Hip Dysplasia Diagnosis

Luckily, our appointment with the pediatric orthopedic specialist was scheduled within a week of baby girl's two month check up. Going in, I had convinced myself that this was just an evaluation by the specialist, but that we would be told everything was good and we were in the clear. I was wrong.

Even at the start of the appointment when we were just talking, the specialist seemed to take the approach that this was just a cover all the bases evaluation. But, when we laid baby girl down and he started moving her hips around, he said he instantly felt the "clunk" and that the pediatrician seemed to be right. He then went on to compare her leg length and said there was a difference. I honestly couldn't tell a difference, but he said one knee was sitting higher. He also showed me the asymmetrical leg folds on the back, which I could see when he specifically pointed it out. I honestly can't remember if he said her left hip was full dislocated or if it was merely dislocatable. They figure this out with a test called the Barlow and Ortalani maneuvers. Essentially, the Barlow test puts pressure on the hip to if it is dislocatable. The "clunk" is the hip shifting or popping out of the socket. The Ortalani test is the reverse, where they see if the hip will go back in the socket. There may be another "clunk" as the femoral head of the hip goes back into the socket. In the moment, I did not fully understand what this test did. Later, a physician assistant friend slowly walked me through what it all meant.

Hearing that my baby did indeed have hip dysplasia was tough. Again, there were tears (on my part) when I was told we were getting put into a harness. At this point, my baby was just shy of 10 weeks and her little body was getting put into a full harness that had to stay on 24/7. The harness has a chest strap, straps over each shoulder, and then straps down the front and back to each foot, which is encased in a soft bootie. The purpose is to hold the hips up in a froggy position so that the femoral head of the hip will sit correctly in the socket and help deepen the hip socket. Our direction was that the harness was full time, under her clothes, and we couldn't take it off even for a bath. I was told to sponge bathe her and spot treat the harness where I could. She was fitted for the harness, a check up was scheduled for two weeks, and an ultrasound scheduled for about three weeks to see if her hip was remaining in the socket. Ultrasounds are used before the age of about six months because their little bones haven't ossified yet and will not be visible on an xray.

The doctor also mentioned that there was essentially only one possible complication with the pavlik harness, which is femoral nerve palsy. He indicated that if she stopped moving her impacted leg (left), to take the harness off because we don't want nerve damage. The odds of this are a very small percentage of babies.

I left this appointment with a baby in a harness, with the expectation that we would spend a minimum of 12 weeks in the harness. Honestly, I had so many questions (how to keep her clean, how to breastfeed, what can she wear, will I hurt her by holding her, etc), but I didn't have the capacity to voice all of them in the appointment. One that I was able to voice was asking if she was in pain. The answer was no. Having hip dysplasia is generally not a painful experience for babies, even if the hip is fully dislocated. That was a bit of a relief, but not a ton.

This was the official start to our hip dysplasia journey.