Hip Dysplaysia Support Group #3

Hi ladies,

Hailey's mum - I have no advice for you I am afraid, but just wanted to wish you and DD good luck! it sounds like it will be quite an ordeal for you both. I live in rural NSW, so I understand about the distance thing. all the best.

Well, No2 arrived - another girl. But good news is that on exam hips seemed OK. just got to wait it out for the u/s. My ob was happy to refer us for an early u/s, but ortho said it wouldn't be worth doing until 12 weeks (see my previous post), so a bit nervous about the wait.

It is interesting that there doesn't seem to be a standard practice - either regarding diagnosis, treatment or follow-up, just what the treating ortho recommends????

Hi ladies,

My little girl was dignosed with clicky hips back in 2005. She was placed in an harness at 2 weeks old and stayed in it up until she was 6 months old. She is now 6 years old and she has no problems at all. We are very lucky that the Ped picked it up early. All my other children have had to go for an Ultrasound at 6 weeks to check there hips.

Abigail - Lily had x - rays done for the first 5 years and than it stopped.

Cathie :)

Hi all

It's been a while since anyone has posted.

My DD was diagnosed today and will be wearing a brace, when it's ready in two weeks.

I have been looking online for clothes and haven't had much luck here in Au, could anyone help me with some ideas ?

Bengal, I just went with bigger sizes. DD was 7 weeks old, and we were heading into winter, so went with tights and skirts (to help hide the brace a bit), onesies in a bigger size and pants in bigger sizes. I got some older kids socks, cut the feet off so they looked more like legwarmers, and they wrapped around the bits on the brace that touched DD's leg so it wouldn't rub (it was a Dennis Browne brace). It wasn't too bad, all the clothes we got in bigger sizes fit her later anyway.

hi

my mchn noticed yesterday at 4 month appt that DD has clicky hips. since birth i have been worried about them, but everyone who checked said they were fine. had a gp appt today who agreed and have an ultrasound booked for monday arvo. was hoping to get in earlier but rang a heap of clinics and that was the earliest.

i just want answers and hoping ultrasound is all clear. ok, off to have a read through the thread...

anybody else diagnosed later?

Hi Hotl, my sister had a similar problem and her daughter wasn't diagnosed till very late. Wish I could remember exactly but I'm pretty sure she was walking before she was diagnosed.

HotI - I am fairly sure PZ 1st DD, and MummyNaomi DS were diagnosed 4-6 months. I will see if can point them this way.

DD1 was dx at about 4 or 5 months. She was checked by 2 midwives, GP's and MCHN's and all said she seemed fine. But her legs were literally uneven, but she had no click so I guess nobody was concerned. Turned out her hip was a mm away from being completely dislocated. So good luck at the US. It was a difficult having it happen later in the game, but we managed okay.

Did miss I have bracing? Any other treatment?

Anyone know the chance of clicky hips not needing treatment? Until now, each time her folds have been even. This week the mchn said she 'could make them look even" (not sure if they were or weren't, but they were close).

if she does need treatment, would I go to RCH?

HotI - my niece was diagnosed around 4-5 months. she had 2 types of braces/harnesses, one was pavlik (sp) & I can't remember the name of the other one. her hips clicked & it was missed at mchn/gp appts. I can ask my sister for details if you're interested.

Interestingly, my ds's folds didn't line up & mchn sent us for an ultrasound to check hips. All good, perfect hips apparently.

Both my DDs had clicky hips picked up at birth. They saw an orthopedic surgeon and had both US and Xrays to ensure no displaysia, neither required additional treatment. In our cases it was purely a maturity thing.

My DD was diagnosed at 3 months, she was in a Pavlic harness for 12 weeks (only allowed out for bath time once a week). She then was supposed to go into a rhino brace but would scream for hours in it so she went back into the Pavlic for 3 months at night time only. She has since been given the all clear. Her folds still didn't line up though:)

Is there any known link bw HD and clubfeet/ talipes?

My bro and I had severe bilateral talipes, and dd2 waa born with mild 'positional' talipes. She was a bigger baby, highly mobile in the womb (breech /transverse right up to birth). She had a mild torticollis, that I read here can be linked with HD.

IS there anything I should be doing while waiting for the ultrasound and specialist? I wonder if I am hurting her or making things worse...

how much do braces cost? Are they made specific or just standard sizes/ adjustable? Are they heavy? Can you use cloth nappies with them ok?

I don't know about a link with clubfeet/tailipes. But there is a link between big babies, breech and girls.

I don't think there is anything in particular you should do, I don't think can hurt them - the only thing I was told to not do is not hold the feet together when doing a nappy change (you know use one hand to hold two feet) so maybe is better to not hold legs straight down together (but if she does it is ok)

We had a Denis Brown brace - which is what they use after a Pavlik normally - I did it all through the RCH who I thought were great and it didn't cost me a penny. They are not heavy and I used cloth nappies fine (DD went straight into Denis Brown brace at 8 weeks - and wore till 5 months) - the one we had adjusted round legs but not across back - if had needed for longer they would have given us a bigger size.

As PZ said, you can have no click and be in a worse position - (DD's didn't click on one side but that was because the joint wasn't deep enough to even get a click) - so in a way the fact that they click can be seen as a positive.

The froggy leg position is good for the hips (as it forces the ball joint into the socket which causes the socket to grow round into more of a socket) - so the Ergo (without infant insert) is a pretty good position.

