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Children’s Leg Bowing May Turn Out To Be Hip Dysplasia

Feng XIE, Chief Pediatric Orthopedic Surgeon, Chair of Orthopedic Surgery

Dear Parents:

Hello everyone,

The reason I’m writing this letter today is that I want to share my personal experience regarding the lack of knowledge about children’s skeletal development, in order that other parents, who are also in this blind area, may attach great importance to this issue.

My daughter, Yaoyao, has been diagnosed with hip dysplasia. My family and I once thought she only had mild symptoms of bowing legs. After Dr. Xie Feng from Shanghai United Family Hospital explained it to me at length, I found that this problem, which may affect a child’s health development, had been easily neglected by most of parents.                                         

Q: As a parent, we want to know at what age do the symptoms of hip dysplasia generally develop, so that we are aware of whether our children is undergoing a safe period.

A: It’s a kind of congenital dysplasia that can be detected in the neonatal period, if neonatal hip screening is popularised. It does not typically produce symptoms in babies less than a year old. My 15-month-old daughter wasn’t timely diagnosed with hip dysplasia due to the lack of prompt screening. There is no safe period until after routine check-up.                                      

Q: Assume that we have neglected the hip dysplasia of our children, how can we be clear about the general and serious consequences, as well as the chances of self-healing for children’s hip dysplasia?

A: Generally, the prevalence of congenital dislocation of the hip is about 0.1% in China, and that of hip dysplasia about 1%. If ignored or untreated, it will result in limping, pains and early onset of hip degenerative osteoarthritis. In my case, Yaoyao would frequently fall down when walking. Dr. Xie said that there are indeed many newborns with hip dysplasia, some of whom can be self-cured with growth during the first three months. I had expected that my daughter can be self-cured, but as my baby is already 15 months old, her hips does not have a chance of being healed on their own anymore. This made me determine to cooperate with the doctor for my daughter’s treatment. From my experience, therefore, I’m eager to tell you that children who were neglected or misdiagnosed with hip dysplasia but not self-cured or properly treated will greatly be affected in the way they walk in the future.         

Q: We want to know the method, period and interval of the children’s hip joint screening.

A: Dr. Xie explained and made me understand about hip joint screening in neonates. Currently, regular ultrasound hip joint screening for newborns is available in Europe, especially in Germany and Austria. In North America, however, the screening is carried out based on family medical history, abnormal foetal position and other risk factors. Shanghai United Family Hospital provides hip joint screening as generally implemented in America. When an infant is suspected of hip dysplasia, timely treatment and re-examination following doctor’s instructions should be applied. Hip joints generally develop until puberty. Therefore, in case of any medical history with hip dysplasia, follow-up should last until puberty. It is a problem requiring long-term care from parents, and we cannot take it lightly.                            

Q: What are the signs of potential hip dysplasia, to which the parents should attach importance, and what are the bad habits by parents that may cause hip dysplasia?

A: Before Yaoyao was diagnosed with hip dysplasia, our family knew nothing about it. I think most of the parents are like us. And so to educate parents and families, the following instructions should be attached with much importance. In the event of a family medical history of hip dysplasia, breech presentation, C Section, asymmetric skin creases of the buttocks and thighs, hip clicking when changing diapers, clubfoot and other congenital malformations, the parents are advised to have their children referred to a paediatric orthopaedic surgeon as early as possible. Many traditional behaviours or habits of parents may also cause problems for their children’s hip joints. Statistics reveal that if an infant is bundled with a swaddle of clothes during neonatal period or the child is kept sitting in a W-shaped position with the child’s knees bent and her legs splayed out behind her, the incidence of hip dysplasia will be higher, whilst the habit of hip separation may reduce the incidence. We used to commit quite a lot of mistakes in parenting without even knowing it.            

Q: What can parents do to help their children recover after they are diagnosed with hip dysplasia?

A: It’s most important to strictly follow medical advice so as to ensure the permanent cure of hip dysplasia. Early diagnosis and treatment may reduce the need for surgery, improve the final result of the hip and shorten the course of treatment.

As a novice mother, I experienced hardships, much concern and even panicking whenever I saw my child’s bowing legs and her frequent falling, until hip dysplasia was finally confirmed later on. I was suddenly enlightened that I had really neglected my daughter’s joint development, which I believe is a common problem for most of parents.

I’m now feeling at ease. I’d like to express my gratitude to Shanghai United Family Hospital, and I really appreciate Dr. Xie’s patience and professionalism in explaining my child’s condition. I’m eager to share my daughter’s story with all parents. Last but not the least, I wish my daughter an early rehabilitation, and may all the babies grow in a healthy and happy way.