Complex Hip Disorders

Pediatric hip conditions can affect children at any age. Hip dysplasia is a condition where the hip socket does not form correctly and can be associated with hip dislocation at birth or abnormal development of the socket as the child grows. If pediatric hip dysplasia is left untreated, it can lead to early hip problems in adulthood, including hip arthritis. Your child's pediatric orthpaedic surgeon may try nonsurgical methods to help the hip develop normally, such as braces or casts.

Some pediatric hip conditions require surgical treatment in order to allow the hip joint to develop normally. These procedures may include cutting and realigning the pelvic and thigh bones and reconstructing the hip joint, procedures known as pelvic and femoral osteotomies. Some osteotomies are appropriate only in small children, while others may be beneficial for older children with hip dysplasia. One such osteotomy, the periacetabular or "Ganz" osteotomy, may prevent the development of early arthritis in older children with hip dysplasia. Emory is one of a small number of centers in the region where this osteotomy is performed.

Pediatric Hip Dysplasia

Hip dysplasia is a condition where the hip socket does not form correctly and can be associated with hip dislocation at birth or abnormal development of the socket as the child grows. This condition, if left untreated, can lead to early hip problems in adulthood, including arthritis. Your child's surgeon may try nonsurgical methods to help the hip develop normally, such as braces or casts.

Older children with hip dysplasia may benefit from the periacetabular or "Ganz" osteotomy to prevent the development of early arthritis. Emory is one of a small number of centers in the region where this osteotomy is performed.

It usually affects the left hip and is predominant in:
• Girls
• First-born children
• Babies born in the breech position (especially with feet up by the shoulders)

Symptoms
• Legs of different lengths
• Uneven skin folds on the thigh
• Less mobility or flexibility on one side
• Limping, toe walking, or a waddling, duck-like gait

Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis (SCFE) is an unusual disorder of the adolescent hip. For reasons that are not well understood, the ball at the upper end of the femur (thigh bone) slips off in a backward direction. This is due to weakness of the growth plate. Most often, it develops during periods of accelerated growth, shortly after the onset of puberty.

The condition is diagnosed based on a careful history, physical examination, observation of the gait/walking pattern, and X-rays of the hip. The X-rays help confirm the diagnosis by demonstrating that the upper end of the thigh bone does not line up with the portion called the femoral neck.

Symptoms
• History of several weeks or months of hip or knee pain and an intermittent limp.
• He or she walks with a limp.
• Will be unable to bear any weight on the affected leg in severe cases.
• The affected leg is usually turned outward in comparison to the normal leg.
• The affected leg may appear to be shorter.

Perthes Disease

Perthes is a condition in children characterized by a temporary loss of blood supply to the hip. Without an adequate blood supply, the rounded head of the femur (the " ball " of the hip) dies. The area becomes intensely inflamed and irritated.

Perthes disease is usually seen in children between 4 to 10 years old. It is five times more common in boys than in girls.

Symptoms
• Limping
• Mild pain in parts of the leg, such as the groin, thigh, or knee
• When the hip is moved, the pain worsens. Rest often relieves the pain.

The child may have had these symptoms intermittently over a period of weeks or even months. Pain sometimes is caused by muscle spasms that may result from irritation around the hip.

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