Dislocated hip in 5 month old...please help

[shinyshilling]

We have just attended a fracture clinic appointment as my dd2 was suspected of having a clicky left hip. She was born in water at home but was diagnosed the day later. I feel so sad as I genuinely expected it to be nothing. I am not a worrier! She is going to have to wear a Pavlik Splint for 6 to 12 weeks and I'm not sure how this will impact on her little life. If anyone has had any similar experiences, please could you let me know what happened? I am worried about lasting effects. My sister in law was born with a disclocated hip which I think was not discovered until she was about 5 (she's 47 now) and she walks with a really pronounced limp.Any tips and advice would be really appreciated.

[shinyshilling]

Sorry, I meant to ask if it can happen because of being born too quickly. My daughter came out very quickly, but I'm not sure that I'm possibly mixing up shoulder dystocia with hip dysplacia!

[cthea]

It must have come as a shock but give it a few days or a couple of weeks and you'll get used to it. It's only a short time and she was diagnosed early, the harness is really effective.

[Pinkjenny]

My dd wore the pavlik until she was fifteen weeks old. She has just had her annual check and is a totally normal 2 year old. You'll get used to it really quickly. And so will she. Honestly.

[cthea]

More frequent in

• racial background; higher in Native Americans and Laplanders, very low among southern Chinese and black populations.
• in children whose parents had this
• intrauterine positioning
• female sex
• being the first-born child
• breech positioning
• oligohydramnios
• the left hip more than the right

Children in cultures in which the mother swaddles the baby, forcing the infant's hips to be adducted, also have a higher rate of hip dysplasia. (surprised at this one)

[Saggarmakersbottomknocker]

shinyshilling - have a look at the STEPS website. They have a discussion forum you might find helpful. It's good that it's been found early.

STEPS

[Doobydoo]

It is very positive that they are taking action early.
It can also be caused by excessive hormones[that soften ligaments in pregnancy]
My sons was spotted at birth but he was not dealt with till he was 7 months old and he wore a Boston Brace for 3 months.I too was worried about the effect it would have on him but he dealt with it very well really.I was also worried about surgery etc.He is now 2 years old and has had a clear xray...he will have another in a year.
Early intervention is highly successful.I would advise the STEPS website also.
Wishing you and your dd well.

[Pinkjenny]

Shinyshilling - just a note of caution about steps, although I know you say you're not a worrier. The majority of families on the CDH pages are cases where the pavlik has not worked and the children have had operations and spica casts, mainly because of late detection. Their experiences are very different (so far) to mine, although my dd will be checked annually until she is 5. Just something to be aware of, as it has a tendency to make me slightly alarmist and hysterical!!

[shinyshilling]

Is there anything I will need to do differently? Will she have to wear dresses instead of trousers? I presume it would be quite difficult to put anything on the legs. Will she have to go in the proper lean back buggy rather than the car seat bit? Is there anything specific I should check tomorrow when the sling is fitted? Thanks

[Pinkjenny]

My dd had a maxi cosi carseat and a Bugaboo and we never had any problems, you should be fine, it's not as rigid as the spica, it's only canvas and velcro. Dd wasn't allowed to wear trousers, no. She did wear babygros (although she was younger than your dd) that fastened around the legs and not straight down. She wore lots of dresses, so this time of year is good. You might need to let her have some time just in the harness this summer, as dd had to wear a vest and socks all the time, so keeping her cool was a challenge. She wore it from May to August, so right through the sumer. I'll keep checking back if you have any more questions, or email me if you like at [email protected].

[Pinkjenny]

Or even summer!!

[starshaker]

my neice was in a cast for 6 months from about the age of 4 months. She is now walking around fine and causing all sorts of trouble. She goes back to the hospital every now and again for check ups but so far so good. She is now 20 months

[Pinkjenny]

How did it go, shinyshilling?

[shinyshilling]

Thanks for asking. It was much worse than we expected. I bought her lots of dresses on MOnday to accommodate the harness, took her to the hospital and was told that it is too severe for a harness and that she is going to need to be in a hip spica for at least three months. I am gutted. She is so small and never complains. I feel particularly cross as it was recognised she had a clicky hip the day after she was born, but it has taken until now to recognise the severity of the problem. We had to change our original appointment as the doctor couldn't make it. He openly said that it would have been easier to treat her had he seen her earlier.

