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

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Hip luxation on the left

Hip luxation left (Nadin)
No history in the family and no breech delivery.

Nadin was treated by a physiotherapist because she showed a strong preference for a certain position. After the second appointment, the physiotherapist referred us to the OLVG hospital in Amsterdam, as Nadin showed a preference for a position like a prawn.  At that time Nadin was 3 months old. At the OLVG an X-Ray was taken from Nadin’s hip which revealed that Nadin suffered hip luxation in her left hip

Treatment

Initially, they tried to correct her hip with a Pavlik harness, but that did not work because Nadin was already a little too big for this treatment. It was then decided to put Nadin under anaesthetics so that the doctors could put her hip back in the right position. After this operation she had to wear a spica cast for 3 months, followed by a Campspreider for another six weeks. In July, we will see the orthopaedist again.

Practical tips

The jumpsuits I bought at KiekHipWear are fantastic. Lovely fabric and very handy when your child is wearing a spica cast.

We also changed nappies more often than we would have done under normal circumstances.

Renting the twin pram* was an absolute necessity.
 *only available in the Netherlands and Germany

Does it run in the family or was it due to a breech delivery?

Neither.

How long did the treatment last and what is the outcome?

The orthopaedist indicated that the treatment will be finished before Nadin’s first birthday at the end of July. All in all less than 12 months! 

We do not yet know the final outcome as yet, but now it looks like both legs are the same length and her preferred position is no longer that of a prawn. 

Hip luxation on the left - Elize

  • No history in the family, no breech delivery.
  • Discovered by the doctor at the infant centre at 3 months.
  • Closed reposition + spica cast, open reposition + spica cast, pelvic osteomy + spica cast, closed reposition + spica cast, open reposition + spica cast.

Elize was born after a “normal” pregnancy and a safe delivery on 2 September 2011. She was not in a breech position. During a standard screening at the infant centre when Elize was 3 months old, the doctor discovered a double gluteal fold and Elize could not stretch her left leg as far as the right one (abduction). After a scan and an X-Ray, the diagnosis was that she had hip dysplasia and hip luxation on the left. When Elize was 4 months old she had to wear a closed reposition and a spica cast for 4 months. During all the checks every four weeks all looked to be progressing well. Elize was 8 months when the spica cast came off. Within two weeks she was able to roll on her tummy and sit up by herself. We were thrilled that all seemed to be going well. However, after another screening 3 weeks later the X-Ray showed a new hip luxation. This only occurred 1 time every two years, according to the specialist.  

Elize was 9 months when she had surgery. Another open reposition and spica cast for three months.

After the second check four weeks after the operation, it appeared that she suffered another hip luxation.

When Elize was 1 year and 1 day she underwent a pelvic osteomy and had to wear another spica cast for 3 months. Three weeks after the operation during a check it appeared that she again had a hip luxation. The spica cast had to stay on despite the hip luxation, because the pelvis had not grown together completely. After two weeks, the spica cast was taken off and another closed reposition followed. The doctor had doubts whether the closed reposition had been successful and CT scan followed. This scan showed that the closed reposition had indeed not been successful. The doctor had not experienced this before and consulted a retired orthopaedist for children to ask advice.

It has been decided that Elize will have another open reposition. Elize was 1 year and 1 month at that time. She had to wear a spica cast for 3 months again. During this operation a lot of tissue was removed. This explained why despite all the treatments, the hip luxation returned. Doctors were confident that this time the treatment would be successful.  

After three months with a spica cast, all looked good. The femoral head showed a significant lag in development, but seemed to be growing. 

When we heard that our little girl was suffering from hip dysplasia, our world collapsed. Thinking about a spica cast and reading more information caused us concern. But after the surgery and when Elize was wearing a spica cast, we got used to it because we saw Elize coping well with it and us becoming more skilful in handling it. We also always looked forward to the moments when the spica cast would come off. However, after 3 disappointments, we just no longer had the confidence that any treatment would be successful. But as long as there are options open to help treat Elize’s hip dysplasia, you continue to go for it. And that is good, because it now looks like it has been solved.

Elize is currently walking behind a push car. Her hip joint is still stiff because of the operations and immobilisation.  The physiotherapist provides us with exercises which we need to practice with Elize at home in order to make her hip joint more supple. Elize is now more than 18 months old.

Elize will continue to be seen by doctors until she has stopped growing. The intervals between the checks are becoming longer. But each time, it is rather stressful to hear how the acetabular cup and femoral head are developing.

Does it run in the family or was it because of a breech delivery?

No hip disorders run in our family. Elize is our third child. Elize has an older twin brother and sister. They were also screened for hip dysplasia, but no anomalies were discovered.

Practical tips

I purchased trousers at KiekHipWear, so that Elize had something to wear on top of her spica cast. If the spica cast is not covered by clothing it becomes rather dirty and with the trousers it felt “softer” when picking her up. We fill the pram up with cushions. When travelling by car we put her in her pram carry cot, with seat belts fastened. Of course this is not very safe, but at least we were able to go out and about with her. 

I washed Elize’s hair on the kitchen top under the kitchen tap, while she was lying on the changing mat.