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

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Hip luxation of the right hip

Hipluxation of the right hip (Lieve)

  • Runs in family (mother and grandad).
  • Discovered at standard check-up at 3 months.
  • Pavlik, traction, spica cast, treatment not completed.

Our daughter has hip luxation/dysplasia (dislocated right hip). She was born with this developmental disorder.  

Developmental disorders of the hip run in our family; my mother had two new hips at the age of 50. My grandad was very young when he already had problems with walking. My mother insisted us on having an X-ray on our daughter’s hips at an early stage, as our cousin also had to wear a body harness for three months. But the paediatrician in the hospital also noticed a difference between the lengths of the legs, a stiff hip and a double gluteal fold.

Lieve had an X-ray at three months which showed that she was suffering from hip luxation. It was quite a shock; a dislocated hip. She was immediately fitted with a Pavlik bandage and could go home with us. It took some time to get used to it, but we mastered the routine of putting it on and getting it off rather quickly. However, our daughter seemed less happy with the bandage as in our opinion she was crying more. Whether her crying was indeed caused by the Pavlik is still not clear. According to our orthopaedist at the time, she could not be in pain??  

After two more X-rays, the progress was made was too little and a traction was planned in a hospital near to us. It was a rather bitter pill to swallow, but we knew it was for her own good and her future!

She had to lie in traction for two weeks with a possible extension of another week. I had taken up short-term care leave and could stay with her. Her daddy visited her after work in the evenings and stayed overnight with her during the weekends. It is great that this is possible nowadays!

She was very happy and cheerful. It seemed that she was glad that the Pavlik had come off. And when in pain, she got painkillers to ease it.

After two weeks, scans showed that the hip was not yet in the right position but that progress had been made. The traction was extended by another week. Unfortunately after that extra week, the scans showed that her hip was still not okay. We were referred to an orthopaedist in the Rijnstate hospital in Arnhem to plan an operation. We were sad as we thought all the treatment so far had been for nothing. She was fitted with a body harness and was allowed to come home with us. She was very weak and floppy. No surprise after lying down for so long and not being allowed to get up at all, not even to have a bath or cuddle.

After two weeks we had an appointment with the orthopaedist in Arnhem. When he heard that she had only been in traction for three weeks, he commented that he found this period too short and that he did not yet want to operate on Lieve, as this would do more harm than good at such a young age. In the hospital in Arnhem, they apply a period of six weeks for traction. So he suggested another period of traction.  

We had to get used to this idea, because we came with the idea that our child had to have an operation, but were told that she had to have another period of traction, and this time for six weeks. The orthopaedist really thought that this was the best way forward, so as parents wanting the best for your child you have no other option than to go for it once again. Only this time, I found it more difficult as many questions ran through my head: “ why would it be successful this time and not the first time, far away from home, how are we going to manage this with work, etc.” 

But after two weeks, my boyfriend and I had both arranged six weeks care leave with our employers. As driving to the hospital would take us 45 minutes, we mainly stayed in the hospital. In turns, we slept with our daughter and rented a room in the hospital. After a bad night in the hospital, we could have a proper night’s sleep the next day. That was very convenient. We were also grateful that our employers allowed us to take up care leave. 

The traction in this hospital is entirely different from the previous hospital, which surprised us as we thought that certain treatments would have been predetermined nationally? But no.

In this hospital Lieve is allowed to leave her bed twice a day for 30 minutes, in the morning and in the evening. In the mornings we give her some bread in her little chair and in the evenings we either bath her or take her outside. So lovely to be able to cuddle her! This time her legs are also more widely spread than last time? And the knowledge of the nurses is also much better, as in this hospital they have children lying in traction much more often. The orthopaedist regularly visits Lieve and keeps us well informed about the progress made. She is doing really well and is still our cheerful little girl. This is a relief as you don’t want to see your child suffering in pain.

We have just heard that Lieve will be treated next week. The orthopaedist expects to able to put the femoral head back in the acetabular cup without an operation being necessary. This is great news, but also nerve-wracking as they can never give a guarantee. If they are not able to put the femoral head back in the cup without an operation, they will proceed with an operation that day as she will be under anaesthetic anyway. Although you hope that an operation will not be necessary, it is good to know that it can be done in one go. We will be keeping our fingers crossed and burning candles for the next few days...

Compared to the previous hospital we strongly believe that it would have been better in Lieve’s case with a severe developmental disorder of the hip if they had referred her to a specialist hospital like this straightaway, as they have more experience here with this kind of treatment and a specialist orthopaedist attending her.  This is something we want to also report here, as it would be great if we could help save other parents from the same disappointment we had after the first traction period.  We would recommend parents to always obtain information about hospitals, their expertise and treatments.

When Lieve is allowed to come home with us in a spica cast, we will definitely encounter some practical problems in the coming eight weeks. But we have received an information booklet from the hospital with practical tips.

It was difficult to find experiences from other parents on the internet and often you first had to become a member, which is ridiculous in our opinion. You learn most from parents with similar experiences. I found contacts of parents who were happy to share their experiences and tips through ‘Marktplaats’.

Transportation is a really problem, in particular for children younger than 9/12 months, as there is no adjusted car seat available. We borrowed an adjusted Maxi Cosi for free from Maxi Cosi itself with extended belts. They only lend these seats to children with a body harness.

Obtaining dispensation for sitting in the car took us a while as we were referred from one institution to another. It seems that you can request a dispensation from the CBR in the Netherlands.

We also bought a Doomoo seat, which is very convenient for children in a spica cast or body harness.

We will take everything as it comes in the next couple of weeks. We first need to wait and see how the treatment/possible operation will go next week...