Price Transparency
Infant and Developmental Dysplasia of the Hip

Infant and Developmental Dysplasia of the Hip

by | Mar 20, 2019 | Hip Disorders

In its highly regarded medical journal, Pediatrics, the American Academy of Pediatricians (AAP) just published a review of current standards for evaluating and treating a condition often recognized in newborns and infants. The condition is called developmental dysplasia of the hip (DDH). Dysplasia is a term that means poorly formed. It describes this condition well because one or both sides of the hip joint do not grow correctly as the child develops.

With later recognition of the condition, the treatment becomes more complex and may even require complex surgery. In order to minimize missed cases of hip dysplasia, the AAP recommends that pediatricians periodically screen for DDH during routine office visits from infancy until the child is walking.1 With effective screening, most cases are identified and managed during infancy, leading to complete correction of hip dysplasia and the development of normal hips.

Though this condition rarely requires surgery, Scottish Rite Hospital has a team of pediatric orthopedic surgeons focused on conditions affecting the hip. Corey S. Gill, M.D., M.A., sees these and other patients in his clinic in Frisco. Here are the top four things parents of newborns need to know and do:

  1. Know that DDH occurs in approximately 1% of children. Though the occurrence is low, early identification of these cases is important.
  2. Ask for an evaluation if your baby has one of the two strongest risk factors for DDH.
    • Delivered feet first (breech position)
    • Related to someone who has been treated or monitored for DDH
  3. If your infant is diagnosed with DDH, there is a greater than 90% chance of correcting the condition without needing surgery.  
  4. Learn how to properly swaddle. Many videos online teach “how to swaddle” your baby. Watch one of our hip experts demonstrate how to properly swaddle a baby and learn more about how swaddling can increase the risk of DDH.

When infants need treatment for hip dysplasia, our first line of defense is a Pavlik harness. The harness is generally worn for 23 hours per day for approximately six weeks, but it is removable for bathing. The harness keeps the legs flexed and rotated in the right position for normal development of the hip joint.  After treatment with a Pavlik harness, we use physical exams, ultrasound and X-rays to monitor growth and confirm the hip joint is developing properly.  Most children require no further orthopedic treatment after wearing a Pavlik harness.

Learn more about our treatment and research in DDH and other conditions affecting newborns.

1Yang S, Zusman N, Lieberman E, et al. Developmental Dysplasia of the Hip. Pediatrics. 2019;143(1):e20181147
Share Your Story: Too Hip for Dysplasia

Share Your Story: Too Hip for Dysplasia

by | Mar 11, 2019 | Hip Disorders

Meet Sadie, a patient who is treated by our experts in our Center for Excellence in Hip. Learn more about her journey below.

Blog written by Sadie’s mom, Sarah Beth, of Longview. 

Sadie on her bed, smiling.

Sadie was diagnosed with Developmental Hip Dysplasia (DDH) at the age of 2 months old, when our pediatrician noticed a clicking in her right hip. We lived in Houston at the time and initially saw a pediatric orthopedic surgeon there. She wore a pavlik harness until she was 6 months old, with little to no improvement, and then switched to a Rhino brace. Both the Pavlik and the Rhino were worn for 23 hours a day, only giving her one hour of “freedom” each day. While she was hitting her development milestones, she was making little improvement on the angle of her hip. As we approached her second birthday, surgery became more and more of an option.
During this time, we moved to the Dallas area and made the switch to Texas Scottish Rite Hospital for Children.

We immediately felt a sense of calmness when we met with Dr. Herring and his staff for the first time.

His knowledge on her condition and his willingness to wait to let her body continue to grow was exactly what we were hoping for. For the first time in Sadie’s hip journey, I felt peace with her condition.

As time passed, we continued with her checkups and eventually decided that a pelvic osteotomy would be necessary for Sadie to gain adequate coverage of her hip socket.  The hospital staff did a great job answering all of our questions and helped us through this journey. Sadie likes to explain the surgery by telling people that her hip was shaped like an “L” and they had to shape it more like a “C.”
Deciding to have a major surgery did not come without some hesitation, but the doctors and nurses were incredibly patient with my lists of questions.

