Congenital Hip Disorders
Painful and Painless Limping
Limp is defined by a deviation from the normal gait pattern expected for a child's age. Limping in children is never normal. Its presence suggests that walking is either painful or difficult because of muscle weakness. The causes of this common childhood problem run the range from splinters in the foot to serious medical problems that could affect the youngster’s life if treatment is delayed.
Developmental Dysplasia of the Hip (DDH)
Developmental dysplasia of the hip (DDH) is the name for a range of conditions of a child's hip. It can affect one or both hip joints.
- In mild cases, the ligaments and other soft tissues around the hip joint are not tight, and they allow the thighbone (femur) to move around more than normal in the hip socket.
- In more severe cases, the joint is loose enough to let the ball at the top of the thighbone (femoral head) come partway out of the hip socket. This is called subluxation.
- Dislocation is the most severe form of DDH. The ball at the top of the thighbone fully slips out of the hip socket (dislocates).
Perthes' disease is a condition of the hip which occurs in some children. Perthes' disease occurs in a part of the hip joint called the 'femoral head'. This is the rounded top of the femur (the thigh bone) which sits inside the acetabulum (the hip socket). Something happens to the small blood vessels which supply the femoral head with blood. So, parts of the femoral head lose their blood supply. As a result, the bone cells in the affected area die and so the bone 'softens', and can fracture or become distorted. The severity can vary.
Slipped Capital Femoral Epiphysis
Slipped capital femoral epiphysis (SCFE) is a hip problem that starts if the epiphysis (growing end) of the femur (thigh bone) slips from the ball of the hip joint. SCFE usually occurs in children between 11 and 16 years old and often occurs in children who are overweight. SCFE may develop in one leg or it may occur in both legs.
In-toeing and Out-toeing
A newborn's feet ordinarily tend to toe out slightly. Out-toeing and in-toeing are common conditions in which an infant's foot is turned outward or inward at birth. In-toeing and out-toeing problems are generally physiologic variants that arise from in-uterus posturing, and that gradually correct spontaneously during the active growing years of the child. If corrective surgery comes under consideration, it is usually deferred until the patient reaches the age of 10.