While it may not exist, parents want perfection for their children when it comes to all aspects of growing up from physical development to learning to social interaction. When a child has a hip or joint abnormality, it can be a trying time for parents and a scary time for the child as both learn about the problem and how to best treat it.
Hips and Joints
The hip is the ball and socket joint at the top of the leg where the thigh bone and pelvic bone meet. They are called ball and socket joints since the top of the thigh moves within a small almost cup like space in the hip. Hips are normally stable joints unless there is an underlying medical condition. Joints can be found on any part of the body where two bones come together. They can be immovable, slightly moveable and freely moveable.
Types of Abnormalities
According to the American Academy of Orthopedic Surgeons, a common hip abnormality in children is developmental dysplasia of the hip or DDH. This means the top of the thigh bone isn't held properly in the hip socket and the ligaments can be stretched or loosened. In children, the bone can be loose or it can be completely out of the socket. Joint abnormalities can present on any joint including the hip. The knees for example can present with genu varum, bow legs or genu valgum, knock-knee deformities. This means the kneed bow out or inward and both can cause osteoarthritis later in life.
Causes
Hip and joint abnormalities in children can be caused by problems during the pregnancy where the fetus does not develop properly. DDH can be hereditary and is seen more often in first born children or children who are born in the breech position. MedlinePlus states that children develop bow legs as a result of the way the legs were folded in the uterus during pregnancy. Bone dysplasia or Blount's disease can also cause bow legs. Knock knees are often the result of a disease that has already been diagnosed in the child.
Treatments
Treatment for DDH depends on how old the child is. Newborns may be placed in a Pavlik harness for 1 to 2 months to keep the thigh bone in place. Surgical treatments are available to place the thigh bone in the proper alignment. Children with bow legs should be evaluated every 6 months to determine if treatment is necessary. In severe cases, special shoes to rotate the feet the proper way are prescribed. Knock knees normally do not need treatment and resolve on their own as the child grows and learns to walk.
Considerations
Children are screened for DDH starting at the first exam as a newborn and then at each recommended check up. Sometimes DDH is not noticed at birth and is only diagnosed when the child starts walking. With proper physician observation, most children do not have long lasting problems with bow legs or knock knees.