HotI my DS was diagnosed at 5 months, there was no audible clicking in his hips

The brace is usually supplied by the public hospital and they come I lots of sizes and then can be adjusted further for the wearer. They don't weigh much, from memory it was only about 500g if that.
You could easily use mcns

DS went into the Dennis brown brace at 7 months old, he wore it 23.5hrs a day for 6 months. After diagnosis as it wasn't severe the surgeon left him for a month to see if normal growth and development would fix, it didn't hence the bracing


It was quite a shock but we got used to it all very quickly


Hope all is fine for your DD xx

DD was in a Dennis Browne Bar. 3 months 24/7, 2m 23/7 and and 2 months overnight. All through the RCH.

DD2 had her ultrasound this afternoon. The dude was lovely, and DD2 was cooperative. I asked him what he thought and he said "i'm still deciding. they are not dislocated, but they look immature" he took more pics and then he said to take a seat outside. We waited outside for the films but he didn't say anymore. I have the films but won't get the report until wednesday.

do you know what he meant by immature?

That's what both my DDs diagnosis' were. From what I can recall, the ortho surgeon said it is based purely on waiting their growth and development in order for proper alignment to occur. Both my girls had xrays and us at 6weeks, then 3 6, 12 and 18mths to ensure that the ball was sitting in the socket.

I would take it to mean that the ball is sat in the socket but the socket is not yet as deep as they would like. Depending on the measurements they might say they just need to keep an eye on them - or suggest a brace (as the positioning of the ball into the socket encourages the correct growth - this is why breech babies are prone to HD as often their feet are more together so the hip angle hasn't encouraged the correct development - same can happen with bigger babies - and with girls they think is linked to them having receptors for the relaxin hormone their mothers produce during pregnancy - so that relaxes their muscles/ligaments so doesn't hold the ball into the socket to encourage the correct growth).

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I would take it to mean that the ball is sat in the socket but the socket is not yet as deep as they would like. Depending on the measurements they might say they just need to keep an eye on them - or suggest a brace (as the positioning of the ball into the socket encourages the correct growth - this is why breech babies are prone to HD as often their feet are more together so the hip angle hasn't encouraged the correct development - same can happen with bigger babies - and with girls they think is linked to them having receptors for the relaxin hormone their mothers produce during pregnancy - so that relaxes their muscles/ligaments so doesn't hold the ball into the socket to encourage the correct growth).

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Exactly this. Best thing you can do in the meantime is baby wear in the froggy position as much as humanly possible. This will encourage the bond into the socket and help deepen it.

I also used to put a double nappy on my girls as the thickness of the nappies kind of forced their legs into the froggy position when they were still too small to fit into the Ergo. By 4 months I just used to wear them in the Ergo

dd2 is not comfy in the ergo froglegged. i tried it yesterday. will try a wrap today and try for a wide seat.

in the hugabub i wore her legs out from birth, but that s not as wide as the ergo. i had her legs tucked in in the ergo.

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Is there any known link bw HD and clubfeet/ talipes?

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I do remember reading that there was, I honestly couldn't tell you where I read it though - HD does have a genetic link (my DD1 had HD which was diagnosed at birth, so all my bubs are considered higher risk, as will be all my kids kids...). The other risk factors (from memory) were first born, breach, low levels of amniotic fluid and more common in girls. And torticollis is common with HD babies too.

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IS there anything I should be doing while waiting for the ultrasound and specialist? I wonder if I am hurting her or making things worse...

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I don't know that you would be hurting her, I am sure you would know if you were, but some things to avoid are tight wrapping of the legs (as in wrapping her up like a sausage - I used to do loose around the legs and tight around the top) and if you are carrying her, rather than squeezing her legs together, have one hand on her pelvis between her legs (yep, pretty much on her fanny/bum area) that way you have no pressure on her hip joints. You can wear her in a carrier or sling provided she is in an upright position (chest to chest, with her weight going through her "seat" aka fanny/bum sorry but best way to describe it). and as others have said, nappy changes, don't lift her bottom up by two feet together, put your hand under her bum and lift her pelvis.

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how much do braces cost? Are they made specific or just standard sizes/ adjustable? Are they heavy? Can you use cloth nappies with them ok?

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my DD harnesses were given free. they are different sizes and we just returned them when they were finished with. a pavlick harness is made of cloth and Velcro so weighs about 100g or so. But you need someone who knows what they are doing (eg experienced physio or ortho) to fit them.
I used disposable nappies while using the harness, just because I could get a more secure fit, and if the harness got dirty or wet, we had to drive an hour back to the physio to fit another, so because it was only for 3 months, I bit the bullet and used disposables.

As others have said, "immature" might mean some time in a harness or brace, or further scans down the track.....Good luck, the waiting is hard. We had to have a second scan for DD2 at 12 weeks, and that 12week wait was a nightmare!

Thank you.

No brace for now! Ultrasound in a month, and referral to the RCH. Thanks for all the tips, we are doing all of them til things grow the way they need to.

great news! keep us posted.

Well the follow up ultrasound was not as good as the first one. I am glad i organised the referral first time around. Will go to the hip clinic this week, and see what they think.

Good luck at the clinic HotI - hope all is ok

DD2 has a Dennis Browne Bar for next few months. She is doing ok. She actually sits better with it!

i think the novelty has worn off. she is p!ssed with the brace now.

Oh HotI - how old is she?

She is almost 6 months. She is doing ok again.

Learning how to be comfortable on the ground again.

thanks.

DS was 7 months when he went into his, big adjustment for them at this agr

Naomi - How long did your DS have a brace for? Is he all good now?

6 months HotI and he's totally perfect now xx it was all worth it

Good to hear. 6 months seem a long time (i'm only one week in), but i know however long it is it is worth it.

took dd2 s brace off for a bath, and she has a sore where it has been rubbing. i noticed it was dry yesterday and put moisturiser on it, not sure if that made it worse ;( thankfully, i have follow up appt with orthotics today so will ask them. maybe the sock i had on it was too thin?