Hi I'm Dr. Laurel Benson. I'm a pediatric orthopedic surgeon at Rocky Mountain
Hospital for Children in Denver. Today I'd like to talk to you about hip dysplasia
and how it affects infants
hip dysplasia is a silent destructive process
in infancy and childhood its absolutely
painless but the damage to the joint is ongoing
the child can walk and crawl on a normal schedule of
milestones but once pain begins to plague the child in adolescence,
the surfaces at the hip are beyond repair the cartilage
is thinned and frayed the degree of arthritis that we see is similar to that seen in
many elderly patients
unfortunately for some older teens and young adults
the process is so destructive that hip replacement surgery in the early
twenties
is their final outcome the surgical procedures that are used to try to
salvage the damaged hip
in the interim are major procedures with long recoveries
it's not something that any parent would want for their child in the past we
worried most about babies who were born breach
or who were in utero for extended periods of time
in the breach position. But recent research conducted at the Naval Hospital
in San Diego California
revealed that even a short period of breach positioning
puts some infants at risk for dysplasia
female babies first borns
and infants with a family history of dysplasia
are also at risk of all these risk factors
breach position seems to mean the most predictive
of hip dysplasia. Knowing that the infant was in the breach position
even temporarily gives the health care provider
the best information possible the goal of treatment in hip dysplasia is to
position the legs
and the body in a brace or harness so that the femoral head
is aimed at the center of the acetabulum pressure there
influences the socket to grow in the center
to create a deeper cup for that femoral head
since infants grow at such a fast rate
the sooner that treatment can begin the better the outcome
hip dysplasia that's recognized and treated in infancy
can have a marvelous success with 95 percent of patients achieving a normal
hip
so in closing I'd like for you to remember these points
hip dysplasia isn't painful but the damage can be significant
and detecting that problem early on
is so important the four
f's to remember are feet up
breach presentation female
firstborn and family history
they're great guideposts to assess
the risk factors for the baby early detection produces better results
ninety-five percent of patients who were treated in infancy
have normal hips on physical exam
one of the best simplest test is to determine whether there's any limitation
to hip abduction
it really can be a trigger to let you know whether further action
is required part of treating hip dysplasia is using
ultrasound images of the baby's hips
because cartilage and bone
in infancy are difficult to determine but on ultrasound we can see that
cartilage
shapes and the relationships that the ball and the socket
have together this will guide not only treatment
options but our way of assessing have a child is responding.
If you have any questions, any concerns
we'd love to see you here
when treated early children with hip dysplasia
can lead normal lives we want you to know about this
follow these guidelines and let us be
at your side to get your child up and going
on the road to get up and go