Dr. Herring with Saddie

The child life specialists were able to provide a sense of calm for Sadie in situations where my husband and I did not know how to keep her calm. 

They walked her through the surgery beforehand, helped keep her entertained throughout her inpatient stay, distracted her when different lines were removed and eventually told her that it was okay to giggle when the cast came off because it may tickle. That team was an absolute life-saver!

Sadie
Sadie spent six weeks in a Spica cast and during that time, learned to army crawl, maneuver herself and function with absolutely no problems. Her attitude and determination during this time was amazing.

Since having her cast removed, she has had two X-rays and they each show good coverage of her right hip socket. She quickly returned to normal activity and seeing her now, you would never know that there had ever been anything wrong with her hip or that she was in a cast for six weeks.

I completely trust the doctors, nurses, child life specialists and staff of the hospital. Their knowledge and welcoming atmosphere have made many potentially stressful situations a lot easier for our family.

From Sadie’s point of view – “My favorite part of staying in the hospital was getting to go the playroom and meeting the Texas Rangers. I love getting popcorn after each checkup and playing on the playground.”

Additional information on Developmental Dysplasia of the Hip

 

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.

Health Care Providers Gather in Frisco to Learn from Hospital Experts

Health Care Providers Gather in Frisco to Learn from Hospital Experts

by | Mar 5, 2019 | Sports Medicine

Over the weekend, Scottish Rite Hospital hosted the Pediatric Orthopedics and Sports Medicine Symposium (POSMS) at the Frisco campus. In its first year, POSMS is a combination of two medical conferences – Pediatric Orthopedics Education Series and the Sports Medicine for the Young Athlete. The one-day meeting welcomed over 110 health care specialists from around the community including pediatricians, advance practice providers, athletic trainers, physical therapists and other medical professionals. Attendees learned the latest in evaluation and treatment of pediatric orthopedic and sports medicine conditions through lectures and hands-on breakout sessions.

Several of the hospital’s staff presented throughout the day. Topics included:

  • Developmental dysplasia of the hip
  • Acute knee injuries in young athletes
  • Hip conditions in young athletes
  • Myths of sports-related concussions
  • Rheumatology
  • Scoliosis screening
  • Hot topics in sports medicine treatments
  • Return to play and testing in the movement science lab
  • Ethical implications in fracture management
  • Safety of popular diet and supplement trends

Here is some of the positive feedback we have received so far:
Every talk was helpful and high-yield. This was all great!
Thank you for such a great conference. Loved the variety of topics and knowledgeable speakers.
The fracture splinting small group was fantastic.
Location is great. Building is beautiful.
All of the speakers were great and engaging.
It was super helpful to have kids demonstrate the exams!
Enjoyed every lecture; very informative and all relevant to my practice.

Course director and sports medicine physician, Shane M. Miller, M.D., said, “We really enjoy the opportunity to connect with the community providers at these events. We genuinely want to support everyone who provides care to children and adolescents. Together, we are better.” 

Learn more about the Center for Excellence in Sports Medicine. 

Hip Dysplasia in Some Linked to Poor Swaddling

Hip Dysplasia in Some Linked to Poor Swaddling

by | Dec 19, 2017 | Hip Disorders, Press Coverage

Development dysplasia of the hip, also known as DDH, occurs in one in 1,000 births, and doctors at Texas Scottish Rite Hospital for Children warn how improper swaddling can lead to the condition.

DDH is a relationship between the ball and the socket of the hip joint, in which the socket of the pelvis doesn’t fully protect the ball of the upper femur.

“Very commonly, the doctor doing the exam can actually push the ball in and out of the socket and feel the hip to be loose,” said Dr. David Podeszwa, at Texas Scottish Rite Hospital for Children.

When swaddling, a baby’s legs should be in a frog-like position and should have enough room to move around. Read the full story here.