Her operation is going to take place mid July. I don't even know if the delay in that happening will make it worse. The doctor said not, but I don't know. I feel like I want to get her sitting up to strengthen her tummy muscles in prepearation for having the cast on. Does anyone know if putting her in a BUMBO seat will cause further damage or make her uncomfortable?

Oh...I don't know. I have looked at the STEPS web site (thanks for that link as it does look really helful)but it's just made me even more worried. I am due to return to work as a teacher in late August, my DD1 is due to start school the same week I start teaching and I'm sure our new childminder will not want to look after a kid in a hip spica. I so much don't want to have to go back to work so I can look after my daughter. I am worried about how long she'll have to wear it...they've said three months, but people seem to wear them for far longer. There's so much to find out about and get my head round. Thanks to all of you who have helped so far though. I really appreciate the support Mumsnet gives as I don't have any parents and my sister lives away down South.

I'm sure we'll be fine. I know people have a lot worse to contend with. I just need to learn more about dealing with it all.

[Pinkjenny]

Oh that's just crap, shinyshilling. Early treatment is so crucial for DDH, and the members of the Steps website do a lot of work lobbying parliament around the importance of early detection and treatment. My dd was diagnosed the day after she was born too, and was put in the harness two weeks later.

Also crap that they told you that the harness would be the treatment plan and then changed their minds! Am really pissed off on your behalf.

I understand what you mean about the Steps website freaking you out, I think I mentioned earlier on that it always sends me into a spin. However, I would recommend that you start your own thread in the DDH forum, with your story, and the members will be extremely helpful and supportive, and share specific experiences which are not designed to panic you even more. One of my friends' daughters wore the hip spica, and has just had a check up and her hips are perfect now. She is on the steps form - Vics - she will definitely be able to answer your questions, she is lovely, and has a positive outcome.

It is really upsetting that she can't be treated with the harness, but she is still so young, she won't remember any of this, and I'm absolutely sure it won't be as bad as you are imagining.

I don't have any experience with the spica, but I will keep checking this thread and offering any support I can.

[shinyshilling]

Thanks so much for your support.

[chatee]

hiya,
my dd wore a pavlik harness for 6-8 weeks and it failed so even getting the treatment early does not always work and my dd needed the operation too, how old is your dd?where are you being treated?
luckily when down in theatre the easier of the 'two' operations was found to work on my dd and then she started to wear the hip spica

please ask if you want any further info....

[shinyshilling]

Thanks Chatee. I live up in Newcastle. I know what you mean about the Pavlik harness not working anyway. That must have been really distressing for you to have to go back to square one. My dd is 5 1/2 months now but will be 7 months by the time she receives the operation at the Freeman Hospital.

How old was your dd? Did you have to buy loads of special equipment? How did you manage the whole nappy thing? Is it really so bad? Did you get stuff sorted before the operation in terms of buggy, car seat etc...or was it a slow process afterwards? Thanks so much.

[PacificDogwood]

I had hip dysplasia and was not diagnosed until I was over 1 year (15 months, I think). I was treated in hip spica for 4 months which stopped me from walking which I had to relearn afterwards, apparently.
I am now 43 and have absolutely no problems.

I appreciate that everyone is different, but just wanted to add a positive story. Obviously I cannot remember a thing about the whole episode. I know my mother is still upset about the whole thing and says herself it was worse for her (feeling so sorry for me) than it was for me.

shinyshilling, hope your little one will be ok and the treatment will be not too traumatic allround.

[shinyshilling]

Thanks PacificDogwood...your story is the same as my sister in law's. She is 46 and has been through the same situation. It wasn't diagnosed until she was about 14 months old. Apparently it is passed on. My sil walks with a deep limp though and experiences bad pain in her hip. Thanks for the positive vibes though and glad to hear that you're fine.Do you think I should take my older 3 yr old daughter to be checked again. We took her last year because her childminder pointed out that her foot turned out when she walked, but the doctor said it was nothing...not sure sure now, but maybe just a little overworried. Oh my God...I never worry at all and in the last 48 hours, worry is all I've done!

