Hip Dysplacia - Medical Negligence
Hip dysplasia is a relatively common condition of infants in which the hip joint is abnormal. The problem can be with the acetabulum (hip socket) or with the hip joint (femoral head) or with both. The actual terminology of the disease is developmental dysplasia of the hip or DDH. It used to be called congenital dysplasia of the hip.
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^^ back to the topNo one knows exactly what causes developmental dysplasia of the hip although there seem to be some predisposing factors. It is more common in girls and is present in 0.4 percent of all births. Other risk factors include having a family history of hip dysplasia, being born under the condition of oligohydramnios or being born in the breech presentation. Club foot or torticollis can be conditions of being seated abnormally in the uterus and hip dysplasia can be a part of this group of symptoms.
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^^ back to the topBabies are tested for hip dysplasia at birth. Doctors do an exam and feel for a hip click when abducting the hips with the knees in the flexed position. The tests, called the Ortolani and Barlow tests, push the hip out of its normal position and indicate that hip dysplasia is present. If a click is felt, the doctor can do an ultrasound of the hip to check the hip joint out. X-rays do little to determine what is going on in the hip joint because the bones haven’t developed enough to be seen well, especially in the joint regions. The ultrasound can show the ball of the hip out of the socket or a very shallow socket that doesn’t hold the hip joint together. Ultrasounds are used for diagnosis as well as for following the nature of the treatment.
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^^ back to the topThe treatment of hip dysplasia completely depends on the age of the infant. The idea behind treatment is to put the hip joint back in place and allow it to hold there permanently. It is easier to treat a very young child with hip dysplasia than it is to treat an older child. The hip joint becomes more fixed in the socket and eventually it stays there without treatment. From birth to six months of age, hip dysplasia reduces easily and the child wears what is called a Pavlik Harness—a device that keeps the hips in place until the baby recovers fully. Using just the brace, about 90 percent of babies need no further intervention. It is used after birth for several weeks until the hip has recovered.
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^^ back to the topIf the diagnosis of hip dysplasia is not made until after six months of age and up to one year, the Pavlik harness will not work very well. Instead, surgery is done under general anesthesia that puts the hip back in its proper place. After that, a spica cast is placed that holds the hip joint in the proper place. The cast is relatively immobile so that it keeps the hip stable until it heals.
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^^ back to the topIf a child is not diagnosed with hip dysplasia until after one year of age, surgery is required to put the hip back in place. Scar tissue is broken down which otherwise interferes with the joint’s ability to go into proper positioning and stay there.
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^^ back to the topThere needs to be adequate replacement of the hip joint within the hip socket and an adequate means of keeping it there. If the child is young or determined to have the condition at birth, the chances of success are great. Older children can achieve success in eliminating hip dysplasia but the process is more extensive and it takes longer for the immobilization of the hip.
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^^ back to the topChildren with hip dysplasia that is not quickly or easily reduced have an increased risk of developing hip arthritis at an early age in life. It is entirely possible that, once this happens, a hip osteotomy (cutting and realigning the bones) or a total hip replacement might become necessary.
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^^ back to the topFor free advice about compensation claims for hip dysplacia, without further obligation just call the helpline, email our offices or complete the contact form.
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