Clicky hips is a condition also known as developmental dysplasia. While it may not cause pain to your baby, this condition can cause serious problems in gait and structure later in life. This condition affects 1-3% of all newborn babies. The sooner you make sure that your baby gets the appropriate treatment, the better is the prognosis for your child.
Developmental dysplasia of the hip (DDH) or clicky hips refers to a range of problems concerning the hip joint. This joint acts as the foundational link between the upper torso and the lower torso.
The hip joint is a ball and socket type joint. The ball on the femur (thigh bone) should ideally sit snugly into the socket of the pelvis. When the ball and socket of the hip joint face issues, it creates instability throughout the body.
DDH occurs when the following conditions are true:
Developmental dysplasia of the hip is a condition that occurs when the hip joint of the pelvis and femur is not stable or secure enough in infants. Developmental dysplasia can affect one or both hip joints. In the latter case, the signs of the condition are significantly harder to notice. This is largely because when both joints are damaged, parents have no visual cue to notice the abnormality of the hips. If left untreated or undiagnosed, developmental dysplasia of the hips can lead to several major complications later on in life such as developing a limp, hip pain, as well as painful and stiff joints.
About one to three percent of babies develop DDH. However, about 60% of babies return to normal within one month and 88% return to normal after two months. Only around 1 to 2 children in every 1000 suffer from actual DDH and require medical assistance.
Note: It is recommended that parents who suspect developmental dysplasia in their infants consult their paediatric specialist for a thorough diagnosis and treatment plan.
Breech babies (babies who are in the bottom-down position while in the womb) are at the highest risk of contracting this condition. Female babies are also more likely to develop hip problems than male babies are. This is because girl babies tend to have more looseness in ligaments than boy babies. Some researchers also suspect genetic causes behind hip problems, but there has been no research to prove its existence.
There are numerous other factors that come into consideration before your infant is diagnosed with this condition. Parents who have children that have been diagnosed with developmental dysplasia are recommended to closely monitor the child and keep a line of clear communication open with the specialist treating the baby.
While genetics do play a role in the development of dysplasia, they are not the main cause of it. The chances of your baby getting developmental dysplasia of the hips are higher if a sibling has had the same condition.
Keep your doctor informed of not just your medical history, but also your baby’s siblings’ history as well. If a parent or a sibling has had developmental dysplasia of the hips, then your baby has a 10% chance of developing the condition.
Note: All statistics mentioned are according to http://hipdysplasia.org/developmental-dysplasia-of-the-hip/causes-of-ddh/
There is no particular cause for the occurrence of developmental dysplasia of the hips in babies. Some of the factors that cause developmental hip dysplasia in infants include:
Your baby’s hip joint is not made of hard bone like an adult’s is. Instead, it is made from soft cartilage that hardens over time. This why you must allow a full range of motion for your baby’s limbs even while he rests.
It is usually hard to notice any hip problems in your newborn. However, your doctor will examine your baby for any abnormalities by performing the following tests:
The above are also things that you can check for yourself.
Keep an eye out for the movement of both your baby’s legs and see if they match each other in the range of movement as well as strength. For example, see if both legs move with equal vigor as you change the diaper.
Once your baby is old enough to crawl, a common symptom of DDH is that the baby seems to be dragging one of his legs.
One of the late-stage signs of DDH could be an abnormal gait. If both hips are affected, this could result in a waddling walk. Your child might also walk on his toes in this condition.
Keep an eye on the usage and development of both legs as your baby grows. Don’t forget to inform your doctor if you notice any abnormalities.
When your doctor is examining your baby, he might hear or feel a click. This is usually a sign of DDH. In fact, it could just be that the joint is moving in and out of alignment. Babies do not feel pain with this condition.
Your doctor might recommend an ultrasound on the hip region to determine the exact cause of the abnormality. X-rays are used to diagnose DDH only for older children, as infants still do not have the required bone density to show up on an X-ray.
The treatment for developmental dysplasia of the hips or clicky hips in babies will depend on the age of your baby. The bone density of your child keeps changing as they grow. Here are some of the non-surgical treatments used for different age groups:
Infant hip dysplasia treatment involves using a Pavlik harness. This is also known as hip dysplasia in babies harness. It is a soft harness that helps keep your baby’s hip joints in their natural position while allowing for free movement. The harness must only be placed or removed by a medical professional. This harness allows the ligaments surrounding the hip joint to strengthen. Your doctors will help you with techniques on how to change diapers, hold the baby comfortably, and how to clean the harness. This harness is usually recommended to be used for one to two months.
In case a harness has proven to be ineffectual, then your doctor might place your baby in a firmer harness known as an abduction harness. Your doctor might also try a closed reduction procedure in which he will gently move the femur and place the ball into the socket and then put the joint in a spica cast. The cast will need special care, and your doctor will advise you on how to take care of it and how to identify problems with it.
Babies who are older than six months will also be treated with a closed reduction procedure with a cast. With older babies, skin traction in also carried out around the hip bone to make preparations for a change in the position of the joint.
In some cases, hip dysplasia surgery is recommended to cure developmental dysplasia of the hips in babies older than 6 months. An incision is made, and the bone is placed into the socket. In some cases, the length of the femur is reduced to fit into the socket properly. After the surgery, the joint is set in a cast and allowed to heal. For hip dysplasia surgery child care, ensure you follow your physician’s instructions thoroughly.
There are four types of surgeries your doctor might recommend. They are:
Note: Parents who have children diagnosed with clicky hips or developmental dysplasia are recommended to stay vigilant with treatments and be vocal with the primary care physician about their concerns. Time is of the essence to ensure a complete recovery from this condition.
Children who need a cast will see a late development of walking. However, once the cast is removed, the development will begin and continue at a normal rate.
Sometimes, the harness might cause skin rashes that could be painful for your baby. The harness does not address differing lengths of the limbs and is an issue that will have to be dealt with in the future.
Even after treatment and care, the problem might persist. In this case, surgery will be required in your baby’s early childhood to correct the anatomy of the joint.
The cast used in your baby’s developmental dysplasia of the hips treatment might have to stay in place for 2 to 3 months. Your doctor might change the cast after regular X-ray screenings of the joint to evaluate the progress.
Disclaimer: Recovery periods are estimates based on a general average. Accurate time of recovery is evaluated on a case to case basis. Consult a doctor for a more accurate period of recovery for your baby.
Unfortunately, since the exact cause of developmental dysplasia of the hip in babies is unknown, it can be near impossible to prevent the condition. However, there are certain practices and precautions that you should observe:
Note: Parents are advised to consult experts specialized in swaddling to learn the appropriate technique for their baby.
Infant hip dysplasia is a condition that can heavily impair your baby’s movements in the long term. Parents are encouraged to be open about all issues regarding developmental dysplasia with their primary care physician.
Disclaimer: Consult your physician before administering any developmental dysplasia medication to your infant.
Conclusion: It is highly recommended that parents not venture into alternative medication for a condition like developmental dysplasia of the hips. If parents choose to, it is recommended that thorough research is done and physicians are consulted on a regular basis. Education about the condition is critical when it comes to treating clicky hips in babies. It is recommended that any medication and treatment is followed to the end and that your primary care physician is kept in the loop about any change in condition at regular intervals.