[chatee]

How old was your dd?
diagnosed at 3 days officially but it was obvious from the moment she was born
first pavlik at 3 weeks then a second(as babies grow pretty quick) and then the decision at 10 weeks that it had failed-we had to wait for dd to gain weight to be operated on(as it's classed as non emergency op)so a date was pencilled in and we had to take her to the ward the week before for the big 'weigh in' had she not weighed enough she would have been cancelled and someone else offered the slot.
dd was operated on at 4 months 10 days old and was the youngest that day- there were four young children in the ward, mine, a girl 6 months, a girl 9 months and a two year old girl that the night before the op was happily running around(although it was more of a waddle)

Did you have to buy loads of special equipment?
we had to buy a new recliner chair as ours was too deep- we found the cheap bouncy material style chair was the best as the legs just stuck out over the edges.
we also found a bean bag was good support too.
special equipment is available to borrow from the hospital(or it was from ours)it was a bit large in our little room but it made it comfier for dd so we were happy for it.

How did you manage the whole nappy thing?
nappy changing and feeding have to be a1 procedures for cleanliness and we used to double bib dd and use a bib with a catching tray(i really found thm offensive cos they were plasticky(ifkwim)but no food or wetness ever got near dd so we had no bad smells or urgent return to the hospital for a cast change.
nappies changed every 2-3 hours and immediately after soiled(which most normal people would do anyway)but literally as soon as it was produced.
you will get shown how to change your dd nappy but we found huggies were quite good as they were more flexible and the velcro was stronger(but the nurses should be able to give you more up to date info)

Did you get stuff sorted before the operation in terms of buggy, car seat etc...or was it a slow process afterwards?
dh had to go out and buy the next stage car seat the day before dd was coming out of hospital as she went in fitting in the first stage car seat and came out in the second stage- we had a britax of some sort(can check with sis inlaw as she has it now as a spare) but the cast does rub off the material from the sides of the seat btu at leats we didn't have to get any extra straps from britax, but i do believe that special car seats are now made and can be hired(i think)

as for returning to work- i really didn't have a choice and had to but it was not a problem and in fact the other children that the cm looked after actually provided company and entertainment for dd as she was very demanding for attention due to being immobile and they were very good company for her...the cm was great with procedures for nappy and feeding too

it is a horrible time and i will admit that i 'bottled' it the first night and couldn't cope by myself and felt ashamed of myself...dh had to be given accomodation in a nearby old nurses block(arranged by pals).the thing i found really hard wa sthe fact that dd did not have head control and i just didn't know where to hold but it didn't take her long to get head control and after that it was so much easier.Personally i would not try and 'teach' your dd to sit up as it will then be frustrating for her to be in the cast at least she won't have that to contend with as she will have never known..
secondly- when the cast comes off, she might go into another smaller harness for a few weeks to give her chance to gain feelings around her before being fully free and when the last thing comes off remember that everything is a new experience for her so this is the time you will need to be really positive and patient and take her the swimming pool as soon as possilble as it is such good therapy.
wow sorry to have gone on but if you do think of anything else that you need to ask just shout out- i wish i had known about mumsnet or steps when i went throught his with dd
GOOD LUCK X

[tkband3]

Just to add to PacificDogwood's story, my CDH was diagnosed at 9 months. I was initially treated by being placed on traction but that didn't work so I had an operation where pins were placed in my hip to hold it in place. I was in plaster from the waist down for 6 weeks after the operation and was subsequently checked annually (though I'm not sure how old I was when the checks stopped).

Anyway, I am now 40, the pins are still in my hip (the bone has grown over them) and I have no problems whatsoever. I couldn't quite get my left leg into the stirrup when I was giving birth to DD1, but that was probably more down to lack of fitness and suppleness (is that a word?) than anything else .

I'm sure it was a much worse experience for my mother than it was for me - obviously I have no memory of it though, but my mother says I pretty much sailed through it - these things are always worse for the parents, so I do feel for you. on your behalf that she wasn't treated sooner. And I would get your older daughter checked out, if only to put your mind at rest.

Hope it all goes ok.

[PacificDogwood]

Yep, I would get older daugher checked again, as well.

Hip dysplasia is familial, and more common in boys, but can of course happen to any child. Good list of predisposing factors quoted above .

[chevre]

you poor thing - i had this. fairly late diagnosis. i was in traction for a while then cast then splints.

i think the fact she is so young is positive and she will make a good recovery.

i have a slight limp (apparently though i don't really notice it!) and am slightly lopsided. but i am sure that is just cos i was a bit older when treated.

good luck.

[chatee]

bump-as similar to another thread

[Digger1995]

Hello, was wondering if everything went okay? My little boy is 5 months in a week and his showing signs. Waiting for a letter to give us a date for a scan. I’m worried sick. I just dreading him needing an operation! Worst thoughts are running through my head :(