What is hip dysplasia?
Developmental dysplasia of the hip (DDH) is a condition that affects the hip joint in babies and young children. DDH can vary from mild to severe. The socket may be shallow, and the structures that support the hip may be lax. This can allow the head of femur to be unstable. In severe cases, the head of femur may lose contact with the socket. This is known as a dislocated hip, and is occurs in around 1-3 of 1000 infants.
Why does my child need surgery for her/his a dislocated hip?
baby with a dislocated hip will usually be given a trial of brace treatment. The hip brace holds the baby’s hip in a position in which it can be captured by the cup and then start to develop normally. In some cases the brace can not successfully hold the hip in the ideal position and a surgical approach is required
Surgery may also be required if a dislocated hip is first noticed when the infant is older.
What surgery is needed for a dislocated hip?
The child’s hip is examined by the surgeon under a general anaesthetic. A dye, which which is visible on X-ray ,is injected into the hip joint. The hip is then gently manipulated to see if it can be positioned safely with in the cup. If a satisfactory position is achieved a plaster jacket known as a hip spica is applied to keep the hip stable.
After the reduction an MRI is performed to ensure the hip is in the best possible position for growth and development.
It is usual to change the hip spica after six weeks so as to check the hips development and to accommodate for growth over this period. This spica is removed six weeks later and the plaster changed for a removable brace that would be worn for a number of months afterwards.
Sometimes an open reduction is required. This surgery involves a small incision in the groin. Tight structures around the hip are released, allowing for the hip joint to be positioned in the ideal position. This is followed by the application of a hip spica and subsequently a hip brace.
If the child is older (greater than 18 months of age) when a dislocated hip is diagnosed, more extensive hip surgery will normally be required.
How long will my child need to stay in hospital?
Your child will normally stay in hospital for 48 hours following the surgery. You will be able to stay in the hospital with your child. The nurses in the hospital will show you how to look after your child with the hip spica in place. Prior to you going home your child will have a MRI to check the hip spica is holding your child’s hip effectively.
What are the possible complications of surgery?
A possible consequence of this surgery is a disruption of the small vessels that provide blood supply to the femoral head. Over many years this can result in a growth disturbance to a child’s hip. For this reason, close ongoing follow up from your child’s orthopaedic surgeon is essential.