What are Clicky Hips in babies?
Understanding this common abnormality in newborn babies.
Clicky hips are one of the most common abnormalities in newborns.
The condition affects 1 to 3% of newborns. If your baby is affected, the sooner the condition is identified the more likely it is that treatment will be successful.
The medical name for clicky hips is congenital dislocation of the hips (CDH).
The hip is made up of a ball, formed by the end of the thighbone (femur) and socket joint, formed by the pelvis.
If the socket is not properly formed, the ball tends to slip out or dislocate, making a slight click when the hip is moved.
Clicky hips are often inherited, and girls are affected more than boys.
What causes clicky hips?
CDH is more common in breech babies and babies who have been tightly squashed in the uterus due to lack of space.
For this reason, it's more common in first-born babies as the uterus tends to be tighter the first time around.
It is also more common in girls, due to the female hormones which can cause the joint to be more lax.
CDH also tends to run in families. So if one girl in the family has CDH, the chances are that her sisters will, too.
If it is detected early it can be successfully treated. But if it is only discovered when your child starts to walk with a limp it is more difficult to treat and may need surgery.
How can I tell if my child has clicky hips?
All babies are checked for CDH at birth. If his hips make a distinctive click, or if your paediatrician is in any way concerned because, say, his leg creases seem uneven, he'll be checked again within a few days.
There are varying degrees of CDH and it can occur in either one or both hips.
An ultrasound scan will be done if there are still concerns about his hips. This scan gives a clear picture of the hip joint.
In some hospitals, all babies born with the three main risk factors for CDH (breech birth, a family history of CDH or congenital abnormality) are screened by ultrasound.
Early diagnosis is important as it gets harder to examine as your child grows bigger and stronger.
In children with CDH who are not diagnosed at birth, it will show up when he begins to walk. He will probably walk late and may have a limp or an unsteady walk.
Your baby's hips will be checked throughout his first year, so it's important not to miss his health checks. However, some babies are born with hips that seen normal, but which then don't develop properly. In which case, you may be the first to pick up the signs.
You may notice that:
* One leg looks slightly longer than the other
* Extra skin creases on one thigh or buttock
* As you change his nappy, one hip may not open as much as the other
* In rare cases, he may start to walk with a limp or walk on his toes on the affected side
How are clicky hips treated?
A lightweight splint will be fitted that pushes his legs apart and keeps his hips in position. It will usually be put on within a few days of the diagnosis. But you may be asked to use double nappies on him until then, which will act like a temporary splint.
The splint is worn under his clothes and left on for the duration of his treatment - around six to 12 weeks.
Some babies may need to have traction to position their hips properly first. This tends to happen with toddlers or older children who are diagnosed later.
If the splint doesn't work, he may have to wear a plaster cast. But first he may have to spend some time in traction in hospital to reduce the chance of complications developing.
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