Hip Dysplasia - Medical Negligence Compensation Claim Solicitors


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The term 'hip dysplasia' was not used consistently to describe the condition until recently when it was formally called 'Congenital Dislocated Hip'(CDH). The new term is more commonly used today as it provides more flexibility to describe the various forms of the condition. Failure to diagnose hip displacia can be due to medical negligence and may result in long term disability. Children may be eligible for Legal Aid and if not, a solicitors claim can be pursued using the no win no fee scheme.

Definition

Orthopaedic specialists in the paediatric/neonatal field use the term to describe unstable or dislocatable hips. Hip dysplasia in an infant (under 12 months) can often be treated using a special harness or splint. It is important the condition is discovered as early as possible for the best outcomes to be achieved. Well-documented research clearly shows that, the later treatment begins, the more complications are likely to occur and a poor result is the most likely conclusion.

It should be noted that not all cases require medical or surgical intervention as it has been found that, in some babies, the condition will correct itself even if not treated. This means that some forms of hip dysplasia are so mild that treatment can be kept to a minimum.

Symptoms

During the first few hours of a baby's life, obstetricians and paediatricians usually check for standard signs :

  • Lack of full joint mobility in the newborn infant
  • As each leg is gently rotated, medical personnel listen for a low 'clunking' noise as the femur engages in the socket
  • The perineum, (the skin between the genitals and anus) is stretched
  • The creases in the skin on the buttocks will not match if hip dysplasia is present
  • Knee joints out of alignment when the knees are held together, with one lower than the other.

Causes

The possible causes of hip dysplasia are both genetic and environmental. These include :

  • One of the most common causes is breech birth (when the baby is born feet first) as the pressure on the hip joints can cause considerable stress.
  • Carrying multiple babies causes crowding in the uterus and may dislocate the hips of one or more of the babies.
  • The uterus and vagina of a first-time mother may be too small and this can cause hip dysplasia due to delayed or prolonged birth.
  • Approximately a third of babies born with hip dysplasia are from a family which has a history of the condition.
  • When babies are born with congenital disorders, such as spina bifida and cerebral palsy, they are much more susceptible this condition, in addition to their other complications.

Treatment

Hip dysplasia is not difficult to treat, providing it is done as young as possible. However, with every passing month after birth, the treatment is likely to become more invasive, difficult and painful.

    Birth to six months: The first form of treatment is commenced six weeks after birth, and uses a special harness which braces the hips in position until they adapt to the new position and set in place permanently. The Pavlik Harness system has 90% success rate if initiated during the first six months of life.

    Six months to a year: The infant usually needs to be placed under general anaesthetic and an orthopaedic surgeon will realign the hips and place the child in a Spica Cast, which is similar to that used on younger babies, but less movement is possible.

    Over one year: This will most certainly require surgery called a hip osteotomy in which the bones are cut and realigned. There is a possibility that it will not be successful due to scar tissue hampering the re-alignment. There is a very long recuperation and a chance that the child will suffer early onset of arthritis. Also, a hip replacement may be needed later in life.

Medical Negligence Solicitors Legal Advice

Late diagnosed or untreated hip displacia can and often does cause long term disability. Where this occurs due to medical negligence our solicitors can help you or your child to obtain compensation. If you would like advice from a specialist medical negligence solicitor without charge and without further obligation just use the helpline or contact our offices by email.


SOLICITORS HELPLINE: ☎ 0330 660 7005


Hip Dysplasia Overview


A normal hip joint is a ball and socket joint that normally fits firmly together at the upper end of the femur. There are ligaments and muscles that keep the ball and socket firmly in place. In babies and small children with developmental dysplasia of the joint, the joint becomes dislocated and the ball becomes loose in the socket.

Hip dysplasia usually is present at birth but it can develop at some time during the child�s first year. This is why doctors should check for it at every well baby visit up until a year of age. Babies who are tightly swaddled are at a greater risk of developing hip dysplasia after birth. Babies shouldn�t be swaddled with knees and hips straight.

In all cases of hip dysplasia, the socket or acetabulum is so shallow that the ball of the femur doesn�t fit well into the socket. The ligaments might be overly stretched. The degree of instability can vary from child to child. The most serious case is a complete dislocation of the joint. In a dislocatable condition, the joint can be dislocated on examination. In a subluxatable condition, which is the mildest case of hip dysplasia, the ball can be moved around within the socket but cannot be completely dislocated.

In the UK, about 1-2 babies per 1000 are born with hip dysplasia. It is a condition that runs in families. It can happen in either hip and is more prominent in the left hip and in girls. It is more prominent in first born children who were breech at the time of birth. If there are lower levels of amniotic fluid, then there is a greater chance of developing hip dysplasia.

Symptoms of hip dysplasia include having legs of different lengths, uneven skin folds noted on the thigh, decreased mobility on one side of the legs and limping or waddling when trying to walk.

The doctor�s examination is crucial to the diagnosis of hip dysplasia. The examination should begin at birth and continue through all baby�s visits to the doctor to the age of one. The exam involves pushing the knees above the level of the hips and abducting the hips. The doctor then tries to push the hips out of their proper position. If there is a palpable click, then hip dysplasia might occur. The diagnosis is confirmed by ultrasound in babies and by x-rays in older children. If the diagnosis is not made in a timely fashion, the baby might not walk well.

The treatment of hip dysplasia depends on its severity and when it is detected. When found at birth, for example, a harness or brace can be used to correct the dysplasia. If it is found at a later date, such as when the baby is walking, the treatment and outcome varies.

When a harness is used, the parents are trained as to how to use it and the child uses it for approximately 1-2 months until there is no longer any subluxation or dislocation.

At 1 month to 6 moths a harness is used but is used full time for 6 weeks and then part time for 6 weeks. If the hip doesn�t stay in place with the harness, a brace is used instead. It is made from material that is firmer than a harness and will keep the baby�s hips in normal position. In some cases, a spica cast is recommended to keep the bones in proper position. The procedure is done under general anaesthesia because it can be painful to put the bones in the proper position and keep them there until the cast is in place.

Babies from 6 months to 2 years need closed reduction and a spica cast placement is used. Skin traction is used to prepare the soft tissues before the cast placement. It can be done at home or at the hospital.

Surgical treatment is done in older children who don�t respond to closed reduction. The surgery shortens the femur so that the head of the femur fits the way it is supposed to in the acetabulum.


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