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Hip Problems in Children

By 7 May 2012February 20th, 2024No Comments

Hip problems in Children may be as some are born with orthopaedic problems such as abnormal hip anatomy (hip dysplasia) or a complete dislocation. This should be picked up at birth or shortly thereafter and may be confirmed with ultrasound scanning. While these patients may initially be treated with bracing, a missed diagnosis may require a surgical realignment procedure of the neck- as well as the cup of the hip joint, often together with an open joint reduction.

Infective hip arthritis is a devastating and potentially fatal condition and usually affects children under 10, who are often difficult to diagnose even by specialist orthopaedic surgeons. Septic arthritis / osteitis is an orthopaedic emergency which requires ICU admission, antibiotics and emergent surgical drainage.

Bone death (avascular necrosis) of the femoral head may occur in children without an injury. This is known as Legg-Calve-Perthes disease or simply Perthes. Children often recover with non-surgical treatment. Although the hip may not be completely normal afterwards, rapid onset arthritis is mostly preventable.

The growth plate cartilage is a potentially weak area during the years of the adolescent growth spurt, especially in overweight boys. A slipped growth plate is notoriousely difficult to diagnose because it often causes referred knee pain and a limp, which may not be initially attributed to the hip. If these patients are not treated early, the slip will worsen and this puts the patient at risk of irreversible bone death and hip joint impingement. This condition is known as slipped upper femoral epiphysis (SUFE). If SUFE is suspected clinically, it is imperative that the child is kept non-weightbearing and that the diagnosis is radiologically confirmed (standard hip X-rays are not sufficient).

There are numerous other non-traumatic conditions of the paediatric hip which may present with hip pain.

Hip fractures in children often require surgical treatment. This may even become an option in less severe fractures in favor of SPICA or brace immobilization, which is often hugely difficult to get right in an ucooperative child.

Femur bone fractures are also treated with surgery far more frequently these days. Intramedullary nailing in children is possible and avoids lengthy periods of traction in bed.

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