What are Clicky Hips?
Clicky hips are a range of hip problems which are known as Developmental Dysplasia of the Hip (DDH). To understand what a clicky hip is, let us first understand how the hip joint is made.
The hip joint is made up of a socket which is made by the hip bone into which fits the ball like head of our thigh bone. Unlike adults, the bones of babies are not dense but rather made of a softer tissue which hardens as we grow, somewhat like wet clay.
Sometimes either from birth or later as the baby grows, the ball does not fit snugly in the socket and slips out of place. This is known as Developmental Dysplasia of the Hip or DDH. Since a ‘click’ sound may be heard when the hip is examined by your kids bone doctor, DDH is also commonly called a clicky hip. The click may also be normal as your baby’s ligaments are still developing. Your doctor will be able to advise you whether your baby’s hip click is normal.
How To Check Your Baby For Clicky Hips or DDH?
In infants and young children, hip dysplasia is mostly painless. Sometimes it may not be detected initially on your baby’s routine examination. This makes it all the more important for parents to know about the below signs and keep a watch:
- Uneven Thigh or Buttock Creases.
Check the creases on your baby’s buttocks and thighs. Uneven creases of the buttock where one buttock crease is lower than the other as seen in the image may be suggestive of a hip dysplasia in one hip. However when it comes to the thigh, uneven creases may not always be a hip dysplasia, unless they are associated with uneven butt creases.
- Limited Range of Movement.
While changing diapers, notice if one leg does not appear to move fully out as the other or both legs seem restricted.
- Unequal length of legs.
When the baby’s hip has been dislocated for months and remains uncorrected, the ball of the thigh bone moves upward in the socket, causing one leg to appear shorter than the other. Check for this as shown in the image below.
- Improper Posture / Walking.
When they start crawling, observe if one leg seems to drag behind the other.
There may or may not be a delay in learning to walk depending on the severity of the displaced hip. However a limp is often seen while walking or the walk is an abnormal waddle with the child walking on the toes on one side.
If both the hips are dislocated, the child may adopt a posture called the sway back where the hip is pushed forward and the chest is pulled backward with the lower back arched. If you notice any of these, get in touch with your paediatric orthopaedic surgeon.
What can you do to prevent Hip Dysplasia?
The risk of developing hip dysplasia is the highest in the first few months. Once your baby is six months old, his / her bones and ligaments are usually strong enough to hold the thigh bone in place.
- Baby Sling / Carrier: Choose a sling that supports your baby’s legs and takes the pressure off their hips. Avoid carriers that leave your baby’s legs dangling straight down. The child’s hips should be supported in a V form with their knees at a higher or same level as their buttocks.
- Baby wearing: The traditional way that Indian and African mothers hold their babies on their hips is one of the best ways – Carrying your baby with his thighs spread around your torso and his hips bent is a practice that is known to reduce the risk of developmental dysplasia of hip.
- Car seats: Car seats should be wide enough to allow your baby enough space to spread his or her legs in a frog like position.
- Swaddling: While swaddling helps many babies sleep better, tight swaddling that keeps the baby’s legs tightly bound straight together can cause hip dysplasia. Swaddle the baby such that there is enough room for your baby’s legs to move up and out.
If you have reasons to believe that your child’s hip may not be normal, do not hesitate to get in touch with a paediatric orthopaedic surgeon at the earliest. When it comes to hip dysplasia, the earlier treatments are simpler when the clay is still wet and can be moulded easily.
Dr. Mandar Agashe is a Paediatric Orthopaedic Surgeon practising at Agashe Paediatric SuperSpeciality Care in Mumbai who has a number of fellowships in pediatric orthopaedics to his credit. To get in touch with Dr. Agashe, you can write in to him with your child’s history at contactus@agashehospital.com or give a call at 022 42435000.
