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For children with a body harness or spica cast by hip dysplasia

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Double hip luxation, the story of Siri

Double hip luxation



How old was Siri when they found out she had hip luxation?

During the half-yearly visit to the health centre the doctor heard a pop in her leg. She thought it was a tendon that went over the bone but to be sure she sent us to the hospital for an X-ray. On the day of the X-ray everything went smoothly and it had not crossed my mind that the outcome could be negative. So it was a big disappointment when the x-ray showed hip luxation on both hips, just 1 mm from being fully symmetric. That is the reason why the gluteal creases were symmetrical at the health centre.

What was our journey like?

The local hospital established a serious deviation and told us that Siri needed traction treatment followed by 3 months in plaster. Because of the difficulty of the treatment the hospital sent us to a Academic Hospital. At the Academic hospital we expected to leave with our daughter the same day but the doctor told us he wanted to start with a Pavlik first. She had to wear the Pavlik for 5 months. At first she was restless during her deep sleep, probably because during deep sleep all of your muscles are relaxed and flex even further. We put pillows under her legs when she was in a lot of discomfort, and removed the Pavlik for a couple of hours. Our orthopaedist told us not to be too hard on her. Better to have a good night’s rest and build up the Pavlik treatment slowly than everyone getting exhausted. This put our minds at rest and within a week she wore the Pavlik all the time; we only removed it when she took a bath.

The doctor was very determined about sitting up; we couldn’t let her sit unless she was able to do so by herself. Before she got the Pavlik we sometimes sat her up in the nursing pillow but this was no longer allowed. She wanted to look around, so this was a big switch for her. We therefore put her back in the bouncer more often, with a towel to increase the height. After 9 months Siri was finally able sit up all by herself. She did this by placing her bottom back against the wall, putting herself up with her hands and placing her legs out to be able to turn to the front…. quite a performance!

Every 2 weeks she had a check-up and after 3 months both hips were in their sockets!! Repositioning was no longer necessary. After this good news she had to wear the Pavlik for 2 more months. When she turned 1 it was better to let her go on her own and encourage her to walk. She got a Campspreider to sleep with. At the age of 18 months she wriggled herself in every way out of the brace. After some adjustments in the plaster room, and eventually a new brace, she was constricted again at night. This gave me a few sleepless nights because every time I heard a murmur I wanted to make sure she was still in position. After a couple of days I slept perfectly well.

In very hot weather we left her brace off. As the brace is made of plastic she needed to wear leggings underneath, which caused her to sweat a lot.

In October 2013 we went back to the hospital for a check-up for both of our daughters. After the discovery of Siri’s luxation our eldest daughter also needed a check. It turned out that she had a mild dysplasia on her right hip. They wanted to wait for another year to see whether the dysplasia would go away on its own, otherwise she would need surgery. Our eldest daughter was given the all clear and Siri was also finished with her treatment. They will both still need an annual check, but the doctor expects that the socket will form perfectly by the pressure and movement on it. This came as a big surprise for us… both our girls were OK. Especially given the stories of other parents we had never expected (and we can almost still not believe) this result.

Practical tips

Pavlik Harness

Siri got the harness in the summer so dressing her was not an issue with leggings from Kiek Hip Wear and a dress. When it started to get colder she wore harem trousers which we bought at Hema (a couple of sizes too big so we could pull up the waistband) and Kiek Hip Wear jumpsuits. The jumpsuits in particular are ideal for changing nappies and are made of very soft material.

Transport

She still fitted in the MaxiCosi by putting a towel under her bottom. She was still small which was an advantage. We used the extra wide foot muff in the pushchair during wintertime.  Siri was also able to sit in the TrippTrapp high chair by putting the seat back a little. When she was sleeping we initially put towel rolls under her legs.

Campspreider

She got used to this brace really quickly. The hospital advised us to hang up a door bouncer, which would encourage her to stretch her legs and push herself up.  Twice a day she would spent 15 minutes in the door bouncer and loved it!

She was already moving around on her bottom wearing the Pavlik and we wanted to progress this to crawling. The doctors told us that this would happen by itself and it was not necessary to visit a physiotherapist. At work I knew someone who was a physiotherapist and she gave me some tips and exercises which would get her to start crawling. Maybe it would also have happened without these exercises but I wanted to make sure she started crawling. I also appreciated that the physiotherapist checked her hips every six weeks.

Our experience?

Looking back, the whole process went better than we expected. I have one last tip: if your child has dysplasia go to a child orthopaedic consultant. If we had stayed at the local hospital the whole process would probably have been totally different.