Hip Dysplasia - Medical Malpractice LawyersLEGAL HELPLINE: ☎ 855 804 7125
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Hip Dysplasia is the technical name for a dislocation of the leg from the pelvis. All medical professionals involved in neonatal health care should be aware of this serious condition and examination of the hips should be an important clinical screening test throughout infancy. Careful examination of a child’s hips should be carried out at frequent and regular intervals from birth until the child is walking normally. As this condition is not always present at birth, but may develop at a later stage, healthcare professionals should take every opportunity to check a child’s hips and if necessary refer the child on for ultrasound or X-ray and subsequent specialist opinion. Delay in making a diagnosis of hip dislocation is a frequent cause of medical malpractice lawyers litigation against those responsible for neonatal health in the community. Delay in diagnosis makes treatment more complicated and may have serious long term effects. Hip dysplasia is often not diagnosed until the child is walking having already been seen by numerous doctors and nurses and treatment at this stage often involves repeated major surgery and a less than satisfactory outcome.
Infant Hip Dysplasia - Medical Malpractice
Infant hip dysplasia is a dislocation of the hip in a newborn or young baby. It is usually not a complete dislocation but the joint pops in and out when the infant moves or when certain pressures are placed upon the joint. If the joint is dysplastic and is not treated, the infant can have problems walking and can have arthritis of the hip later in life if the joint is continually popped in and out of the joint. Doctors need to screen for hip dysplasia and need to treat the condition promptly so that the condition doesn't worsen and cause the baby to have problems later in life.
The evaluation for hip dysplasia is done at the newborn examination. The doctor draws up the knees and widens the hip joint outward. This rolls the hips and the doctor feels for a "click" in the groin area, where the hip joint is. If a click is heard or felt, there is the chance of hip dysplasia and the doctor needs to go further in the evaluation of dysplasia. If not click is felt or heard, there is no hip dysplasia and the child is normal.
It is more common to see congenital hip dysplasia in female infants, in firstborn infants, in infants who are large, in infants who are born in the frank breech presentation, and in infants born by Caesarean section. Diagnosis needs to be done as early in life as possible so as to use the right braces and fix the problem before the child walks. It is treated more easily if it is treated early in the child's life. If it isn't diagnosed until the child is walking, treatment is difficult and the damage may already have begun.
Once the click is heard or felt, the doctor goes on to do x-rays or a hip ultrasound that will further define whether or not the hip displaces itself. Ultrasound testing is the best test for congenital hip dysplasia because the infant bones are very soft and not easily seen on x-ray. If the dislocation is found, treatment needs to be undertaken. The type of treatment depends on the age of the child and how severe the hip dysplasia is.
A Pavlok harness is the usual way to treat congenital hip dysplasia in young infants. It is worn for twenty-two out of twenty-four hours of the day or can be used the whole day. It holds the hips in a position in which it is not dislocated so that the joint capsule can form around a normal hip joint. The harness is soft and somewhat comfortable. It is connected via Velcro. The infant is often irritable and crying because of the position their hips must be in during the time they are wearing the Pavlok harness. The parents are often stressed out because of the crying infant and, unfortunately, if it doesn't work after a few months, further treatment needs to be undertaken.
A spica cast is the next treatment done to prevent permanent hip dislocation in infant. It is a cast that holds the legs an abducted position at all times with a hole for the diaper to fit in. It is severely invasive and the infant is very irritable and changing the diaper is problematic. It is worn for a few months so that the hip joint grows in the proper position. There is no mobility of the joint while wearing the spica cast. The invasiveness of the cast makes it one of the last choices for the infant. The only other choice is surgery, which doctors want to avoid.
Surgery is the last step to treat congenital hip dysplasia. It is very invasive and painful for the infant and requires that the infant wear a spica cast for two to three months after the surgery is over. The Pavlok harness is used for several months after that and finally the infant is free of any appliances. It impairs the timeline of when the infant walks but is sometimes the only way to prevent complications later in life.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here