Is My Daughter at Risk for Congenital Hip Dislocation?

Q: Is My Daughter at Risk for Congenital Hip Dislocation?

Hello： In response to your question, first-born girls and children born in the breech position are more likely to develop developmental dysplasia of the hip (DDH), with an incidence rate of about 2%. <br>This is a relatively common orthopedic condition that may not be easily iden

Is my daughter suffering from congenital hip dislocation?

Hello Doctor: First of all, thank you for your response! My daughter is three months and six days old.
We just discovered that her left foot is slightly more than one centimeter shorter than her right foot, but both feet have the same width and she has good mobility.
Her buttocks are also symmetrical; it's just that the sole of her left foot is a bit smaller than that of her right foot.
Since I live in the United States, a nurse comes every two weeks to measure my child's height, and this issue was only noticed yesterday.
I read online that first-born girls and children born in the breech position are more likely to have this problem, so I would like to ask for your advice and also to know what possible examination methods there are (as English may be a bit difficult to understand).
Thank you! Janice

Janice, 30~39 year old female. Ask Date: 2006/11/23

Dr. Li Wenlin reply Orthopedics

Hello: In response to your question, first-born girls and children born in the breech position are more likely to develop developmental dysplasia of the hip (DDH), with an incidence rate of about 2%.
This is a relatively common orthopedic condition that may not be easily identifiable at first glance.
The following methods can help parents check for abnormalities in their children.

First, when changing the baby's diaper, lay the infant flat on their back and open their thighs.
Observe whether the skin folds on the inner thighs are symmetrical.
While asymmetry does not always indicate a problem, if the skin folds on the inner thighs are not symmetrical, caution is warranted, and further evaluation may be needed to determine if a specialist should be consulted.

Second, compare the size of the baby's buttocks on both sides to see if they are equal.

Third, open the baby's thighs and compare the angles at which both hip joints can be opened.
If one side shows significant limitation or a larger opening angle accompanied by a sound (such as a click), this may indicate an issue.

Fourth, with the baby lying flat, bend both knees and place the soles of the feet flat on the bed.
At this point, both knees should be at the same height.
If there is a noticeable difference in height, this could be a concern.

If any of the above signs are present, it is best to consult an orthopedic specialist (preferably a pediatric orthopedic surgeon) for further diagnosis as soon as possible.
I hope this information is helpful, and I wish your precious daughter good health and a happy growth journey.

Reply Date: 2006/11/23

More Info

Hello Janice,
Thank you for reaching out with your concerns regarding your daughter's potential risk for congenital hip dislocation. It’s understandable to feel anxious when you notice something unusual about your child's development. Let’s break down your concerns and provide some clarity on this matter.

Congenital hip dislocation, more accurately referred to as developmental dysplasia of the hip (DDH), is a condition where the hip joint does not properly form in infants and young children. It can lead to dislocation of the hip joint if not identified and treated early. There are several risk factors associated with DDH, including being the firstborn child, being female, and being in a breech position during delivery. Since you mentioned that your daughter is a firstborn female and was in a breech position, she does fall into a higher risk category.

The signs of DDH can vary, and in some cases, it may not be immediately apparent. The fact that you noticed a slight difference in leg length and foot size is worth discussing with a pediatrician. However, it’s important to note that a small difference in leg length can be quite common in infants and may not necessarily indicate a problem.

To assess whether your daughter is at risk for DDH, a pediatrician or an orthopedic specialist will typically perform a physical examination. They will look for specific signs, such as:
1. Leg Position: The doctor will check how the legs move and whether they can be spread apart easily. Limited range of motion in the hip joint can be a sign of dysplasia.

2. Asymmetry: They will assess if there is any asymmetry in the folds of the skin on the thighs or buttocks, which can indicate a hip issue.

3. Leg Length: They will measure the length of both legs to see if there is a significant difference.

4. Ortolani and Barlow Tests: These are specific maneuvers used to check for hip dislocation or instability in infants.

If there are concerns based on the physical examination, your pediatrician may recommend imaging tests, such as an ultrasound, which is commonly used for infants to visualize the hip joint and assess its development.

In terms of next steps, I recommend scheduling an appointment with your pediatrician as soon as possible. They can perform the necessary examinations and, if needed, refer you to a pediatric orthopedic specialist. Early detection and treatment are crucial in managing DDH effectively, and the earlier it is addressed, the better the outcomes.

In the meantime, keep observing your daughter’s movements and any changes you notice. It’s also beneficial to maintain open communication with your healthcare providers, as they can provide you with the most accurate information and guidance tailored to your daughter’s specific situation.

I hope this information helps alleviate some of your concerns. Please feel free to reach out if you have any more questions or need further clarification. Your daughter’s health and well-being are of utmost importance, and taking proactive steps is the best approach.

Best wishes,
Doctor Q&A Teams

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