So your baby has been diagnosed with hip dysplasia but youre still confused as to what this means for her?* Debbie Clemens of Hip Babes sheds some light on hip dysplasia, what can be done about it and how you can help your child adjust to her treatment.

What is hip dysplasia?
Hip dysplasia or developmental dysplasia of the hip (DDH), the preferred medical term, refers to a range of disorders of hip instability. DDH is an abnormal development of the hip joint. The ball at the top of the thighbone (called the femoral head) is not stable within the socket (called the acetabulum). The ligaments of the hip joint, which hold it all together may also be stretched and loose.

Why does my baby have hip dysplasia?
Although the causes of DDH are unknown, influencing factors include:
• abnormal rotation of the developing hip during the first trimester.
• neuromuscular disease, especially in the second trimester.
• abnormal mechanical forces e.g. breech presentation.
• female infants (who are more susceptible to the maternal hormone relaxin).
• postnatal mechanical forces associated with swaddling.

Interestingly, the last point mentioned is thought to be relevant where there are cultural differences. The highest incidence of infant hip dislocation is said to be in cultures such as the Najavo Indians and the Canadian Eskimos, where it is a common practice to tightly swaddle infants or strap them to cradle boards. In cultures within Africa and the Far East, where mothers carry their babies on their backs or hips in a widely abducted straddle position, the disorder is relatively unknown.

How will my baby be treated?
If your baby is at high risk, he or she will have an ultrasound performed at about six weeks after birth.

With early management through splinting (hip bracing) the hip joint can develop as normal and your baby may avoid the need for surgery.

In the event that your baby needs to be fitted with a hip brace (usually a Dennis Browne bar or Pavlik Harness in Australia), she may be recommended to wear this device for 23-24 hours a day for a significant number of weeks or months.

If your babys hip remains dislocated following a trial of bracing or if hip dislocation is detected when she is much older, surgery and the use of a hip spica (plaster) may be necessary.

Continued Hip Dysplasia in Babies – Page 2