offer to help as far as you can. But other than the practical nuisance, it may cause few other problems, and may improve rapidly with treatment.

 

 

 

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