Hesperian Health Guides
Chapter 18: Hip Problems
Every day 20,000 people visit the HealthWiki for lifesaving health information. A gift of just $5 helps make this possible!
Make a gift to support this essential health information people depend on.
A hip is dislocated when the thigh bone is out of its socket at the hip. Some babies are born with one or both hips already dislocated. Sometimes these babies have no other problem. With early treatment, the problem can often be corrected easily, and the child will not be disabled or have a limp.
|NORMAL HIP: The round head of the thigh bone is inside the hip socket.||DISLOCATED HIP: The head of the thigh bone often lies above the socket.|
For this reason it is important to examine all babies when they are 10 days old to see whether they have dislocated hips.
|1. Compare the 2 legs. If one hip is dislocated, that side may show these signs:|
|2. Hold both legs with the knees bent, like this,||If one leg stops early or makes a jump or click when you open it wide, the hip is dislocated.|
|and open them wide, like this.|
|3. To test a slightly older child, bend the knees and compare their height.||If one knee is lower, the hip on that side is probably dislocated.|
Keep the baby with his knees high and wide apart. To do this,
In places where babies are traditionally carried with their legs spread on the woman’s hips or back, usually no other treatment is necessary.
|Dislocated hips with other orthopedic problems|
|bottle to catch urine|
|The stick here helps to keep the legs apart.|
If it is difficult to keep the legs apart, you may need to use casts or make special braces.
The casts should be used for 2 to 4 months or longer, depending on the child’s age (longer for older children) and the amount of the deformity. (Use a cloth or bottle to catch the baby’s pee, so it does not run inside the cast.)
Not all dislocations can be corrected in these ways. Some need surgery, and in some cases the hip is so deformed that the dislocation cannot be corrected, even with surgery.
With spina bifida, if one hip is dislocated, surgery may help. But if both hips are dislocated, hip surgery usually will not help the child to walk any better.
|Dislocated hips can also occur after the child is born, either from an accident or as a complication of some other disability—especially polio (due to weakness in the muscles and cords that hold the hip joint together) or cerebral palsy (due to spasticity and contractures).||DISLOCATED HIP|
|The spasticity and contracture of this muscle cause dislocation of the hip.
legs crossed like scissors
THE TELESCOPE TEST
To find out if the hip is dislocated or can easily be pulled out of joint, place the child on his back.
Dislocations that are complications of polio or cerebral palsy can seldom be corrected without surgery. But often it is better not to operate, because the operations do not always turn out well, and the children who have the possibility of walking will walk in spite of the dislocated hips.