Julian Haeger

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Babies legs, one shorter than the other - Developmental dysplasia of the hip

June 4, 2011

This post is going to be a little off topic, but as I said in my opening post, I’ll occasionally be posting about various things that interest me. This subject has come to interest me greatly in the last couple of weeks because it concerns the health of my daughter. My daughter is 8 months old. Some time ago, probably when she was around 3 - 4 months we noticed that one leg was a little shorter than the other, by about 1 - 1.5 cm. Some time after that we booked a Dr’s appointment as we figured we should probably get an opinion on it before she got too near an age where she might want to try standing up, but we didn’t think it was too urgent. Since birth various midwives, health visitors and Dr’s had performed the standard rolling of the hips check some 3 or 4 times, so we didn’t think it could be anything wrong there.

Our local Dr agreed that there was indeed a difference in the length of our daughter legs and referred her to a pediatrician, who in turn referred her to an orthopaedic Dr at a children’s hospital who performed an examination and took x-rays.

It turns out that our daughter doesn’t actually have one leg shorter than the other. The problem is that the “short” leg isn’t in a hip socket, because she doesn’t actually have one on that side. The head of the leg has instead found a home some place further into the pelvis, making the external portion of the leg appear shorter.

We now know our daughter has a condition called developmental dysplasia of the hip, or DDH. As I understand it, this can occur with varying severity, from a shallow hip socket with a propensity to dislocate, to a complete lack of socket. It seems our daughter’s condition is towards the latter end of the scale. Strangely, she doesn’t seem to have any pain when either we or she move her leg, nor is there any noticeable “clicking” feeling as you do so (which is why the problem was missed by routine screening).

Fortunately there is a treatment for this condition which we are told should hopefully work. Unfortunately the treatment involves manipulating the leg into position under general anesthetic and plaster casting her from feet to waist (known as a hip spica) for 9 months! The theory of this is that, up to a certain age, the body has the ability to grow the necessary socket in response to the pressure from the head of the leg. Although her condition was missed for several months and the train of referrals added further months, we are told that she should still be young enough for the procedure to work, but if we had left it longer it may not have been so simple.

If you’ve found this post through searching for advice having noticed a difference in your child’s legs, get an appointment with your Dr as soon as you can, and push it as far as necessary to be sure either way whether your child also has DDH. Even if they’re happy and pain free, they may still have it, and left untreated can leave a child crippled! Or so we’re told - I am not a medical professional.

Caring for a baby encased from hip to toe in plaster is obviously going to present some complications. For one thing, the cast must be kept dry, so that means no baths or swimming - they’ve warned us she will stink! This also means of course that we need to be extra careful about leaking nappies and need to change them with greater frequency, a procedure which I believe involves multiple nappies, scissors and sticky tape to work around the opening in the middle of the cast. Her increased size and fixed position is also going to require a new car seat, which we have already imported, and new high chairs etc which we may need to build.

I’ll post updates from time to time among this blogs usual content, especially as we find solutions to the little problems which this is bound to bring up. Hopefully that’ll be useful to others in similar situations who may come across this.

Posted June 4, 2011

author Julian HaegerSoftware Engineer with over 11 years experience shipping solutions in node.js, Typescript, Elixir, C#, and C++