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Understanding Developmental Hip Dysplasia: Guiding Your Baby's Journey

paediatrics Aug 18, 2023
Pavlik harness

Developmental Hip Dysplasia, commonly known as 'clicky hip', refers to the abnormal development of the hip joint in infants and children. This condition arises when the femoral head (hip ball) lacks stability within the acetabulum (pelvic socket), often due to factors such as a flattened femoral head, shallow socket, and lax ligaments[^1^].

This condition affects approximately 1 in 6 newborns, with a higher prevalence among girls[^2^].

Understanding Hip Dysplasia: Causes and Indicators

Developmental Hip Dysplasia typically results from a combination of loose ligaments and abnormal bone growth or development. While not always evident at birth, certain risk factors include:

- Breech position after 32 weeks of gestation
- Family history of hip dysplasia
- Improper swaddling techniques
- Being a firstborn child[^3^]

Recognizing Hip Dysplasia in Your Baby

Several distinctive signs can point towards hip dysplasia in infants:

- Audible clicking or clunking during hip movement
- Uneven thigh or buttock skin creases
- Leg length discrepancy
- Weight-bearing imbalance while sitting
- Reluctance to bear weight on the affected side
- Limping or discomfort when walking
- Walking on tiptoes on one side
- Difficulty in spreading legs apart[^4^]

Guidance and Care for Your Baby's Hip Dysplasia

Newborns usually undergo routine hip dysplasia screenings, often repeated during the initial months. A positive diagnosis necessitates vigilant monitoring and follow-up ultrasounds to ensure proper hip development[^5^].

As an Advanced Paediatric Osteopath, I am equipped to conduct comprehensive assessments, refer for diagnostic imaging offer suitable treatments, and collaborate with Paediatricians or GPs for further evaluations and referrals. For mild-to-moderate cases, conservative management involving gentle manual therapy, home exercises, and positioning advice is typically effective.

In more severe scenarios, consultation with a certified orthotist might lead to harnessing or bracing. For the most critical instances, consideration of orthopedic surgical intervention under experienced guidance might be recommended[^6^].

Tips for Managing Your Baby's Hip Dysplasia

- Allow natural leg and hip positioning whenever possible, encouraging knees to bend outward.
- Minimize the use of tight swaddling to promote healthy leg movement.
- Avoid car seats or carriers that press legs together at the knees.
- Utilize carriers like Ergo or Manduca, positioning your baby facing you with knees bent outward for optimal hip socket development[^7^].

For a thorough consultation or to explore treatment options, please contact us at (02) 4655 5588. 

 

References:
[^1^]: Terjesen, T. (2018). Ultrasonography and hip dysplasia. Journal of Children's Orthopaedics, 12(3), 225–233.
[^2^]: Rosendahl, K., Markestad, T., & Lie, R. T. (2011). Congenital hip dislocation: A prospective epidemiological study. Journal of Pediatric Orthopaedics, 31(3), 225–232.
[^3^]: Novais, E. N., Hill, M. K., Carry, P. M., & Heare, T. (2014). The A, B, Cs of developmental dysplasia of the hip: Are we on the right track? Journal of Pediatric Orthopaedics, 34(Suppl 1), S51–S56.
[^4^]: Dezateux, C., & Rosendahl, K. (2007). Developmental dysplasia of the hip. Lancet, 369(9572), 1541–1552.
[^5^]: International Hip Dysplasia Institute. (2023). Hip dysplasia: Screening and diagnosis. Retrieved from https://hipdysplasia.org/developmental-dysplasia-of-the-hip/hip-dysplasia-screening-diagnosis/
[^6^]: Upasani, V. V., Bomar, J. D., Matheney, T. H., Sankar, W. N., & Mulpuri, K. (2014). Evaluation and management of developmental hip dysplasia in the infant and young child. Journal of the American Academy of Orthopaedic Surgeons, 22(12), 769–778.
[^7^]: American Academy of Pediatrics. (2020). Babywearing safety tips. Retrieved from https://www.healthychildren.org/English/ages-stages/baby/wearing-your-baby/Pages/Babywearing-Safety-Tips.aspx

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