Hip dysplasia

In a luxated hip, the femoral head is partially or completely displaced from the acetabulum so the femoral head isn’t positioned correctly in the acetabulum.
Congenital hip dysplasia means that the hip joint is not fully formed yet at birth. Girls are affected about six times as often as boys.

Hip dysplasia can have various causes, and both internal and external factors may be involved.
Insufficient room in the womb is an important external factor causing hip dysplasia in infants. Hip dysplasia with hip luxation may develop when the femoral head shifts in the acetabulum due to the child’s limited ability to move and presses against the edge of the acetabulum for an extended period of time, causing it to become deformed. Possible causes for a lack of space include:

• First pregnancy

• Breech presentation

• Low volume of amniotic fluid

• High maternal blood pressure during pregnancy

The typical symptoms for hip dysplasia and hip luxation, which may be only slight or already fully evident, are as follows:

• Instability of the hip joint

• Dislocation and reduction of the femoral head

• Limited abduction of the affected hip joint

• Asymmetrical folds on the rear of the thighs

• Apparent shortening of the affected leg

Hip dysplasia and luxation are mostly unilateral (approximately 60 per cent), but the symptoms can also occur on both sides. An initial indication of hip dysplasia in newborns is an unstable hip joint. However, this corrects itself in 80 per cent of all cases. Further external pressure on the femoral head (for example, putting on nappies with the hip joints in the extended position) can lead to a hip luxation.

If maldevelopment is suspected after a physical examination of the infant, an ultrasound examination follows. This allows the doctor to assess whether the suspicion of hip dysplasia or hip luxation is correct.
X-rays are only taken when treatment is necessary. Treatment is followed by another, final X-ray examination to exclude a breakdown of the joint (necrosis of the femoral head).

Therapy depends on the extent of the symptoms and the age of the child at the time of diagnosis. Generally speaking, though, the younger the affected individual, the easier it will be to successfully treat hip dysplasia and hip luxation.
In the early stage, therapy is often unnecessary and the hip dysplasia frequently corrects itself within the first two months. You can promote the spontaneous healing of hip dysplasia by putting on your baby’s nappy with the hip flexed, carrying the infant in a baby sling and consistently avoiding early extension of the hip.
When hip dysplasia continues beyond the age of two to four weeks, spreader pants are a suitable means of therapy. Your doctor will decide whether muscle relaxation exercises such as physiotherapy will be used in addition if needed. In the case of hip dysplasia with hip luxation, the femoral head has to be repositioned in the acetabulum. This can be done with the help of an orthosis. The femoral head has to be subsequently prevented from popping out of the acetabulum again. This is also done with the help of orthoses.