One of the most common pathologies in babies: when should parents worry?

The most common orthopedic condition in children, occurring in 1 in 100 babies, is hip dysplasia, and one in 500 newborns is born with completely dislocated hips. Although no parent would want to hear such a diagnosis, it is important to know what hip dysplasia is, what myths are associated with it, and how important the baby’s first exam at the orthopedist’s office is. We will answer these questions together with Julija Ravinskiene, orthopedist-traumatologist at the Center for Medical Diagnosis and Treatment.

The importance of the first doctor’s recommendation

As soon as the baby is born and the first emotions disappear, it is examined by a neonatologist. This exam is extremely important because the doctor may notice extremely important and important things, such as foot or other congenital deformities, instability of the hips, writes the press release. Therefore, if it is recommended to consult an orthopedist-traumatologist at the time of discharge from the maternity hospital, there should be no delay.

“If you notice such or similar changes, the treatment of the newborn should be started as soon as possible. It also happens that foot deformities are observed even before the baby is born, during an ultrasound examination. In this case, it is possible to register with anticipation for a consultation with an orthopedic-traumatologist If the baby was born with foot deformities, a doctor should see a doctor within the first two weeks, if hip instability is suspected, within the first month after birth. At an orthopedist-traumatologist, the formation of the baby’s musculoskeletal system is evaluated. In short, the feet, legs, arms, chest, back, neck, and head are examined. Its shape, proportions, joint movements ”, says J. Ravinskienė, orthopedist-traumatologist.

Still, the doctor tends to start with the question of whether all babies really need to be seen by a traumatologist-orthopedist. According to her, it is not necessary to consult all puppies, but there are situations when examination by an orthopedic traumatologist is necessary. One such case is hip dysplasia.

What is hip dysplasia?

Dr. J. Ravinskienė realizes that there is no need to fear this diagnosis, but it is necessary to know.

“Hip dysplasia is a degree of instability in the hip joint due to insufficient or altered joint development. This term defines a very wide range of pathologies, from a small degree of anatomical insufficiency to complete dislocation of the hip joint. It is the most common orthopedic pathology in children and occurs in 1 out of every 100 babies. One out of every 500 newborns is born with completely extinct clubs, ”says J. Ravinskienė.

Hip dysplasia is diagnosed by an orthopedic traumatologist and he immediately recommends the optimal treatment, which depends on the degree of dysplasia and the age of the baby. According to Dr. J. Ravinskienė, hip dysplasia is almost always completely cured with prompt treatment and strict adherence to all recommendations.

There is no mandatory universal screening of babies for hip dysplasia in Lithuania. Still, family doctors, knowing the urgency of the problem and suspecting hip dysplasia, send many babies for an orthopedic-trauma examination. “For this reason, most cases of congenital hip dysplasia are found and cured early. We can be happy that every year we see fewer and fewer untreated and neglected cases, ”says Dr. J. Ravinskienė.

Why does hip dysplasia occur?

However, it is not entirely clear how and why hip dysplasia occurs, but it is important to pay attention to several risk factors when this condition occurs more frequently. According to the doctor, the main risk factor is gluteal prematurity. If the baby was born with a premature buttock, it is necessary to consult an orthopedist in the first weeks after birth. Another risk factor is whether the mother or grandmother has been treated for a congenital dislocation of the hip joint. The doctor recommends that these babies be shown to an orthopedist-traumatologist during the first month after birth.

Another important thing to keep in mind is that hip dysplasia is a developing pathology. “Even under unfavorable conditions, even healthy clubs can develop unevenly. Therefore, it is very important that the child develops freely, it is not possible for him to develop with tight legs, as was usual,” says Dr. J Ravinskienė.

Treatment of hip dysplasia

Dr. J. Ravinskienė points out that hip dysplasia is a curable condition, however, it requires the attention of both parents and doctors. Treatment for the most serious hip dysplasia can take an average of three months or more until normal anatomy is achieved. In rare cases, babies need surgery.

“The goal of treatment is good concentration of the femoral head: repositioning it in the pelvis. This encourages proper further development of the hip joint. We can achieve this by bending and extending the hips. To maintain this situation, special splints are used (Pavlikas straps, Freikas cushion), in more severe cases, plaster splints ”, says Dr. J. Ravinskienė.

A child who has been diagnosed with hip dysplasia and has started treatment is monitored until puberty, X-rays are taken, and development of the hip joint is evaluated. If the hip joint does not continue to develop well until the third birthday, surgery is necessary. However, it is important to note that the outcome of the treatment depends on the degree of hip dysplasia, the age at which treatment is started and especially
of the collaboration of parents with doctors and compliance with the recommendations.

Myth with the truth?

It is often heard in society that hip dysplasia is more common in girls than boys. As Dr. J. Ravinskienė observes, this is true because left hip dysplasia is more common in a newborn girl: “Up to 6 out of 10 babies with hip dysplasia are first-born and 8 out of 10 are girls,” he says. Dr. J. Ravinskienė.

Another common statement about hip dysplasia is that if the first baby in the family was born with hip dysplasia, it is very likely to happen to the second. According to the doctor, in particular, if there is at least one case of hip dysplasia in the family, the baby up to 6 weeks old should be shown to an orthopedic doctor.

As Dr. J. Ravinskienė observes: “If the first baby in the family was born with hip dysplasia, the probability that the second child will also have it is about 6 percent. If the hip dysplasia was in one of the parents, the probability increases to 12 percent. If the dysplasia was in one parent and in their first child, the chance that the other children have it is about 36 percent. “

What should I know before my first visit to an orthopedic traumatologist?

Puppies are very sensitive to the emotions of their parents, they feel and absorb them perfectly. Therefore, according to the doctor J. Ravinskienė, before the first visit to the traumatologist, you should first worry as little as possible, as it will also cause additional anxiety to the baby. “It would also be good if the child is not hungry, not tired, it is worth thinking about clothes, because the child will have to undress almost naked. Several laces and buttons are intentionally broken in the hands of excited parents, so it is difficult to concentrate and listen to what the doctor says, ”advises J. Ravinskienė.

Another important thing is that before the first visit, parents should do their homework and remember their own history and that of their family. If parents, siblings, or grandparents had orthopedic conditions during infancy, received treatment, or underwent surgery, this can be an important factor in evaluating a baby’s orthopedic condition. Also, the course of pregnancy and delivery is often asked during the examination.

The doctor advises you to remember to have backups as well, as surprises can happen during the visit.