Infant hip dislocation can be an unexpected diagnosis following birth. A dislocated hip is a type of birth defect that requires treatment to prevent disability and permanent damage to the hip. Fortunately, this condition is relatively easy to identify based on risk factors and appearance, and correction can establish stability of the hip joint.
Congenital Hip Dislocation
Hip dislocation in infants is most commonly the result of a congenital defect known as developmental dysplasia of the hip, also called DDH. The hip joint is a type of joint called a ball-and-socket, where the end of the leg bone fits into the socket in the pelvis. According to Children's Hospital of Pittsburgh, DDH occurs in one out of every 1,000 births. It may appear as a complete dislocation, or the leg bone may slip in and out of joint.
Causes
Hip dislocation is commonly caused by factors that occur during pregnancy. A baby with little room to grow during pregnancy may develop a dislocated hip because of positioning within the womb. This also can occur with infants who develop and remain in a breech position during pregnancy. Hip dislocation can also be caused by a reaction to a mother's hormones during development or because of teratogens during pregnancy that can cause birth defects.
Risk Factors
Risk factors for congenital hip dislocation include a baby that is a first-born for a mother. A woman who has not been pregnant before has a smaller uterus. This decreases the size of the area in which the baby will grow. A family history of hip dislocation also puts infants at risk, and the incidence seems to be greater among girls than boys. Babies that have another type of orthopedic issue, such as clubfoot, also have a greater chance of developing a hip dislocation.
Diagnosis
Hip dislocation is diagnosed by a physician if an infant has high risk or shows symptoms. A baby may be born with one leg shorter than the other or may have a large, uneven fold of fat on the buttocks. A doctor may examine a baby and hear a clicking or popping sound while pushing the legs back. A diagnosis is confirmed by a leg and hip X-ray or an ultrasound of the hip joint.
Treatment
Treatment of hip dislocation includes use of a special type of harness or surgery. A Pavlik harness is one that draws a baby's legs outward and holds them into a position that will allow the joint to stay in place. This type of harness is typically worn for 12 weeks or as recommended by a doctor. Severe forms of hip dislocation or those that do not respond to harness treatment may need surgery. A surgeon may deepen the socket joint or shorten the ligaments surrounding the joint to keep it in place.
